Delivered during the 14th Annual PIRMCCM Meeting

Message from Dr Liu Yunguo
WHO Representative for the South Pacific
Director, Pacific Technical Support (DPS)
10 April April 2014
Nadi, Fiji

Acting Madam Chair of PIRMCCM, Mr Enkhjin Bavuu, Senior Fund Portfolio Manager, South & East Asia Global Fund Dr Paula Vivili, SPC Acting Director of Public Health Country representatives and colleagues,

Good Morning!

It is a privilege for WHO to address annually PIRMCCM colleagues working on different capacities across the three different programmes. It is a particular pleasure for me to meet you and attend this meeting for the first time.

As a new person in the PIRMCCM group, I am here to listen and learn, and contribute as much as I can to this meeting and collaborate with you in the three programs and health system strengthening in future.

Thank you for allowing me to share my views with you:

Firstly, we would like to express our gratitude for the Global Fund support that marked important milestones in many countries, including the Pacific. Same level of gratitude to all our development partners country colleagues including civil society who continuously ensures that people in need are receiving prevention, treatment, care and support services for STI, HIV, TB and Malaria. Thus, any changes that bring about uncertainty or unpredictability to these funding support will destabilize existing programs across all countries.

Secondly, I want to raise a set of questions, which are challenges we have to address jointly.

For STI and HIV, there is a need to intensify the quality and reach of STI and HIV prevention programmes for general population and also place emphasis on neglected most at risk groups to reduce new cases of STI and have zero new HIV infections in the Pacific.. Keep in mind that sexual transmission is still the primary mode of transmission in the Pacific. It is just a matter of time before we see prevalence on HIV escalating. We need to raise the urgency bar now to talk about this concern. My first question: what will be the appropriate strategies and approaches, including design for a sustainable financing for high STI and low HIV epidemic scenario in the Pacific setting?

TB epidemiology presents very different scenarios across pacific island countries. There are countries with an estimated incidence as high as Sub-Saharan Africa. There are moderate burden countries where somehow TB seems impacting mostly among high risk groups, and there are countries with a burden comparable to Europe and Australia. The burden of drug-resistant TB seems to be low, however, not all the patients have access to diagnosis for drug resistance. My second question: how do we better address the needs of countries with such different scenarios. To be able to support especially high burden countries while promoting action to reduce significantly the incidence in moderate burden countries and finally sustain capacity in countries seeing one or two TB cases per year and HIV/TB co-infection

Malaria program of Solomon Islands and Vanuatu received significant financial investment to intensify their interventions and move towards malaria elimination in the future. Throughout the last ten years of investment, significant impacts in reducing the annual malaria incidence for these two countries were made. These impacts resulted from universal access to vector control interventions and effective diagnosis and treatment services. My third question: What should these two countries do to strengthen their resource mobilization efforts and mutually agree on options that will mitigate the impact brought about by the reduction in the over-all investment of GF and the changes in the funding architecture for the next two years.

Colleagues and friends, now that funding windows are narrowing, it is imperative that all programme planners, managers and decision-makers review the progress made by countries in achieving their goals and targets; re-assess programme directions, strategies and focus, and develop new approaches that are truly tailored to the Pacific context.

Therefore, my 4th question is, are we looking closely to the uniqueness of the Pacific? As we gear towards Universal Health Coverage, we are aware of the fact that the delivery of services in geographically isolated small islands is always challenging and costly. To ensure that services are available, accessible, affordable, acceptable and of good quality, we need to invest more in strengthening the health systems.

It is time to look at the Pacific setting more closely; and tailor the programming, the management style and the funding mechanism accordingly. We have to be cautious when suggesting to the Pacific to shape their actions according to the models developed for bigger countries.

My final message is, put people at the center of our work. The bottom-line in doing all these programmes is for our beneficiaries. Looking through the perspective of the beneficiaries, the people we want to serve. Rights-based programming, gender-mainstreaming and health equity are core guiding principles in all of our policy development and program planning.

Reiterating as my closing words, all of our decisions should result in ensuring uninterrupted access to prevention, treatment, care and support services for the people in the pacific.

Let’s work together, with our wisdom, enthusiasm and cooperative spirit, to address these challenges innovatively.

Thank you.