Your Excellency Denis Sassou Nguesso, President of the Republic of the Congo,
Your Excellency President of the Assembly,
Your Excellency Prime Minister,
Excellencies and Ministers of the Republic Congo,
Excellency Mr Abdoulaye Diouf Sarr, Chair of the Regional Committee, the outgoing
And Excellency, Jacqueline Lydia Mikolo, Minister of Health of the Republic of Congo, the incoming chair
Excellencies, Ministers
Excellencies, Heads of Delegation,
Excellencies, Ambassadors
And my sister Regional Director, Dr Moeti,
Dear colleagues and friends,
Bonjour à tous!
I am improving my French but it’s very difficult!
This is really a great honour to be with you once again.
I offer my deep gratitude to Your Excellency the President and the people of the Republic of the Congo for hosting not only this meeting, but for being WHO’s home in Africa.
I would also like to use this opportunity to thank the President for all his support to our Regional Office.
And I would also like to use this opportunity to congratulate the First Lady, Antionette Sassou Nguesso, for her work on sickle cell disease.
As my sister Dr Moeti said, today we pay tribute to the thousands of humanitarian workers all over the world who, as we speak, are putting themselves in danger to serve others.
Their efforts are nothing short of heroic.
So far this year, as Dr Moeti outlined, WHO has documented hundreds of attacks. Despite these dangers the health workers and humanitarians are undeterred.
And let’s be clear: their efforts have saved lives and prevented a much larger emergency in the Democratic Republic of the Congo.
More than 191,000 people have been vaccinated, 184,000 contacts have been traced and 82 million travelers have been screened.
We now also know that we have two highly effective medicines to treat Ebola.
These therapeutics have been used for months, but we now have the data to show that they are saving lives.
I congratulate Professor Muyembe, the government of the Democratic Republic of the Congo and our partners who participated in the study.
It means that we now have a vaccine that is more than 97% effective and treatments that are more than 90% effective if used early enough.
Ebola is preventable and treatable.
We need to make sure everyone in the affected area knows that.
Nevertheless, the outbreak is still with us.
Insecurity, community mistrust and political instability have undermined the response.
As you know, last month the Emergency Committee recommended that I declare the outbreak a public health emergency of international concern.
Now is the time for the international community – and especially the Democratic Republic of the Congo’s neighbours - to stand with it in solidarity.
But this is far more than just an outbreak. It’s one of the most complex humanitarian emergencies any of us have faced. It’s not an emergency that the Democratic Republic of the Congo’s Ministry of Health or WHO can solve on our own.
We need the full force of all partners.
The risk of this outbreak becoming far worse than it already is remains very high.
We have now had four confirmed cases in Goma, and three in Uganda.
And just on Friday there were two cases reported in South Kivu.
Although these are disturbing developments, they are not unexpected.
The Ministry of Health, WHO and our partners have been preparing for months for the spread of Ebola to neighbouring provinces and countries.
I congratulate Burundi for the Ebola vaccination campaign among health workers launched last week, following similar campaigns in Uganda, Rwanda and South Sudan.
We continue to work closely on preparedness with nine of the Democratic Republic of the Congo’s neighbours, based on the level of risk that Ebola could spread across their borders – four that we consider “category one” and five “category two”.
So far, those efforts have paid off. There are currently no confirmed cases in either Goma or Uganda.
This underlines a crucial point: countries that invest in preparedness will save lives – and save money.
Beyond Ebola, the region has made good progress on emergency preparedness, although gaps remain.
All except four countries have completed joint external evaluations of their International Health Regulations capacities.
The bad news is that these evaluations show that no country in our region has all the capacities required under the International Health Regulations.
However, 24 countries have developed “all-hazards” health security plans. If funded and implemented, these plans will address the most important gaps in preparedness.
That’s why the Regional Strategy for Integrated Disease Surveillance and Response is so important, as outlined by Dr Moeti. It sets concrete milestones and targets for countries to build their capacities and keep their people safe.
But even as we focus on ending the Ebola outbreak, we must look beyond it.
I have traveled to North Kivu with my sister Dr Moeti six times during this outbreak. Frankly, I am embarrassed to talk only about Ebola.
An outbreak of measles in the Democratic Republic of the Congo has killed more than 2500 people since January – more than Ebola in less time – and yet it gets little international attention.
And malaria, the leading cause of death in the Democratic Republic of the Congo, kills more than 50,000 people every year.
It’s not just the Democratic Republic of the Congo. Malaria continues to take an unacceptable toll across the continent.
But before going to malaria, I will share with you some of what one of the people of the Democratic Republic of the Congo said during our visits to eastern the Democratic Republic of the Congo.
When we talk about Ebola only and ignore the rest of the problems that they have, they say, “Why are you overplaying Ebola? Our health system is weak. There is a measles outbreak, there is a malaria outbreak, there is cholera, there is chikungunya. So, are you here to protect yourselves from Ebola, or are you here to save us or protect us?”
This is a very important question. And the international community should really understand. So, when we give support, are we giving support to keep away the diseases from the rest of the world? Or are we serious about supporting those people who are in need in the Democratic Republic of the Congo and in addressing all the problems and especially the root cause of the problems.
That’s why I say this was very embarrassing. There are other killers in the the Democratic Republic of the Congo, other diseases that are killing more people. So we have to be honest.
That is why in the Democratic Republic of the Congo we have to address the problem in a comprehensive way, not only Ebola but all other major problems, including the health system.
Now coming to malaria, which is a major problem in the Democratic Republic of the Congo, and in the rest of the world.
70% of the world’s malaria burden is concentrated in just 11 countries. Of the 11 one is India, but all the rest are in sub-Saharan Africa: Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Uganda and the United Republic of Tanzania.
In 2017, all 10 of these countries reported an increase in malaria cases over the previous year.
In response, WHO and the RBM Partnership have launched “High Burden, High Impact”, a targeted approach to reinvigorating the response by using the most effective tools in the most effective way.
The Framework for the Implementation of the Global Vector Control Response in the African Region complements this approach by setting out a clear vision for a region free of vector-borne diseases.
It includes better data, better guidelines, and better coordination.
But it starts with political commitment. Today, I ask each of the 10 affected countries to demonstrate that commitment.
If we can make an impact in the 10 countries, that would be a significant change in the overall malaria situation in our continent.
Without it, we are in danger of allowing malaria to make a comeback.
And I join my sister, Tshidi, to congratulate Algeria in becoming free of malaria, certified this year.
There is better news about tuberculosis.
In the past 5 years, several countries in southern Africa have achieved impressive declines in TB incidence, including Eswatini, Lesotho, Namibia, South Africa, Zambia and Zimbabwe.
South Africa, for example, is a global leader in rolling out preventive treatment and rapid diagnostics for TB.
Progress is also being made in finding the missing people with TB and closing gaps in care, thanks to the “Find. Treat All” initiative.
Following the High-Level Meeting on TB at the UN General Assembly last year, I wrote to Heads of State and Heads of Government of 48 countries with the highest TB burden, including 17 from this region, urging them to accelerate country action to meet the End TB targets.
As with so many other health issues, the keys are visionary leadership, multisectoral accountability and constructive engagement, especially with civil society organizations.
As you know, even as we continue to fight the familiar foes of communicable diseases, we are contending with a new threat: the epidemic of noncommunicable diseases.
One of the key drivers of that epidemic is the double burden of malnutrition.
Almost 60 million children in Africa are stunted and 14 million suffer from wasting. At the same time, 10 million children are overweight – almost double the number in 2000.
On current trends, we are unlikely to meet either the global nutrition targets for 2025, nor the nutrition targets in the Sustainable Development Goals.
Although we have made great progress against hunger over the past 50 years, access to diverse and nutritious food has not improved equally for everyone.
Foods high in salt, sugars, saturated fats and trans fats have become cheaper and more widely available.
Conversely, foods that contribute to healthy lives are less accessible and less affordable.
So political commitment that results in policy change or investments to address these problems is required as a matter of urgency.
The strategic plan to reduce the double burden of malnutrition in Africa spells out exactly what those policy changes should be, from promoting breastfeeding to regulating the marketing of foods to increasing taxes on sugary drinks.
As the plan makes clear, this is not a job for ministries of health alone. It will take a whole-of-government approach that addresses the root causes of malnutrition.
Your Excellency Mr President, ladies and gentlemen,
Emergency preparedness. Malaria and TB. Malnutrition and NCDs. Each of these issues requires a tailored response.
But the common denominator in addressing each of them is primary health care.
In Astana last year, all WHO Member States reaffirmed that primary health care is the bedrock of universal health coverage.
So I’m glad to see the Framework for Provision of Essential Health Services through Strengthened District or Local Health Systems on your agenda this week.
Many of your countries have made impressive progress towards delivering essential health services at the district level, including Ethiopia, Ghana, Lesotho, Malawi, Rwanda, South Africa, Republic of Congo and Uganda.
But large gaps remain.
Across the region, only one-third of people can access essential health services, and only one-third can do so without fear of financial hardship.
Strengthening primary health care must therefore be the number one priority for every country.
During the African Union Summit in February this year, your countries endorsed the Addis Ababa Call to Action, a powerful commitment to increase domestic financing for health, especially for primary health care.
I have said already that I remind health leaders to honor their commitment. And the best investment in primary health care is in human capital.
Nurses, midwives and community health workers are especially important for delivering the services that can promote health and prevent people from needing a hospital.
Excellencies, ladies and gentlemen,
WHO is committed to supporting you to address each of the challenges you are facing.
And we are committed to becoming the organization you need us to be.
Since we last met 12 months ago, the Regional Directors and I have been hard at work transforming WHO into an agile organization that works seamlessly across all 3 levels to deliver the Sustainable Development Goals.
The African region has been a pioneer of a number of initiatives that are now being scaled globally as part of our transformation project.
For example, we are now rolling out a new Global Leadership and Management training initiative, which has been developed here in the African Region under the leadership of Dr Moeti.
For this we owe a vote of thanks to the Regional Director Dr Moeti and the ministers of this region for driving this change.
And as my brother, Dr Abdoulaye, the outgoing chair, said: African ministers are acting as vanguards of the change.
We now have a new programme budget to support the General Programme of Work, which you approved at the World Health Assembly last year.
To build this new budget, we turned our planning process upside down, so that country needs explicitly drive the work of headquarters and the regions.
For example, for the first time in our history, all three levels of the organization have worked together to define exactly what headquarters will produce in the coming biennium. As a result, we now have a list of nearly 300 specific “global public health goods” – the technical tools you need to make progress towards the “triple billion” targets.
But we’re not just changing what we do, we’re also changing how we do it.
Our new operating model aligns the organization at all three levels and will enable us to work together more effectively and efficiently.
One of our key priorities was to make sure every single WHO employee can connect their work to the corporate priorities.
Today, 75% of staff can link their day-to-day work to the General Programme of Work, compared with only 47% at the start of this year.
We are also committed to increasing diversity across the organization. We’ve already achieved several quick wins.
We have started rolling out 13 new or redesigned processes to harmonize and optimize the way we do business, from the way we develop norms and standards, to recruitment, procurement, communications and more.
And we have announced plans for the WHO Academy, a major initiative to revolutionize health learning globally and train health workers to implement WHO norms and standards.
The agreement was signed with His Excellency President Macron, and the academy will be in Lyon.
Africa will be a priority in terms of capacity building from the WHO Academy.
Excellencies, ladies and gentlemen,
First, I would like to thank you for your commitment and support.
I leave you with three requests.
First, mobilizing domestic resources to invest in primary health care must be the top priority for every country. That is what you as Member States committed to in the Addis Ababa Call to Action during the AU Summit earlier this year.
One of the key ways you can do that is by raising taxes on tobacco products, alcohol, sugary drinks and other products that harm health.
This is a win-win for health because it helps to prevent noncommunicable diseases by reducing consumption of products that cause them, and it raises revenue that can be reinvested in health.
Second, fix the roof before the rain comes. No country can afford simply to wait for an outbreak. Investments in preparedness will save lives and save money.
The Joint External Evaluations have shown where the gaps are. Now all countries must act decisively to close those gaps. And we call upon the international community to support in closing the gaps.
Third, the high-level meeting on universal health coverage in New York next month is a vital opportunity to catalyze political commitment. We need as many Heads of State or Government as possible. I urge you to do everything you can to make sure yours, your leaders, are there in New York to show their commitment to universal health coverage.
Finally, I want to say a few words about my sister Dr Moeti.
I don’t need to tell you what an outstanding job she has done over the past five years.
The reforms she has initiated are bearing fruit.
And as I said earlier we even bench-marked some of them to be globally implemented as part of the transformation agenda of the headquarters.
It has been an immense pleasure to work with her, and I look forward to working with her during her next term.
Together, we are committed to serving you as one WHO to promote health, keep the world safe and serve the vulnerable.
Thank you so much. Merci beaucoup.