The Work of WHO in the African region: annual report of the regional director

The work of WHO in the African Region 2006 is a progress report on the implementation of theProgramme Budget 2006-2007 in the African Region for the first year of the biennium. As a generalorientation for 2006-2007, the Director-General was committed to the decentralization policy in orderto strengthen WHO’s capacity in countries. This policy required delegation of authority and shiftingappropriate human and financial resources to country level where they were most needed.2. In line with this policy, the Regional Director, in a document entitled Strategic orientations forWHO action in the African Region, 2005–2009, defined five priorities for work. These included (i)strengthening the WHO country offices, (ii) improving and expanding partnerships for health, (iii)supporting the planning and management of district health systems, (iv) promoting the scaling up ofessential health interventions related to priority health problems, and (v) enhancing awareness andresponse to the key determinants of health.3. The areas of work constituted the essential organizational elements of the Programme Budget2006-2007. This report thus presents the progress made during the year 2006 in the various areas ofwork. The report also highlights the main achievements with regard to the priorities of the Region.4. The decentralization of WHO functions closer to countries and the establishment of the IntercountrySupport Teams approached completion. There was increased technical support to all 46countries based on the implementation of the Strategic orientations for WHO action in the AfricanRegion. This resulted in an increase of about 13% in technical support to countries over the previousyear. The Regional Office was fully located in Brazzaville. Financial prudence was givenconsiderable attention during the year.5. In order to address the major health issues of the populations in the African Region, the mainobjective for 2006 was to scale up interventions and programmes towards achieving the MillenniumDevelopment Goals (MDGs). To achieve this, there was pursuit of greater partnerships andunderstanding of the critical factors affecting public health and the patterns of morbidity. A number ofpartnership meetings were held. One result was that various agencies, heads of state and stakeholderssigned agreements to commit to specific health goals and intervention activities. In addition, thePartnership for Facilitating Health Development was created in collaboration with variousdevelopment partners, the aim being to accelerate the achievement of the MDGs. Progress in reducingchild and maternal mortality and morbidity remained slow, malnutrition was high, and there wasincreased stunting in several countries. Immunization services, however, made significant progress:DPT3 coverage was over 50% in 44 of the 46 countries of the Region.6. HIV and AIDS remained major public health challenges in the African Region. An estimated2.8 million adults and children were infected with HIV in 2006. This was more than all other regionsof the world combined. HIV and AIDS remained the leading causes of mortality among adults aged15–49. Provision of antiretroviral therapy (ART) expanded substantially. About 23% of the people inneed of ART received the required drugs compared to 17% at the end of 2005.7. The Africa Region continued to have the highest tuberculosis rates per capita. Defaulter andtransfer out rates exceeded 15% in several countries. During the year, the existence of TB strainsresistant to second-line anti-TB drugs was reported in the Region for the first time. Malaria stillxnegatively impacted on infant and maternal mortality. Despite the availability of cost-effectiveinterventions and increased funding, coverage of at-risk populations remained unacceptably low.Avian flu received funding and technical support. Little progress was made in preventing andcontrolling the neglected tropical diseases.8. Although access to prevention, treatment, care and support interventions for all conditionsimproved, it still fell short of demand. Inadequate human resources and weak health systems weresome of the major contributing factors to limited access to health services. Gains were made in percapita expenditure on health, but macroeconomic policies did not fully impact on health servicedelivery. Improvements are still needed in a number of factors relating to public expenditure targets,inflation control, tobacco tax, and alternative health financing mechanisms.9. In 2007, a concerted effort will be made to scale up activities using enabling factors such assynergistic interventions across the three levels of the Organization, as well as closer collaborationwith the African Union, Economic Commission for Africa and regional economic communities.Working relationships with United Nations agencies, World Bank, International Monetary Fund,bilateral donors, and public and non-government sectors will be pursued.