Ministers Strive to Scale Up Cost-Effective Interventions

March 16, 2007

Ministers Strive to Scale Up Cost-Effective Interventions:
Policymakers from the East, Central, Southern African Health Community meet to discuss critical health problems and their solutions

On 14-16 March, the Disease Control Priorities Project supported the East, Central, Southern African Health Community in their presentation and debate of the "best health buys" important to the region. Delegations from 10 countries gathered in Arusha, Tanzania, to discuss those health problems that create the greatest burden of disease in the region.

Interventions proven to be cost-effective by DCP2 in addressing diseases and conditions such as malaria, HIV/AIDS, tuberculosis, maternal and newborn mortality, injuries, and diabetes were prioritized in the resolutions adopted by the Ministers of Health and their delegates. Participants highlighted the importance of strengthening health systems and mitigating the human resources crisis as cross-cutting priorities in scaling up health programs.

DCP2 editors, Sir George Alleyne and Dr. Anne Mills, thoroughly engaged participants with thought-provoking presentations on evidence-based policymaking and health systems priorities. The ministers developed resolutions with more specific actions and timelines than ever before. Country delegations finalized the conference motivated to address these health issues specifically and determined to learn from each other as implementation progresses.

Ministers' Press Statement

We, the Ministers’ of Health from member states of the East, Central and Southern African Health Community, met for the 44th ECSA Health Ministers’ Conference from March 2007 here in Arusha Tanzania.

During this conference, we deliberated and shared experiences and progress made by our member states towards the health related Millenium Development Goals (MDGs).

The conference theme was Scaling-up Cost effective Interventions to Attain the MDGs in ECSA region.

We discussed country experiences within the context of the resource constrained environments of our member states and took into account the fact that we are now approaching the mid-point remaining target period for the MDGs.

Following these deliberations, we have made 11 key resolutions in the following areas:

1. Maternal, Reproductive, Newborn and Child Health
2. Scaling-Up Cost Effective Malaria Control Interventions in ECSA
3. HIV and TB
4. Injury Prevention and Control
5. Prevention and Management of Diabetes
6. Enhancing the Performance of Health Systems to Accelerate Attainment of MDGS in the ECSA Region
7. Improving Human Resources for Health
8. Monitoring and Evaluation
9. Avian Influenza Preparedness and Response
10. Control of Emerging and Re-Emerging Diseases
11. Injection Safety

We are concerned that the death rates of mothers, newborn babies, and young children remain persistently high in our member states and note that the contributing factors and cost-effective interventions to address the issue are well known.

• As member states, we therefore resolve to, increase financial resources to implement the Roadmap for Accelerated Reduction of Maternal and Newborn Morbidity and Mortality by increasing the national budget allocation for health to at least 12% of the national budget as a step toward achieving the 15% target of the Abuja Declaration by 2009.
• We will increase the number of skilled birth attendants by at least 5% and equitably distribute them across the health system as well as enhance their competence, enable these cadres to perform procedures, and provide services including active management of the third stage of labour.
• We will initiate outreach programmes to rural health facilities, establish continuous quality improvement programmes, and ensure that at least 60% of appropriate health cadres have been trained and 100% of the health facilities have copies of policies, guidelines, and service delivery standards and norms for maternal, newborn, and child health by end of 2008.
• We will promote the integration of reproductive health and HIV care services in accordance with national guidelines within a period of three years.

We are aware that malaria remains a leading cause of illness and death in most of our member states in spite of ongoing efforts to combat the disease and note that the gap in responding to malaria problems in our countries are due to inadequate coverage and access to cost-effective interventions among the poor and vulnerable groups.

• We will develop competencies in leadership and management of malaria prevention and control at the service delivery level to ensure better coordination and integration of activities, to ensure timely reporting of RBM indicators annually, to increase access to medicines and commodities for comprehensive management of malaria within the next year, and to strengthen and revitalise malaria public awareness and social mobilisation campaigns.

We acknowledge the need to accelerate universal access to HIV/AIDS prevention, treatment, care, and support and are aware of the high rates of HIV/AIDS and tuberculosis co-infection and the relationship between HIV/AIDS, alcohol, and drug abuse.

• We therefore resolve to improve quality of care through increasing access to essential drugs and commodities and integrate prevention of mother-to-child transmission of HIV programmes into all hospitals at district level and in more than 50% of lower level health facilities by December 2008.
• We will ensure that every counseling and testing center is linked to a specific comprehensive HIV care center; we encourage member sates to develop HIV/AIDS workplace policies and establish a multi-sectoral task force to address the linkages between HIV and alcohol and other drugs within the national HIV/AIDS framework and begin implementing the policies by 2009.
• We know that that injuries cause 40% of all deaths, and that this is a silent epidemic in the ECSA region. We note the high incidence of road traffic, home, and work related injuries which are largely preventable through proven cost-effective interventions.
• We resolve to develop injury prevention policies and action plans to guide the implementation of cost effective interventions strategies by 2009 and facilitate the development of multi-sectoral injury prevention policies and actions.
• We will develop strategies to train first responders in emergency care at each level of the health system and advocate for the recognition of road traffic and work place accidents as important public health concerns.

We note that non-communicable diseases (NCDs) such as diabetes are on the increase in our countries and are aware of the risk factors of diabetes yet this has not been adequately addressed by our health sector policies and work plans.

• We resolve to strengthen prevention of obesity, diabetes, cardiovascular diseases, and other NCDs by establishing the prevalence of diabetes in our countries by January 2008 and initiating public awareness campaigns on diabetes and prevention strategies by January 2008.
• We will ensure that comprehensive diabetes care services are available in all hospitals by December 2008 and initiate screening programmes in schools, workplaces, and communities by January 2009.
• To improve our health systems, we will initiate a process to facilitate the purchase of essential drugs and medical supplies as a block within the ECSA member states in order to take advantage of economies of scale and bargaining power by December 2008 and institutionalize the biennial National Health Accounts and allocate budget lines for its implementation within the next one year.

We recognize that the shortage of health workers is a global concern and that Africa suffers 25% of the global burden of disease but has only 3% of the global workforce and 1% of the resources spent on health and further recognize that the additional disease burden as a result of HIV, malaria, and tuberculosis has worsened the human resource crisis.

• We resolve to develop or revise national human resource strategies that address recruitment, motivation, and retention of health workers and improve their productivity to include both financial and non-financial incentives by end of 2008, and we support and endorse policies and protocols to manage and mitigate the costs of migration by December 2008.
• We note that the monitoring and evaluation of resolutions passed at the ECSA Health Ministers Conferences and the sharing of information is generally weak. We resolve to strengthen the ECSA Secretariat’s capacity to conduct monitoring and evaluation and to appoint focal persons for monitoring and evaluation within the ECSA country core groups by July 2007.

We recognize the threat of outbreaks of Rift Valley Fever and potential outbreaks of Avian Flu on the life and economies in Africa. We resolve to strengthen monitoring and evaluation frameworks, including the setting of clear targets to guide the implementation of the preparedness and response plans prepared by member states, within the next 12 months.

• We will approve and allocate budgets, as a matter of urgency, for the implementation of preparedness and response plans in situations where this has not taken place, including integrating these into the national disease surveillance systems within the next one year.

We recognize that injections are the most common medical intervention and provide the foundation of delivery of most health care programmes in developing countries. We take cognizance of the health burden caused by unsafe injection practices, especially in the transmission of HIV, hepatitis, and other blood-borne diseases. We resolve to implement, support, or scale up existing comprehensive injection safety programmes and to ensure appropriate quality safe injection devices within the next one-year.

These are our resolutions as Ministers of Health of the ECSA Health Community delivered on 16 March 2007.

Related Disease/Condition:
Diabetes
Emergency Care
HIV/AIDS
Infectious Diseases
Injuries & Violence
Malaria
Maternal & Neonatal Conditions
Maternal Conditions
Neonatal Conditions
Noncommunicable Diseases
Tuberculosis
Unintentional Injuries
Women's Health