Framework for health systems development towards universal health coverage in the context of the sustainable development goals in the African Region: report of the Secretariat

1. The 2030 Agenda for Sustainable Development was adopted to guide global development, with healthembodied in the third Sustainable Development Goal. Universal Health Coverage underpins theachievement of the health and related SDG targets. Health systems strengthening for universal healthcoverage was identified by WHO as one of the key instruments for the change offered by the 2030 Agenda.2. Member States have made substantial improvements in population health outcomes over the past 25 years.These improvements are reflected in better availability and utilization of services targeted at addressing thepriority disease burdens, matched by an increase in total health expenditure and general governmentexpenditure on health. However, this masks large variations within and across Member States, withimplications for health delivery. In addition, national health systems in the Region are not well aligned withthe changing needs and expectations in facilitating health in sustainable development.3. The Region is experiencing demographic, economic, social, security and environmental changes that placeunique demands on health and related service delivery systems. New/re-emerging health threats arediverting significant human and financial resources away from routine services. The devastating Ebolaoutbreak in West Africa underscored the need for effective and resilient health systems in low-incomecountries.4. This action framework presents the approach Member States need to consider in order to strengthen and realigntheir health systems to ensure that they are able to achieve their health development goals. Itrepresents a foundational plan for Member States to ensure that health is playing its role in facilitatingmovement towards sustainable development.5. The proposed priority actions emphasize the need to ensure the availability and coverage of health andrelated services, increase the population protected from financial risk, enhance health security, improveclient satisfaction and address interventions targeted at other SDGs that impact on health. Key measures formonitoring health system performance such as health system resilience, effective demand for healthservices, equitable and efficient access and quality of care are defined. A scope of investments in healthsystems across health governance, service delivery systems, health workforce, access to medicines andhealth technologies, health infrastructure, sustainable financing for health and health information systems isalso outlined.6. The Regional Committee examined and adopted the actions proposed in this framework

Regional strategy for the management of environmental determinants of human health in the African Region 2017–2021: Report of the Secretariat

1. In the African Region, the burden of disease attributable to environmental determinantsand the consequent socioeconomic impact is substantial. Environmental risks account for23% of the burden of disease in the African Region. Vector-borne, diarrhoeal andcardiovascular diseases, as well as lower respiratory infections are significantly attributableto environmental determinants. Air pollution, water, sanitation and hygiene are the maindrivers of these diseases.2. In response, African Ministers of Health and Environment adopted the LibrevilleDeclaration on Health and Environment in Africa (2008) in which they committed themselvesto jointly address environmental determinants of human health and ecosystems integrity.However, progress made across the Region in the implementation of the Declaration has beenslower than anticipated. The adoption of the Sustainable Development Goals (SDGs) alsogenerated renewed impetus in addressing environmental determinants of health.3. Addressing the environment and health nexus therefore requires an up-to-date andintegrated strategy, rooted in the Libreville Declaration and aligned with the SDGs. Therefore,the proposed strategy seeks to strengthen an integrated approach to the management ofenvironmental determinants of human health in order to accelerate the implementation of theLibreville Declaration. Its implementation will contribute to the attainment of the SDGs.4. The principal areas of focus of the strategy include safe drinking-water and sanitation andhygiene, air pollution and clean energy, chemicals and wastes, climate change, vector controland health in the workplace. Its implementation will require reviewing and reinforcing existinginstitutional arrangements, establishing a sustainable financing mechanism, strengtheningnational capacities for research, advocacy and communication, and integrated surveillance,monitoring and evaluation.5. The Regional Committee reviewed and adopted the strategy.

Global health sector strategy on sexually transmitted infections 2016–2021: implementation framework for the African Region

1. Sexually Transmitted Infections (STIs) are a highly endemic public health challenge in the AfricanRegion and worldwide. At global level, it is estimated that each year there are 357 million new cases of thefour major curable STIs among people aged 15–49 years: chlamydia infection (131 million), gonorrhoea (78million), syphilis (6 million) and trichomoniasis (142 million). The prevalence of some viral STIs is similarlyhigh, with an estimated 417 million people infected with herpes simplex type 2, and approximately 291million women harbouring the human papillomavirus (HPV). The African Region is particularly affectedwith a high prevalence of these infections. The total number of new cases for these four curable STIs in theRegion was estimated at 63 million in 2012, representing 18% of the global incidence.2. These STIs have a profound impact on the health and lives of the population worldwide. This includesthe high risk of fetal and neonatal morbidity and deaths due to syphilis in pregnancy; the risk of cervicalcancer due to HPV infection; the risk of infertility mainly due to gonorrhoea and chlamydia infection, as wellas the facilitation of sexual transmission of HIV.3. In order to adequately respond to this high burden of disease and in line with the 2030 Agenda forSustainable Development, WHO has developed a global health sector strategy on STIs, 2016–2021. Theproposed strategy is based on achievements and lessons learnt from the previous global strategy, whichcovered the period 2006–2015. The development of the strategy followed a broad consultative processinvolving Member States, organizations of the United Nations system and other key partners such as donorand development agencies, civil society, nongovernmental organizations, scientific and technical institutionsand networks, and the private sector.4. he goal of the strategy is to end STI epidemics as major public health concerns. The strategy defines aset of priority actions to be undertaken by Member States, which are organized under five strategicdirections, namely information for focused action, interventions for impact, delivering for equity, financingfor sustainability and innovation for acceleration of the response.5. The proposed regional implementation framework provides programmatic and policy guidance toMember States to facilitate implementation of the global strategy. It describes actions and roles that MemberStates and partners should take to fast-track STI prevention and treatment interventions in the African Regiontowards ending the STI epidemic. The actions proposed include prioritizing STI prevention, expanding STItesting services using diversified approaches and scaling up treatment by adopting innovative servicedelivery models.6. The Regional Committee examined and adopted the proposed implementation framework.