Inaugural Speech by WHO Regional Director For Africa Dr Luis Gomes Sambo

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1 February 2005

 

Colleagues

I thank the Almighty God Who has given me the privilege to serve this Region in my new capacity as Regional Director of the World Health Organization. I pay tribute to Dr Ebrahim Malick Samba whose work in this Region has taken AFRO to a higher level of hard work and recognition. I wish him continued health in his retirement.

Exactly 16 years ago, I began my professional career in the World Health Organization. During this period, I have served at the country level as WHO Representative; at intercountry level as a member of the Health Systems Team; at the Regional Office as Head of the HFA Unit, Director of Health Systems and Health Services Division, and as Director of Programme Management until my election as the Regional Director in September 2004.

Together, we have experienced and managed the diverse health and humanitarian challenges confronting our Region. Undaunted by them, we remain committed to the principles of Health for All.

I want to thank all the colleagues in country offices, intercountry teams, and at AFRO. I thank you for the excellent support and the rich values, knowledge and experiences that we have shared over the past years.

Today, we begin a new chapter in the work of WHO in the African Region. The challenges are many and heavy, including weak and fragmented health systems; inadequate resources for scaling-up proven interventions; limited access to available health services and technologies; poor management of human resources for health; weak application of policy actions to health determinants; limited intelligence for decision-making; recurrent natural and man-made disasters and emergencies and extreme poverty. However, it is not how heavy the load, but how you carry it that determines the degree of success.

As we proceed in the years ahead, 
- a core of competent and dedicated personnel will determine our potential; 
- our shared vision will dictate the direction of our team; 
- an effective work ethics will determine our readiness; and 
- leadership at all levels will determine our overall success.

We have based our goals on international and regional agreements such as the MDGs, Health for All for the 21st Century: Agenda 2020, NEPAD Health strategy and various Regional Committee resolutions. These goals will help create priorities, determine direction, predict our choices and dictate our companions as we work to improve the health of Africa's peoples, our most valued resource. We count on the support of the Director General of WHO, Dr Lee, the African Union, Regional Economic Communities and our partners for Health Development in Africa.

Colleagues, 
Our work will focus on:

  • Responsiveness to country needs for better health outcomes;
  • Enhancing efficiency and effectiveness of WHO support to countries;
  • Strengthening our stewardship role in health.

Responsiveness to the needs of countries for better health outcomes
WHO has over the years developed many proven and evidence-based strategies that can make a difference to the health of people. The Regional Office will focus its actions on a few priorities and proven, cost-effective interventions that make the most impact on the lives of our people.

The African Region remains the most affected by communicable diseases especially the triad of HIV/AIDS, Malaria and Tuberculosis. Through a better integration of activities in these 3 areas, we will maximize human, financial and material resources, and thus decentralize such resources more to countries. We will actively pursue the attainment of the 3X5 target, the Abuja health targets and the MDGs relating to HIV/AIDS, Malaria and Tuberculosis.

We shall actively collaborate with Member States to finalize and implement the International Health Regulations. We shall improve our system of Epidemic Alert and Response within the global system; and create an effective Multidisease Surveillance Centre for adequate preparedness and response to epidemics.

Vaccine preventable diseases remain a priority for our Region. We are committed to eradicate poliomyelitis in spite of recent difficulties. We shall explore all diplomatic and political avenues to assure a healthy start in life for the children of Africa. We shall improve and sustain routine immunizations in order to reduce infant mortality rates.

One of the strategic directions of the Health-For-All Policy for the 21st Century: Agenda 2020 is the creation of the conditions that will enable women to participate in, benefit from and play a leadership role in health development. In April 2005, the World Health Day will focus on Maternal and Child Health with the theme: Making Every Mother and Child Count. Our Region bears the greatest burden of neonatal, child and maternal morbidity and mortality. Building on the expressed commitment of Member States and the African Union, and applying the proven strategies identified in the "Road Map for accelerating the attainment of the MDGs relating to maternal and newborn health in Africa", we will support countries to scale up interventions, improve coverage and achieve measurable impact. Within the Regional Office, we will restructure in a way to improve and promote maternal and child health interventions through Making Pregnancy Safer and Child and Adolescent Health, including the Integrated Management of Childhood Illness.

Addressing non-communicable diseases will require focusing attention on Health Promotion through health information and education, and healthy lifestyles. This will impact positively non-communicable and communicable diseases including HIV/AIDS.

We will intensify advocacy and support to countries in the areas of Framework Convention on Tobacco to increase the number of African countries that accede to the Convention.

A major prerequisite to a healthier population and overall sustainable development in our Region is functional health systems; which links the individual, families and communities to all levels of care, and makes services available, accessible, acceptable and affordable. Particular attention will be paid to supporting countries in implementing appropriate Health Financing and Social Protection mechanisms thus reducing out-of-pocket expenses for health.

The most valuable resource in the health sector is the workforce. International migration of health personnel is a challenge for the health systems in the African Region. The Fifty Seventh World Health Assembly adopted a resolution that called on WHO to explore additional measures that might assist Member States in ensuring quality training of the appropriate cadres of staff, and to identify effective mechanisms for their motivation, retention and continuing capacity development.

Targeted efforts will be made in assisting countries to increase availability, accessibility, and affordability of Essential Medicines, in particular antiretrovirals. We shall continue to support local production of scientifically proven traditional medicines in the context of primary health care.

True to our mandate, health is first on the agenda, but we must not lose sight of the major determinants of health, some of which are outside the health sector. Poverty is a threat to health and development in Africa. We will support countries' efforts in addressing poverty alleviation, health inequalities, and improved economic performance.

Natural and man-made disasters are a frequent occurrence in our Region. WHO AFRO will need to strengthen mechanisms for Emergency Preparedness and Response, and mobilize additional resources to improve national and regional response.

We shall work together with countries to bridge the "know-do" gap from research to practice. We must turn scientific knowledge into effective action for people's health. Every Division should invest in health research and budget appropriately for it.

The health challenges enumerated above will dictate our companions - our partners in health. We shall strengthen partnerships and enter into an era of networks as never before. We will work with the Member States, African Union, Regional Economic Communities, and bilateral and multilateral partners to improve health dialogue, develop synergies and bring additional support to national and regional health development efforts.

Enhancing the efficiency and effectiveness of WHO support to countries

Our efforts in the coming years will be country-focused and people-centered. The Country Cooperation Strategy will provide us the essential entry point into the WHO managerial process within the context of the 11th General Programme of Work (2006 - 2015).

Following on the Director General's commitment to decentralize WHO Resources to Regions and Countries, the Regional Office will also decentralize for greater effectiveness of our support to countries. We will strengthen WHO's Core Presence in countries.

We have already made a good start in strengthening our country offices, and this will continue. A first major step is defining the country office profile, in particular, the core team. This will ensure that we have in place a more technical, smarter, committed and accountable workforce that is adequately equipped to strategically engage countries with measurable outcomes. In addition, we will support capacity building at country level to address the priority heath programmes. The WHO Representatives will be called to take more responsibilities in managing WHO cooperation programme in countries.

Strengthening our stewardship role

The Regional Office must be more efficient and visible. Recognizing that one of the best methods of estimating the intelligence of a leader is to look at the men and women he has around him, we shall re-engineer the various Divisions and Units at the Regional Office with clear segregation of responsibilities. We will implement a clear human resource management plan that eliminates prolonged short-term positions, assures the commitment and pride of our personnel and increases efficiency and output. We will not only use all the brains we have, but all that we can borrow through regional expert committees, task forces and pools of consultants with relevant expertise and experience. This core of dedicated personnel will determine our potential.

The Regional Office will be strengthened through efficient management and a workforce that is devoid of mediocrity. The greatest destroyer of a winning team is a weak player who should not be on that team. To this end, our selection process at all levels will continue to emphasize excellence and merit; and for serving officers, excellence and quality will be recognized.

Having a strong workforce at both regional and country levels will enhance the process of staff rotation with minimal disruption. We will through this mechanism inject new or fresh ideas into both the regional and country levels.

We shall work closely with the Staff Association and facilitate continuing dialogue, between the management and staff. Elected staff representatives have a cardinal role to play in the consideration of conditions of employment and work, as well as in all matters of staff welfare. I will facilitate this dialogue! Whenever conflict arises between staff and management or among staff, the Office of the Ombudsman is open for assistance.

We will strengthen the Administrative and Finance Division ( and establish a Formal Treasury operation ). We will improve our results-based management and reporting processes. We will harmonize ICT, AMS and ROAFI in the context of integrated management of the Programme-Budget.

We are entering a new era of connectivity where virtual conferencing, improved e-communication and publishing will reduce cost and improve efficiency. We have to create conditions to operate the newly created Area of Work called - Knowledge Management and Information Technology.

Colleagues, 
Our culture of writing, documenting, and publishing must improve. 
I have no doubt that a lot of good work is going on in countries as well as in various Areas of Work and Divisions at the Regional Office. Each Area of Work and Division must intensify efforts at identifying the best practices in health, document and disseminate such for replication. We will improve the Publications Committee and accelerate the work of the PDS Unit to expedite publications whilst not losing sight of quality.

In 2005, the first edition of the African Health Report will be launched. This is a step towards regular reporting on the status of health of the people - this is a stewardship role of WHO AFRO.

We will support countries to improve their health information systems and intelligence so that they can measure progress in the health of their populations using agreed indicators. This is an important step in disseminating health information and intelligence in order to measure progress towards the attainment of the Millennium Development Goals, the NEPAD Health Targets and the Health for All.

We must improve and make more participatory our regular management and leadership unit and divisional meetings to ensure direct and efficient supervision and leadership; because vision, policies, and plans are more or less useless unless they are known to all who may be concerned with them. I do believe in collective intelligence. Therefore, we will maximize the inputs from the available technical experts in the Region for optimal institutional good as opposed to individual results.

The principle of working across levels and across Areas of Work will be institutionalized in our Region to improve synergies and overall impact of WHO support at country level. Work planning and budgeting in priority Areas of Work should take account of crosscutting Areas of Work that are crucial to their achievements but usually poorly resourced. For example, HIV/AIDS should allocate resources for Health Promotion; and Malaria should do the same for Health and Environment.

We will intensify the mobilization of resources, so badly needed for scaling up efforts to reach communities and the under-served populations for improved health outcomes. Whilst trying to improve on our current level of externally generated resources, we will vigorously pursue the sourcing of funds within the Region. We shall forge new partnerships. We will advocate with African governments to become donors in health. We will boost the confidence of our traditional donors and partners by being transparent and accountable. We will ensure better appropriation of resources in support to country needs for tangible results, especially the improvement of critical health indicators in the Region.

In conclusion, as we work together as a team, 
we shall be better than we are; 
and we will multiply our value to others and thus have more partners.
No task will be too great, no accomplishment too grand for us to achieve.