Your Excellency Daniel Kablan Duncan, Prime Minister of Côte d'Ivoire; Honorable Ministers, Excellencies, Ladies and Gentlemen.

Good morning everyone. I am delighted to welcome you to the African Development Bank for the West Africa Ministerial Dialogue Meeting on Strengthening Public Health Security in Africa. Thank you all for honoring our invitation.

Nothing could be more important. The saying goes "health is wealth". Our meeting today is crucial, for building resilient health systems to ensure that Africa can deal effectively with public health emergencies and support its economic transformation. A healthy population will translate into increased productivity, and drive to sustainable economic growth.

Over the past two decades, Africa has made significant progress in terms of health outcomes. For instance, child mortality has declined in Sub-Saharan Africa (SSA) by more than 50% between 1990 and 2015. Similarly, maternal mortality rates declined by 45% in SSA and 59% in North Africa over the same period.

However, some challenges remain. The disease burden remains high in Africa. Although progress has been made, with malaria cases declining by 42% between 2000 and 2010, the continent still accounts for 88% of global malaria incidence.

Also, Sub-Saharan Africa faces a deficit of skilled health workers. While the region accounts for 25% of the global disease burden, it represents only 4% of the global health workforce.

Lack of access to safe, quality and affordable medicines remains a major challenge. This is worsened by weak regulatory systems and the preponderance of fake drugs.

Due to high levels of poverty and inequality, access to quality healthcare care by the poor is also a major challenge in Africa. Out-of-pocket spending is the predominant source of financing for healthcare for the poor. The absence of health insurance makes them even more vulnerable to health shocks.

Providing financial protection is therefore crucial for poor households, who may easily fall into unemployment or lose their wages and experience long-term disabilities.

The Ebola pandemic was a wakeup call. The crisis exposed the fragility of our public health systems, and the under-investment in health infrastructure in many African countries. During the crisis, nearly 13,000 lives were lost in Guinea, Liberia and Sierra Leone. Families and households were devastated. The disease also wiped out an estimated US $2.2 billion of the Gross Domestic Product (GDP) for the three countries.

The African Development Bank was the first international financial institution to rally support in the fight back against Ebola, providing about US $300 million for emergency and post-Ebola Recovery programmes in the affected countries, and some neighboring countries.

One of the major lessons from this crisis is that building an effective health system is fundamental to ensuring that Africa can better respond to health emergencies, build resilient economies, and improve the life expectancy of its people.

This must start with greater investment in public health systems in Africa. However, Government spending on health remains low, with only 4 countries exceeding the 15% budgetary allocation to the health sector agreed under the Abuja Declaration.

According to IFC's estimates, US $25-30 billion is required to address the healthcare investment gap in the continent. Closing this deficit calls for scaling up investments and partnerships involving public, private, philanthropy, and development financing institutions.

This is why the African Development Bank is expanding its interventions in the health sector. Since the

With the rise in epidemics and other health risks, the Bank is supporting emergency preparedness by strengthening disease surveillance at regional and country levels. The Bank is collaborating with the African Union Commission and other partners, to establish African Centers for Disease Control. The Bank will partner closely with the World Bank and the WHO to establish the center in West Africa. The Bank has also committed $14 million towards establishing national disease surveillance, alert and response systems for Guinea, Liberia and Sierra Leone.

Furthermore, to address the knowledge gap, and promote research and development in the health sector, the Bank is supporting the establishment of Centers of Excellence across the continent, including West Africa.

We have also invested about US $70 million in Private Equity Funds to catalyze over US $1 billion in investments to build sustainable and scalable health care systems across Africa. These include the Investment Fund for Health in Africa (€10 million); the Africa Health Fund (US $12 million); Abraaj Africa Health Fund (US $25 million) and Rx Healthcare Fund (US $20 million).

Excellencies, Ladies and Gentlemen

Africa cannot harness its economic potential and achieve the SDGs with a broken health system. We must change the healthcare delivery paradigm and link public health to overall economic development.

We must fix the fundamentals. In the absence of electricity, doctors perform surgeries in the dark or rely on unstable power supplies. Medicines and vaccines cannot be safely stored without power.

Without access to adequate nutrition, millions suffer from malnutrition and stunting. It was the father of medicine, Hippocrates that said "let thy food be thy medicine and thy medicine thy food". With 54 million children stunted, 14 million wasted and 10 million obese, Africa is suffering a major health challenge linked to access to adequate and nutritious food. Africa loses over $25 billion annually to stunting. Stunted children today leads to stunted economies tomorrow. We must invest in "grey matter infrastructure for Africa".

With high levels of unemployment or underemployment, millions are unable to afford the cost of health care, especially the youths. They become vulnerable. And without well-integrated labor, trade and financial markets, economic opportunities are constrained for many.

That is why the African Development Bank has adopted the High 5s: to Light up and power Africa; Feed Africa; Industrialize Africa; Integrate Africa; and Improve the quality of life for the people of Africa.

The Bank's High 5s are enablers for achieving public health security in Africa.

The Bank will support African countries to develop sustainable health financing systems and close the health investment gap. In addition, the Bank will support policy reforms to put in place a conducive enabling environment for investment in health care.

Greater involvement of the private sector and other actors will be critical, as well as innovative financing models to mobilize increased investments, leveraging public-private partnerships.

I know that we are up to meet the challenges of financing health care systems that will respond effectively to the needs of Africa. The African Development Bank stands fully ready to work with you, the Ministers of Finance and Ministers of Health, to get this done. Let us make sure that indeed "health is wealth". For only through universal health care coverage, backed with a sound financing system, can we truly achieve improved quality of life for the peoples of Africa. I am sure we can do that

- so let's get to work on it - together!

Thank you very much.