west african health organisation organisation ouest ... · west african health organisation...
TRANSCRIPT
1
WEST AFRICAN HEALTH ORGANISATION
ORGANISATION OUEST AFRICAINE DE LA SANTE
ORGANIZAÇÃO OESTE AFRICANA DA SAÚDE
WAHO’s 2014 PROGRESS REPORT
JANUARY 2015
2
TABLE OF CONTENTS ........................................................................................
ACRONYMS AND ABBREVIATIONS ............................................................. 3
INTRODUCTION ................................................................................................. 3
I. Overview of the health update in the ECOWAS region ............................ 4
II. Status of implementation of major recommendations relative to the 15th ordinary
meeting of the ECOWAS Assembly of Health Ministers. ............................ 8
III. Major Achievements of WAHO in 2014 .................................................... 9
III.1 Managerial Activities of the Directorate General: ......................................................................... 9 III.1.1 Statutory Meetings ................................................................................................................ 10 III.1.2 Meetings with Political Authorities in Member States ......................................................... 11
III.1.3 Strategic Partnership and Resource Mobilisation ................................................................. 10 III.2 Implementation of Programmes .................................................................................................. 10
III.2.1 Policy Coordination and Harmonisation Programme: .......................................................... 11
III.2.2 Health Information Programme ............................................................................................ 13 III.2.3 Research Development Programme ..................................................................................... 13 III.2.4 Promotion and Dissemination of Best Practices Programme: .............................................. 14 III.2.5 Human Resources Development for Health Programme ...................................................... 14 III.2.6 Medicines and Vaccines Programme .................................................................................... 15
In the area, WAHO’s interventions helped to achieve the following major results: ....................... 15 III.2.7 Traditional Medecine Programme ........................................................................................ 15 III.2.8 Diversification of the Health Financing Mechanisms Programme ....................................... 18 III.2.9 Institutional Capacity Building Programme: ........................................................................ 15
III.2.10 Monitoring and Evaluation Programme: ............................................................................ 15 III.3. Status of Financial execution: ..................................................................................................... 16
III.4. Administrative situation: ............................................................................................................ 16
IV. Challenges and prospects: ................................................................. 16
IV.1. Challenges .................................................................................................................................. 16 IV.2. Prospects ..................................................................................................................................... 16
CONCLUSION ................................................................................. ANNEX ....................................................................................... 18
3
ACRONYMS AND ABBREVIATIONS
AfDB: African Development Bank
AHM: Assembly of Health Ministers
AIDS: Acquired Immune Deficiency Syndrome
ARV: Anti Retrovirals
CADESSO: Practice Centre for the Specialised Postgraduate Degree in Ophthalmology
CAPS: Leadership Capacity Strengthening Project
CBM: Christoffel Blindel Mission
CHUSS: Sanou Souro University Hospital Centre
CHW: Community Health Workers
DESSO: Specialised Postgraduate Degree in Ophthalmology
DHIS2: District Health Information System 2
ECOWAS: Economic Community of West African States ENDSS: National School of Social and Health Development
EONC: Emergency Obstetrical and New Born Care
FHS: Faculty of Health Sciences
FMCS: Special Status Bilingual Faculty
FP: Family Planning
HIV: Human Immune Virus
HIV/ AIDS: Human Immune Virus/ Acquired Immune Deficiency Syndrome
IMNCI: Integrated Management of Neonatal and Childhood Illnesses
KfW: German Financial Cooperation
LMG/WA: Leadership-Management and Governance / West Africa
MDGs: Millennium Development Goals
MoU: Memorandum of Understanding
NHAs: National Health Accounts
NHIS/IDSR: National Health Information System/Integrated Disease Surveillance and Response
NITAGs: National Immunization Technical Advisory Groups
PAANS: Pan African Association of Neurological Sciences
ResHum: Human Resources
SAP: System Application Products
SARANF: Society for Anaesthesia and Resuscitation in Black Francophone Africa
SIDV: Ivorian Society for Dermatology and Venereology
SOBUSAM: Burkinabe Society for Mental Health
TRIPs: Trade-Related Aspects of Intellectual Property Rights
UA: Unit of Account
UHC: Universal Health Coverage
UNICEF: United Nations Children’s Fund
USAID: United States Agency for International Development
WACN: West African College of Nursing
WACP: West African College of Physicians
WACS: West African College of Surgeons
WAHO: West African Health Organisation
WAPMC: West African Post Graduate Medical College
WARDS: West African Regional Epidemiological Disease Surveillance Programme
WHO: World Health Organization
4
INTRODUCTION
In view of achieving its mandate of providing the highest level of healthcare to the people of the
ECOWAS region, WAHO further undertook programmes in 2014 towards resolving the health issues
affecting the ECOWAS region. All these programmes undertaken as well as the outcomes are
summarised in the institution’s 2014 Annual Report. Thus, emphasis was laid on the following points:
Evolution of the status of health in the ECOWAS region;
Status of implementation of the major recommendations of the 15th Assembly of Health Minsters
of ECOWAS;
Major achievements of WAHO;
Directorate General’s managerial activities;
Implementation of programmes;
Status of financial execution;
Administrative situation;
Lessons learnt;
Difficulties/constraints;
Challenges and prospects for 2015.
I. Overview of the health situation in the ECOWAS region
The health situation in the ECOWAS region was mainly characterised by the outbreak of the Ebola Virus
Disease as well as other epidemics such as Cholera, Lassa fever and Malaria. Similarly, the countries
notified several cases of epidemic-prone diseases. In addition, the other features of the health situation in
2014 are relative to Maternal and Child Health, Nutrition, Neglected Tropical Diseases as well as Non-
Communicable Diseases.
In general terms, the update on epidemic-prone diseases is summarised in Table 1.
5
Table 1: Cases (confirmed and/or suspected) of epidemic-prone diseases by the ECOWAS countries in 2014
Pays Cholera Meningitis Measles Yellow Fever Lassa Fever Ebola Newborn Tetanus
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
Benin 832 12 711 88 1749 3 81 0 16 9 0 0 4 0
Burkina Faso 0 0 3490 360 2353 11 957 24 0 0 0 0 4 2
Cape Verde 0 14 0 0 0 0 0 0
Côte d´Ivoire 197 11 193 5 633 0 681 17 0 0 0 0 24 5
The Gambia 0 0 132 18 50 0 0 0 0 0 0 0 1 1
Ghana 28922 243 484 39 725 0 396 0 0 0 0 0 4 1
Guinea 2 0 645 51 5734 13 92 0 2706 1708 28 8
Guinea-Bissau 16 2 0 0 0 0 1 0 0 0 0 0 1 0
Liberia 52 0 4 0 4 0 1 0 40 0 8017 3423 4 0
Mali 0 0 326 4 626 0 133 1 0 0 7 5 13 5
Niger 2059 80 327 40 1086 4 31 0 0 0 0 0 4 2
Nigeria 35996 755 1175 81 15989 85 989 36 20 8
Senegal 0 0 203 3 1084 0 512 25 0 0 1 0 3 0
Sierra-Leone 2 0 3 0 94 0 22 0 290 15 9409 2732 2 0
Togo 262 11 351 14 742 0 314 2 0 0 0 0 20 7
ECOWAS 68340 1114 8058 703 30869 116 3221 69 1335 60 20160 7876 112 31
Source: NHIS/IDSR data in Member States
Ebola Virus Disease:
Guinea made the official announcement of the Ebola virus epidemic on 21 March 2014. A total of six (6)
countries of the region were affected (i.e. Guinea, Liberia, Sierra Leone, Nigeria, Senegal and Mali).
As at 28 December 2014, a total of 20,160 cases including 7,876 deaths were reported by the six (6)
ECOWAS countries, thereby accounting for an overall lethality rate of 39.1%.
The overall update is presented in the table below:
Table 2: Update on the Ebola Virus Diseases cases and deaths in the ECOWAS region (according to
available information as at 28 December 2014)
Countries
notifying the
cases
(Suspected, probable and
confirmed) cases and deaths per
country
Proportion of cases
per country Date of updating data
Cases Deaths Lethality Cases Deaths
Guinea 2706 1708 63,1% 13,4% 21,7% 28-Dec-14
Liberia 8017 3423 42,7% 39,8% 43,5% 28-Dec-14
Mali 7 5 71,4% 0,0% 0,1% The three countries
were declared free of
the disease
Nigeria 20 8 40,0% 0,1% 0,1%
Senegal 1 0
Sierra-Leone 9409 2732 29,0% 46,7% 34,7% 28-Dec-14
ECOWAS 20160 7876 39,1% 100,0% 100,0%
Sources: Affected countries
The following observations can be surmised from the table:
o Sierra Leone having 9409 cases, recorded the highest number of cases;
o Liberia having 3423 deaths recorded the highest number of deaths;
o Nigeria, Senegal and Mali were declared free of the epidemic
Finally, the downward trend with regards to the new cases in all the countries is due essentially to preventive
measures and treatment of existing cases.
Cholera:
About 68 340 cases and 1 114 deaths were notified in 2014 by ten (10) countries (namely Benin, Côte
d’Ivoire, Ghana, Guinea, Guinea-Bissau, Liberia, Niger, Nigeria, Sierra Leone and Togo). This situation
largely exceeds the cases in 2013 whereby 8982 cases were recorded including 287 deaths in eleven (11)
countries cases.
The recorded Cholera cases were mainly concentrated in three (3) most affected countries, Nigeria with 35
996 cases followed by Ghana with 28 922 cases and Niger with 2 059 cases. These countries account for
more than 98% of the total cases. Figure 2 shows that the cases were recorded in the region throughout the
Year 2014.
7
0
250
500
750
1000
1250
1500
1750
2000
2250
2500
2750
3000
3250
WK1
WK2
WK3
WK4
WK5
WK6
WK7
WK8
WK9
WK10
WK11
WK12
WK13
WK14
WK15
WK16
WK17
WK18
WK19
WK20
WK21
WK22
WK23
WK24
WK25
WK26
WK27
WK28
WK29
WK30
WK31
WK32
WK33
WK34
WK35
WK36
WK37
WK38
WK39
WK40
WK41
WK42
WK43
WK44
WK45
WK46
WK47
WK48
WK49
WK50
WK51
WK52
Numberofcasesperweek
Fig.2:Evolu onofCholeracasesperweekinthemostaffectedcountries
Ghana Nigeria Niger
Meningitis:
In 2014, 8 058 cases were notified including 703 deaths in fourteen (14) countries compared to 5 536 cases
in 2013 in twelve (12) countries. Only Guinea Bissau was not affected in 2014 compared to three (3)
countries in 2013 namely The Gambia, Guinea-Bissau and Liberia. The lethality rate in 2014 stood at 8.6%
compared to 10% in 2013. Burkina Faso was the most affected with 43.3% of the cases followed by Nigeria
with 14.6%.
However, no health district hit the epidemic threshold in 2014.
Lassa Fever:
A total of 1 335 cases including 60 deaths were notified during the year 2014 by four (4) countries namely,
Benin, Liberia, Nigeria and Sierra Leone. Conversely, the number of cases ion 2013 was slightly in decline.
However, the number of affected countries increased with Benin notifying confirmed cases for the first time
in more than five years. The increase in the number of affected countries is a source of concern calling for
actions to be undertaken at the regional level.
Poliomyelitis:
This is the third consecutive year that only Nigeria notified cases of Poliomyelitis, being the only country in
the sub region to have recorded confirmed cases of the disease. The disease has been on a downward trend
since 2012.The number of notified cases fell from 122 in 2012 to 51 cases in 2013 and dropped to 6 cases in
2014, thereby underscoring efforts made by the Nigerian authorities to control the disease.
Yellow Fever:
8
In 2014, fourteen (14) countries compared to ten (10) notified a total of 3221 (confirmed and/or suspected)
cases in 2013 including 69 deaths compared to 1 679 cases in 2013. Cape Verde and The Gambia did not
record any case. However, Nigeria did not notify of any cases.
The most affected countries were Burkina Faso, Côte d’Ivoire, Senegal, Ghana and Togo.
Measles:
Measles are part of the diseases that should be eradicated. However, since 2010 the number of notified
measles cases has continually increased from year to year. With respect to 2014, a total of 30869 (suspected
and/or confirmed) cases were notified including 116 deaths by thirteen countries. Cape Verde and Guinea
Bissau did not record any case.
II. Status of Implementation of Major Recommendations of the 15th Ordinary Meeting
of the ECOWAS Assembly of Health Ministers
On the whole, the fifteenth ordinary meeting of the ECOWAS Assembly of Health Ministers made four (4)
recommendations to the countries, twenty-three (23) directed at WAHO and three (3) to the WAHO Liaison
Officers.
They are as follows:
To the Member States:
Ensure advocacy with Heads of State and Government for the setting up of a Solidarity Fund to be
domiciled at WAHO and which could be promptly mobilised to cater for emergency public health
response;
Strengthen communication between WAHO and the Member States for better ownership of the
organisation’s interventions;
Put in place a legal framework and ensure the required political support for the Universal Health
Coverage (UHC);
Put emphasis on the promotion of health and strengthening of primary healthcare within the
framework of the UHC with WAHO’s support.
To WAHO:
Draft and disseminate the standard template for monitoring the implementation of AHM
recommendations;
Update the Terms of Reference of the Liaison Officers in accordance with the Praia
Recommendations and send them by official channels to the Ministers of Health;
Systematically send the reports of meetings/workshops organised by WAHO to the Liaison Officers
in the fifteen (15) countries;
Take measures for systematic labelling and inventory of all the materials and equipment supplied to
the countries by WAHO;
Draft and make available the Manual of Current Management Procedures of Petty Cash Expenditure
to the Liaison Officers;
Improve the working conditions of the Liaison Officers for better visibility of WAHO activities in
the countries;
The WAHO Annual Report could be improved with more information on epidemic-prone diseases
and citing the reasons for the non-implementation of certain recommendations;
WAHO should explore the mechanisms for better monitoring of the implementation of AHM
recommendations;
9
Undertake an in-depth situational analysis on the UHC in the region aimed at developing a regional
support strategy for the Member States;
In order to improve the response to the on-going Ebola Haemorrhagic Fever outbreak, countries
should: mobilize resources from governments, regional institutions and Partners, harness
multisectoral synergies, engage the media and other actors for public education and to document
their experiences;
WAHO and other regional institutions should strengthen the capacity of reference laboratories in the
rapid diagnosis of pathogens in disease outbreaks in the Region;
Choose a lead organisation for each thematic forum;
Foster institutional anchoring of regional programmes within WAHO;
WAHO should take ownership of the programme under the Ouagadougou Partnership and ensure the
direction for all the interventions in terms of family planning in the ECOWAS countries;
The establishment of an epidemic response fund should be referred to the Ministers of Health for the
next course of action;
Retain vector control including the household sanitation as a key pillar for malaria elimination;
The WARDS project being a catalytic project, an advocacy should be addressed to the Ministers of
Health and the ECOWAS Council of Ministers for the purpose of securing a bigger project so as to
face up to the issues of epidemics in the region.
Draft and review the terms of reference of the Partners’ Forum;
Create thematic fora bringing together partners around key themes/areas/priorities/programmes;
In line with the theme of the year, identify 2-3 partner presentations and share the experiences of
other partners through posters;
Follow up the establishment of the Solidarity Fund, which could be rapidly mobilised for public
health emergency response, at the level of the ECOWAS Commission;
Undertake the external evaluation of the WAHO 2009-2013 Strategic Plan;
Follow up the recruitment process with the ECOWAS Commission relative to filling the key vacant
positions within WAHO.
To the WAHO Liaison Officers:
Fine-tune the expectations of the Liaison Officers towards WAHO so as to improve their working
conditions;
Justify and make timely requisitions for replenishing the petty cash account;
Improve WAHO’s visibility in the countries though the presence of Liaison Officers;
Sixteen (16) recommendations directed at WAHO were implemented, five (5) are being implemented and
two (2) are yet to be implemented. The details of the actions taken to this effect are in the table presented in
the annexe.
III. Major Achievements of WAHO in 2014
The major achievements over this period centre on the following points:
The Directorate General’s managerial activities;
Implementation of programmes;
Status of financial execution;
Administrative situation.
III.1. Directorate General’s Managerial Activities:
In the course of 2014, the activities implemented within the framework of the Directorate General’s
managerial activities focus on participation at statutory meetings, meetings with government authorities and
partners, resource mobilisation, the establishment and strengthening of strategic partnerships as well as
WAHO’s coordination activities.
10
III.1.1. Statutory Meetings
The Directorate General participated in Community-wide statutory meetings namely: Two Authority of
Heads of State and Government Summits including an extraordinary Summit on the Ebola Virus Disease,
Sessions of the Council of Ministers, Meetings of the Assembly of Health Ministers including an
extraordinary meeting on the Ebola Virus Disease, the 8th Joint ECOWAS Institutions’ Retreat and the
Administration and Finance Committee meetings.
Meanwhile, with regards to the implementation of the Regional Plan for Multisectoral Ebola Virus Disease
Control, the Directorate General organised ministerial coordination group meetings as well as those of the
technical monitoring and watch group. In addition, it undertook special verification missions relative to the
implementation of the recommendations arising from the various meetings on Ebola and other meetings with
the Technical and Financial Partners (TFPs) on resource mobilisation.
III.1.2. Meetings with Political Authorities in the Member States
Since their assumption of office on 3rd of February 2014, the Director General and his deputy have visited
all the Member States to meet with the political authorities in order to exchange ideas on WAHO activities.
They carried out advocacy on the implementation of the Abuja Declaration on key population-centred
health-related issues and sought their wise counsels and invaluable advice for the smooth running of the
institution.
In addition, the Year 2014 was characterised by a strong advocacy for combating the Ebola virus. To this
end, the Director General and the Deputy Director General visited fifteen (15) Member States to meet with
Heads of State and Government, National Parliaments and Ministers.
Indeed, these meetings facilitated the implementation of the multisectoral plan, strengthening of preventive
measures, lifting of border closure measures, mobilisation and deployment of human resources as well the
contribution of countries to the Regional Solidarity Fund.
III.1.3. Strategic Partnership and Resource Mobilisation
In view of its mandate of seeking solutions to the health issues affecting the region in a strategic and
collective manner, WAHO pursued cooperation with various partners.
In the same vein, WAHO continues to identify and establish partnerships within and outside the region. To
this end, WAHO participated in several events organised by the partners namely meetings of statutory
organs, symposiums and other scientific events and exchanges aimed at strengthening partnership in several
health-related areas.
In terms of resource mobilisation, 2014 witnessed the completion of the “Sahel Demographic Dividend
(SWEED)” project, the “Regional Nutrition Project”, the “Moving Maternal, Newborn and Child Health
Evidence into Policy in West Africa” and the “Leadership Capacity Strengthening Project (CAPS)” and the
effective take off of the “West Africa Regional Diseases Surveillance (WARDS)” Project.
Similarly, during the same period under review MoUs were signed between the CBM, UNICEF,
DESSO/CADESSO and Bioforce. Two financing agreements were signed with the AfDB, one of which was
worth three million five hundred thousand US dollars ($3 500 000) and another to the tune of seven million
US dollars ($7 000 000) within the framework of Ebola Virus Disease control.
III.2 Implementation of Programmes
11
The institution’s set objectives are as follows:
Promote the coordination and harmonisation of health policies in the ECOWAS region;
Strengthen the development of health information management systems for disease prevention and
control in the ECOWAS region;
Promote health in the ECOWAS region;
Support the training of health professionals in the implementation of the curricula and harmonised
accreditation criteria to facilitate the movement of health professionals within the ECOWAS region;
Facilitate access to essential medicines, vaccines and other quality health commodities and reduce
the use of uncertified medicines in the Member States;
Support the institutionalisation of traditional medicine in the health systems of the region;
Promote new financing mechanisms, prioritise resource mobilisation and immediate-impact activities
on the health of the population and advocate increased health budget allocation;
Prioritise transborder and multi-country activities (mobile laboratories, corridor);
Prioritise strategic partnerships.
Within the framework of the above-mentioned objectives, several activities were conducted between
January and December 2014. However, the retained option in this report was to focus mainly on the
outcomes.
In terms of physical implementation, the programmes were implemented up to 63% in 2014 compared to
98% in 2013. This decline is due, among other things, to inadequate provision of funds from both the
Community Levy and of course the Ebola Virus Disease Control Fund.
III.2.1 “Policy Coordination and Harmonisation” Programme:
In 2014, WAHO continued the coordination and harmonisation of health policies in terms of communicable
diseases, nutrition and non-communicable diseases, Maternal and Child Health, Practice of Health
Professions and strengthening of the Health Systems. The major outcomes are as follows:
Improving the Practice of Health Professions:
In view of making operational the effective free movement of health professionals in the ECOWAS region,
WAHO focused its attention on the production of texts relating to the harmonisation of professional
practices of the various health professions. The outcomes are as follows:
- Harmonised codes of practice for regulating the practices of community health workers and several
other categories of health professionals in the ECOWAS region;
- A document on the Standards for the Nursing and Midwifery professions that is available in the three
official languages of ECOWAS.
Nutrition and Non-Communicable Diseases:
The programmes undertaken in this area is aimed mainly at supporting the countries in combating non-
communicable diseases and strengthening nutritional capacities. To this end, the following results were
achieved:
- The setting up of the Multisectoral Non-Communicable Diseases Coordination Committee in
Benin Republic;
- The National Non-Communicable Diseases Control Programmes were strengthened in Benin,
Ghana, Guinea Bissau, Côte d'Ivoire, Burkina Faso and Guinea thanks to the provision of
financial and technical assistance;
12
- The multisectoral cooperation and nutritional governance programmes in Togo and Liberia were
effectively implemented thanks to the provision of financial and technical assistance for joining
the “Scaling Up Nutrition” Movement;
- Eighteen (18) professional officers from Francophone countries were trained in nutritional
leadership.
Communicable Diseases:
In this area, WAHO’s achievements in 2014 focused on malaria control, HIV/AIDS and Tuberculosis. They
are as follows:
- The ECOWAS regional antiretrovirals buffer stock was established and became functional;
- The Regional Strategic Plan for malaria control and elimination was validated by the ECOWAS
Member States;
- The malaria vector control activities were launched in collaboration with the ECOWAS
Commission;
- The officers responsible for National Tuberculosis Control Programmes in Nigeria, Ghana, Sierra
Leone, The Gambia and Liberia were trained in Tuberculosis/HIV Co-Infection Management.
Maternal and Child Health:
The WAHO interventions in 2014 relative to maternal and child health in the ECOWAS countries centred
mainly on the following points:
- Strengthening human resources for effective management of issues relating to pregnancy and child
birth through the setting up of pools of EONC trainers in three (3) countries: Togo, Côte d’Ivoire and
Benin;
- Strengthening human resource development through the effective management of child health issues
through the setting up of pools of IMCI trainers in Niger and Togo;
- Strengthening the vaccination programmes in the countries:
o Six (6) countries (i.e. Benin, Burkina Faso, Côte d'Ivoire, Mali, Niger and Senegal) for the
establishment and effective operation of their NITAGs in view of improving decision-making
in terms of vaccines and immunisation;
o Benin for the review of its Multiyear Comprehensive EPI Plan within the operationalisation
framework of the Global Plan for Vaccines and Immunisation.
- Capacity building of the countries for revitalising family planning:
o With the Agir/FP, three (3) countries namely (Burkina Faso, Niger and Togo) developed and
disseminated their Maternal and Newborn Health Advocacy and FP, RAPID;
o In the five (5) pilot countries (i.e. Benin, Burkina Faso, Ghana, Guinea-Bissau and Niger) of
the regional reproductive health and HIV prevention programme:
91,5% of the needs expressed for the acquisition of contraceptives were covered
for total sum of CFA francs 2 886 210 78;
200 000 Noristerat phials were transferred from Burkina Faso to Benin, which was
out of stock;
The capacities of Family Planning service providers were strengthened;
13
The sensitisation/promotion services of the Family Planning and sessions of free
distribution of Family Planning commodities/services were conducted;
594 555 Couple-Years of Protection (CYP) were achieved, that is 594 555 women
were effectively protected;
The social marketing agencies are organised in a network.
- The document on the situation analysis of Reproductive Health and Family Planning (RH/FP) in the
ECOWAS countries is available.
Epidemic Control:
The epidemic control was the main focus of WAHO in 2014 and the undertaken programmes led to the
following outcomes:
- Two mobile laboratories were positioned in Nigeria and in The Gambia;
- Prevention, management of cases and reinforced surveillance due to support;
- Strengthening of the regional epidemiological surveillance system with the effective implementation
of the "West African Regional Disease Surveillance -WARDS" programme.
Concerning the Ebola Virus Disease epidemic:
- A multisectoral regional Ebola Virus Disease epidemic plan was developed;
- A Ministerial Coordination Group and Technical Monitoring and Surveillance Group were set up;
- Funds mobilised and granted to countries to the tune of $7 000 000 for the acquisition of logistical
equipment for epidemic control (vehicles, medical ambulances, personal protective gears, thermo-
flash, sprayers, medicines, hygiene and sanitation commodities, laboratory reagents and
consumables, etc.);
- The 15 ECOWAS countries have an Ebola Virus Disease prevention and response plan;
- Technical documents were developed and made available to the Member States;
- One hundred and fifteen (115) doctors, nurses and hygiene technicians were trained and put at the
disposal of the three (3) affected countries;
- Redeployment of WAHO staff to the three (3) most affected countries so as to strengthen national
coordination of efforts.
Strengthening of the Health Systems
In this area, the following points are noteworthy:
- The Orientation guide for Member States in developing national health services quality assurance
policy was finalised and validated;
- A harmonised policy framework for biomedical equipment management, maintenance and repair in
the ECOWAS region was developed.
III.2.2 Health Information Programme
In this framework in 2014, the programmes undertaken by WAHO produced the following outcomes:
- Capacity building was developed in terms of NHIS in Burkina Faso, Cape Verde, Côte d’Ivoire, The
Gambia, Ghana, Guinea-Bissau, Liberia, Niger, Nigeria, Senegal et Sierra Leone in health
information through the development of a DHIS2 platform and the training of national trainers;
- Creation of a new WAHO database containing more than six hundred references;
III.2.3 Research Development Programme
14
The outcomes of these implemented programmes to develop health research area as follows:
- A document on the status of health research in the ECOWAS region is available;
- An evaluation report on the regional project for strengthening national health research systems in
four (4) countries namely (Liberia, Sierra Leone, Mali and Guinea-Bissau) and the 2009-2013
Strategic Plan is available.
III.2.4 Promotion and Dissemination of Best Practices Programme:
In the area of best practices promotion and dissemination in 2014, WAHO recorded the following major
achievements:
- The comprehensive implementation brochure in the communities relative to four promising High
Impact Package of Interventions was finalised and disseminated in the countries for capitalisation/
exploitation;
- The ECOWAS Health Best Practices Forum was created.
III.2.5 Human Resources Development for Health Programme
In the Human Resources for Health sector, WAHO implemented programme and provided technical and
financial assistance to countries and partner institutions for the capacity building of health professionals with
the following main achievements:
- Capacity building of fifteen (15) young health professionals;
- Data collection and analysis on the health workers’ training institutions in seven (7) countries (Benin,
Cape Verde, Côte d’Ivoire, Guinea, Guinea-Bissau, Liberia and Sierra Leone);
- IMNCI training for fifty-six (56) teachers from health schools and institutions (36 in Niger and 20 in
Togo);
- Three Pools of National Trainers/EONC Champions (12 trainers per country) are set up in three
countries: Benin, Côte d’Ivoire and Togo;
- Fifteen (15) professionals benefited from Professional Exchange and Linguistic Programme (PELP)
for the enhancement of their linguistic and professional competencies;
- Financial assistance in favour of Training Institutions and Scientific Societies and the partners
hereinunder in terms of Human Resources Development for Health towards: Improving Hospital
Equipment and Quality of Care in the Institutions, sponsoring of multilingual conferences on the
harmonised curricula, facilitation of regional integration among trainers.
They are:
o WACP (West African College of Physicians);
o WACS (West African College of Surgeons);
o WACN (West African College of Nursing);
o WAPMC (West African Post Graduate Medical College);
o SOBUSAM (Bukinabe Society of Mental Health);
o PAANS (Pan African Association of Neuroscience);
o SIDV (Ivorian Society of Dermatology and Venereology);
o SARANF (Society for Anaesthetics Resuscitation of Francophone Black Africa);
o ENDSS of Dakar;
o CHUSS (Sanou Souro University Health Centre of Bobo-Dioulasso);
o Sylvanus Olympio CHU (Lomé);
o Special Status Bilingual Faculty (FMCS) of Benin;
o FSS of Kankan Moussa University of Mali.
15
III.2.6 Medicines and Vaccines Programme
In this area, WAHO’s interventions helped to achieve the following main results:
- An ECOWAS Regional Pharmaceutical Plan was developed;
- An implementation guide on the flexibilities relative to the TRIPS agreements was developed and
validated;
- A bill on counterfeit and illicit drug trade control was drafted;
- The process for the registration of harmonised medicines in the region was rolled out.
III.2.7 Traditional Medicine Programme
The implementation of WAHO programmes in this priority area helped to produce the following results in
2014:
- Capacity building for thirty (30) trainers from fifteen (15) Member States in terms of traditional
medicine for the treatment of six (6) priority diseases which are: diabetes, HIV (opportunists
diseases), arterial hypertension, lung tuberculosis, malaria, sickle cell;
- Capacity building in terms of research and production of three (3) research institutions at IRSP of
Mali, CHU of Abidjan and University of Kumasi;
- Review and adaptation of the traditional medicine training curricula;
- Drafting and dissemination of two traditional medicine documents (Herbal formulae and manual of
herbal treatments for forty diseases in West Africa).
III.2.8 Diversification of the Mechanisms for Health Financing Programme
WAHO carried out programmes with a view to increasing health sector financing. These programmes
produced the following results:
- The private sector health profile in the fifteen (15) ECOWAS countries was produced;
- Capacity building initiatives were carried out in terms of resource mobilisation of Advocacy
Champions Network for adequate health financing for six countries (namely Benin, Burkina Faso,
Guinea, Guinea-Bissau, Niger and Togo);
- Two networks of Advocacy Champions for adequate health financing (Guinea and Senegal) were
established, thereby increasing the total number of networks to ten;
- Three networks were supported towards the implementation of their Annual Action Plans namely in
Niger, Burkina Faso and Benin;
- Capacity building initiatives were carried out in favour of eight (8) professional officers from Benin,
Burkina Faso, Côte d'Ivoire, Niger, Togo and Senegal in the area of National Health Accounts;
- Capacity building initiatives were carried out in Universal Health Coverage in favour of twenty (20)
professional officers from Benin, Burkina Faso, Côte d'Ivoire, Mali, Niger, Senegal and Togo.
III.2.9 Institutional Capacity Building Programme:
In the area of capacity building of WAHO, the programmes implemented produced the following results:
- Training of twenty four (24) staff members in the SAP/Ecolink programme;
- Training of ten (10) staff members in leadership and management;
- Training of twenty-seven (27) staff members in the use of the ResHum software.
III.2.10 Monitoring and Evaluation Programme:
- The internal evaluation report of the 2009-2013 Strategic Report is available.
16
III.3. Status of financial execution:
WAHO’s 2014 overall budget amounted to UA 23 612 333 and broken down as follows: UA 5 863 628 for
general administration accounting for 25% of the budget and UA 17 748 70 earmarked for programmes,
thereby accounting for 75% of the budget.
The administrative budget was executed to the tune of 62% as against 66% in 2013 and 49% for
programmes compared to 79% in 2013. Thus, overall budget execution rate stood at 52%.
ECOWAS is the main source of funding for WAHO. The financial situation of the institution in 2014 is as
follows:
Total amount of receivables from ECOWAS UA16 936 259;
Total amount of actual receipts from ECOWAS UA12 141 379 (about 74%);
Amount expected from partners UA6 667 704;
Actual amount received from Partners UA4 820 171(about 72%).
III.4. Administrative Situation:
The Year 2014 witnessed the pursuit of actions leading to the consolidation of WAHO’s human resources,
administrative and financial management capacities. The outcomes are as follows:
- Rehabilitation of the Director General’s office premises, DG’s residence and construction of a car
park;
- Acquisition of two new vehicles;
- Acquisition of computer equipment and office furniture for newly recruited staff;
- Recruitment of six (6) news members of staff made up of two (2) general services staff and four (4)
professionals;
- Finally, the year witnessed the departure of four (4) staff members including two statutory appointees
and two (2) professionals including a director. The two (2) new statutory appointees assumed office
in February 2014.
IV. Challenges and Prospects:
IV.1. Challenges
The Year 2014 in the ECOWAS region was characterised by several familiar constraints.
In the area of health, WAHO was faced with the following factors that hampered the implementation of
planned activities:
- Control and eradicate the EBOLA Virus Disease epidemic;
- Contain the persistent onslaught of epidemics and emerging diseases in the region;
- Implement the resolutions, decisions, recommendations of the various decision-making organs;
- Guarantee the implementation of programmes in view of insufficient and late provision of funds by
the ECOWAS Commission;
- Allocate a budget to WAHO taking into account the level of health challenges in the region;
- Fill up the key vacant positions within the institution;
- Ensure ownership of WAHO activities by the Member States.
IV.2. Prospects
17
Thus, the prospects as far as WAHO is concerned are as follows:
- Strengthening epidemic control (resource mobilisation, establishment of a rapid regional intervention
team, launching of the process leading to the establishment of the Regional Centre for
Epidemiological Surveillance and Disease Prevention);
- Evaluation and development of activities relating to the Universal Health Coverage;
- Evaluation of the level of realisation of the Abuja Declaration on health financing;
- Pursuit of the implementation of on-going projects/programmes (LMG, WARDS, RMHP/FP,
malaria and neglected tropical diseases control project in the Sahel, demographic dividend project,
regional nutrition project, Moving Maternal, Newborn and Child Health Evidence into Policy in
West Africa Project, CAPS etc.).
CONCLUSION
In 2014, despite the difficulties encountered (namely in terms of financial issues, staff shortage and the
Ebola epidemic, etc.), WAHO strengthened its relations with the Member States, the other community
institutions as well as Technical and Financial Partners. The implemented activities led to the completion of
several projects and programmes. It goes without saying that the major efforts made to control the Ebola
Virus Disease were crowned with success.
In addition, WAHO implemented major activities aimed at controlling other diseases as well improving the
local production of medicines. The Year 2015 will be dedicated to the drafting of the WAHO 2016-2020
Strategic Plan and the implementation of the above-mentioned prospects.
ANNEX: STATUS OF IMPLEMENTATION OF RECOMMENDATIONS OF THE 15th AHM
I. RECOMMENDATIONS OF THE LIAISON OFFICERS’ MEETING directed to WAHO:
RECOMMENDATIONS
STATUS OF
IMPLEMENTATION PROGRAMMES
UNDERTAKEN OBSERVATION
Impleme
nted
On-
going
Non-
Implemente
d
1. Draft and disseminate a standard template for
monitoring the implementation of all AHM
recommendations. x
A template was drafted and
disseminated while some
comments were received. The
compiled version is available.
2. Update the Terms of Reference of the Liaison
Officers in accordance with the Praia
Recommendations and send them by official
channels to the Ministers of Health
x
The Terms of Reference were
updated and sent to all the
Liaison Officers through the
Ivorian Liaison Officer.
3. Systematically send the reports of
meetings/workshops organised by WAHO to
WAHO Liaison Officers of the 15 Member
States.
x
Reconsider the content of the
recommendation of the
meeting to the Liaison
Officers.
4. Take all the measures for systematic labelling
and inventory of all materials and equipment
supplied to the countries by WAHO.
x
A preliminary inventory will
be carried out in 2015 to this
effect.
19
RECOMMENDATIONS STATUS OF
IMPLEMENTATION
PROGRAMMES
UNDERTAKEN OBSERVATION
5. Draft and make available a manual of
procedures to Liaison Officers for the day-to-
day management of the petty cash
expenditure.
x
Manual drafted and sent to
the Liaison Officers in June
2014.
6. Improve the working conditions of the
Liaison Officers to ensure better visibility for
WAHO activities in the countries. x
Stipends increased
Systematic involvement of
Liaison Officers in WAHO
activities in the countries.
To the Liaison Officers: (directed at WAHO for monitoring by Liaison Officers)
RECOMMENDATIONS
STATUS OF IMPLEMENTATION
PROGRAMMES
UNDERTAKEN OBSERVATION
Implemen
ted
On-going Non-
Implemented
7. Fine-tune the expectations of the Liaison
Officers with a view to improving their
working conditions. x
8. Justify and make prompt requisitions for
replenishing the petty cash account. x
9. Improve WAHO’s visibility in the countries
thanks to the presence of Liaison Officers. x
20
II. RECOMMENDATIONS OF THE MEETING OF EXPERTS directed at WAHO:
RECOMMENDATIONS
STATUS OF IMPLEMENTATION
PROGRAMMES
UNDERTAKEN OBSERVATION
Implemen
ted
On-going Not
Implemented
1. The WAHO Annual Report should be
improved with the provision of more
information on epidemic-prone diseases and
citing the reasons for the non implementation
of some recommendations
x
Taken into account in the
drafting of the WAHO 2014
Annual Report
2. WAHO should explore mechanisms for better
implementation of AHM recommendations
x
Several follow up meetings
on the implementation of the
recommendations were held
at WAHO. The departments
were tasked with the
monitoring of the
implementation.
3. Undertake an in-depth situation analysis on
the UHC in the region aimed at developing a
regional strategy for supporting the Member
States
x
A regional workshop for the
review of the status of
Universal Health Coverage in
the ECOWAS region is
scheduled for 2015.
4. In order to improve the response to the on-
going Ebola Haemorrhagic Fever outbreak,
countries should:
mobilize resources from governments,
regional institutions and Partners;
harness multisectoral synergies;
engage the media and other actors for
public education and to document their
experiences.
x
Preparation and
implementation of the
Regional Multisectoral Ebola
Virus Disease Control Plan
Establishment of the Ad Hoc
Ministerial Coordination
Committee and Technical
Monitoring and Surveillance.
Group
21
RECOMMENDATIONS STATUS OF IMPLEMENTATION
PROGRAMMES
UNDERTAKEN OBSERVATION
Conduct of mission for
monitoring the
implementation of
interventions
Writing of messages on the
EVD epidemic and
identification of
dissemination medias and
channels
Harmonisation and sharing /
dissemination of sensitisation
messages
Sending of generic messages
to the countries and support
relative to the adaptation and
dissemination of the
messages
Assistance to Member States
in intensifying the
sensitisation activities by
involving all the actors
5. WAHO and other regional institutions should
strengthen the capacity of reference
laboratories in the rapid diagnosis of
pathogens in disease outbreaks in the region
x
Financial support was given
to the national laboratories.
22
III. RECOMMENDATIONS OF THE PARTNERS’ FORUM directed at WAHO:
RECOMMENDATIONS
STATUS OF IMPLEMENTATION PROGRAMMES
UNDERTAKEN OBSERVATION
Implemen
ted
On-
going
Not
Implemented
1. Choose a lead institution for each thematic
forum x
The Lead Institution was selected
for the sixteenth AHM
2. Foster institutional anchoring of regional
programmes within WAHO x
Apart from programmes managed
by WAHO, efforts were made to
ensure the management of new
regional programmes that are
being prepared
3. WAHO should take ownership of the
programme under the Ouagadougou
Partnership and take the lead for all the
interventions in terms of family planning in
the ECOWAS Member States.
x
Participation in two meetings
organised by the Ouagadougou
Partnership
4. The establishment of an epidemic response
fund should be brought to the attention of the
Ministers of Health for appropriate decision.
x
Recommendation was already
made through the Monrovia
Declaration and relative to an
AHM recommendation directed at
WAHO
5. Retain the vector control activities, including
the sanitation of the household as key pillar
for malaria elimination x
This recommendation was
considered under the Strategic
Regional Malaria Control and
Elimination Plan
6. The WARDS project being a catalytic
project, an advocacy should be directed to the x
Advocacy was carried out and
directed at both the partners and
23
RECOMMENDATIONS STATUS OF IMPLEMENTATION PROGRAMMES
UNDERTAKEN OBSERVATION
Ministers of Health and the ECOWAS
Council of Ministers with the purpose of
securing a bigger project in order to face up
to issues of epidemic in the region.
ECOWAS
7. Draft and review the terms of reference of
Partners’ Forum. x
A proposed updated TOR was
drafted
8. Create thematic fora by bringing partners
together around key themes/areas/
priorities/programmes x
The best practices forum is being
activated for this purpose.
9. According to the theme of the year, identify 2
to 4 partners’ presentations and share the
experiences of other partners through posters. x
The WHO will make
presentations on the themes: “The
status of the Ebola Virus Disease
(EVD) and the global process for
revitalising the health systems of
the three heavily affected by the
epidemic” and “Update on
vaccines and medicines in the
framework of Ebola control”
In addition, the UNICEF’s
presentation will focuse on
Health, Hygiene and Sanitation,
other partners
(HKI, UNICEF, etc.) will give
posters to the participants.
24
IV. RECOMMENDATIONS OF THE 2014 AHM directed at WAHO:
RECOMMENDATIONS
STATUS OF IMPLEMENTATION PROGRAMMES
UNDERTAKEN OBSERVATION
Implemen
ted
On-going Not
implemented
1. Follow up the establishment of the Solidarity
Fund, which shall be rapidly mobilised, with
the ECOWAS Commission for response to
public health emergencies;
x
The Fund was established and
domiciled at the Commission.
WAHO can access this fund
upon request.
2. Undertake the external evaluation of the
WAHO 2009-2013 Strategic Plan; x
A consulting firm was
recruited to this effect and
evaluation began during the
first week of February 2015.
3. Follow up with the ECOWAS Commission
relative to the recruitment to fill up the
remaining key positions at WAHO; x
Recruitment on-going for 4
professional cadre positions
(DAF, Accountant and 2
epidemiologists)
25
To the Member States: (WAHO for in-country monitoring)
RECOMMENDATIONS
STATUS OF IMPLEMENTATION
PROGRAMMES
UNDERTAKEN OBSERVATION
Implemen
ted
On-going Not
Implemented
4. Ensure advocacy with the Heads of State and
Government for the establishment of a
Solidarity Fund, which shall be rapidly
mobilised and domiciled at WAHO for
response in public health emergencies;
x
Several missions of the
management and the
ECOWAS Commission
5. Strengthen communication between WAHO
and the countries for better ownership of the
organisation’s interventions x
Missions of the management
in the countries with the
involvement of Liaison
Officers in all activities
undertaken in the countries.
6. Put in place a legal framework and ensure the
required political support for the UHC x
20 Francophone professional
officers trained in the
preparation, implementation
and progress monitoring of
UHC
7. Put emphasis on the promotion of health and
strengthening of primary health care within
the framework of UHC with the support of
WAHO.
x
Will be taken into account in
the drafting of the future
Strategic Plan