Milestones :: Perspectives
Statement on the Lake Chad Region – Berlin Humanitarian Conference
by Dr Rick Brennan, WHO Director of Emergency Operations
Berlin, Germany 3 September 2018
As others have observed today, the narrative and dialogue around the Lake Chad Basin crisis has matured significantly since we met in Oslo last year.
We need to make the humanitarian-development peace nexus concrete. There is a general recognition that robust and principled humanitarian action is necessary – but not sufficient – to meet the needs of the people in the region. There is also an acknowledgment that root causes must be met, resilience of communities and institutions built, and the humanitarian-development-peace nexus operationalized.
Our challenge remains to shift from agreeing on these concepts and principles, to ensuring their concrete implementation – and to identify the solutions that Mark Lowcock constantly urges us to develop.
There are unique opportunities for effective implementation of the New Way or Working within the Lake Chad Basin sub-region, especially within the health sector. In fact, there is probably no better opportunity in the world today than the Lake Chad Basin region to demonstrate that it is possible to effectively implement the New Way of Working. And it is the view of WHO and our health sector partners, that health presents unique opportunities in this regard.
Humanitarian health response has been effective to date and must be sustained. Humanitarian health action has already documented some remarkable achievements over the past two years in Northeast Nigeria. Through progressively expanding access to essential health services – and working in collaboration with other life-saving sectors – we have documented a sharp drop in mortality in Northeast Nigeria. Mortality rates, which were dramatically elevated above emergency thresholds early in the response, are now within normal limits, at least among those populations to whom we have access. Last year, a collaborative malaria control effort with the Ministry of Health, UNICEF and other partners averted at least 6500 childhood deaths due to malaria. We have also jointly responded effectively to major outbreaks of measles, cholera, meningitis and polio. You may recall that polio established its foothold back in Africa due to the crisis in Northeast Nigeria.
Resilience in the health sector must be built at individual and systems levels. While we all aim to maintain a strong humanitarian response for the short-to medium- term, we see several important opportunities to build the resilience of both individuals and the health system. Firstly, there are few factors that make individuals more resilient physically and mentally than good health and strong nutritional status. Continued strengthening of the coverage and quality of essential health services will help to ensure that individuals are both resistant to disease and recover more rapidly when they do become ill.
Similarly, we need to make the health system itself resilient. Perhaps the best example of this is through building its capacities to prevent, detect and respond to outbreaks of infectious diseases. The Lake Chad region is remarkably prone to outbreaks of disease that have crossed borders, such as meningitis, cholera and hepatitis E. Building capacities for disease surveillance, laboratory diagnosis, and rapid response is vital to the resilience of any health system – and this is nowhere more evident than in the Lake Chad region.
Good governance is essential for sustainable health system development. We also need to be concrete about how we lay the foundations of longer-term health system recovery and development. This can be a complex process, as we have learned in other contexts. But I would like to highlight a sine qua non for sustainable development within the health sector – and that is good governance and leadership. All of the support from international partners will come to naught in the longer term unless authorities at all levels take strong ownership of the health system, ensure transparent management processes and provide an inclusive voice for communities. Involvement of civil society and the private sector has been demonstrated to contribute to health system recovery in several examples and we need to accelerate this process in the context of Lake Chad.
The health sector can contribute to peacebuilding. Finally, the health sector can play its own modest role in advancing peace and reconciliation. Public health campaigns can be opportunities for humanitarian pauses and can be a leading wedge for opening up humanitarian access. Polio vaccinations have helped to open access for other health services in Northeast Nigeria, for example. Re-establishing health services can be a confidence and trust-building process. This is especially true when they are extended to populations who have historically been neglected by central authorities and when they are designed to address longer-term inequities.
In summary, ladies and gentlemen, we must collectively move from agreeing on what needs to be done, to taking concrete steps to implement the humanitarian-development-peace nexus across all sectors. Conceptual frameworks and good intentions and are not enough – we must implement, and we must do so with the full engagement of communities and national partners.