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AFRICA HEALTH NEWS
A WHITAKER GROUP PUBLICATIONSEPTEMBER/OCTOBER 2008
WHO R
EGIONAL
C
OMMITTEE
 
FOR
A
FRICA
AFRICA COMMENDED ONHEALTH CARE ADVANCES
Dr. Margaret Chan, Director-General of the World Health Organiza-tion (WHO), has commended African governments on their leadershipin advancing health care across the continent.At the opening of the 58th session of the Regional Committee forAfrica on September 1, 2008, in Yaoundé, Cameroon, Dr. Chan said,“You have demonstrated that, with enough commitment and support,truly anything can be done.”She noted that with nearly three million people in low and middleincome countries now receiving antiretroviral treatment for AIDS - the vast majority of them in Africa - a milestone had been reached. “Whatmany considered impossible has now been achieved. Drug prices candrop. Complex interventions can be delivered in resource-poor settings.Patients can adhere to treatment regimens. Treatment outcomes here inAfrica can be just as good as anywhere else in the world,” she said.Dr. Chan gave special recognition to Kenya, Malawi and Rwanda fortheir “striking progress” in integrating HIV and tuberculosis services.Such integration, she said, pointed the way forward and gave an impe-tus to improving the efficiency of health services.She also gave an upbeat assessment of the continent’s success in re-cent years in introducing underutilized vaccines. By the end of 2008,she reported, all but five countries will have introduced the Hib (Hae-mophilus influenza type B) vaccine. Next year, Gambia, Kenya andRwanda plan to introduce the new pneumococcal immunization.“Right now, every country in the region is including the hepatitis B vaccine, which also protects against liver cancer, in routine immuni-zation,” Dr. Chan said. “If you can maintain the current commitment,liver cancer will drop off the list of leading health problems in our life-time. is will be true progress for public health.”Dr. Chan also pointed to the tremendous scaling up of funding forhealth care in Africa as cause for optimism. Public and private fundinghas more than doubled this century, she said, from $6.5 billion in 2000to $16.7 billion in 2006. And, she added, that aid is being used far moreeffectively than ever before.“e major funding agencies are now combining the purchase inter- ventions with funds to strengthen systems for their delivery,” Dr. Chansaid. “International partnerships and health initiatives now recognizethat progress depends on strengthened health infrastructures and ser- vice delivery.”Delegates at the session included African health ministers, expertsfrom the health sector and leading stakeholders from multinational in-stitutions, NGOs and the global pharmaceutical industry.
Partnerships
Global Health Progress, an initiative that fosters partnerships be-tween research-based biopharmaceutical companies and global healthleaders to improve health in the developing world, co-hosted a workingdinner on September 4 with e Whitaker Group (TWG) for Minis-ters of Health, heads of delegation and other senior delegates attendingthe WHO Africa Committee session. Nearly 100 delegates, including10 African Ministers of Health and representatives from 28 Africancountries, discussed the theme, “Global Resources Aligned Against Ne-glected Tropical Diseases.”TWG moderated the discussion which followed the official openingof the dinner by the Honorable André Mama Fouda, Minister for PublicHealth for Cameroon. Additional speakers included Dr. Joseph Kamg-no, Technical Advisor for the National Cameroon Onchocerciasis Con-trol Program and Director of the Filariasis Research Center in Yaoundé,Professor Wilfred M’bacham, Associate Professor of Public Health andBiotechnology, University of Yaoundé, and Mr. Alain Aumonier, Direc-tor of International Relations for sanofi-aventis and Chairman of thePublic Health Advisory Committee, International Federation of Phar-maceutical Manufacturers and Associations (IFPMA).Speakers highlighted the successes of ongoing public-private part-nerships for health in Cameroon as well as existing commitments by theglobal research-based pharmaceutical industry to address health chal-lenges in Africa. Participants also received copies of the latest healthresource guide developed by Global Health Progress to assist Minis-ters and senior health officials with up-to-date information on availablehealth care resources and programs.Global Health Progress serves as a global convening point for publichealth officials and global health stakeholders to engage, lend advocacy to shared goals, identify best practices for programs that address healthneeds, and facilitate partnership and research and development effortsto fight neglected diseases in the developing world.
Health ministersfrom countries of theAfrican Meningitis Beltadopted the YaoundéDeclaration at the WHORegional Committee forAfrica session.
e Declaration com-mits them to implement-ing comprehensive men-ingitis control plans; toundertake joint actionto address the threat; toimprove information ex-change for epidemic re-sponse; and to contributefinancially to activities tocontrol epidemics.A new vaccine is expected to be introduced in Burkina Fasoin 2009-2010 and will be phased into an additional 24 coun-tries between 2010 and 2015.
THE YAOUNDÉ DECLARATION 
 A child in Sudan is vaccinated against meningitis
 
P
AGE
T
WO
UN CITES PARTNERSHIPS AS KEY TOPROVIDING ACCESS TO MEDICINES
M
ILLENNIUM
D
EVELOPMENT
G
OALS
A United Nations Millennium DevelopmentGoal (MDG) task force has reported that anumber of developing countries have madeprogress towards providing universal accessto essential medicines by building effectivepartnerships between governments, pharma-ceutical companies and civil society.
The report,entitled
Deliver-ing on the Global Partnership for  Achieving the Mil-lennium Develop-ment Goals
, citedthe differentialpricing agreementthe Governmentof Kenya has withpharmaceuticalmanufacturer No- vartis to increase the availability and afford-ability of artemether-lumefantrine 20/120 mgfor the treatment of uncomplicated falciparummalaria.“Adequate financing and affordable pro-curement prices are key determinants of medicine availability in the public sector,” thereport stated. The principle behind differentialpricing is that prices should be adapted to thepurchasing power of governments and house-holds in lower-income countries so that they receive the lowest possible prices for pharma-ceuticals.The task force also pointed to infusions of financial support from the UN Global Fund toFight AIDS, Tuberculosis and Malaria as key to substantial improvements in Kenya’s ability to make essential drugs available.The report went on to add, however, thatdespite progress in some African countries,the overall average availability of medicines inthe public sector in Africa is only 38.2%, whileaverage private sector availability is 58.9%.The task force stated that accelerated prog-ress toward access to essential medicines re-quires explicit national and global targets.At the national level, it recommended thatcountries: eliminate taxes and duties on essentialdrugs; update national policy on medicines; update the national list of essential medi-cines; adopt generic substitution policies for es-sential medicines; seek ways to reduce trade and distributionmarkups on prices of drugs
 
; ensure adequate ava
 
ilability of essentialmedicines in public health care facilities; and regularly monitor medicine prices andavailability.At t
 
he global level, the task force recom-mended: encouraging pharmaceutical companiesto apply differential pricing practices to reduceprices of medicines where generic equivalentsare not available; enhancing the promotion of the produc-tion of generic medicines and removing barri-ers to uptake; and increasing funding for research and devel-opment in areas of medicines relevant to de- veloping countries, including children’s dosageforms and most neglected diseases.
T
UBERCULOSIS
PARTNERSHIP TAKESAIM AT TB THREAT INSOUTH AFRICA
e Lilly MDR-TB (multidrug-resistanttuberculosis) Partnership and the WorldEconomic Forum’s Global Health Initiativelaunched a new toolkit in June to boost theinvolvement of South African companies intackling the country’s tuberculosis (TB) cri-sis.
Developed with inputs from national andinternational partners including the privatesector, the toolkit provides concrete guidelinesto help South African companies rapidly in-crease their TB control programs by adoptinga joint approach to diagnosing and treating thegrowing number of TB patients who are alsoHIV positive.With 70% of TB patients also infected withHIV, South Africa now accounts for 28% of HIV-TB positive cases worldwide. Takenwith the emerging threat of fatal drug-resis-tant strains of the disease, the Government of South Africa has recognized the importance of engaging the private sector in achieving its TBcase detection and treatment targets.“Businesses have a fundamental responsi-bility towards both their employees and thewider community, and for preservation of their long-term interests by ensuring the na-tional development of human capital to driveeconomic growth,” said Mr. Alex Azar, EliLilly and Company’s Senior Vice-President forCorporate Affairs and Communications. “Tu-berculosis has the capacity to undermine all of this.”e TB toolkit aims to arrest the progres-sion of the disease by giving businesses guide-lines that help them leverage their existinghealth infrastructures and management toolsand resources to greater effect. It will also helpcompanies increase opportunities and activi-ties in the prevention, diagnosis and treatmentof TB/HIV co-infections in the workplace.Eli Lilly and Company launched the Lilly MDR-TB Partnership, an alliance of 14 publicand private organizations, in 2003. It providescomprehensive services for individuals andfamilies afflicted with MDR-TB - diagnosis,treatment and surveillance of patients; train-ing of doctors and nurses; community sup-port, patient advocacy and anti-stigma effortsin the workplace; and transfer of Lilly d
 
rug-manufacturing technology to pharmaceuticalcompanies in high-burden MDR-TB countriesto increase local drug supplies.
HIV/AIDS
M•A•C COSMETICS FUNDS GRASSROOT SOCCER
e M•A•C Aids Fund (MAF) has launcheda new Global Youth Initiative for HIV Pre- vention with the announcement that it wouldfund 11 new grants including one to Grass-root Soccer, an organization that uses soccerto educate African youth about the dangersof HIV.
e new initiative, announced in Septem-ber in New York by Grammy Awarding-win-ning singer, Fergie, is aimed at preventingthe spread of HIV among young people agedfrom 15 to 24. Other organizations to benefitfrom the intiative include seven groups basedin the US and one each in India, Canada andMe
 
xico.Grassroot Soccer operates principally inSouth Africa, Zambia and Zimbabwe with im-plementing partners in Botswana, Ethiopia, Li-beria, Malawi, Sudan, Namibia, Lesotho, Côted’Ivoire and Burkina Faso. It a
 
ims to bring itsHIV prevention and life skills curriculum to1.25 million African youth by 2010.To date, M•A•C has raised $128 million ex-clusively through the sale of M•A•C’s VIVAGLAM lipstick and lipglass
 
, donating 100% of the sale price to AIDS prevention programs.
 
P
AGE
T
HREE
P
REVENTION
AFRICAN MINISTERS LINK HEALTHAND ENVIRONMENT
African Ministers of Health and the En- vironment, meeting in Libreville, Gabon,have resolved to build a strategic allianceto reduce environmental threats that se- verely impact the health of the continent’scitizens.
At the con-clusion of theFirst Inter-ministerialConferenceon Healthand Environ-ment in Afri-ca in August,the Ministerssigned the Li-breville Dec-laration whichcommits theirgovernmentsto buildingstronger link-ages both na-tionally and regionally between health andenvironmental policies.e World Health Organization (WHO)has estimated that in 2002 a
 
lone unsafe wa-ter, pollution, poor sanitation, inadequatewaste disposal, insufficient vector controland exposure to chemicals claimed about2.4 million lives.Dr. Luis Sambo, WHO Regional Directorfor Africa, described the Declaration as “thefirst step towards saving the lives of millionsof people from the harmful effects of chang-es in the environment.”“We will work together to promote stra-tegic alliances between health and environ-ment. I am delighted that we have managedto secure political commitment to catalyzeinstitutional changes needed to improve thehealth and well-being of communities inthe region,” he added.Conference delegates, who also includedhealth experts, academics, policy makersand representatives from multilateral in-stitutions and other NGOs, discussed theneed to address health, environment andeconomic development issues in an interre-lated manner and to seek out partnershipswith civil society, including the private sec-tor, to improve environmental conditions in
Children in Ghana return from fetching water froma river 
Africa and address potential new challeng-es presented by global climate change.“For too long both health and environ-ment have sought to cope with the down-stream consequences of policies regardingenvironment, health and economic devel-opment that have been designed in par-allel, not in concert,” said Mr. MounkailaGoumandakoye, Regional Director for theUnited Nations Environment Program(UNEP), which partnered with the WHOto organize the meeting hosted by the Gov-ernment of Gabon.e Libreville Declaration urges mem-ber states to update their national, sub-re-giona
 
l and regional frameworks to moreeffectively address the linkages betweenhealth and the environment within poli-cies and national development strategies;to ensure health and environmental issuesare integrated into poverty reduction strat-egies; and to strengthen health and envi-ronmental institutions.“e Libreville Declaration is a mile-stone for Africa. Nowhere is the humanhealth impact of environmental threatsmore urgent,” said Dr. Maria Neira, WHODirector for the Department of PublicHealth and the Environment. “e chal-lenge now is to ensure Africa moves on tothe global environmental health agenda.”Dr. Richard Walker, Project Director of the Enteric Vaccine Initiative of PATH, aglobal health NGO, described the confer-ence as potentially providing the momen-tum to bring about changes that wouldsubstantially reduce childhood deathsfrom diarrheal dis
 
ease, the second leadingcause of child death worldwide.“Most environmental improvementsand health initiatives are trapped in sepa-rate worlds - housed in different buildings,ministries, mindsets and money flows,”Dr. Walker wrote in a guest column runon
allAfrica.com.
“Increasing political willto address diarrheal disease in a coordi-nated fashion could s
 
pur major progresson Millennium Development Goals 4 and7 - reducing child mortality and improv-ing environmental sustainability - result-ing in success for both the environmentaland health sectors, and a major win for thechildren of Africa.”
ETHIOPIA SIGNSNATIONAL HEALTHCOMPACT
D
ONOR
C
OORDINATION
Ethiopia, as part of a commitment to makerapid progress towards achieving the UnitedNation’s Millennium Development Goals,has become the first country to sign an Inter-national Health Partnership (IHP) Compactwith its development partners.
e purpose of t
 
he agreement, signed inAddis Ababa in August, is to harmonize differ-ent aid flows to the health sector so as to maxi-mize their impact. It provides an overarchingframework for health aid coordination in Ethi-opia, and commits development partners andagencies and the Government of Ethiopia towork together more effectively to coordinateaid flows and national policies.e IHP concept was launched by the devel-opment community in September 2007. Bu-rundi, Kenya, Mozambique and Zambia havealso commit
 
ted to signing compacts.Ethiopia’s Minister of Health, the Honor-able Dr. Tedros Adhanom, said the compactwas designed to bring health services “closerto the household.”“Ethiopia is commited to ensuring that all of its people have access to primary health servic-es by 2010 and is now rolling out a new HealthExtension Program,” he said.“Because donors have different - and oencomplex - rules and reporting requirementsfor the projects that they offer to fund, andbecause we don’t have enough staff to manageprojects in accordance with their rules and re-quirements, we can’t actually make use of all of the funding that donors offer us for health,” headded. e new compact is designed to ame-liorate the problem.“In Ethiopia, we recognize harmonization- which basically means the need to makeaid more effective by supporting nationalplans rather than imposing external prioritiesand procedures - as a major challenge to theachievement of our objectives in health,” Dr.Adhanom said.Among those who signed the IHP with theGovernment of Ethiopia are the World Bank,the World Health Organization (WHO), theGovernments of the United Kingdom, Cana-da, Norway and Germany, the UN PopulationFund, UNAIDS, UNICEF, the GAVI Alliance,the Bill & Melinda Gates Foundation, the Af-rican Development Bank, the Global Fund toFight AIDS, Tuberculosis and Malaria and theUN Development Group.
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