People's Health Movement Ghana (PHM/Ghana)
Health for All Now!!
Ref: PHM-GH-WHO/AFRO/RC-1
30th August, 2011.
Hon. Joseph Yieleh-Chireh
Minister of Health,
Accra.
Dear Hon. Joseph Yieleh-Chireh,
Issues for consideration at the 61st WHO Regional Committee for Africa
We, the People’s Health Movement Ghana (PHM-Ghana) and representatives from a number of
civil society groups from across the country, write to you in connection with the 61st World
Health Organisation Regional Committee Meeting for Africa scheduled to take place in
Yamoussoukro from August 29th to September 2nd, 2011. The Regional Committee meeting
provides an opportunity to deliberate and commit to crucial issues of health in the WHO African
region.
PHM-Ghana is a registered civil society organization in Ghana, and is an affiliate (the Ghana
circle) of the People’s Health Movement (PHM). PHM is a global network of organizations
working locally, nationally and globally for ‘health for all’. Our basic platform is articulated in the People’s Charter for Health which was adopted at the first People’s Health Assembly in
December 2000. More information about PHM can be found on our website:
www.phmovement.org.
PHM is committed to a stronger WHO, adequately funded, with appropriate powers and
playing the leading role in global health governance. PHM follows closely the work of WHO
through the governing bodies and the secretariat. However, WHO in the African Region does
not make it easy for civil society participation in the regional committee meetings. The process
of participation is unclear and organizations in official relations with WHO are not invited to
attend. Further, the background documents for the regional committee meeting are not
uploaded on the website early enough to allow for a more thorough discussion and
consultation with various constituencies. We write to convey to you PHM-Ghana’s position on some of the key agenda items.
Agenda Item 8: Panel Discussion – Health financing: Sharing experiences in securing funding to achieve national health development goals
Secretariat’s Note
The panel discussion will be a forum to discuss and share experiences on how best to address the huge health financing needs in the African Region: to discuss the financial implications and funding requirements to meet the gap, attain national health development goals and sustain achievements; and share country experiences in securing funding; and strategize for the possible ways forward.
PHM-Ghana’s Comment
PHM-Ghana welcomes this discussion on health financing in Africa. However, PHM-Ghana is concerned that the panel discussion is not anchored on the right to health. Furthermore, PHM-Ghana recognizes that meeting health financing commitments, such as the 15% Abuja target, alone may not dramatically improve health. PHM-Ghana calls for health investments to be matched with investments in comprehensive primary health care and on the social determinants of health.
Agenda Item 9: Framework document for the African Public Health Emergency Fund
Secretariat’s Note
In recognition of the inadequate resources available to Member States of the WHO African Region to combat epidemics and other public health emergencies in the African Region, the 59th session of the WHO Regional Committee for Africa adopted Resolution AFR/RC59/R5 entitled “Strengthening outbreak preparedness and response in the African Region in the context of the current influenza pandemic”. The resolution requested the Regional Director to facilitate the creation of an “African Public Health Emergency Fund” that will support the investigation of and response to epidemics and other public health emergencies. The Regional Committee is invited to review and adopt this Framework and the related resolution, including taking decisions on options contained in the Framework.
PHM-Ghana’s Comment
The idea of an African Public Health Emergency fund is laudable and PHM-Ghana fully supports it. However, PHM-Ghana is concerned that the resolution is silent on countries defaulting on
3 their commitments regarding the agreed appropriations. Further, the document does not indicate how often the scenarios for determining levels of contributions will be reviewed.
The paper does not mention the importance of strengthening national public health emergency agencies and the need to put in place national and sub-national emergency preparedness plans. We believe actions aim at preventing or minimizing the impact of public health emergencies are of equal importance as actions during emergencies.
Agenda Item 10: WHO Reform for a Healthy Future
Secretariat’s Note
By its resolution WHA64.2 entitled “The future of financing for WHO”, the Sixty-fourth World Health Assembly, endorsed the agenda for reform as set out in the Director-General’s report in document A64/4. Resolution WHA64.2 requests the Director-General to present: (i) a detailed concept paper for the November 2012 World Health Forum; (ii) a first report on the independent evaluation of the work of the WHO to the Sixty-fifth World Health Assembly in May 2012. The resolution also requests the WHO Executive Board to establish an appropriate process to examine the issues related to WHO’s governance identified in the report.
PHM-Ghana’s Comment
First, the overview of the WHO Reform Agenda (document AFR/RC61/5) indicates that the Regional Committees will receive an overview paper, along with three Concept papers – on the governance of WHO, an independent evaluation of WHO, and the World Health Forum – together with a summary of a consultation with the Geneva-based missions. However, the documents shared do not include the summary of the July consultations as promised.
Further, the resolution states that consultation with Member States and staff will continue throughout the coming months. However, there is no opportunity for civil society to contribute to these consultations.
On the Concept Paper on Governance (AFR/RC61/CP/1), PHM-Ghana supports the fourth proposal for the promotion of more active engagement and participation of all Member States in the governance of WHO. PHM-Ghana calls of Members States to consider the inclusion of Civil Society in these discussions.
The proposed World Health Forum (AFR/RC61/CP/3) has the potential to promote the interest of the private sector at the expense of a member states’ driven process. The rationale and need for such a forum is not made clear; and there is no discussion about how such a proposal would avoid undermining or duplicating the role and mandate of the WHO. The WHO must not pursue public-private partnerships without ensuring safeguards against corporate influence over policy making and pernicious conflicts of interest. We urge you to consider the risks of this proposal and hope you will not endorse it in its current form.
Agenda Item 13: Measles elimination by 2020: A strategy for the African Region
Secretariat’s Note
This document summarizes the progress made in achieving current targets and goals and presents information on the feasibility of achieving a further goal of measles eradication. It provides an assessment of programmatic challenges to achieving measles elimination in each WHO region, and proposes milestones and intermediate targets to be attained
PHM-Ghana’s Comment
There is need to emphasis routine immunization as the foundation. PHM-Ghana calls for efforts to be made to ensure that routine immunization programs are strengthened to the greatest extent possible to serve as the backbone for embarking on eradication.
It is recognized that effective and efficient vaccine delivery requires and should be mediated through well functioning health systems. It is less widely recognized that a pre-occupation immunisation delivery can disrupt health care delivery with serious negative consequences.
The strategy called for Member States to achieve the highest quality of case-based surveillance systems including laboratory services. However, given that most rural communities do not have access to laboratory services, and cognizance of the way specimens are handled and transported, Member States will have to consider investing in those resources especially at the sub-national levels.
There is need to invest in community mobilization strategies and actions on the social determinants of health. This will contribute to addressing the resistance of some communities to immunization.
Furthermore, PHM-Ghana calls on Member States to show sustained commitment at the highest levels, including providing financial commitments for implementing the Operational Plans for these strategies at the national level.
Conclusion
We sincerely hope that you will be able to incorporate our recommendations into the draft documents and resolutions. We would also like to stress that we see the need for the highest level of official representation in the regional committee meeting.
Yours sincerely,
John Eliasu Mahama
Coordinator, PHM-Ghana
PHM-Ghana, Box CT 6103, Cantonments, Accra. Email: phmghana@gmail.com
Globally, People’s Health Movement (PHM) has an organized presence in 86 countries
E-mail: globalsecretariat@phmovement.org Web: www.phmovement.org
Cc:
Minister of Foreign Affairs
Accra, Ghana.
Chief Director,
Ministry of Health,
Accra, Ghana.
Director General,
Ghana Health Service,
Accra, Ghana.
Ghanaian Embassy in Abidjan,
Abidjan, Cote d´Ivoire.
The WHO Country Coordinator
Accra, Ghana.
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