Ensuring human security
Dr Margaret Chan
Director-General of the World Health Organization
Colleagues, ladies and gentlemen,
When we talk about health security in Africa, we can make a few sweeping generalizations. Africa is made particularly vulnerable by factors relating to climate, geography, and ecology. Let me give some examples.
The continent is vulnerable to disasters, such as floods, droughts, and famine. The right ecological conditions have given Africa a meningitis belt prone to explosive outbreaks. Africa has the deadliest form of the malaria parasite, and the most efficient mosquito species. The continent’s rich diversity of wildlife makes it prone to the emergence of new diseases, of which around 75% arise from animals.
These factors shape the reality. And the reality is stark: of all regions, Africa is the least likely to reach the health-related Millennium Development Goals. This is true most especially for the goals set for maternal health and for the high-mortality infectious diseases.
But here the generalizations end. We are now seeing too many success stories, in individual countries, for individual diseases, and for integrated approaches, such as those for the management of childhood illness.
Countries are tackling malaria in nation-wide approaches, often led by heads of state, and striking declines in mortality are the result. Globally, almost three quarters of people receiving antiretroviral therapy for HIV/AIDS are in Africa. With support from the Measles Initiative, African countries have cut measles deaths by more than 90% over the past six years.
These are stunning achievements that show the power of partnership within the context of country ownership. They show Africa’s determination, and they point the way to a vibrant future.
In last month’s Ouagadougou Declaration, African leaders expressed their commitment to revise national health policies and plans according to the primary health care approach. I believe this is an absolutely critical step towards achievement of the health-related Goals.
We have very good interventions and strategies for reaching these goals. What we need most are robust and equitable delivery systems.
Resilient health systems increase the capacity to cope with shocks to human security. Africa will be hit early and hard by the consequences of climate change. In just a dozen years from now, crop yields in some countries are expected to drop by 50%.
We are all aware of the crisis of soaring food prices and what this means for nutrition, which is fundamental to health throughout the lifespan. Poor households spend, on average, 50–75% of disposable income on food. More money for food means less money for health, especially for the millions of Africans who rely on out-of-pocket payments.
Addressing the principles of equity and social justice, embodied in the MDGs, also means finding fair ways to finance health care. Greater efficiencies in service delivery help. A primary health care approach provides the best opportunity to achieve these efficiencies.