WHO-EMfARDf00 1/En, Distribution: Lirni ted Report on the
ANNUAL MEETING OF THE REGIONAL DIRECTORS OF WHOEMRO AND UNICEF/MENARO
EMRO/Cairo, Egypt, 9 September 2002
World Health Organization
Regional Office for the Eastern Mediterranean Cairo, Egypt 2003
O World HeaIth Organization 2003
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CONTENTS 1.
INTRODUCTION ............................................................................................................ -1 RECOMMENDATIONS FOR JOINT ACTION .............................................................. 2 Annexes
2.
2.
1.
AGENDA .......................................................................................................................... -7 LIST OF PARTICIPANTS................................................................................................. 8
1.
INTRODUCTION
The Annual Meeting of the Regional Directors of the Eastern Mediterranean Regional Office (EMRO) of the World Health Organization (WHO), and the Middle East and North Africa Regional Office (MENARO) of the United Nations Children's Fund (UNICEF) in 2002 took place at the WHO Regional Office for the Eastern Mediterranean in Cairo, on 9 September 2002.
The meeting was attended by 24 participants representing the two organizations. Eleven agenda irems were thoroughly discussed in three sessions. The agenda and list of participants are given in Annexes 1 and 2, respectively. Many recommendations for joint action were agreed upon. In their opening remarks, Dr Hussein A. Gezairy, WHO Regional Director for the Eastern Mediterranean and Mr Thomas McDemott, UNICEF Regional Director for the Middle East and North Africa emphasized the importance of such annual meetings between the two sister agencies as a forum where the senior policy-makers and technical staff of both regional offices can jointly review the programme strategies, analyse the challenges and take
stock of lessons learned from the experience of both agencies in the field. Thcy acknowledged their appreciation of the continuous growth of collaboration arrd
coordination that exist between the two agencies at all levels, and particularly at country level where daily interaction, coordination and exchange of ideas and joint programming take place. They highlighted some of the major challenges that the two regions are facing, such as high infant, chiid and maternal mortality, increasing prevalence of communicable and noncommunicable diseases and the high incidence rates of malnutrition, anaemia and micronutrient deficiencies. These challenges are further exacerbated by poverty, debt servicing, poor utilization of the meagre resources available and underfunding of the health sector in many of the countries in the region. Nevertheless, they acknowledged the efforts made by national authorities. in the countries of the region to tackle these problems more efficiently and effectively. The health systems in many countries are unclerguir~gI-cfur-rri pruccsscs lhat will enable them to better respond to the various challenges. L)r Cjezairy highlighted the several global initiatives and funds established recently, such as the Global Alliance on Vaccines and Immunization (GAVI), the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria (GFATM), the Global Alliance to Improve Nutrition (GAINS) and Healthy Environments for Children. He urged both agencies to maximize their efforts to use these resources in a more rational way.
Mr McDermott emphasized the good and special collaboration between EMRO and MENARO as a good example of regional collaboration among UN agencies. He urged the two offices to play an increasing rolc in controlling the quality of the documents produced ill
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Page 2 country level, such as the Common Country Assessment (CCA) and the United Nations Development Assistance Framework (UNDAF) which have become among the main bases for programming and partnership development. The regional offices should provide more support to countries for this purpose. Mr McDermott stressed that the board of the United Nations Development Group will not approve any country programme unless the CCA and UNDAF documents have been finalized. He added that the annual and mid-term reviews with government can provide further opportunities for coordination and collaboration at country level. UNICEF country offices have been empowered to utilize funds on the basis of the fiveyear p ~ ~ amlne, o g ~ mid-te~ 111 review and ar~rlual ylarinirig. Mr McDemott emphasized the need for close coordination with the World Bank at country level. The World Bank is a partner on issues such as the Poverty Reduction Strategy Paper (PRSP), which is to be driven by CCA and UNDAF and not to be dealt with separately.
Dr M.A. Jama, Deputy Regional Director, EMRO, presented highlights of the outcome of the preparatory meetings, which took place between WHO and UNICEF teams one day prior to the annual meeting. He explained the agreed framework of each presentation, which included situation analysis, policy issues, areas for collaboration, strategic issues that the two organizations can adopt and finally the plan of action. He compared the modus operandi of the two organizations and noted that although operationd modalities may differ, the two offices are united in action at country level. He presented the overall managerial framework of WHO and Listed the global and regional priority programme areas. He described the operarional planning overview, illustrated the logical structure of a workplan and explained the transparency and clarity of work of WHO with governments. The participants discussed issues raised and emphasized the need for: streamlining the channels of communication between the two organizations; greater coordination and collaboration in the UNDAF process; clear mechanisms to support staff at country level to work together; greater harmonization of the budget cycle; focusing on capacity-building in countries; experience sharing on initiatives and new approaches, such as BDN, healthy villages and the action-oriented schnnl health crlrrici~l~~rn; working with more than one.
ministry; and attracting more partners in development in addition to other traditional partners, 2.
RECOMMENDATIONS FOR JOINT ACTION
Child and adolescent health and development Child healrh At regional level:
Joint planning for the strategy of integrated child health with special emphasis on development. community component and psychosoc~al Joint intercountry meetings. Workshops on the Convention On the Rights of the Child.
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Page 3 At country level:
Support for implementation of the strategy of integrated child health at country level
Adolesce~zthealth Prepare a guide for interventions to be undertaken in collaboration with Member States, with specific focus on psycho-social development of young people, and HIVfAIDS. Prepare appropriate advocacy documents and reports that address adolescent health and development-related issues in the community. Promote research work on adolescent health and development, and establishing a gender-disaggregated database, in order to facilitate evidence-based policy formulation and programme planning in Member States. Expand exchange of information on UNICEFiWHO experiences and activities in the field of adolescent health and development. Set up mechanisms and indicators for monitoring and evaluation of the existing programmes and activities. Collaborate with all partners, including young people thernsetves.
.
.
Improve knowledge. Data sharing and harmonization. Review of existing tools and methodologies in prevention and capacity-building approaches. Exchange of major planning documents and reports. Participation i n major planning, training and technical events: annual national ATnS
programme. Contribution by UNICEF to the EMRO website with regard to sharing information ahnut specific cor~ntry and regional initiatives including GFATM. Possibility nf extranet
development to be explored. Information exchange, sharing and communication. Analysis of available data from existing national studies related to young people.
Conduct of multicountry behavioural studies concerning young people through a joint protocol. Mnkc dntabasc rcflcct thc situation of young pcoplc.
Development of a subregional initiative for the Horn of Africa. Co-host the multi-agency consultation for development of the strategic framework addressing HIV in the Hor-n of Afi-ica.
Collaborate under UNAIDS mechanisms. Collaborate on the theme of young people and HIV in the region including meeting to be convened by UNICEF
IEC materials Action-Oriertjed Sclzool Healtl~Curriculum (AOSHC) WHOAJNESCO/ ISESCO/ UNICEF initiative I FRESH.
Rapidassessment.
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Redesign for wider reach, new themes (tobacco, adolescent health, substance abuse, violence) and address out-of-school youth. Promotion of physical activity and sports Utilize resources: School health education against AIDS Adolescent health education Mental health manual. Facts for Life (Arabic Version)
UNICEF to print 15,000.WHO may join. WHOAJNICEF to review terminology.
WHO/UNICEF joint launch/dissemination. Arabic glossary
Standard setting Religious messages New themes (adolescent health).
Youth survey cooperation Joint development.
EPI and Polio eradication EPI
Support routine immunization to raise coverage in Djibouti, Iraq, Sudan and Yemen (joint advocacy, support to the preparation of national plans of action for social
mobilization). Ensure better coordination on GAVI activities at regional level through strengthening and rehabilitating GAVI Regional Working Group (RWG). Ensure adequate functioning of Interagency Coordination Committees to play leading role at country level through WHO and UNICEF collaboration on proper use of GAVI allocated resources, proper implementation of EPI national multi-year plan, and on monitoring and evaluating progress.
Continue joint efforts to reduce measles mortality in priority countries (especially south Sudan).
Support Sudan and Djibouti to implement the recommended measles acceleration plan. Conduct joint advocacy with Ministries of Health in Morocco, Egypt and Islamic Republic of Iran to collduct llleasles catch-up campaigii, and in Libyan Arab Jamahiriya to develop and implement the recommended measles elimination strategies (catch-up campaign).
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Page 5 Support social mobilization for measles catch-up campaigns in Morocco, Egypt, Islamic Republic of Iran, Iraq and Yemen. Continue supporting annual intercountry meetings on measles accelerated control and elimination. Continue supporting implementation of neonatal tetanus elimination activities (high-risk approach) in Egypt, Iraq, Sudan and Yemen. Polio eradication
Continue supporting intercountry meeting on EPI: concentrate on "endgame" at next meeting. Monitor situation all over the region with special emphasis on priority countries. Support and ensure continued effective participation in the Technical Advisory Group (TAG) meetings on polio. Continue efforts for fund-raising for priority countries (Egypt, Sudan and Yemen). Continue supporting international and national staff working for polio eradication and EPI with special attention to endgame actions. Continue support to priority countries for polio eradication, with emphasis on quality of subnational immunization activities and surveillance. Joint collaboration for community and social mobilization for immunization. Share information freely on immunization.
Maternal health Develop a framework for essential support in maternal and perinatal health, with specific focus on emergency obstetric care especially in the priority countries (e.g. Sudan, Djibouti, Yemen). Advocate support among policy-makers and other interested parties, to ensure that safe motherhood is kept high on the international development agenda. Build effective partnerships at country level, especially in priority countries, in order to ensure better planning and coordination, maximize the use of existing resources and help monitoring i n d evaluation. Expand and improve channels of communication between the two regional offices to facilitate coordination and support to countries. Strengthen and promote a joint regional network on safe motherhood, and other related issues to make optimal use of existing resources in the region. Assist countries in monitoring and evaluating their safe motherhood-related interventions and programmes.
Micronutrients Sa E t iodization Jointly assess the status of Member States implementing salt iodization in accnrdance with WHO/UNICEF/ICCIDD guidelines. Jointly advise and advocate in Member States to ensure that universal salt iodization (i.e. all salt intended for human consumption) is adequately indized at the legal level nf 30 ppm iodine, allowing for a margin of + 10 ppm.
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Page 6 Continue joint advocacy efforts with Member States for reducing taxation on iodized salt and exemption of potassium iodate from customs levy and taxation. WHO to organize training at Iocal, national and regional levels, in different aspects of salt production and iodization, monitoring and evaluation of IDD control and prevention programmes. UNICEF to encourage country offices to fund participation of national counterparts at these training courses. Participate in joint assessment missions to recognize the IDD-free status of Member States in accordance with the existing criteria of UNICEF/WHO/ICCIDD, and in line with the recommendations of the regional meeting on "recognition of IDD-free status".
Oil fortification Participate jointly in the development of terms of reference for a regional technical committee (in line with the recommendation from the workshop on fortification of oil), comprising Member States, WHO, UNICEF, interested internationalhilateral organizations and representatives of oil producers and vitamin premix producers. Participate jointly in the preparation of a regional plan of action for the technical committee. The plan should include identification of mechanisms to reduce cost, create demand and a joint procurement policy for premixes. Flour fortification Develop jointly effective advocacy, social marketing and communications,strategies and skills to enhance and sustain flour fortification in countries and at the regional level,
subject to availability of funds. Support the deveIopment and upgrading of relevant legislation and food standards at regional, sub-regional and country levels, subject to availability of funds.
UNICEF to encourage country offices to make procurement services available for ensuring sustainable premix procurement for large, national scale fortification programmes.
Information and communications technology (ICT) Establishment of discussion groups and listservs. Access to intranets (extranet development). Video conferencing. Joint development/deployment of software. Sharing of databases (library, directories, mailing lists). Electronic publishing on the web and on CD-ROM. Sharing of calendars and plans of action. Sharing of telecommunications infrastructure in field offices.
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Annex 1
AGENDA Joint work planning and our respective calendars of annual events Level of representation in meetings Financing roles of region and country offices Joint couiltry support and project programme monitoring
Adolescent health and development IECItraining resource materials specially related to new areas of programming Expanded Programme on Immunization (EPI)
Polio eradication
MV/AIDS Maternal health Flour, oil, salt fortification and general micro-nutrient issues Child and adolescent health with
special
reference
to
UN
General
Assembly
Special Session on Children (UNGASS) Declaration
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Page 8 Annex 2
LIST OF PARTICIPANTS
Dr Thomas McDermott, Regional Director Ms Naheed Aziz, Deputy Regional Director Mr Jan Van Manen, Regional Planning Officer Dr Qussay Al-Nahi, Regional Health Adviser Mr Anis Salem, Regional Communication Officer Mr Emad El-Nimah, Project Officer, Programme Support Communications
Dr H.A. Gezairy, Regional Director Dr M.H. Khayat, Senior Policy Adviser to the Regional Director Dr M.A. Jama, Deputy Regional Director Dr A. Assa'edi, Assistant Regional Director Dr A. Saleh, former Deputy Regional Director Dr M.H. Wahdan, Special Adviser (Poliomyelitis) to the Regional Director Dr G Hafez, Special Adviser (Gender Issues) to the Regional Director Dr Z. HalIaj, Director, Communicable Disease Control Dr H. Lafif, Director, General Management Dr B . Sabri, Director, Health Systems and Services Development Dr A. Verster, Director, Health Protection and Promotion Support Dr N. Al-Shorbaji, Regional Adviser, Health Information and ~elecommunicat'ion Dr K. Bagchi, Regional Adviser, Nutrition and Food Safety Dr S. Farhoud, Regional Adviser, Child and Adolescent Health Dr A. Joukadar, Regional Adviser, Health Education Ur K. Mahaln~, Keglonal Adv~ser, Women's and Reproductive Health Dr E, Mohsni, Medical Officer, Vaccine Preventable Diseases and Immunization Dr J. Tawilah, Regional Adviser, A D S and Sexually Transmitted Diseases