THE FIRST ANNUAL REPORT OF THE OFFICE OF THE COUNSELLOR MEDICAL AT THE PERMANENT MISSION OF THE REPUBLIC OF KENYA TO THE UNITED NATIONS AND OTHER INTERNATIONAL ORGANIZATIONS IN GENEVA, SWITZERLAND
Additional financial resources are needed to help excluded people gain access to ftindamentaI social rights such as food, basic healthcare, and access to safe drinking water and education for all. Official development assistance, which developed countries have committed to scaling up to 0.7% of GDP, has increased over the last few years. But it will continue to be insufficient to raise the sums required. Therefore, new innovative financing mechanisms, such as UNITAID and Advance Market Commitments (ANC have been put in place and many more are expected to be put in place to raise additional resources to finance basic healthcare needs for the most vulnerable people in the world.
Every year global wealth grows by around two thousand billion euros. It is noted that additional sums required to meeting the Millennium undertakings have been evaluated at 100 billion euros annually, which is only 5% of the Increase in global wealth! What is lacking is a sustainable mechanism to redistribute some of this wealth to the less fortunate human beings in the world’s poor. The Health office in Geneva puts Kenya in a position to better leverage on new opportunities to access international development assistance in health for all Kenyans, in addition to providing effective leadership in health in Africa.
Dr Tom Mboya Okeyo MBchB MPH COUNSELLOR MEDICAL
1. The Government of Kenya established the Office of Counsellor Medical at the Permanent Mission of Kenya in Geneva in May 2006. The Office coordinates Kenya’s relations with the World Health Organization, UNAIDS, The Global Fund to Fight AIDS, Tuberculosis and Malaria, GAVI Alliance, UNITAID and other international organizations working in health. Geneva is the headquarters of these health agencies.
2. Global health security, particularly HIV/AIDS, poses one of the greatest challenges to the security of nations as it can compromise a country’s stability and security, and requires the concerted responses and collaborative efforts of the international community.
3. Kenya is a member of the Executive Board of the World Health Organization and also a member of the Programme Coordinating Board of the Joint United Nations Programme on Human lmmunodeficiency Virus/Acquired Immunodeficiency Syndrome (UNAIDS).
4. Health experts from Kenya are regular visitors to Geneva, where they participate in several expert consultations on health matters. Effective preparations for the Health Assembly, the Executive Board, UNAIDS Board and other important health meetings was often inadequate due to lack of prior knowledge and understanding of the views of other stakeholders within the context of multilateral health diplomacy.
5. Kenya also lagged behind in accessing new international resources for health.
6. The Geneva-based health office has improved the efficiency and effectiveness of the Ministry of Health in taking advantage of new Global health initiatives with the view to improved participation in decision making at global level and mobilising additional resources to fund priority health needs of all Kenyans.
7. Ensuring effective follow-up on decisions agreed on between the Minister for Health, the Permanent Secretary and the Director of Medical Services with Heads of Health Agencies in Geneva is a priority activity of the Office of Counsellor, Medical. The Global Fund disbursed USS 80 mIllion to Kenya between May 2006 and end-June 2007
8. HIV/AIDS, Tuberculosis and Malaria programmes in the Ministry of Health received a boost of US$ 80 million dollars between May 2006 and end of June 2007 disbursed from the Global Fund to Fight AIDS, tuberculosis and Malaria. The release of these funds involved sustained formal and informal meetings between The Global Fund management with the Geneva based health officer together with the Ambassador / Permanent Representative.
9. These additional resources have enabled the Government to provide effective treatment for malaria in all public health facilities and to provide adequate anti-tuberculosis drugs to all health facilities. In addition the resources have ensured uninterrupted supply of anti-retroviral drugs to 42,000 Kenyans on treatment.
10. Thus, the additional resources has made it possible to implement the political decision by His Excellency President Mwai Kibaki to provide free treatment for HIV/AIDS, Tuberculosis and malaria in all public health institutions in Kenya.
 Strategy for sustainable anti-retroviral financing In Kenya developed
11. The Geneva office has coordinated High-level WHO led interagency mission to Kenya which has assisted the Ministry of Health to develop a sustainable financing strategy and plan for anti-retroviral treatment in Kenya. The strategy provides for among others, in the medium term, the mobilisation of additional resources from the Global Fund Round 7 call for proposals.
12. Following this mission, high level meetings have been held in Geneva to sensitize The Global Fund, UNAIDS, UNITAID, the European Commission and the World Health Organization on the critical and urgent need for additional resources for Kenya HIV treatment programme.
13. The 20 UNAIDS Board Meeting in Geneva has decided to commission an independent study to identify sustainable financing mechanisms for F-IIV/AIDS. This resolution was sponsored by all African countries and adopted by UNAIDS Board by consensus.
14. World He3lth Organization Director-General, Dr Margaret Chan visited Nairobi and paid a Courtesy Call on His Excellency President Mwai Kibaki. She reiterated the commitment of WHO to support the Government health programmes. UNAIDS Executive Director Dr Peter Piot also visited Kenya. The Permanent Mission of Kenya in Geneva coordinated these visits.
 UNITAID agreed to underwrite anti-retroviral drug needs for all children In Kenya
15. IJNITAID, which is a new international drug purchase facility to accelerate access to high-quality drugs and diagnostics for HIV/AIDS, malaria and tuberculosis in selected countries has included Kenya in the list of selected beneficiary countries. The Executive Secretary of UNITAID has confirmed to the Permanent Secretary, Ministry of Health, the commitment by UNITAID to finance through the Clinton Foundation all the anti-retroviral drug needs for children in Kenya (this means close to I 0O% coverage compared to the Global coverage of I 8% on the same).
16. UNITAID will also contribute some of the second line anti retroviral drug needs for Kenya. The presence of the Geneva office has made it possible to develop effective working relationship with UNITAID management and the Board for the benefit of all Kenyans.Strategy for sustainable financing of reproductive health services In Kenya.
17. The Office has coordinated a second high-level Mission from the World Health Organization Headquarters to Kenya to assist the Ministry of Health strengthen reproductive health services. The mission developed a strategy for sustainable financing of reproductive health services in Kenya.
18. Dr Margaret Chan, the Director-General of the World Health Organization has decided that Kenya be a beneficiary of the New Norwegian Fund to WHO for maternal and child health activities (MDG 4 and 5). She announced this in a meeting with the Kenya delegation to the Sixtieth World Health Assembly in May 2007.
19. Kenya has participated in the development of the final Global Business Plan on MDG 4 and 5 which will be launched in New York in September 2007 as part of the UNGAS activities.
 Improved relations with GAVI Alliance
20. The Geneva office has improved communication with the GAVI Alliance. The Executive Secretary has recognized the important role the office has played in improving relationship between his organization and the Ministry of Health. GAVI Alliance has committed sufficient resources to finance enough vaccines for Kenya immunization programme up to the year 2010.
21. The Ministry of Health has also submitted a proposal to GAVI Alliance on health systems support. Kenya elected Coordinator of Africa Group on health matters.
22. Communication between the Health agencies based in Geneva and the Ministry of Health has greatly improved. Kenya’s visibility in all major health meetings has been enhanced and respected. The 53 Member States from Africa have elected Kenya their Coordinator on health matters.
23. The Office has enabled Kenya to play a leadership role in
Public Health, Research and Intellectual Property Right and in the implementation of two Health Treaties — the InternationalHealth Regulations (2005) and the Framework Convention on Tobacco Control.
 Harmonization with Kenya Vision 2030
24. Kenya Vision 2030 aims at creating a globally competitive and prosperous Nation with a high quality of life by 2030. Quality of life, and therefore the health of the Nation is fundamental to the realization of the three pillars of Vision 2030, which are:
• The Economic aspiration — sustaining economic growth of 10% per annum
• The Social aspiration — creating a just and cohesive society and
• The Political aspiration — creating an issue-based, people centred, result-oriented and accountable democratic political system
25. Ensuring access to quality healthcare by the population has been the ignition for the engine that has propelled newly industrialized nations. Kenya is on the road to joining this club.
26. Healthy Nation comes first before economic prosperity, It is only healthy people who can work hard and spar sustainable economic development.
HEALTH AND FOREIGN POLICY
27. Globalisation, Climate Change, impact of new and re-emerging diseases such as SARS, Avian Flu Pandemic, Extensively Drug- Resistant Tuberculosis, HIV/AIDS and Malaria have given health policy objectives new impetus. New international Instruments for solving global health problems such as the International Health Regulations (2005) Treaty and the WHO Framework Convention on Tobacco Control Treaty are taking centre-stage in the fight against disease and re-engineering the role of multi-lateral organizations.
28. The International Health Regulations (2005) Treaty, which comes into force on June 1 5, 2007 legally bind all Member States to implement actions which are of public health interest but have direct consequences on travel, trade and foreign policy in case of an international public health emergency.
29. The WHO Framework Convention on Tobacco Control (WHO FCTC), the first treaty negotiated under auspices of the World Health Organization developed in response to globalisation of the tobacco epidemic entered into force on January 2005, 90 days after it was acceded to, ratified, accepted, and approved by Member States.
30. Health, trade and environment policies are contributing to reforms of Foreign Policy oblectives in all countries. AR FOR cOLLABoRATION AND PARThERSHIPS WITH OTHER MULTI-LATERAL AGENCIES IN THE PERMANENT MISSION OF KENYA, GENEVA SWITZERLAND Specialised area Organization Mission Partner
1. TRIPS and Public Health
World Trade Organization
Trade Attaché, Ministry of Trade and Industry
2. Social protection in health (Social Health Insurance Objectives)
International Labour Organization
Ministry of Labour and Human Resources
Kenya Intellectual Property Institute
3. Traditional Medicine
World Intellectual Property Organization
4. Right to health
United Nations Human Rights Commission
Ministry of Foreign Affairs Focal Points
5. Health and humanitarian Emergencies
International Red Cross and Red Crescent Organization,
United Nations High Commission for Refugees,
United Nations Office in Geneva
Focal Point, attaché, Office of the President.
 SUGGESTED FUTURE ORGANISATION STRUCTURAL REFORMS TO INCREASE
EFFICIENCY AND EFFECTIVENESS OF THE HEALTH DEPARTMENT IN THE
PERMANENT MISSION OF KENYA IN GENEVA
Head, reporting to the Ambassador/Permanent Representative on administrative matters; reporting to Permanent Secretary/Ministry of Health and the Director of Medical Services on technical matters.
Deputy Head of Department (2 positions), one responsible for United Nations General Assembly Health matters (preferably be based in New York) and the second Deputy responsible for managing partnership with other multi-lateral organisations (WTO, ILO, WIPO etc).
Provide adequate transport and support staff
TARGETS HARMONIZED WITH VISION 2030
1. Mobilise additional international resources through public private partnerships for health sector in Kenya — US$ 360 million by 2010
• No. of successful proposals submitted to donors
• No. of health resource mobilisation strategies developed
• No. of disbursement requests funded by Global Fund, GAVI, and UNITAID
2. Improved Kenya leadership in international health dialogue and policy formulation
• Reports of World Health Assembly and WHO Executive Board meetings
• Reports of UNAIDS Board Meetings and other global health meetings
• Effective coordination of the Africa Group on health matters
3. Work towards integration of health tourism to increase total visitor arrivals to Kenya
• Number of international health conferences/meetings held in Kenya
• Number of visitors attending the international health meetings
Additional financial resources are needed to help excluded populations gain access to fundamental social rights such as food, basic healthcare, and access to safe drinking water and education for al I. Official development assistance, which developed countries have committed to scaling up to O.7% of GDP, has increased over the last few years. But it will continue to be insufficient to raise the sums required. Therefore, new innovative financing mechanisms, such as UNITAID have been put in place and many more are expected. Every year global wealth grows by around two thousand billion euros. It is noted that additional sums required to meeting the Mfllennium undertakings have been evaluated at 100 billion euros annually, which is only 5% of the increase in global wealth! What is needed is a sustainable mechanism to redistribute this wealth to the less fortunate members of Global Community. The Health office in Geneva puts Kenya in a position to better leverage on new opportunities to access international development assistance in health for al Kenyans, in addition to providing leadership in health fn Africa.
DR TOM MBOYA OKEY0 MD MPH