Initiative: Great Lakes.

The World Health Organization (WHO) and five countries of the African Great Lakes region - Burundi, the Democratic Republic of the Congo, Rwanda, the United Republic of Tanzania and Uganda - have recently signed in Kigali a protocol to intensify regional cooperation for the improvement of health of their population, especially the prevention and control of epidemics and poliomyelitis eradication.

During a two-day meeting, senior experts from different countries addressed the main health problems of the general population, particularly in the internally displaced and refugee camps. More emphasis was put on epidemic-prone diseases due to the conditions in these countries, where 10 per cent of the population are refugees or internally displaced persons living in highly overcrowded conditions and very poor sanitation. This population deserves a particular attention, as well as the local host population.

The diseases of major concerns in the Great Lakes region included cholera, meningitis epidemic, bacillary dysentery, typhus, plague, measles and malaria. The issue of accelerating poliomyelitis eradication efforts was also discussed and intercountry collaboration was pointed out as a unique and good opportunity to simultaneously organize national immunization days.

It was agreed upon that partnership development and inter-agency cooperation is needed more than ever. No single agency can effectively control epidemics alone.

Intercountry cooperation is very important in dealing with identified problems at individual country level. Experts have developed a protocol of cooperation that covered the main areas, including the creation of intercountry contingency stocks of drugs and vaccines, the establishment of an intercountry technical support team, standardization of case management, improvement of water supply and sanitation, joint operational research on health problems of common interest, simultaneous organization of national immunization days to eradicate poliomyelitis in the region and regular meeting of health officers from neighbouring districts in order to facilitate exchange of information. The protocol has also been translated into a series of activities to be undertaken during the next three years.

The protocol of cooperation, along with the plan of action, have been discussed by the Ministers of Health during their two days meeting and signed on 15 August. The key elements in their implementation are: strengthening epidemiological surveillance; strengthening national and regional laboratory network; and improvement of the communication system.

A catalytic budget estimated at $2.5 million will be needed to implement the intercountry activities for the next three years. WHO representatives have been requested to mobilize additional funds and support the implementation of the plan of action without delay. Each national government, each non-governmental organization and each technical partner have a critical role to play for the implementation of the plan of action and all partners were invited to support country efforts towards the improvement of the health status of the population and especially the prevention and control of epidemic-prone diseases.