Thank you, Ms. Bikitsha, for the kind words of introduction. I’d also like to thank Prime Minister Hailemariam for his warm welcome, and would like to express my gratitude to the Government and people of Ethiopia for hosting this Conference. My thanks also to Chairperson Dlamini-Zuma for helping to open this historic meeting.
Finally, thank you to all of you who have come here today, from across the country and around the world, to participate in what I am sure will be a landmark meeting.
I am honored to be here today. I have worked in public health for my entire career, for more than 35 years. I have seen first-hand the tremendous impact that access to immunization can have on children -- as well as on their families, communities and nations.
We have an unprecedented opportunity – here, today – at this first-ever Ministerial Conference on Immunization in Africa, to make the commitments that will ensure we achieve universal access to immunization across the continent by 2020.
Here’s why I’m optimistic about our ability to succeed in this campaign.
In less than a generation, Africa has made tremendous gains in increasing access to immunization and driving down child deaths. Vaccines are a major reason that the rate of child deaths across Sub-Saharan Africa plummeted by 54 percent from 1990 to 2015.
That is a stunning statistic – one we should all be proud of.
Effective new vaccines for pneumonia and rotavirus, the two leading infectious killers of children, are being rolled out in many African countries.
And we can also point to great successes in the fight against polio and meningitis.
Let’s look at polio. Just several years ago, polio threatened the future of millions of children across Africa. Today, thanks to international partnerships, well-designed immunization campaigns, and the tireless efforts of health workers, local communities and national governments, the continent has not had a case of wild polio virus in more than a year and a half.
This is a historic milestone and a critical step toward a polio-free world, but the job is not yet done. Countries will need to stay vigilant in polio eradication efforts so that the African region can be officially certified polio-free next year.
And in order to secure a polio-free future, African countries will need to take several important steps. This includes introducing the inactivated polio vaccine into routine immunization programs, and preparing to switch from using trivalent oral polio vaccine to the bivalent oral polio vaccine in order to boost immunity and protect children from all types of polio.
At the same time, countries must prepare for the eventual decrease of donor support. This means capturing the lessons learned from decades of polio eradication efforts and ensuring the infrastructure created by this work is transitioned into ongoing public health programs, including our capacity to detect and contain outbreaks of other diseases. This is not only to keep Africa polio-free, but to also provide broad benefits to children’s health for generations to come. It is because of the polio program that we are better able to reach all children with vaccines – whether that be through a stronger cold chain systems or trained health workers. Now we must take steps to develop transition plans and ensure this great infrastructure isn’t lost.
We have also made great strides in the fight against meningitis. Through an innovative partnership with the Bill and Melinda Gates Foundation, as well as African Ministries of Health, WHO, PATH and Gavi, the groundbreaking MenAfriVac® vaccine was designed specifically to meet the needs of Africa’s “meningitis belt.” This vaccine has nearly eliminated meningitis group A in the countries where it has been introduced.
This is all amazing progress, it truly is. Yet, despite these gains, Africa’s progress on immunization is in danger of stagnating.
The African Region still lags behind every other region of the world in access to vaccines. 1 in 5 children in Africa does not receive all the vaccines they need.
A number of countries are off track in their efforts to reduce tetanus, measles and rubella – vaccine-preventable diseases that were once thought to be on the verge of elimination.
Countries around the world, including African countries, have committed to the Global Vaccine Action Plan, or GVAP, a framework for universal access to immunization for every child, everywhere. Yet, Africa is off track to reach 5 out of 6 GVAP goals.
So what is driving these trends?
Put simply, health systems in Africa remain under-resourced and under-equipped to reach all children with vaccines.
They are under-equipped to procure the vaccines we need, under-equipped to physically deliver these vaccines to the people who need them, and under-equipped to mount the public education initiatives that are essential to build community awareness of and trust in new health technologies.
And all too often, our weak health systems are put under further strain by armed conflicts, natural disasters, and the emergence of new health challenges, such as last year’s Ebola outbreak and the current Zika outbreak.
Today, at this first-ever Ministerial Conference on Immunization in Africa, we have an unprecedented opportunity to step up our efforts to build strong and sustainable health systems, which in turn will enable us to achieve universal access to immunization in the African Region.
We have a clear blueprint to achieve this vision.
First, we need governments across the continent to renew their commitment, and reaffirm that universal access to immunization is a cornerstone of health and development.
Leadership is needed at all levels to address persistent barriers in vaccine delivery and health care systems, especially in the poorest and most marginalized populations.
Many current national budgets for immunization are inadequate, and countries can put their immunization programs on a path to long-term sustainability by increasing domestic investment.
We have some great examples of African countries who are taking a lead. In recent years, South Africa has been financing new vaccines almost entirely from domestic resources, primarily through taxation. Last year, Nigeria – to its credit – recognized that it had lost some momentum in taking national ownership of its immunization efforts, so it established a National Immunization Financing Task Force. One of its main directives is to establish an externally and publicly capitalized Immunization Financing Trust Fund for the country.
Second, we need creative solutions to some of the biggest challenges facing immunization programs. Key focus areas that we need to address with bold new ideas include supply chain management, community engagement, and data monitoring and evaluation.
Recently, a team from Uganda joined forces with PATH and visited Vietnam to learn from that country’s experience. The team’s goal was to enhance Uganda’s capacity to pinpoint specific supply chain bottlenecks and address them with innovative technological and programmatic solutions. As Dr. Henry Luzze, deputy program manager of the Uganda National Expanded Programme on Immunization, put it: “If Vietnam can do it, Uganda can do it.”
And third, we need to continue to forge and foster effective national, continental and international partnerships – because we can do so much more together than any one organization can do alone, as our recent successes in immunization demonstrate.
Of course, every organization in this effort needs to make a concrete commitment, and that includes the World Health Organization.
Last year, in part due to lessons learned from the Ebola crisis, the WHO Regional Office for Africa launched an ambitious Transformation Agenda, which will guide our efforts to become a more responsive, nimble and ultimately more effective agency.
As part of this process, strengthening immunization systems – and health systems more broadly – is a key priority for us. We stand ready to help countries develop more resilient and agile public health systems that function properly in times of crisis and consistently meet the needs of their people.
Here today, I am honored to stand with ministers from across Africa, along with community advocates and technical experts. Together, we will reaffirm our commitment to ensuring that every child on this continent has access to the vaccines they need by 2020.
We know this is achievable, and we know that we must do this for the sake of future generations and their families.
I have no doubt that, with the support and efforts of everyone in this room, we will realize the dream – we will deliver universal access to immunization for the children of Africa.