African NCDs Network Advocacy Statement on WHO71st AFRO Regional Committee Meeting

The ANN is a coalition of legally recognized Civil Society Organizations which aims to advocate for NCDs prevention and control in African continent by ensuring universal health access, affordability and population based risk factor mitigation.

As one way of full filling the mandate during the WHO 71^st AFRO RCM the ANN organized some activities which included mobilizing members of the network to effectively participate at this event, organizing virtual multistakeholder side event ahead of WHO71st where members discussed the Agenda Items related to NCDs and UHC, presentation of statement at the WHO71 and following up on advocacy with stakeholders after the RCM.

The following statement represents what members discussed regarding the Agenda and it gives the background information, progress achieved, challenges/barriers faced and also the strategies put in place to achieve the goals:

Agenda item 13: Framework for the Implementation of the Global strategy to accelerate the elimination of cervical cancer as a public health problem in the WHO African Region (Document AFR/RC71/9)

Background

Cervical cancer is the fourth most common cancer among women globally and is caused mainly by persistent infection by the sexually transmitted human papillomavirus (HPV). The African Region accounted for 21% of global cervical cancer with the current trend pointing to a mortality increase to 30% by 2030¹. The African Region is disproportionately affected with 19 Member States having the highest burden of cervical cancer globally. Socioeconomic and cultural factors and poor access to health care services in the Africa Region contributing greatly to it. The prevalence of HIV has also increased the risks for women to develop Cervical Cancer

Progress

• There is still a big challenge in its
• Schools are the main avenue for the delivery of the vaccines in most African
• More accessibility to the vaccines in terms of delivery points and age coverage should be considered and this comes hand in hand with the vaccines availability

Challenges/barriers

• Education barriers; little education on the myths and misconceptions of the vaccines is given leading to a common effect of ignorance in determining society’s
• Negative notions and news on the vaccines and the side effects, these scare the recipients and their guardians.
• Religious beliefs play a major role in determining community response and some of the negative attitude towards community distorts the whole process of vaccine
• Leaders politicize the vaccines as a means of funds receptions and use this as an umbrella to get what they want and this leaves the community with uncertainties and negative attitude towards the

Strategies

• Increase advocacy strength, understanding the actual need for the vaccination. This is a role to the civil society groups but also to other key stakeholders including the government organs and
• Meaningful involvement – fore front liners should be those with lived experiences and actually affected by the condition which will create real life examples on the
• Awareness campaigns – a lot are unaware, sensitization needs to be done from the community levels to schools and even at national levels including stressing necessity of the

Agenda item 14. Framework for implementing the Global strategy on digital health in the WHO African Region (Document AFR/RC71/10)

Background

The development and use of Information and Communications Technology (ICT) in the African Region has accelerated in the last decade. Although, access to mobile telecommunication has increased from 32.2% in 2008 to 83.2% in 2020, as well as internet users from 4% in 2008 to 30% in 2020, only 12 of the 34 Member States of the WHO African Region which have developed digital health strategies have actually implemented them by December 2020.

As of 2015, mHealth was the most widely used digital health service in the Region (24 Member States). Others are social media (21 Member States), telemedicine (20 Member States), eLearning (17 Member States), electronic records (six Member States) big data (two Member States) and others (human resource information systems, laboratory information systems, supply chain and logistics management information systems (11 Member States).

Progress

• Telemedicine policy is in the pipeline in some countries, however the availability of these policies and guidelines in other countries needs to be
• There are several practicing telemedicine companies in majority of the WHO-AFRO member countries created by both civil society organizations and private sector for-profit companies created to solve different challenges within service delivery in prevention, diagnosis, management, and information sharing in NCDs
• There is still no clear guidance on how multisectoral actors can leverage the digital space to increase reach and impact.
• More research is still needed in all member states to understand the common and unique circumstances and to what extent they affect digitalization in health and by how much e-

Health can increase accessibility, reduce costs and what challenges stand in the way of achieving a thriving digital health space.

Challenges/barriers

• Restrictive taxation of internet services minimizes access and use of digital health
• E-commerce, which makes digital service payments easier, is emerging in WHO-AFRO member nations but accessibility to some of these services is still very
• Majority of patients living with NCDs are often from very disadvantaged circumstances and caught in the cycle of poverty and cannot readily access digital tools or services and when they can access it, often not sustainably due to costs of

Strategies

• Country level research and policy development
• Governments should enact relevant inclusive policies to govern management and access to digital services
• Multilaterals bodies should guide and support member states to enact and implement digital services
• Civil Society should build coalition and joint advocacy for policies allowing for increased access to digital services in health service delivery
• Private Sector should recognize that healthy individuals have more ability to make money and enact policies that allow employees access insurance and information and policies needed to prevent NCDs and access services needed to manage and maintain their
• Business organizations should require their member businesses to integrate health promotion and insurance for their employees into their company policies
• Healthcare facilities should adapt and create digital services to ease access to information and services for prevention, early diagnosis, and management of NCDs

Agenda item 16. Framework for implementing the priority actions of the global plan of action of the Decade of Healthy Ageing 2021–2030 in the African Region (Document AFR/RC71/12)

Background

The Decade of Healthy Ageing was adopted by the Seventy-fifth United Nations General Assembly as a UN Decade. Its objectives are change how we think, feel and act towards age and ageing; ensure that communities foster the abilities of older people; deliver integrated care and primary health services responsive to older people and provide access to long-term care for older people who need it.

Before this, in 2016, the Sixty-sixth Regional Committee for Africa endorsed the implementation framework (AFR/RC66/19) for the Global strategy and action plan on ageing and health (WHA69.3). Despite progress in implementing its priorities, health and social systems are at different stages. On average, 85% of the countries have received orientation in integrated care for older persons; 57% have put in place a mechanism or developed a national strategy on healthy ageing; 40% have national focal points dedicated to healthy ageing; 40% have established or designated multidisciplinary coordination committees; 23% have established or are putting in place long-term care policies; while 11% have started on the processes to create age-friendly environments.

In Africa, the national health and social systems are beset by various issues and challenges, which might be exacerbated by the estimated doubling of the proportion of older people from 10% to 20% will take a much shorter time in most African countries than in developed countries. Member States will therefore have a shorter timeline to adjust and establish the infrastructure and policies necessary to meet the needs attendant on their rapid demographic change.

Challenges and barriers

• Lack of adequate economic empowerment upon retirement age to afford healthcare
• Focus on treatment more than prevention
• Lack of technical innovation to support elderly e. g. Trackers to find lost persons with Dementia
• Awareness is focused on urban areas, not grassroots where needed most
• Lack of awareness targeting illiterate majority in illiterate populations

Strategies needed

• Improve economic empowerment for retiring persons
• Improved awareness with simple visual illustrations for the illiterate
• Technical innovations for elderly persons
• Review insurance policies for elderly persons
• Proactive awareness to prepare for old age including hereditary NCDs
• Focus on targeted approaches in grassroots communities
• Invest in research with national collated evidence based data
• Engage in media advocacy to gain visibility and public support
• Raise awareness on modifiable factors for people in their early ages to prevent or reduce NCDs challenges in their old age

Agenda item 17. Framework for strengthening the use of evidence, information and research for policymaking in the African Region (Document AFR/RC71/13) 

Background

The attainment of the Sustainable Developments Goals and UHC in the African Region is largely dependent on the availability and use of sound data, information and knowledge for health policy formulation. While a range of health research evidence is produced and processed for use globally, health policies in the Region are sub optimally informed by it.

In 2015, Member States endorsed the resolution on “Research for health: a strategy for the African Region, 2016–2025”, calling for country-led research and use of evidence for health policy-making. In response to the resolution and to alleviate some of the challenges connected to its implementation, the WHO established Evidence-Informed Policy Network (EVIPNet) to facilitate knowledge translation and use of evidence for policy-making in countries. However, up to date, only 13 Member States have joined the network and it’s been found that the use of research evidence for action involves a complex system of interactions between researchers and decision-makers and extends beyond the Network.

The availability of a formally adopted implementation framework to guide Member States will then enable to foster capacities, interests and accountability on fine-tuned information for health policy- and decision-making. Thus the document that will be discussed during the upcoming RCM meeting is a proposal for such a framework with clearly articulated objectives, milestones and time-bound targets as well as priority interventions and actions to be uptaken by the Member States.

Priority interventions and actions to be adopted by Member States:

• Strengthen national health information systems, align with national statistics bureaus and policies, harmonize health indicators and establish an integrated health
• Establish and promote national health research institutes and systems
• Increase country capacities for the development of evidence-informed policies
• Mainstream the use of evidence in health policy formulation and setting of targets and indicators pertaining to the SDG and UHC agenda
• Develop and strengthen national regulatory frameworks
• Establish and build the capacity of EVIPNet country teams for improved evidence uptake into policy and practice:
• Strengthen health research infrastructure; engage in research that meets country needs
• Develop a research and development coordination mechanism between the ministry of health and other relevant ministries:
• Ensure adequate financing
• Develop monitoring and evaluation tools

Key responsibilities and proposed commitments for the WHO AFRO and partners would be:

• Provide advice and support to Member States in the establishment of governance mechanisms and in building sustainable capacity and skills;
• Advocate and provide guidance for strengthening national health research systems and institutions;
• Promote intercountry interactions and networking, promoting sharing of best practices and lesson learnt, including through WHO collaborating centres and national health observatories;
• Track progress in the implementation of this framework in the Region

Note:

This statement has been supported by The Global NCDA with thanks to its partnership with The Leona M. and Harry B. Helmsley Charitable Trust.