International Conference on Primary Health Care and Health Systems in Africa (Ouagadougou, 28-30 April, 2008)
International Conference on Primary Health Care and Health Systems in Africa:
28-30 April, 2008, Ouagadougou, Burkina Faso
Your Excellency, Honoured guests and colleagues;
It gives me great pleasure to be able to be with you today and the Executive Director of UNICEF, Ms Ann M Veneman, has asked me to particularly express her heartfelt support and encouragement to this process.
Its thirty years since the International Conference of Primary Health Care at Alma-Ata in the then Soviet Union declared that half the world’s population did not have access to proper health care, that such provision was a human right and pledged to close the gaps between the ‘haves’ and the ‘have nots.’
The declaration stated - ‘a main social target of governments, international organisations and the whole world community in the coming decades should be the attainment by all peoples by the year 2000 of a level of health that will permit them to lead a socially and economically productive life’.
We all have learned a great deal over the remarkable years since Alma Atta about extending the benefits of health to all. One of the most important of those lessons is that the mothers, fathers and children in the communities we all strive to serve, are key. We can never afford to lose sight of them, to lose touch with them or lose hold of our partnership with them.
We have many great, committed and generous partners in this work to improve the health and save the lives of children. But none are more important than the "primary" health partnership with those millions living in their communities.
We need to press, with unflagging energy, for the high impact interventions that we've learned do work and which save lives. Working hand in hand with communities, we need to put those measures in place and bring them to scale.
We know their value and so do so many of the mothers and fathers of Africa. We've seen families walk many miles and wait long hours so their children will be protected from disease through the expanded programme on immunization plus. We need to work to expand that knowledge at community level and not take it for granted.
We know that when women come to an ante-natal clinic, and return home with insecticide-treated nets and oral re-hydration packets- as well as information about breastfeeding- that those women are helping change the world, as well as protect their families.
Their actions and knowledge are helping chip away at the tragically high under-five death rates that persist across this great continent. These interventions and efforts must be boosted to reach more people more effectively. We should not underestimate the benefit of parents meeting a health professional face to face and getting the right advice.
Health systems and services across Africa have to be strengthened. The bottlenecks in terms of personnel and supplies are enormous and dangerous. Chad and Tanzania, for example, have less than half the workforce they require to meet their people's essential health needs. Thirty six countries in Africa have fewer than two and a half health professionals per 1,000 population. Without adequate budgets to train health personnel and manage health services and supplies, progress will remain stalled.
It is surely right that at this Conference there will be also consideration on the role in PHC of Youth. With the proportion of population aged under 18 in West and Central Africa standing at 51%, young people are a resource that is too often left idle, and which should be engaged as much as possible in creating a healthier Africa for all.
Africa accounts for just over half of all the deaths of children under five globally. This is an ominous and disproportionate toll. All too soon we will be nearing the target year for the Millennium Development Goals. If there isn't a breakthrough, if there are no new and significantly accelerated efforts, most countries in sub-Saharan Africa will not be able to attain the targets and in fact will have made preciously scant progress from where the baselines set in 1990.
In Eastern and Southern Africa a 10 per cent decrease per year is needed to bring the region into striking distance of the 2015 target. In Western and Central Africa an 11 per cent annual decline is needed.
We meet as we all are more concerned that ever before by the rising cost of food and the effect this will have on the poorest, the most vulnerable and urban populations. The higher costs will cause many families to buy less nutritionally rich foods as they struggle to main their intake of calories. This may have long term, detrimental effects on children which could affect the rest of the lives - leaving them less productive and less able to escape poverty.
Governments, UN agencies and partners need to work together to ensure that the worst effects are mitigated, that provision is made for the most vulnerable and that children do not suffer.
Once again it is our ‘primary’ partners, those millions living in their communities who will be facing the hardest burdens. As was recognised thirty years ago at Alma Ata, they have a right to our support- now as much as ever.