Remarks by WHO Regional Director for Africa, Dr Matshidiso Moeti
Good afternoon everyone and thank you for joining us.
I’m pleased to be joined by colleagues from the Economic Commission for Africa and the Executive Chairman of Africa Health Business, because we know the COVID-19 pandemic is having significant economic impacts, and particularly in vulnerable communities, we need balanced action to save lives and livelihoods.
The private sector has a vital role to play, from providing care to those affected, to manufacturing the key items required for the response, as well as innovating and developing new tools like vaccines and medicines.
There are now more than 51,000 confirmed cases and 2000 have lost their lives across the African continent.
We are very concerned that almost 1000 African health workers have been infected with COVID-19. We know that most African countries already have catastrophic shortages of health workers and when our frontline workers fall ill or are absent from work, communities do not have access to essential services like immunization, safe deliveries and treatment for chronic and infectious diseases, in addition of course to what impact these shortages will have on our ability responding to the COVID-19 pandemic.
Due to global shortages of personal protective equipment, our frontline health workers, and other frontline workers, remain at increased risk of infection. We are working with countries and partners to replenish supplies so that health-care workers can safely continue to provide routine services, that I’ve mentioned.
Remarks by WHO Regional Director for Africa, Dr Matshidiso Moeti
To: Tedros Adhanom Ghebreyesus
Director General and Team,
The World Health Organization,
Dear Dr. Tedros and Team,
We the undersigned have noted with concern the recent personal and institutional attacks against you and WHO. We want to let you know that the world and humanity needs the institution of the World Health Organization (WHO) now more than ever. In the wake of the COVID -19 pandemic the technical guidance and leadership of the WHO that you and the leadership team in Geneva, Regional and Country Offices round the world is valued and appreciated.
A number of us were members of the Commission that released the report “The Neglected Dimension of Global Security: A Framework to Counter Infectious Disease Crises” in 2016. Having reviewed a wide range of options for a coordinated global response to infectious diseases, we concluded that the WHO is best placed to play the leadership and coordinating role and that if there was no WHO, we would have to invent one.
This is why we are writing to you to let you know that at this critical time in human history, it has fallen upon you and your WHO team to carry the singular responsibility of leading and coordinating the global charge to stop COVID -19 from killing more people and wreaking more collateral economic and social damage to the world.
We would like you to know that we have noted some of the attacks that have been leveled at WHO and to you personally. We know that some of these attacks are motivated by a number of factors that have nothing to do with your leadership of the WHO.
We are delighted and encouraged that despite these attacks you and WHO are committed to continue to focus on saving lives and controlling the pandemic with statements such as “No time to waste. Let’s focus on saving lives. Collaboration across party lines important to ensure national unity to fight the virus more effectively. National unity is a foundation for global solidarity. When we do this, we quarantine political covid. Stop politicizing #COVID19”.
Civil Society Organizations (CSOs) in Uganda are calling on the government to ensure that critical care and other emergencies get as much attention during the fight against the COVID19 pandemic.
Under the umbrella “Coalition to Stop Maternal Mortality in Uganda” the CSOs have written an open letter to the Prime Minister Rt. Hon. Ruhakana Rugunda, urging his office to prioritise maternal health and rights in the fight against COVID19.
They commend efforts by the government to stop the spread of the pandemic through measures such as home isolation and social distancing.
However, with the country currently on lockdown, the CSOs express concern that the most vulnerable Ugandans are struggling to get their urgent health services and needs addressed.
This especially follows media reports that showed a number of mothers dying in labour due to lack of a means to travel to hospital; and that many others are giving birth from the roadside.
“While we all want to have the pandemic suppressed and not spread further, other health need need to be provided and thatfundamental health rights are not violated during this period,” the letter reads in part.
It should be noted that the maternal mortality ratio in Uganda is high at 336/100,000 live births, according to the 2016 Demographic and Health Survey. The deaths are often due to preventable causes such as excessive bleeding, sepsis and lack of skilled care during childbirth.
The CSOs thus make several recommendations as follows:
1. Ensure continuity of blood donation services by giving exemptions to the Uganda Blood Transfusion Services to collect blood. Also, make provisions for people who would like to donate blood to do so.
2. Designate emergency vehicles for each Sub-County that are solely to be used for responding to non-elective, urgent and emergency health issues including antenatal care visits, accidents, dialysis, pressure, ART refills, immunizations, etc... The contact information for this driver shall be made available to all residents, and published locally and nationally to ensure transparency and accountability. Health facilities shall be made aware of this service and must share this information with their patients to enable responsiveness to bona fide urgent health needs.
3. The national toll-free call centre shall be upgraded to include a designated number only for Ugandans who have urgent non-COVID-19 health queries, for example, that need to know the contact details for their sub-county ambulance, or need to know how they are expected to travel to the clinic during this lockdown period. This line will be staffed by trained people who understand how the Government is managing urgent health issues during this period and can communicate that effectively.
4. Recommend to Cabinet a revision to the supplementary budget request to give further prioritization to health sector expenditures beyond the currently allocated UGX82.5 Billion.
5. Immediately direct NGO partners implementing maternal health care programmes in the health sector to work during this period under a waiver that authorises their movement, so that they are able to support women visit clinics safely.
6. Supply three months of family planning commodities to clients; rapidly develop and implement new protocols for community based family planning outreach and service provision so that gains in sexual and reproductive health and rights are not lost due to concerns regarding infection control.
Compiled by Carol Natukunda, Communications Specialist, ACHEST
“Health Workers for All and All for Health Workers” Slogan of the First Global Forum on Human Resources for Health
“Our job is to ensure access to a skilled, supported and motivated health worker for every person in every village everywhere” Dr. J W Lee, former WHO Director General.
In these trying times of the COVID -19 pandemic, there are Health Workforce (HWF) issues that keep recurring in all countries. Yet HWF is one of the most critical inputs into the pandemic control response. This message needs to be appreciated by all intersetoral actors in governments and the general population. There are persistent complaints about lack of protective equipment, long working hours, hazards of travel to and from work in the face of lock down regulations and lack of support to undertake non COVID related medical work leading to collateral damage to public health.
“Health Workers for All and All for Health Workers” was the slogan of the First Global Forum on Human Resources for Health in 2008. Another related trending theme at that time and still relevant today is the quote from Dr. J W Lee that “Our job is to ensure access to a skilled, supported and motivated health worker for every person in every village everywhere”.
Let us take the discussion forward based on this quotation:
1. Skilled HWF need general knowledge, attitudes and skills for good and bad times and the required competencies for this are:
• Prepared to work where services are most needed: selection process, attitudes, socially accountable
• Able to respond to health needs of community: training in real life situations in community
• Able to deliver quality care with available (limited) resources. (Achieving the most with available resources.)
• Clinical excellence as foundation for teaching and research.
• Able to be leader, manager , teacher and change agent: mentors
• Continuous self-directed learners
• Effective communicators: team based learning, practice
The HWF also needs to be prepared and fit for purpose to handle the special skills for COVID-19 and the required competencies are:
• Full understanding of Infection control practices including correct use of PPEs
• Knowledge of Novel Corona virus behavior and its manifestations especially modes of transmission, symptoms, signs and complications
• Team work and empathy with ability to delegate skills through Task Shifting approach
2. Supported HWF should have:
• Enjoy the full support of political leadership with established structures for HWF planning and management embracing all relevant sectors
• Enjoy full support supervision of competent technical leaders with clear structures for dialogue and communication
• Enjoy the full support and understanding of the general population
• Have access to the tools that they require for their work such as PPEs, supplies,
• Organized and well led HWF with a critical mass of individuals professional associations and other institutions that work with their respective governments as both support and accountability agents, for sustaining highly performing health systems