President Ellen Johnson Sirleaf has called on all health partners to identify ways in which, working together, Africa can continue to ensure that the progress made is maintained and enhanced regarding women’s health and in combating malaria in the African region.
According to an Executive Mansion release, President Sirleaf, who is Honorary President of the Commission on Women’s Health and Chair of the African Leaders’ Malaria Alliance (ALMA), spoke on Monday, December 17, when she officially launched two very important World Health Organization documents – the Women’s Health Commission Report on Addressing the Challenges of Women’s Health in Africa (the first ever developed for the African region); and the World Malaria Report 2012 – at the Monrovia City Hall. Together, the two initiatives seek to improve the situation of women’s health in Africa, and prevent malaria worldwide.
The Women’s Health Commission serves as a forum to re-energize efforts and commitment, in partnership with multilateral and bilateral institutions, to address the problem of women’s health, gender and human rights in order to achieve rapid and tangible impact in the African region. Similarly, ALMA is an alliance of African Heads of State and Government which serves as a critical forum and mechanism for advocacy, action and follow-up in implementing malaria-related objectives.
Speaking on the Women’s Health Commission Report, President Sirleaf said it highlights the enormous contributions women make to Africa’s socio-economic advancement, as well as the vexing problems of dealing with preventable causes of death for women; women’s poor access to education and to decision-making positions, and their low income. “These factors contribute greatly to women’s limited capability to protect their own health and that of their families, which in turn increases their social, physical and financial vulnerability.” The Report, she said, details steps that nations can take to address these problems.
Consistent with the high level of political will, President Sirleaf noted that most countries in the region have developed roadmaps on reducing maternal and newborn deaths. For its part, she said Liberia has developed a 10-year National Health and Social Welfare Policy and Plan, as well as a comprehensive Essential Package of Health Services, with emphasis on free healthcare for women, children and men. She also mentioned the new Agenda for Transformation – the successor to the Poverty Reduction Strategy – which was launched last week at the Vision 2030 National Conference in Gbarnga, Bong County, which recognizes the importance of reducing maternal and newborn deaths and identifies maternal health as one of the priorities of the Health Ministry.
“In addition, President Sirleaf continued, “we have developed a Reproductive Health Policy and Guidelines; our referral system is being improved with ambulances in most of our country hospitals; we are installing equipment for basic emergency obstetric care services in some county hospitals; staff are being trained in life-saving skills; and, mindful of the importance of increasing skilled births in our communities, two midwifery training schools are open and functioning in two of our rural counties.”
On malaria, the ALMA Chair admitted that while the continent still has a long way to go in defeating malaria in endemic countries – sub-Saharan Africa being the worst affected – the World Malaria Report 2012 presents encouraging data which show a steady decline of the burden of malaria, thereby signifying a huge improvement. Malaria interventions are highly cost effective and inexpensive, the President said, and the Report encourages countries to adhere to the WHO-recommended combined treatment for malaria, to reduce the emergence of drug resistance and ultimately improve the survival of the peoples of Africa and the world.
President Sirleaf also informed the meeting of her role as co-Chair of the UN High-Level Panel tasked with crafting a successor global development agenda to the Millennium Development Goals (MDGs). Although there are still three years to go before the MDGs expire in 2015, she said, “we should not take our eye of the ball; every country should look at where they are, what they can do to accelerate their efforts, how they can pinpoint particular goals that might be achieved with an extra effort, so that the new development agenda builds upon the record of the MDGs.” She added, “That remains our position when it comes to reducing malaria in Liberia and elsewhere, as well as in implementing all of the MDGs.”
For his part, the WHO Regional Director for Africa, Dr. Luis Gomez Sambo, who represented the WHO Director-General, Dr. Margaret Chan, at the launch of the two Reports, warned that Africa cannot achieve further progress unless it strengthens health systems and ensures sustained and predictable health financing. “Governments, partners and communities should also find new ways of improving efficiencies of healthcare delivery systems and move towards universal health coverage,” Dr. Sambo suggested.
He said the launch of the Women’s Health Commission Report on Addressing the Challenges of Women’s Health in Africa comes at an opportune time when the urgent need to address the health challenges facing women continues to dominate international and national agendas. “The very high maternal mortality ratio, the high burden of HIV/AIDS, malaria and tuberculosis, gender-based violence and other harmful practices, cervical cancer and other non-communicable diseases are critical barriers to the socio-economic development of women,” Dr. Sambo said. He added that low access to education, decision-making positions and poor economic status limits women’s ability to protect their own health, increases their vulnerability and compromises the important role they play in their families, communities and the society at large.
He said that among other things, the report demonstrates the enormous role of African women in socio-economic development, as well as the potential to achieve much more if they are healthier; it highlights the interplay between biological and social determinants of women’s health and argues that women’s health needs to go beyond sexual and reproductive concerns; and it identifies critical actions that need to be taken to improve the social status of women and promote gender equity.
Of the World Malaria Report 2012, Dr. Sambo said malaria remains a significant public health problem that affects Africa’s development. Providing some statistics, he said that “in 2010, there were an estimated 174 million cases and 596,000 (about 90 percent) of malaria-related deaths in the African Region. However, the past decade has witnessed a great expansion in the financing and implementation of malaria control programs. This has enabled endemic countries to increase access to preventive, diagnostics and treatment services.”
He said that an estimated 1.2 million malaria deaths have been averted, primarily as a result of a scale-up of malaria control interventions. “Twelve countries in Africa have reduced malaria morbidity and mortality by more than 50 percent, thus exceeding the Abuja 2010 targets. In spite of this progress, millions of people are at risk of malaria as they continue to lack access to vector control interventions, preventative therapies, diagnostic testing and quality-assured artemisinin-based combination therapies,” The WHO Regional Director for Africa said.
Dr. Sambo said the World Malaria Report 2012 points out some worrisome signs about the sustainability of the gains achieved so far. The current level of funding remains insufficient to achieve universal coverage of WHO recommended malaria control interventions. “There is an urgent need to identify and tap on new funding sources,” he said, adding that the Malaria Report underscores the importance of high-level political commitment, inter-sectoral collaboration and inter-country cooperation.
As Africa move towards 2015, Dr. Sambo said, particular attention should be given to mitigating the risks of resistance to medicines and insecticides, as well as ensuring universal access to proven cost-effective interventions. He added that stronger disease surveillance systems are the eyes and ears of public health efforts to address malaria. “This is a requirement for prevention of outbreaks, prompt effective response and monitoring of progress, he advised.
Also speaking on the topic of malaria, the Executive Director of ALMA, Mrs. Joy Phumaphi, reiterated the message of ALMA Heads of State and Government for sustained funding, sustained leadership and political commitment, finding new technologies, good governance and better managed programs.“Given the limited resources and urgency of sustaining and scaling up investments, it behooves us to focus on efficiency gains, value for money and increased accountability at all levels,” Mrs. Phumaphi said.
“Financial management controls to improve accountability in the health sector are critical, to ensure efficiency, effectiveness and economic use of all resources. ALMA Heads of State and Government have charged the African Development Bank and World Bank with accelerating country support in this area,” she said.
“Malaria and women's ill health fuel poverty,” the ALMA Executive Director cautioned, pointing out that parasite prevalence rates in children and women's ill health are highest among poorer populations. Between the year 2000 and now, she said, the fight against malaria has averted 274 million malaria cases and prevented 1.1 million deaths. However, there is still a long way to go, with only nine countries in Africa on track to meet the World Health Assembly’s Roll Back Malaria target of reducing the incidences of malaria cases by 75 percent before 2015. “The war against malaria has reached a critical turning point. We have to push harder and faster to remain on track. Failure is not an option,” she said.
Also addressing the meeting was the Special Representative of the Secretary-General and Coordinator of United Nations Operations in Liberia, Madam Karin Landgren. Health is a fundamental right, she said, one which influences all aspects of life. “Women, men and children should have equal access to health care, and the participation of the population, including women, in all health-related decision-making processes at the community and national levels, is an important aspect in shaping the agenda on the right to health.”
She said that although sexual and reproductive health actions are needed to improve the health status of women, all should also focus on broader and more comprehensive actions to address the social status of women, promote gender equity and equality, and empower women to contribute actively to social and economic development.
Gender-based violence is a risk for many women, particularly in their homes and communities, Ms. Landgren observed. “Not only is this a violation of human rights, but it has wide-ranging consequences for women’s physical and mental health, and on the health systems of the communities where they live,” she observed, noting further that the relatively high mortality rates of women are a reflection of unequal gender relations, inequalities in resource distribution, lack of socio-economic opportunities and increasing poverty often affecting more women than men.
She hoped that the two Reports will be utilized by governments in the region for putting in place or strengthening comprehensive medical care programs with a focus on sexual and reproductive health and malaria prevention and control, in order to reduce maternal, newborn and child deaths in the region. She pledged UN support to the Liberian government in implementing the recommendations in both documents.