Director-General

Conference of African Health Ministers

Cairo, Egypt
28 June 2005

Your Excellency, Honourable Ministers,

Our common goal is universal access to safe, affordable and effective health care. Nowhere in the world is this more urgently needed than in sub-Saharan Africa. We warmly welcome every initiative that can help to control the devastation being caused there by communicable diseases. Particularly, today, we welcome President Mubarak's initiative to establish a disease control centre for Africa.

Egypt has demonstrated great leadership in the fight against communicable diseases, most recently in its efforts to eradicate polio. It has a strong disease surveillance system, coupled with high routine immunization coverage supplemented by repeated polio vaccination campaigns. These measures have brought Egypt closer than ever to polio eradication.

However, the recent technical advisory group meetings here in Cairo on polio eradication warned against the continued risk of polio importations to countries across the continent, particularly in the Horn of Africa. As we discussed in Geneva at the World Health Assembly, these risks can only be managed through the personal oversight of Health Ministers and strong regional collaboration.

Africa is the only continent in which the incidence of TB is still rising. This is partly because of co-infection with HIV, and partly because of poverty, weak infrastructure and struggling health systems. An unprecedented effort to combat this regional emergency is needed now from African governments.

This means, above all, strengthening DOTS services, and giving them the necessary financial support, as well as increasing the support provided by communities, NGOs and the private sector. WHO is continuing to increase its technical assistance to Member States for intensified TB control activities, and for the enhancement of local TB drug manufacturing and procurement facilities.

HIV/AIDS has become a formidable obstacle to TB control, and is also an overwhelming challenge in its own right. There are 23-28 million people living with HIV/AIDS in Africa at present, which is 7-8% of the adult population. A tremendous effort is in progress to increase the numbers of those with access to antiretroviral treatment and prevention services. However, the current perception is that demand is still outstripping supply. There is a pressing need for more sustainable financing. The emphasis of WHO support for your work has been on technical assistance for strategic planning, drug procurement and supply management, and building human resources capacity.

The response to these efforts has been deeply encouraging. Now it is of the utmost importance for countries to continue and increase their political and financial commitment to responding comprehensively to HIV/AIDS. Health workers and service sites need to be equipped to deliver a comprehensive package of HIV treatment and prevention interventions.

Malaria continues to be the most important single cause of death in under-five-year-olds in sub-Saharan Africa. The Abuja target of 60% coverage with preventive and curative interventions by the end of 2005 is unlikely to be met. Nevertheless there has been a sharp rise in malaria control activities, and in funding. Our main task now is to ensure that the resources becoming available are used with maximum effect, and that they continue to increase.

There is strong interest, both from industry and from donors, in scaling up the use of bednets treated with long-lasting insecticide. Artemisia-based combination therapy has now been adopted as first or second-line treatment by 34 African countries. The Roll Back Malaria Partnership has been working hard on solving supply chain problems for the components of this treatment, and expect to bring the existing shortages to an end during the coming months.

All of this is taking place within the long-term effort to build and strengthen health systems in Africa, which includes some of the most difficult conditions and situations in the world. Other disease control activities, such as guinea-worm eradication, leprosy elimination, and the highly effective campaign in recent years against onchocerciasis have been, and continue to be, a vitally important part of this effort.

Where persistence has prevailed in spite of setbacks, conflicts and natural disasters it has been thanks to the courage of local health workers, the determination of national leaders, and the solidarity between countries. That solidarity, through the African Union, NEPAD, and the other regional and global international organizations, as well as bilateral agreements, is gathering strength. Today's conference bears witness to this trend, as do the current developments in devising mechanisms for debt relief and major increases in funding for development.

A further manifestation of this trend is last month's adoption by the World Health Assembly of the revised International Health Regulations. It reflects the awareness of all our 192 Member States that the only way to provide effectively for the health of their own peoples is to support one another's disease control activities and participate fully in the task of coordination.

A major concern in those discussions was the danger of an avian influenza pandemic. At the moment this danger is felt most keenly in Asia, but with today's volume and speed of travel, all parts of the world would be exposed to a disaster of this kind. Combined, as it would be, with the other severe health problems on this continent, it would have extremely grave consequences for Africa. Experience with Ebola and Marburg fever can give us some idea of what a widespread outbreak of lethal disease would be like.

The Health Regulations give us a framework and a set of procedures for preparing ourselves for this event. The effectiveness of these preparations will depend on the efforts and commitment of every country. I would like to take this opportunity to urge all of you to make that effort of preparedness now, while there is still time.

In short, not only do we have to be relentless in our effort to control established diseases, but we have to prepare ourselves fully for the emerging ones. This often seems like an impossible task, but many past successes prove that with the support of colleagues and the partnership between nations and organizations, it is possible.

Today, thanks to the initiative of the Government of Egypt, we have an excellent opportunity to draw together the expertise and decision-making capacity needed to combat infectious diseases on this continent. Let us make good use of it.

Thank you.

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