COORDINATING AFRICAN HEALTH LEADERSHIP
Dear Colleagues,
Here is our topic for this month.
I participated at the 5th Global Forum on Human Resources for Health (HRH) convened by the World Health Organization (WHO) in Geneva, from 3rd to 5th April 2023. This is the top global HRH event that takes place every two to three years; hosted by different countries around the world. At this Geneva meeting, the African Regional Office of WHO (WHO Afro) presented a draft of the African Health Workforce Investment Charter that is being developed by that office. The following day, The African Centers for Disease Control (Africa CDC) presented another draft of the African Health Workforce Strategy being developed by the Africa CDC. Upon making inquiries, it became evident that these two African Health institutions' efforts to develop Health Workforce plans for Africa are in parallel and not coordinated. This is the reason I am moved to write about the urgent need for coordination and harmony between the WHO Afro and the Africa CDC. There are likely to be other areas of work where parallel, uncoordinated, and conflicted pieces of work in Africa are being undertaken by these two institutions that will result in duplication of efforts, undesirable competition, and create more problems than solutions to Africa’s health agenda.
According to the websites of the two organizations, “Africa CDC is a continental autonomous health agency of the African Union established to support public health initiatives of Member States and strengthen the capacity of their public health institutions to detect, prevent, control and respond quickly and effectively to disease threats. Africa CDC supports African Union Member States in providing coordinated and integrated solutions to the inadequacies in their public health infrastructure, human resource capacity, disease surveillance, laboratory diagnostics, and preparedness and response to health emergencies and disasters. It was established in January 2016 by the 26th Ordinary Assembly of Heads of State and Government and officially launched in January 2017. The institution serves as a platform for Member States to share and exchange knowledge and lessons from public health interventions”.
On the other hand, “the mission of the WHO Afro is to enhance AFRO's technical support to countries for scaling up proven public health interventions; and strengthen partnerships with UN agencies, regional economic communities and other stakeholders”.
I raised the matter of parallel efforts between Africa CDC and WHO Afro with Dr. Tedros Adhanom Ghebreyesus, the Director General of WHO. He confirmed his support for the Africa CDC and showed me a news item from Aljazeera in which Dr. Tedros, in 2013 as Ethiopian Minister of Foreign Affairs at the African Union Executive Council meeting in Abuja, Nigeria is quoted as follows “Ghebreyesus said Ethiopia is proposing to establish an African Center for Diseases Control and Prevention (African CDC) or Health Commission for Africa under the umbrella of the African Union.” Dr. Tedros believes that WHO Afro and Africa CDC can work well side by side synergistically provided there is clear guidance and clarity of roles provided by the African Union and that there are leaders in these institutions who are willing to work collaboratively and in partnership.
I have personally been active in the African health space for some time and I remember how WHO and the African Union worked well together to adopt the first African HRH Strategy by Health Ministers, coordinated by NEPAD. I also remember Bience Gawanas, then Commissioner for Social Affairs at the African Union, co-chairing a WHO Task Force on Education and Training of HRH.
It is critically important for the newly created Africa CDC to work harmoniously with the 75-year old WHO Afro. If this does not happen, the health of the people of Africa is in danger. Both organizations are overseen by the same Health Ministers who meet regularly and the structures for harmonization are available. The two organizations should also take note of the fact that there are other structures in Africa that have been created by the same authorities on health. Examples are the Health bodies of the Regional Economic Communities such as the West African Health Organization and the East, Central and Southern African Health Community.I have seen these two organizations effectively move many health programs in the countries. Along with these, are Civil Society organizations that have knowledge and expertise on various health topics. For example, we have the African Platform on HRH that has convened a number of consultations and has capacity to support the African HRH agenda.
This is a call for cohesion and synergy in moving the African health agenda forward as a global public health good. The development partners, donors, and funders should keep this in mind as they support coordinated Africa’s health development.
What do you all think?
Francis
Comments (4)
Prof. Miriam Khamadi Were
Thank you very much for your informative message.
It was particularly important to take note of the two offices of Africa CDC and WHO Afro.
As you rightly point out, proper coordination of the activities of the two offices is crucial.
I add my voice on advocating that steps be taken to coordinate the work of the two offices of
Africa CDC and WHO AFRO.
Midion Mapfumo Chidzonga
Who controls Africa CDC and WHO? The UN who I I believe controls WHO and Africa CDC is controlled by AU?? iThe UN is controled by the all powerfull Security Council in which Africa has no say whereas Africa has full control of Africa CDC.Let the two bodies exist as is.I believe they can collaborate with little difficulty
.Midion
Elsheikh Badr
I add my voice to your call for synergy and I am sure it can add value to the work of all parties and this should be simple and straightforward. However if we take a systems perspectives we can identify some factors that discourage meaningful collaboration including:
- Funding and the way its arranged for instance we know from our long experience that vertical funding has promoted isolated action in our countries
- Accountability requirements are sometimes set in a way that promote hasty action to meet obligations and as such collaboration is seen as a delay factor
- The lack of technical capacity and its adverse influence on implementation sometimes discourage further collaboration as the value added is not realized
Therefore I recommend taking a systems thinking approach in addressing isolated action in our content in order to identify and deal with the root causes. Advocacy is also needed to promote collaboration even if for communication and exchange of information. The approach of entering into MOUs could be an option as it establishes formal links to realizes exchanges and joint work..
In the WHO Eastern Mediterranean Region we have recently seen a positive move through an MOU that brought two important entities to synergize and work together for public health: the WHO EMRO and the Easrern Mediterranean Public Health Network (EMPHNET)....this could be emulated to address the case of WHO AFRO and the CDC Africa
Best Regards
Elsheikh Badr
C A Samkange
Thank you for putting it so clearly. If I maybe a bit presumptuous and think I can add to a piece that is so clear and to the point:
The tragedy for Africa is that there is no shortage of people who think they can authoritatively speak for Africa. The second tragedy is the number of people who speak for Africa without reference to Africans or African Institutions. The third tragedy are the authors who do not check what is already written before publishing. The imperative, more than anything else, is that individuals, organisations or organs should always check with others when embarking on a mission; further, collaboration with like-minded institutions should always be the guiding principle
Let this be a lesson to Africa CDC and WHO Afro
C A Samkange