by Dr Rick Brennan, WHO Director of Emergency Operations
Oslo, Norway 24 February 2017
As several speakers have noted today, while there are enormous food security, nutrition and protection dimensions to the crisis in the Lake Chad Region, this is also a public health crisis, with rates of death, malnutrition and disease rarely seen over the past 20 years.
In Nigeria and the Lake Chad Region, lack of qualified health workers, essential medicines and the destruction of medical facilities hamper the delivery of lifesaving health care. Widespread food insecurity and malnutrition are associated with severe health consequences. As you know, malnutrition lowers the body’s capacity to fight infection – a malnourished child is far more prone to contract an infectious disease such as pneumonia, diarrhoea and measles – and then to die from that disease. As one of our local staff in Niger said to me once – between malnutrition and death, there is always disease.
All four countries in the Lake Chad Region have similar health priorities: rapidly expanding access to a package of essential health care – including child and reproductive health; boosting immunization rates; preventing, detecting and responding to disease outbreaks; effectively treating malnutrition and its consequences. We also must address psychosocial problems, sexual and gender-based violence, and violent trauma leading to physical injuries. Together, health sector partners seek to help 8.2 million people this year.
The most urgent needs are in north-eastern Nigeria, particularly Borno State. This is the heart of the Lake Chad Region crisis, where at least 6.9 million people, including 1.8 million internally displaced persons, urgently need the expansion of life-saving health services.
In Borno State, people in many communities have not received any form of health care in years due to conflict. A major health assessment by WHO found that 60% of health facilities are not functional. Of those facilities that are still functioning, only a modest proportion is supported by one or more of our 18 health sector partners. We invite more partners and ask for more resources to expand the response, and we know other sectors face similar capacity constraints.
Over 2016 there were serious outbreaks of measles and polio – in fact, the eradication of polio in Africa, and globally, is threatened by the crisis in Northern Nigeria. The risk of further disease outbreaks is compounded by weak surveillance networks and the limited capacities of outbreak alert and response. This also highlights the importance of a sub-regional approach for disease control across the four affected countries.
The situation is grave, but progress is being made. We are inspired by the spirit and resilience of the communities that we serve and we are doing what we can, where we can with the limited resources we have.
When local responders, WHO and health sector partners gain access, we see results. Government authorities are key to securing that access. Together we are operating over 100 mobile medical teams across Borno State that are providing life-saving services to the most vulnerable countries. We have increased disease surveillance to 160 sites covering 85% of internally displaced persons. Working with the governments, UNICEF and partners, together we vaccinated 10 million children across the region against polio and 4.7 million people against measles.
We need rapid disbursement of humanitarian funds and sustained commitments from partners to expand our impact. But during 2016, the health sector received only 32% of all requested funds across the region, including 22% for northern Nigeria. In 2017, the health sector has collectively appealed for US$ 125 million for the region. We can only hope that an appropriate proportion of the pledges committed today will be directed to health partners
Finally, we have repeatedly heard from speakers over the past two days that we must address the underlying causes of the crisis. No one appreciates this better than the health sector – where the principle that prevention is better than cure is one of our greatest truisms. Perhaps this can be the guiding principle that we apply collectively, as we commit to moving from providing humanitarian assistance to promoting integral human development in the Lake Chad Region and beyond.