WORLD HEALTH ORGANIZATION

HORN OF AFRICA INITIATIVES

The Horn of Africa countries (Djibouti, Kenya, Eritrea, Ethiopia, Somalia, Sudan and Uganda) face common crises with similar hazards and vulnerabilities, including drought, floods, environmental degradation, land pressure, armed conflicts, acute food shortages and mass displacements, not to mention chronic underresourcing and lack of access to any health services for vast numbers of people.

Although the crises affects all areas, death from starvation and disease is most severe in frontier and remote areas because the majority of national and international resources are concentrated in the capitals and in central areas. The remoteness of many communities living near international borders and their prevalent pastoralist life style makes it difficult to provide primary health care, including preventative services. The social integrity, safety and “health security” of border communities and “border crossers” are widely neglected and relegated to a marginal position in the development agenda. Armed conflicts are commonplace in border areas and, in fact, no country in the Horn of Africa has escaped this fate. Environmental degradation and land pressure, compounded with droughts and floods, are also common features.

To alleviate this burden, collaboration, co-ordination, innovative projects and flexibility amongst bordering countries has to be promoted and developed. WHO began the Initiative in 1996 after the First Conference on Public Health in the Horn of Africa, a conference jointly organized in 1996 by WHO and the Government of Italy to combat the neglect of these vulnerable populations. By focusing on common problems and working on health-related issues in early warning, community emergency preparedness and response, food security, conflict mitigation and peace-building activities, the Initiative was intended to offer substantial opportunities for shifting the focus of activities in these critical and postconflict situations from emergency work to rehabilitation and development.

In March 1998, the Health Ministers of the HOA countries signed a Protocol of Cooperation, which sought to address cross-border health problems. WHO was asked to facilitate the implementation of the provisions of the Protocol.

WHO established the Horn of Africa Initiatives (HOAI) to implement the recommendations of Health Ministers. The main objectives of the Initiatives are to foster collaboration among border districts in polio eradication and surveillance and control of communicable diseases such as HIV/AIDS, tuberculosis, Malaria and diarrheal diseases.

In the first phase of the HOAI, four cross-border sites (Ethiopia-Somalia, Ethiopia-Djibouti, Ethiopia-Kenya and Ethiopia-Sudan) were selected. Cross-Border Health Committees (CBHCs) were established and joint activities were organized. Capacity building, in terms of provision of equipment and instruments, training in management and control of communicable diseases, were also implemented. In the area of polio eradication, synchronization of national immunization days (NIDs) and exchange of health teams and vaccines at border districts were also initiated.

In July 2001, WHO/HQ, Regional Offices and WHO Representatives of the HOA countries evaluated the Initiative implementation. The main outcomes of the meeting were to extend the HOAI activities for five more years and integrate it with the regular activities of the WHO and ministries of health. The main focus of the Initiative will continue to be:

  • Strengthening health services at border districts
  • Polio eradication and surveillance and control of communicable diseases at cross border level
  • Strengthening of communication network of border districts and exchange of information on epidemics
  • Promotion of health activities as bridge for peace

The implementation of the activities, WHO collaborates with all UN agencies that have activities at border areas. The partners in the HOAI are UNDP, UNHCR, UNICEF, WFP and the World Bank. Moreover, at each border site, NGOs with projects related to HOAI objectives also contribute.

Since 1996, WHO is in contact with the Inter-governmental Authority for Development (IGAD) to establish collaboration in the field of health. Both organizations have signed a protocol of cooperation. The goal of the cooperation between WHO/HOAI and IGAD is to encourage and support the latter to form a Health Desk.

Address:

Horn of Africa Initiative

WHO Office/ECA Building

P.O. Box 3069

Addis Ababa, Ethiopia

Contact Persons:

Dr Michele Jancloes, EXD/WHO Representative, Ethiopia ()

Dr Alessandro Loretti () and Dr Lianne Kuppens (), WHO/EHA, Geneva

Dr Abdullahi M. Ahmed, HOAI Coordinator, Addis Ababa ()