Health is key to sustained peace and prosperity in Sudan
The Comprehensive Peace Agreement (CPA) follows two decades of war and misery for millions of Sudanese. It offers the enticing prospect of security, recovery and increased prosperity. But the people of Sudan are not yet healthy enough to benefit fully from this opportunity.
"To reap the benefits of peace, Sudan's people must survive threats of disease," says David Nabarro, WHO Representative of the Director-General, "For example, women must be able to deliver without risking death or disability; and children must be helped during vulnerable early years through proper health care."
Sudan's child and maternal death rates are among the worst in the world with most deliveries still occurring at home. The threat from HIV/AIDS grows each year while millions are in danger due to disease epidemics, such as malaria. The country is also prone to natural disasters – the latest being the impending drought in Darfur and Kordofan.
To compound this grim situation health services are difficult to access when at all available. Existing healthcare centres are short of staff, ill-equipped and dilapidated. People seeking quality hospital care can become indebted for the rest of their lives. If they fail to recover, the debt can pass to their children.
"The urgent requirement is that health needs are assessed, responses are properly coordinated, and important gaps in service provision are filled," says Dr. Nabarro, "Health workers need training and then support to do their job well. Only then will the people of Sudan be able to expect healthy lives and the chance of sustainable livelihoods".
The Government of National Unity, the Government of Southern Sudan and all their partners need sustained support to refashion basic services. Well functioning accessible and effective health services are key to recovery. The World Health Organization (WHO) works with all national and international groups working towards improving the health of Sudan's people.
Good health depends on access to water, on hygiene and sanitation, on shelter and the control of disease, and on access to a small number of essential basic health services. These needs are clearly identified in the 2005 United Nations and Partners Work Plan for the Sudan. They are further elaborated in the report of the Joint Assessment Mission (JAM). A healthy population can contribute to the transition of Sudan from a period of conflict to lasting peace. Populations made insecure by the threat of disease are less able to work for peace and contribute to prosperity.
WHO has already scaled up its programmes in Sudan to provide technical support as national and international partners – such as UNICEF, UNFPA and major NGOs – implement strategies for responding to widespread enormous health needs. An expanded WHO field presence is planned, with increased capacity to carry out health assessments, support coordination and encourage effective management of external aid. This expanded presence will increase the capacity for monitoring health needs at local level, and for aligning humanitarian responses with longer term health system development. Initiatives supported through the global campaign to eradicate polio and the global fund to fight AIDS, tuberculosis and malaria will be woven into the unified UN approach led by the Special Representative for the Secretary-General.
"Health must be given priority as experience from elsewhere indicates that sound investments in health are central to creating peace and promoting prosperity through consolidated public systems. WHO has risen to the challenge and calls for a robust and sustained engagement from the donor community," concludes Dr. Nabarro.
Some health statistics for Sudan:
- 86% of child births still occur at home (SMS, 1999)
- Infant mortality rate per 1,000 live births is 68 in the North and 82 in the South (SMS 1999)
- Under 5 mortality rate per 1,000 live births is 104 in the North and reaches 132 in the South (SMS 1999).
- Maternal mortality rate per 100 000 is 509 in the North and ranging from 365-865 in the South (SMS 1999).
- HIV/AIDS prevalence rate is 1.6% with an estimated 500,000-600,000 people living with HIV/AIDS (SNAP, 2002, FMoH).
- Approximately 7 500 000 cases of malaria expected annually (WHO/EMRO Annual Report of the Regional Director)
- limited utilization of health services (at aggregate level, 40-60%)