Editorial


Africa Health subscription information


There is a three-tier price structure: 1. For African-based readers see below for details.


2. For UK and EU-based readers £76 (airmail postage included).


3. For readers in all other countries £108 or S$181(airmail postage included).


Subscribe locally


Healthcare professionals within Africa can subscribe to Africa Health for just £40 per annum. Copies will be sent by airmail from the UK. Payment can either be made by transfer (Western Union is OK) to our UK office with payments made out to FSG Commu- nications Ltd (and email advice to: penny@fsg.co.uk), OR you can pay the equivalent of £30 in local currency to the offices below. Please note, copies of the journal will be posted to you from the office you pay to. • Ghana To: PMB Accra North, Accra, Ghana. Cheques payable to: Knowl- edge Innovations. Queries to: Mr Kwami Ahiabenu II +233 244 319181 Email: kwami@penplusbytes.org


• Kenya To: Africa Health, c/o Phil- lips Pharmaceuticals Ltd, Power Technics Complex, Mombasa Road, P O Box 46662-00100, Nairobi, Kenya. Email: ppl@phillipspharma.com- Cheques payable to: Phillips Phar- maceuticals Ltd


• Nigeria To: Africa Health, PO Box 7247, Lagos, Nigeria. Queries to: Dr A P Balogun +234 809 999 9256. Cheques payable to: Afrocet Ltd. Email: balo@afrocet.com


• Tanzania To: Africa Health, c/o APHFTA, 55/644 Lumumba Street P O Box 13234 Tel: +255 22 2184667/2184508. Email: ogillo@yahoo.com. Cheques payable to APHFTA.


• Zimbabwe To: Africa Health, c/o USK International Ltd, P O Box 4891, Harare, Zimbabwe. Email: usk@ecoweb.co.zw. Cheques pay- able to: USK International Ltd.


In search of goals


It seems the starting pistol has been fired in the search for what will succeed the Millennium Development Goals (MDGs) which of course ‘expire’ in 2015. Well they don’t actually expire, as for many countries achieving them is still work in progress, but the deadline expires. So what comes next? And maybe more im- portantly, who should be defining what comes next. There is a feeling that the MDGs,


whilst emerging through the United Nations system, might have had a bit too much input from international organisa- tions and agencies, rather than the coun- tries themselves. So whilst every care is being taken not to denigrate the laud- able goals of the MDGs, Africa wants to ensure it is placed more squarely in the middle of the discussions for the SDGs… the Successor Development Goals as they are being called. A conference held in Tunis at the be- ginning of July brought together Minis- ters of Finance and Health from around Africa for a meeting entitled ‘Value for money, sustainability and accountability in the health sector: a high level dialogue between Ministers’. The core driver was that while the evidence for investment in health in terms of economic (and employment) benefits seems irrefutable, maybe the only way to persuade Finance Ministers to dig deep into their pockets would be to get them to the conference table and convince them. It was an interesting experiment. The Deputy Minister of Finance from Egypt (with tongue in cheek) joked about the potential conflict of interest on the im- pact on pension payments of keeping people alive longer! A Chinese delegate explained how the take-off for health in China occurred post-2003 when the Min- ister of Finance was reshuffled and made Minister of Health. Rather than constantly capping expenditure, he suddenly expe- rienced how impossible it was to manage on the funds supplied. A scale-up fol- lowed. Huge benefits ensued. Speaker after speaker then provided the irrefutable evidence that the dividend


July 2012


of investing in health can only be ben- eficial, both for wellbeing AND for em- ployment. Margaret Chan, DG of WHO was there, Donald Kaberuka, President of the African Development Bank (and host of the meeting) was there, Abdou- laye Janneh, Executive Secretary of the United Nations Economic Commission for Africa was there… and all appealed to the Finance ministers to loosen up and invest in health. But perhaps the defining appeal came from Dr Hans Rosling, Chairman of the Gapminder Foundation, whose lucid use of Power- Point to trace global change since 1960 was both entertaining and irrefutable. And where did it lead us? Over the


34 years I’ve been with this journal I’ve seen us move through the gears from the advent of Primary care post Alma Ata, through the wretched years of Structural Adjustment programmes in the 1980s, and the stagnation of the 1990s, fol- lowed by Africa’s heady growth spurt since the turn of the Millennium (in part natural economic progress, in part MDG stimulated), I was intrigued to see that the consensus on the way forward was solid: we need to seek the ‘demographic dividend’. And what does that mean? Family planning. Back to a phrase that went out of fashion about 30 years ago. (We’ll bring more on this in the coming issues, no time this time). And for the SDGs? Again, very inter- esting, with ministers at the end of the meeting submitting off the cuff recom- mendations to Dr Kaberuka and Mr Jan- neh. They varied between Ivory Coast’s call for ‘a Marshall Plan for health’ through to Chad’s appeal that Africa should look at itself as being relatively rich and stop feeling sorry for itself. In between three firm themes: we must build capacity; increase finance; and invest in industrialisation to create the wealth that can pay for the health.


Bryan Pearson (bryan@fsg.co.uk)


Africa Health 3


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76