Milestones :: Perspectives

Milestones :: Perspectives

Editor’s Note:
We include the full text of the extraordinary and precedent-setting declaration and commitments taken by African states at Addis Ababa below, and an associated commentary by the WHO Regional Director for Africa.

DECLARATION ON “Universal Access to Immunization as a Cornerstone for Health and Development in Africa”
EnglishFrench | Portuguese | Arabic
[text bolding from original text]
We, African Ministers of Health, Finance, Education, Social Affairs, Local Governments attending the Ministerial Conference on Immunization in Africa, which took place from 24 to 25 February 2016 in Addis Ababa, Ethiopia, and convened by the World Health Organization in collaboration with the African Union Commission, are committed to continued investment in immunization programs and a healthy future for all people of the African continent.

Recognizing the tremendous advances that are improving the health of Africa’s citizens, including:
:: A 50% decline in child death rates, and ever-growing numbers of children attending school;
:: Widespread access to vaccines that were not available to African children and adults just a decade ago;
:: Higher vaccine coverage rates across the continent in each five-year periods between 1999-2014;
:: The remarkable achievement of the Africa continent for interrupting wild poliovirus transmission for more than one year; achieving near elimination of Meningococcal meningitis A epidemics, and the significant reduction in disease burden and mortality due to measles.

Bearing in mind the recently ratified Sustainable Development Goal target of Universal Health Coverage which calls for access to immunisation for all (New York, September 2015); and that health is fundamental to social and economic development;

Acknowledging that, broad-based, inclusive growth in Africa is dependent on a healthy population; and that strong immunization programs are a cornerstone of robust systems that help achieving universal health coverage, which is critical to helping national leaders achieve their economic and development goals;

Reaffirming the economic imperative and benefits of reducing vaccine-preventable diseases and consequential deaths, which will improve overall health, empower our future generations and allow every person to achieve his or her full potential;

Recalling the Heads of State Declaration on Polio Eradication in Africa: “Our Historic Legacy to Future Generations” (Johannesburg, June 2015); the World Health Assembly resolution (WHA68.6) on the Global Vaccine Action Plan (Geneva, May 2015), the commitment made by African Ministers of Health on Universal Health Coverage in Africa (Luanda, April 2014); the Immunize Africa 2020 Declaration (Abuja, May 2014) endorsed by African Heads of State; the World Health Assembly resolution that commits all 194 Member States to apply the vision and strategies of the Global Vaccine Action Plan (GVAP) (Geneva, May 2012), and the African Heads of State endorsement of the Pharmaceutical Manufacturing Plan in 2012 as the framework for African people to have access to essential, quality, safe and effective medical products and technologies.

Recognizing that despite progress, universal access to immunisation by 2020, as endorsed under the GVAP, is largely off track in Africa as indicated by the 2014 GVAP report; but that with resolve we can still achieve the GVAP target of at least 90% coverage in our countries and at least 80% coverage in every district for all nationally available vaccines;

Admitting that to sustain the progress made in vaccine introduction and coverage – and achieve the full potential to save children’s and adult’s lives – current national budgetary allocations to vaccination programmes within the context of national health systems financing will need to be further increased;

We hereby collectively and individually commit ourselves to:
:: Keeping universal access to immunisation at the forefront of our efforts to reduce child mortality, morbidity and disability, and in doing so help our countries achieve their long-term health, economic and development goals;

:: Increasing and sustaining our domestic investments and funding allocations, including innovative financing mechanisms, to meet the cost of traditional vaccines, fulfil our new vaccine financing requirements, and providing financial support for the operational implementation of immunization activities by EPI programs;

:: Addressing the persistent barriers in our vaccine and healthcare delivery systems, especially in the poorest, vulnerable and most marginalized communities, including the strengthening of data collection, reporting and use at all levels as well as building effective and efficient supply chains and integrated procurement systems;

:: Increasing the effectiveness and efficiency, as well as changing the approaches as needed, of our immunization delivery systems as an integrated part of strong and sustainable primary health care systems;

:: Attaining and maintaining high quality surveillance for targeted vaccine preventable diseases;

:: Monitoring progress towards achieving the goals of the global and regional immunization plans;

::Ensuring polio legacy transition plans are in place by end-2016 that will allow future health programs to benefit from the knowledge and expertise the polio program has generated through the eradication initiative;

:: Developing a capacitated African research sector to enhance immunization implementation and uptake;

:: Building broad political will, working with communities, civil society organizations,  traditional and religious leaders, health professional associations and parliamentarians, for the right of every child and every community to have universal access to life-saving vaccines, and by extension the best possible chance for a healthy future;

:: Promoting and investing in regional capacity for the development and production of vaccines in line with the African Union Pharmaceutical Manufacturing Plan including the strengthening of national regulatory authorities.

We call upon:
:: Member states and partners, including African development banks and African regional economic communities, to support the implementation of this Declaration, and to increase their efforts to mobilize resources and secure new investments to strengthen national immunization programmes to achieve the GVAP goals and overall health care delivery systems in the Member States;

:: Member states and partners, to negotiate with vaccine manufacturers to facilitate access to available vaccines at affordable prices, and in increasing price transparency as well as developing price databases in line with resolution WHA68.6;

:: Gavi, the vaccine alliance to consider refugees and internally displaced populations as eligible recipients of Gavi support for vaccines and operational costs;

:: The World Health Organization and the African Union Commission to support member states to share experiences, strengthen capacity, and establish mechanisms for monitoring progress towards the fulfilment of these commitments.

We thank his Excellency Hailemariam Desalegn, Prime Minister of the Federal Democratic Republic of Ethiopia, and host country for this Ministerial Conference on Immunization in Africa, for agreeing to champion this declaration and further request him to present it to the African Heads of States at the 26th Summit of the African Union, to be held in June 2016.
Done at Addis Ababa on 25 February 2016


Statement by the WHO Regional Director for Africa Following Historic Commitment to Immunization at 28th African Union Summit
31 January 2017, Addis Ababa, Ethiopia
Today, at the 28th African Union Summit, heads of state from across Africa adopted a Declaration on Universal Access to Immunization in Africa, in which they endorsed the Addis Declaration on Immunization, a historic and timely pledge to ensure that everyone in Africa – no matter who they are or where they live – has access to the vaccines they need to survive and thrive. The WHO Regional Office for Africa applauds this landmark commitment to immunization.

The theme of this year’s African Union Summit is “Harnessing the Demographic Dividend through Investments in Youth” – and there is no better way to invest in young people and in our continent’s future than prioritizing universal access to vaccines. Vaccines are among the most effective and cost-effective public health tools available, saving between two and three million lives every year and yielding economic benefits 44 times greater than initial investments. The economic case is simple: When children are given a healthy start, they can stay in school and grow into healthy, productive adults. At the same time, their families, communities and governments can save and reinvest the time and money previously spent caring for sick children.

A healthy generation of young people in Africa will have tremendous ripple effects. Today, Africa’s youth population is growing faster than that of any other region in the world. Between now and 2050, the working age population in sub-Saharan Africa is projected to more than double. This surge in young working-age adults could catapult many African nations into periods of rapid economic growth and stability – the “demographic dividend” – but only if every young person is equipped to thrive. That starts with ensuring children have access to life-saving vaccines.

Political will at the highest levels is an essential precursor for success toward achieving universal access, and today’s commitment couldn’t have come at a better time. While Africa has made impressive gains over the last 15 years toward increasing access to immunization, progress has stagnated, and the continent is falling behind on meeting global immunization targets.

The stakes have never been higher for African nations to make immunization an urgent priority. International funding for immunization is expected to decline in the coming years. More countries are approaching middle-income status, which will make them ineligible for donor funding through Gavi. Domestic funding – both through government budgets and innovative financing mechanisms – is needed to ensure immunization efforts are uninterrupted, particularly during upcoming transition periods.

Today’s commitment to the ADI – at the highest levels of government – demonstrates that Africa’s leaders are ready and prepared to tackle the challenges ahead. WHO and its partners are committed to supporting Member States’ efforts to ensure that life-saving vaccines reach every child, and, ultimately, improve child health and drive sustainable development across the continent.

We are grateful to Heads of State and to the line ministers who have championed the ADI over the past year for their unwavering dedication to immunization. We leave this historic African Union Summit filled with optimism and ready to work. With the right mix of political will, financial resources and technical know-how – we can ensure that no child in Africa dies of a vaccine-preventable disease.


Editor’s Note:
The WHO Executive Board concluded its meetings earlier this week. While we have not identified a summary or digest of main outcomes posted on the ED meeting site, working versions of Resolutions and Decisions have been posted with the caveats on “definitive versions” as below.

140th session of the Executive Board
23 January–1 February 2017, Geneva

In an effort to respond to Member States’ needs, the present texts have been made available as quickly as possible. The definitive versions of the resolutions and decisions adopted by EB140, edited for the Official Records, will be made available in due course.

EB140.R1 – Appointment of the Regional Director for the Eastern Mediterranean
EB140.R2 – Appreciation of the outgoing Regional Director for the Eastern Mediterranean
EB140.R3 – Nomination for the post of Director-General
EB140.R4 – Post of Director-General: draft contract
EB140.R5 – Improving the prevention, diagnosis and management of sepsis
EB140.R6 – Scale of assessments for 2018–2019
EB140.R7 – Preparation for the third High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases, to be held in 2018
EB140.R8 – Confirmation of amendments to the Staff Rules: revised compensation package, related entitlements and salaries for staff
EB140.R9 – Salaries of staff in ungraded positions and of the Director-General

In an effort to respond to Member States’ needs, the present texts have been made available as quickly as possible. The definitive versions of the resolutions and decisions adopted by EB140, edited for the Official Records, will be made available in due course.

EB140(1) – Post of Director-General: options for the conduct of the election at the Executive Board on the basis of paper-based voting

EB140(2) – Post of Director-General: options for the conduct of the election at the Health Assembly on the basis of paper-based voting

EB140(3) – Human resources for health and implementation of the outcomes of the United Nations’ High-Level Commission on Health Employment and Economic Growth

EB140(4) – Poliomyelitis [see text below in “Polio”]

EB140(5) – Decision concerning the Pandemic Influenza Preparedness Framework for the sharing of influenza viruses and access to vaccines and other benefits

EB140(6) – Member State mechanism on substandard/ spurious/falsely-labelled/falsified/ counterfeit medical products

EB140(7) – Draft global action plan on the public health response to dementia

EB140(8) – Overall programme review of the global strategy and plan of action on public health, innovation and intellectual property

EB140(9) – Promoting the health of refugees and migrants

EB140(10) – Engagement with non-State actors

EB140(11) – Award of the Dr A.T. Shousha Foundation Prize
EB140(12) – Award of the Sasakawa Health Prize
EB140(13) – Award of the United Arab Emirates Health Foundation Prize
EB140(14) – Award of the Dr LEE Jong-wook Memorial Prize for Public Health
EB140(15) – Provisional agenda of the Seventieth World Health Assembly
EB140(16) – Date and place of the 141st session of the Executive Board