WEST AFRICAN HEALTH ORGANISATION ORGANISATION OUEST AFRICAINE DE LA SANTE ORGANIZAÇÃO OESTE AFRICANA DA SAÚDE. WAHO s 2014 PROGRESS REPORT

Transcription

1 WEST AFRICAN HEALTH ORGANISATION ORGANISATION OUEST AFRICAINE DE LA SANTE ORGANIZAÇÃO OESTE AFRICANA DA SAÚDE WAHO s 2014 PROGRESS REPORT JANUARY

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 15 th ordinary meeting of the ECOWAS Assembly of Health Ministers III. Major Achievements of WAHO in III.1 Managerial Activities of the Directorate General:... 9 III.1.1 Statutory Meetings III.1.2 Meetings with Political Authorities in Member States III.1.3 Strategic Partnership and Resource Mobilisation III.2 Implementation of Programmes III.2.1 Policy Coordination and Harmonisation Programme: III.2.2 Health Information Programme III.2.3 Research Development Programme III.2.4 Promotion and Dissemination of Best Practices Programme: III.2.5 Human Resources Development for Health Programme III.2.6 Medicines and Vaccines Programme In the area, WAHO s interventions helped to achieve the following major results: III.2.7 Traditional Medecine Programme III.2.8 Diversification of the Health Financing Mechanisms Programme III.2.9 Institutional Capacity Building Programme: III.2.10 Monitoring and Evaluation Programme: III.3. Status of Financial eecution: III.4. Administrative situation: IV. Challenges and prospects: IV.1. Challenges IV.2. Prospects CONCLUSION... ANNEX

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 3

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 15 th Assembly of Health Minsters of ECOWAS; Major achievements of WAHO; Directorate General s managerial activities; Implementation of programmes; Status of financial eecution; Administrative situation; Lessons learnt; Difficulties/constraints; Challenges and prospects for 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. 4

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 Burkina Faso Cape Verde Côte d Ivoire The Gambia Ghana Guinea Guinea-Bissau Liberia Mali Niger Nigeria Senegal Sierra-Leone Togo ECOWAS Source: NHIS/IDSR data in Member States 5

6 Ebola Virus Disease: Guinea made the official announcement of the Ebola virus epidemic on 21 March A total of si (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 si (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 Cases Deaths Lethality Cases Deaths Date of updating data Guinea ,1% 13,4% 21,7% 28-Dec-14 Liberia ,7% 39,8% 43,5% 28-Dec-14 Mali ,4% 0,0% 0,1% The three countries Nigeria ,0% 0,1% 0,1% were declared free of Senegal 1 0 the disease Sierra-Leone ,0% 46,7% 34,7% 28-Dec-14 ECOWAS ,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 eisting cases. Cholera: About cases and 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 eceeds 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 cases followed by Ghana with cases and Niger with 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 Fig.2: Evolu on of Cholera cases per week in the most affected countries 3250 Ghana Nigeria Niger Number of cases per week 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 Meningitis: In 2014, cases were notified including 703 deaths in fourteen (14) countries compared to 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 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 Lassa Fever: A total of 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: 7

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 cases in 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 (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 15 th 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 Ependiture 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 eplore the mechanisms for better monitoring of the implementation of AHM recommendations; 8

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 eperiences; 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 net 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 eperiences 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 eternal evaluation of the WAHO 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 epectations 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; Siteen (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 annee. 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 eecution; 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. 9

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 etraordinary Summit on the Ebola Virus Disease, Sessions of the Council of Ministers, Meetings of the Assembly of Health Ministers including an etraordinary meeting on the Ebola Virus Disease, the 8 th 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 3 rd of February 2014, the Director General and his deputy have visited all the Member States to meet with the political authorities in order to echange 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 echanges 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 ($ ) and another to the tune of seven million US dollars ($ ) within the framework of Ebola Virus Disease control. III.2 Implementation of Programmes 10

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 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 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 tets 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 noncommunicable 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; 11

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 Si (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 epressed for the acquisition of contraceptives were covered for total sum of CFA francs ; Noristerat phials were transferred from Burkina Faso to Benin, which was out of stock; The capacities of Family Planning service providers were strengthened; 12

13 The sensitisation/promotion services of the Family Planning and sessions of free distribution of Family Planning commodities/services were conducted; Couple-Years of Protection (CYP) were achieved, that is 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 $ for the acquisition of logistical equipment for epidemic control (vehicles, medical ambulances, personal protective gears, thermoflash, 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 si hundred references; III.2.3 Research Development Programme 13

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 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/ eploitation; - 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-si (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 Echange 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. 14

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 fleibilities 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 si (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 si 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 Strategic Report is available. 15

16 III.3. Status of financial eecution: WAHO s 2014 overall budget amounted to UA and broken down as follows: UA for general administration accounting for 25% of the budget and UA earmarked for programmes, thereby accounting for 75% of the budget. The administrative budget was eecuted to the tune of 62% as against 66% in 2013 and 49% for programmes compared to 79% in Thus, overall budget eecution 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 UA ; Total amount of actual receipts from ECOWAS UA (about 74%); Amount epected from partners UA ; Actual amount received from Partners UA (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 si (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 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 16

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 Strategic Plan and the implementation of the above-mentioned prospects. 17

18 ANNEX: STATUS OF IMPLEMENTATION OF RECOMMENDATIONS OF THE 15 th AHM I. RECOMMENDATIONS OF THE LIAISON OFFICERS MEETING directed to WAHO: RECOMMENDATIONS 1. Draft and disseminate a standard template for monitoring the implementation of all AHM recommendations. 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 3. Systematically send the reports of meetings/workshops organised by WAHO to WAHO Liaison Officers of the 15 Member States. 4. Take all the measures for systematic labelling and inventory of all materials and equipment supplied to the countries by WAHO. STATUS IMPLEMENTATION Impleme nted OF Ongoing Non- Implemente d PROGRAMMES UNDERTAKEN A template was drafted and disseminated while some comments were received. The compiled version is available. The Terms of Reference were updated and sent to all the Liaison Officers through the Ivorian Liaison Officer. OBSERVATION Reconsider the content of the recommendation of the meeting to the Liaison Officers. A preliminary inventory will be carried out in 2015 to this effect.

19 RECOMMENDATIONS STATUS IMPLEMENTATION OF PROGRAMMES UNDERTAKEN OBSERVATION 5. Draft and make available a manual of procedures to Liaison Officers for the day-today management of the petty cash ependiture. 6. Improve the working conditions of the Liaison Officers to ensure better visibility for WAHO activities in the countries. Manual drafted and sent to the Liaison Officers in June 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 7. Fine-tune the epectations of the Liaison Officers with a view to improving their working conditions. 8. Justify and make prompt requisitions for replenishing the petty cash account. 9. Improve WAHO s visibility in the countries thanks to the presence of Liaison Officers. STATUS OF IMPLEMENTATION Implemen ted On-going Non- Implemented PROGRAMMES UNDERTAKEN OBSERVATION 19

20 II. RECOMMENDATIONS OF THE MEETING OF EXPERTS directed at WAHO: RECOMMENDATIONS 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 2. WAHO should eplore mechanisms for better implementation of AHM recommendations 3. Undertake an in-depth situation analysis on the UHC in the region aimed at developing a regional strategy for supporting the Member States 4. In order to improve the response to the ongoing 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 eperiences. STATUS OF IMPLEMENTATION Implemen ted On-going Not Implemented PROGRAMMES UNDERTAKEN Taken into account in the drafting of the WAHO 2014 Annual Report Several follow up meetings on the implementation of the recommendations were held at WAHO. The departments were tasked with the monitoring of the implementation. A regional workshop for the review of the status of Universal Health Coverage in the ECOWAS region is scheduled for 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 OBSERVATION 20

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 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 Assistance to Member States in intensifying the sensitisation activities by involving all the actors Financial support was given to the national laboratories. 21

22 III. RECOMMENDATIONS OF THE PARTNERS FORUM directed at WAHO: RECOMMENDATIONS 1. Choose a lead institution for each thematic forum 2. Foster institutional anchoring of regional programmes within WAHO 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. 4. The establishment of an epidemic response fund should be brought to the attention of the Ministers of Health for appropriate decision. 5. Retain the vector control activities, including the sanitation of the household as key pillar for malaria elimination STATUS OF IMPLEMENTATION Implemen ted Ongoing Not Implemented PROGRAMMES UNDERTAKEN The Lead Institution was selected for the siteenth AHM Apart from programmes managed by WAHO, efforts were made to ensure the management of new regional programmes that are being prepared Participation in two meetings organised by the Ouagadougou Partnership Recommendation was already made through the Monrovia Declaration and relative to an AHM recommendation directed at WAHO This recommendation was considered under the Strategic Regional Malaria Control and Elimination Plan OBSERVATION 6. The WARDS project being a catalytic project, an advocacy should be directed to the Advocacy was carried out and directed at both the partners and 22

23 RECOMMENDATIONS 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. 7. Draft and review the terms of reference of Partners Forum. 8. Create thematic fora by bringing partners together around key themes/areas/ priorities/programmes 9. According to the theme of the year, identify 2 to 4 partners presentations and share the eperiences of other partners through posters. STATUS OF IMPLEMENTATION PROGRAMMES UNDERTAKEN ECOWAS A proposed updated TOR was drafted The best practices forum is being activated for this purpose. 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. OBSERVATION 23

24 IV. RECOMMENDATIONS OF THE 2014 AHM directed at WAHO: RECOMMENDATIONS 1. Follow up the establishment of the Solidarity Fund, which shall be rapidly mobilised, with the ECOWAS Commission for response to public health emergencies; 2. Undertake the eternal evaluation of the WAHO Strategic Plan; 3. Follow up with the ECOWAS Commission relative to the recruitment to fill up the remaining key positions at WAHO; STATUS OF IMPLEMENTATION Implemen ted On-going Not implemented PROGRAMMES UNDERTAKEN The Fund was established and domiciled at the Commission. A consulting firm was recruited to this effect and evaluation began during the first week of February Recruitment on-going for 4 professional cadre positions (DAF, Accountant and 2 epidemiologists) OBSERVATION WAHO can access this fund upon request. 24

25 To the Member States: (WAHO for in-country monitoring) RECOMMENDATIONS 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; 5. Strengthen communication between WAHO and the countries for better ownership of the organisation s interventions 6. Put in place a legal framework and ensure the required political support for the 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. STATUS OF IMPLEMENTATION Implemen ted On-going Not Implemented PROGRAMMES UNDERTAKEN Several missions of the management and the ECOWAS Commission Missions of the management in the countries with the involvement of Liaison Officers in all activities undertaken in the countries. 20 Francophone professional officers trained in the preparation, implementation and progress monitoring of UHC OBSERVATION Will be taken into account in the drafting of the future Strategic Plan 25