Strengthening international co-operation

Five-year objectives

• Support initiatives linked to the concept of the African Renaissance including co-ordination of the SADC Health Sector.
• Fulfil commitments made in terms of international conventions, treaties and agreements, including decisions of the United Nations agencies to which the Department is party.
• Consolidate and review bi-lateral and multi-lateral health agreements and expand agreements, especially with developing countries and multilateral agencies.

Key objectives for 2001/2

• Maintain quality of support for SADC health sector.
• Contribute to drafting of plans for New Partnership for Africa’s Development.
• Commence sector preparations for World Summit on sustainable Development.
• Participate in forums critical to strengthening response to major developing world diseases.
• Align new bilateral agreements with spirit and requirements of Nepad.

The leadership of the Minister of Health is a critical dimension of this priority area. In 2001/2 Dr Tshabalala-Msimang undertook a full programme of travel to targeted events and selected countries. She also hosted several important visits and international meetings, some of which are described below. The advisors to the Minister also play a substantial role in supporting her international activities.

SADC Health Sector

The objectives are to strengthen regional health sector development through co-operation in five priority areas defined by SADC Health Protocol, namely:

• HIV, AIDS and STIs.
• Reproductive health.
• Standardisation of health information and surveillance systems.
• Communicable disease prevention and control.
• Mobilisation of resources – especially financial and human resources – to implement the protocol.

Activities during the year took account of the restructuring of SADC institutions and the forthcoming absorption of the Health Sector into the new Directorate for Social and Human Development and Special Programmes. Planning was geared at ensuring continuity of joint initiatives and redeploying personnel from the SADC Health Sector Coordinating Unit, based in the Department in Pretoria, into the Department’s International Health Liaison section.

The SADC Health Sector held its major strategic planning session in October 2001 in Swaziland.

The SADC programme on HIV and AIDS was strengthened through the recruitment of two project managers. A special focus during the year was the integrated management of HIV, AIDS and TB. Programme managers for tuberculosis and HIV from across the region met to exchange approaches, identify training needs and develop a framework for addressing them.

Activities to raise awareness about malaria were coordinated in eight SADC member states. November 9 was observed as SADC Malaria Day and all countries used the same promotional materials. As mentioned earlier in this report, a multi-national malaria control programme has been developed with Swaziland and Mozambique.

Nepad

The Department participated actively in drafting health aspects of the Nepad document, which are contained in the section on human development. The health proposals accord equal weight to strengthening health systems and achieving results in terms of health status.

Focus areas are:

• Strengthening disease control programmes.
• Securing the health system.
• Supporting sectoral development.
• Enabling personal action to improve health.
• Focusing on the poorest and most marginalized.
• 4Securing sustainable financing.

International commitments

From the section on Reducing mortality and morbidity it will be clear that the Department takes seriously its commitment in terms of global health targets set by the WHO – as in the polio eradication programme, Stop TB and Right to Sight.

Tobacco control

The Department, with leadership from the Ministry, continued to participate actively in the development of the WHO Framework Convention on Tobacco Control. South Africa participates in the international bureau co-ordinating this initiative and attended all major regional and international consultations held. The Framework Convention will not only set minimum standards for tobacco control for signatory nations but also will also address responsibilities in relation to international aspects of control – such as smuggling of tobacco products.

HIV, AIDS and communicable diseases

In relation to the HIV and AIDS epidemics, there were a number of key international consultations during the course of the year and the Minister of Health, her office and senior officials of the Department participated in all of these.

In April 2001, the Abuja Summit of African heads of state concluded with the Abuja Declaration on HIV,AIDS, Tuberculosis and Other Related Infectious Diseases. This constituted a commitment by the signatories to “place the fight against HIV,AIDS at the forefront and as the highest priority in our respective development plans” and a challenge to donor countries to “complement our resource mobilisation effort to fight the scourge of HIV,AIDS”.

In June 2001, the United Nations General Assembly held its special one-week session on HIV and AIDS.

Shortly afterwards, UN Secretary-General Kofi Annan announced the formation of the Global Fund to Fight HIV,AIDS, Tuberuclosis and Malaria. The Ministry of Health, along with representatives of many other African nations, engaged very actively with stakeholders from other parts of the world to shape the principles and the operational guidelines for the Global Fund. A Ministerial advisor spent a month in Brussels in late 2001 at the conclusion of the preparatory phase.

Sustainable development

In January 2002, the Minister of Health and WHO hosted an interministerial consultation for the SADC region and the E9 nations on Health and Sustainable Development. The meeting was intended as part of the preparatory work for the World Summit on Sustainable Development (WSSD) to be held in Johannesburg in August-September 2002. It was a strategic move to position health more highly on the development agenda and to underscore the interdependence of health and various aspects of development.

The meeting produced the Johannesburg Declaration on Health and Sustainable Development. The content of this Declaration was to be carried forward into the preparatory meetings for WSSD and the World Health Assembly.

Bilateral and multi-lateral agreements

A number of bilateral agreement, memoranda of understanding and statements of intent were signed. These included: Rwanda (May 2001 – institutional cooperation in health); Iran (February 2002 – medical education); Nigeria (March 2001 – health and medical science); and India (April 2001 – health matters broadly).

Discussions on agreements with Algeria and Egypt were at an advanced stage.

Major assistance projects funded by multilateral agencies, such as the European Union, WHO and Unicef, proceeded as planned. The areas of work include the Hospital Revitalisation Programme, district health development, sub-district development, HIV and AIDS, child health and human resource development.

Several new bilateral agreements were concluded during 2001/2. They include: Ireland (assistance to the Free State); Japan (assistance to KwaZulu-Natal); Denmark (HIV and AIDS impact study and project to combat violence against women and children); United States (amendment to long-standing Equity Project); and Italy (assistance to Gauteng).

Several other assistance proposals had been discussed in detail and only the formalities of agreement had to be concluded by the end of the financial year. In addition, work progressed in terms of existing assistance agreements with a range of countries.

The Cuban Training Programme was extended during the year with an offer by Cuba to accommodate post-graduate students for fields of study not offered in South Africa.

Another 69 South Africans left for undergraduate medical studies in Cuba in September 2001 and 58 Cuban doctors arrived in South Africa in November 2001 as part of an ongoing programme that has been of particular benefit in the rural areas.