Reproductive, Child, Adolescents Health and Nutrition Unit

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The unit’s aim is to strengthen the implementation of Regional Integrated Sexual, Reproductive Health and Rights initiatives and programmes by advocating for and facilitating the development, adoption, harmonisation and dissemination of policies, quality standards and guidelines for Sexual Reproductive Health and Rights (SRHR) priority issues, including gender health issues in the region.

Currently, the unit is implementing three (3) projects namely:

Invest in Adolescents: Building Advocacy Capacity in East Africa

This is a European Commission supported project, in the EAC Partner States, implemented in partnership with the Deutsche Stiftung Weltbevölkerung (DSW).

The overall objective of the project is to contribute to the improvement of adolescent and youth SRHR and ultimately, the achievement of the MDGs 3, 5 and 6 as well as promoting a holistic approach to SRHR in line with the principles of the International Conference on Population and Development (ICPD) and the ICPD+5 Programme of Action.

Specifically, the SRHR project aims at building the individual competences, collective capabilities and overall capacity of adolescent and youth serving Civil Society Organisations (CSOs) necessary to advocate effectively for the development and implementation of adolescent and youth sensitive SRHR policies, programs and budgets. The project recognises that adolescent and youth SRHR needs are poorly understood and their contribution to decision-making processes is minimal. Although in East Africa the young are increasingly involved in voluntary activities that promote both their development and that of their communities (e.g. as volunteers in health centres, home-based caregivers for HIV & AIDS patients and as heads of households), their involvement in decision-making processes and advocacy strategies remains nevertheless often token.

Because they lack the skills to articulate and communicate their needs, their understanding of and ability to contribute to local and national civic processes is limited. Involvement of knowledgeable and empowered adolescents and youth is crucial to strengthen SRHR. The project will achieve its objective through the following three main ways:

• Developing SRHR advocacy and funding capacity of adolescent serving CSOs through workshops and networking;
• Increasing Youth Organisation’s representatives’ capacity to comprehend, articulate and communicate their needs in order to contribute meaningfully to local and national civic processes through peer education programmes and trainings; and
• Building an enabling environment for networking, dialogue, and South-to-South learning and collaboration through a range of activities involving the three stakeholders.

The project works to ensure access of SRHR for all, including adolescents and youth by advocating for the scale up of cost effective interventions, political commitment that translates into policy and action, and availability of adequate resources. The project recognises the comparative advantage of adolescent and youth serving CSOs and therefore, focuses on building their capacity and enhancing their great potential and advocacy capacity to ensure that SRHR policies, programmes and budgets better reflect adolescent SRHR needs. In addition, the project also aims enhancing the capacity of adolescents and as well as decision-makers.

The project is expected to achieve the following results:

• 125+ adolescent and youth serving CSOs lobby more effectively for adolescent SRHR.
• 2000+ adolescents and youth are reached through peer education programs of 200 Youth Organisations. 250 young people are made into champions and leaders.
• Support for adolescent and youth SRHR needs by 250 decision makers is reflected in their policies and budgets.

East African Community – International Planned Parenthood Federation - United Nations Population Fund Collaboration

This collaboration involves the following three initiatives:

• Strengthening of Human Resource capacity of EAC Health Department;
• Review and implementation of SRHR Strategic plan; and
• Advocacy with the EAC Regional Inter-Parliamentary Forum on Health, Population and Development (EALA and EAC Partners States National Parliaments) plus EAC Sectoral Council of Health and forum of Ministers responsible for Social Development.

The Open Health Initiative

The third project under the Reproductive Health Unit is the Open Health Initiative whose overall goal is to contribute to the improvement of maternal and child health and ultimately, the achievement of the Millennium Development Goals (MDGs) 4 and 5 within the EAC Partner States.

More specifically, the objectives of this initiative are to promote innovative interventions and enhance access to data and information for better results, better tracking of resources and stronger oversight of results and resources for women’s and children’s health nationally and regionally within the EAC Partner States.

This regional approach could greatly serve to leverage the tremendous efforts already on-going across all countries in the region. For example, this regional initiative will:

1. Increase Value for Money: Across all EAC countries, numerous and often similar initiatives and pilots are being implemented to tackle MDGs 4 and 5. The high up-front investment costs (i.e. time spent designing an intervention, testing it, evaluating it) could be reduced if these were shared across the region: a successful intervention in one country could lead it to being more rapidly adapted and / or adopted in another country if shared appropriately. Though each country has indeed its own specificities, many of the challenges are nonetheless similar and we do need to ‘re-invent’ the wheel every time. Similarly, investments in new systems, tools, technologies could benefit from greater economies of scale, in particular in the areas of e-health.
2. Leverage Political Momentum: The ‘Open Health Initiative’ is also a way to increase political commitments, generate greater political momentum towards reaching MDGs 4 and 5, and raising the profile of some of the thematic areas beyond the health sector. Furthermore, in order to more quickly address some critical issues – such as greater transparency and accountability - the five EAC Partner States would stand to gain by speaking as one voice, both internally as well as when engaging with external partners.
3. Learn and Scale-up: All five EAC Partner States are making progress towards MDGs 4 and 5. At current rates, however, most will not reach these goals by 2015. This approach seeks to harness what has already been achieved in each country and leverage that across the region in order to accelerate scale-up. Networking, sharing of lessons learnt and facilitating scale-up could make a dramatic difference as the countdown to 2015 begins. Experience has taught us that such sharing and learning does not happen automatically: it must be facilitated and supported, something the EAC is well positioned to do.

In this initial phase of the ‘Open Health Initiative’, the EAC Secretariat will work with all EAC Partner States to develop a robust ‘Open Health Initiative’ Strategy, supported by concrete and costed implementation plans across all three thematic areas. A particular focus will be placed on developing a regional e-health strategy in order to accelerate advances made by several countries already such as Rwanda and Kenya. In consultation with all EAC Partner States, the EAC Secretariat will also design a platform and mechanisms that will enable all EAC Partner States to more actively and constructively share best practices and lessons learnt in order to accelerate the achievement of MDGs 4 & 5.

Medicines and Food Safety Unit

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The Medicines and Food Safety Unit aims to “ensure a high level of consumer protection and restore and maintain confidence in the quality and safety of medicines, food and health products”.

The unit’s main objective is “to develop and facilitate implementation of regional policies, regulations strategies, guidelines and standards to enhance affordability, quality, efficacy and safety of human and veterinary medicines as well as ensure food safety in the EAC Partner States”.

The Medicines and Food Safety Unit is currently implementing the EAC Medicines Registration Harmonization (MRH) Project. This project is part of the African Medicines Registration Harmonisation (AMRH) Programme created to assist African countries and regions to respond to the challenges posed by medicines registration.

AMRH seeks to support African Regional Economic Communities and countries in harmonising medicines and aims “to improve public health by increasing rapid access to good quality, safe and effective medicines by reducing the time taken to register essential medicines for the treatment of priority diseases”.

The rationale for medicines harmonisation is based on the fact that most African countries implement disparate medicines regulatory regimes which lead to a lot of duplication of efforts and wastage of scarce resources and in turn, hamper the delivery of quality healthcare.

Drug regulatory harmonisation is, therefore, a desirable goal as it will effectively lead to:

• Quicker access to affordable, priority essential medicines of assured quality for patients;
• Improved public health outcomes;
• More effective medicines control by the strengthened national drug regulatory authorities;
• Improved procurement practices for securing priority medicines; and
• Cost efficiency for governments.

The EAC Medicines Registration Harmonisation (MRH) Project

The EAC MRH Project is supported by the World Bank and is part of the global effort to harmonise medicines regulations. It is envisioned that the following benefits will accrue from the implementation of the EAC MRH Project:

• Harmonised registration dossier format and technical requirements;
• Increased technical capacity and efficient use of resources;
• Increased applications for registration from manufacturers;
• Cost savings;
• Greater access to good quality and affordable medicines; and
• Greater impact on efforts towards reaching the Millennium Development Goals (MDGs) with regards to the three health-related MDGs (4 = to reduce child mortality, 5 = to improve maternal health and 6 = to combat HIV/AIDS, Malaria, and other diseases).

HIV & AIDS Unit

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Throughout East Africa, the HIV/AIDS pandemic has resulted in shortened life spans, increasing numbers of orphans, fewer people in the age cohort which can support both the older and younger dependent populations, as well as changes in household size and household structure.

Workers affected include both males and females, and particularly those who have advanced education or technical training.

Rural and urban areas have not shown the same patterns of changes, especially with regard to gender roles. Poverty, minimal health facilities and lack of education have all been blamed for the on-going changes.

Changes in household composition and in cultural practices are evident. Some can be attributed directly to the increased mortality and morbidity, but at the same time some have grown out of increasing global connectiveness, both in communication and transportation, as modernisation with increasing urbanisation and industrialisation has begun to spread throughout less developed areas.

The EAC HIV & AIDS Unit is responsible for managing activities related to HIV & AIDS. The Unit provides leadership, coordination and management of EAC’s regional response to HIV & AIDS, guided by the EAC Regional Integrated Multi-Sectoral HIV & AIDS Strategic Plan (2007–2012).

This strategic plan is under implementation with support of the International Cooperating Partner HIV & AIDS Group consisting of the Swedish International Development Cooperation Agency, Irish AIDS and UNAIDS.

The programme is managed by the EAC Secretariat and implemented through the National AIDS Control Councils, National AIDS and STI Control programmes and the Ministries of Health in the EAC Partner States.

The goal of the HIV & AIDS Programme is “to reduce incidence of HIV infection in the East African region in order to secure sustained socio-economic development in the EAC region”.

The programme aims “to attain a healthy population and mitigate the impact of HIV and AIDS among the infected and affected population through coordinated and harmonised efforts in East Africa”.

Strategic Objectives

The EAC HIV & AIDS Programme had eight (8) strategic objectives namely:

1. To enhance the institutional capacity of the EAC Secretariat so as to secure effective implementation of regional and national responses to HIV & AIDS;
2. To mainstream HIV & AIDS in the EAC Organs, Institutions and Sectors;
3. To improve the effectiveness of interventions through the harmonisation of EAC Member States’ HIV & AIDS protocols, policies, plans, strategies and legislation;
4. To improve the design and management of regional responses to HIV & AIDS through the generation of and easy access to strategic information and knowledge on the epidemic;
5. To scale-up regional and national responses to HIV & AIDS through the strengthening of political leadership and commitment towards addressing the epidemic;
6. To consolidate effective partnerships among strategic partners both within and outside the EAC region in response to HIV & AIDS;
7. To improve the work environment by developing and operationalising an EAC Workplace Policy on HIV & Aids; and
8. To strengthen regional responses to mitigate the effects of vulnerabilities related to HIV & AIDS that result from internal and cross-border population mobility within the East African region through harmonised responses and interventions by various multi-sectoral stakeholders.

The programme has also put its focus on the following key issues:

• Harmonisation of EAC Partner States HIV & AIDS policies, laws, protocols, guidelines and strategies.
• Accelerating responses to reduce spread and mitigate the impact of HIV & AIDS in the cross-border areas, with focus on the mobile populations and other most-at-risk populations.
• Generating and sharing information and knowledge on HIV & AIDS in the region to influence HIV & AIDS programming, policy and change in the EAC region.

East African Integrated Disease Surveillance Network

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The East African Integrated Disease Surveillance Network (EAIDSNet) is a regional collaborative initiative of the national ministries of the EAC Partner States responsible for human and animal health in collaboration with the national health research and academic institutions. The project is implemented with support from the Rockefeller Foundation and the main objectives of the initiative are to:

• Enhance and strengthen cross-country and cross-institutional collaboration through regional coordination of activities for the prevention and control of both human and animal (zoonotic) diseases under the “One Health” Initiative;
• Promote exchange and dissemination of appropriate information on Integrated Disease Surveillance and other disease control activities;
• Harmonise integrated disease surveillance systems in the region;
• Strengthen capacity for implementing integrated disease surveillance and control activities; and
• Ensure continuous exchange of expertise and best practices for integrated disease surveillance and control.

The overall goal of the project is to reduce morbidity and mortality due to common communicable diseases in the East African region through the establishment of a strong network capable of generating useful epidemiological information for early warning of impending epidemics as well as supporting joint planning and implementation of disease control measures.

Structure

Under the auspices of the East African Community (EAC), the EAIDSNet structure delineates the organisational system under which it is being implemented.

The EAIDSNet Steering Committee provides direction to the Network by:

• Approving and monitoring the implementation of the Network’s plan;
• Approving the terms of reference and monitoring the activities of Technical Working Groups; and
• Approving the addition of new institutions / organisations to the Network.

Strategies of the EAIDSNet Network

The implementation of the Network activities utilises several strategies which include:

• Strengthening National Disease Surveillance Systems through the establishment of National Networks which involve all stakeholders including the research community, disease control groups from the Ministry of Health, non-governmental organisations and public health associations;
• Focusing attention on priority diseases for surveillance identified by the Network in order to enhance utilisation of epidemiological information and preventive methods thus developed;
• Strengthening border district capacities for data management as well as capacity to recognise impending epidemics and setting the support systems early enough;
• Enhancing synergistic actions in response to epidemics and the development of functional alarm systems;
• Promoting use of Geographical Information System in disease surveillance by securing training courses and funds on behalf of the health staff; and
• Functioning and implementing Network activities through and with support from the EAC.

EAIDSNet Achievements

Some of the achievements registered since the establishment of EAIDSNet include:

• Establishment of mechanisms for disease surveillance and control in each EAC Partner State;
• Identification of priority diseases for surveillance in each country;
• Establishment of strong links between research, control, and policy and decision makers;
• Each country is in the process of finalising and testing disease surveillance guidelines;
• Each country has identified an operational focal point and activities related to disease surveillance and control;
• The network has an established coordinating mechanism; and
• Production of a Newsletter.