Date: 29/04/2011
Source; The Department of Health
Title: SA: Motsoaledi: Address by the Minister of Health, at the first global Ministerial conference on healthy lifestyles and non-communicable disease control, Moscow

'Strengthening National Capacities: What are the priorities for international collaboration?'

Chairperson,
Fellow Ministers,
Distinguished guests,
Ladies and gentlemen
Good morning
Allow me to start with three important issues that are contained in the Brazzaville Declaration on Non Communicable Diseases Prevention and Control in the World Health Organisation (WHO) African Region signed on 6 April 2011, in preparation for this meeting.
• The first is that we have to be 'cognisant of the ever increasing double burden of communicable and non communicable diseases in the WHO African region'.
• The second is that we have to reaffirm 'our commitment to strengthening national health systems as the basis of a comprehensive approach to equitable health outcomes'.
• The third is that 'management of communicable diseases in many countries&can provide ample opportunities to accelerate prevention and control of National Coalition on Dispensing (NCD). Such opportunities should be identified and harnessed to address integrated care in the context of primary health care and health systems strengthening'.
The issues contained in the Brazzaville Declaration must therefore be central to what countries in the African region do and what the international community should commit to support.

In a recent issue of the Lancet, my country, South Africa was identified as having a quadruple burden of disease.
These are
• HIV and TB
• maternal and child mortality
• NCDs and
• Violence, injuries and trauma.
This means that we need to find creative and innovative ways to deal with all four contributors to morbidity and mortality in a way that balances national needs. For this to take hold; partnerships between governments, regions and the international community, including technical partners, bilateral agencies and agreements as well as the multilateral organisations are critical.

Developing countries have serious challenges in dealing with NCDs in the face of a total onslaught from communicable diseases especially HIV and AIDS, TB and Malaria. However, as the burden of NCDs increases and their relationships with certain communicable diseases such as HIV becomes clearer it is important that we start to focus more on NCDs even as we upscale the fight against communicable diseases.

I must therefore thank the Minister of Health and Social Development of the Russian Federation and the World Health Organisation for organising this conference and creating an environment of open dialogue around NCDs. This conference is a good example of international collaboration that will, I am sure, help strengthen a robust stance of what we take to the United Nations (UN) General Assembly on NCDs while at the same time it will help countries strengthen their national capacities to deal with NCDs.

If we are to look for lessons for redressing NCDs from other international UN agreements, including the Millennium Development Goals, the importance of setting targets with time frames becomes very evident. If the UN NCD Heads of State Summit is to make the difference at a national and global level that we all know it must , we must make sure that we come out of the Summit with such targets and indicators.

I want to also briefly mention other levels of international collaboration such as bilaterals between countries and regional and continental agreements which we should not neglect or disregard as we focus on high level global collaboration. Inevitably agreements that include every country in the world must be broad in their scope whereas those between two countries or within a region may be more specific; but clearly both are needed to move the NCD agenda forward.

As the Brazzaville declaration provides some ideas on what needs to be done with respect to service delivery in the AFRO Region, with specific reference to health system strengthening and primary health care, allow me to briefly mention what we are doing in South Africa.

Since democracy was attained in South Africa in 1994 we have been committed to transforming our health system using the primary health care approach as the foundation of the national health system.However we did not make much progress. As a result we are now embarking on a very extensive and concerted programme to re-engineer our primary health care service. In this case we are keen to learn from other countries that have done so. If we collaborate, exchange ideas and experiences and learn from the best practices of others we can all change the way we do things and thereby improve our health systems and get better health outcomes.

As an audience interested in NCDs I must assure you that our new primary health care model will emphasise prevention of disease and promotion of health. Waiting for people to first get ill and try to fix them for the first time in a hospital is a practice we must discourage even at an international level. This will apply equally to communicable and non-communicable diseases; it will focus on early detection of health problems as well as introduce mechanisms to improve control of individuals suffering from all chronic diseases.

Community Health Workers will become central to our health care system and we were excited to hear yesterday from the Indian Minister of Health about their plans to introduce 800 000 community health activists. We hope to learn from their experience as much as we believe we have something to offer as part of our international collaboration. Through this primary health care system we should also be able to improve our information on all diseases so that we can respond based on need.

Speaking on behalf of my country which has many competing needs, and I am sure for many others with a raging HIV epidemic, I must emphasise that even as we legitimately request foradditional resources for NCDs this must be additional to what is currently being provided to deal with communicable diseases and maternal and child health. This means that as advocates for NCDs we must work alongside those who advocate for HIV, TB and maternal and child health in an integrated manner, and the two must not be made to compete againsteach other.

The Brazzaville Declaration states very clearly and I hope that this meeting understands this position and that development partners and civil society organisations will be urged 'to provide new and substantive financial resources to address NCDs, while not jeopardising current and future funding of communicable diseases'. We on the African continent hope that this view will also be reflected in the Moscow Declaration. We also want to strongly add that we hope that the Moscow Declaration willalso include issues of universal coverage in the form of various health care insurances - which are even more needed in poorercountries. There is no point in attending summits talking aboutgood quality health care which is financially beyond the reach of the majority of the people of the world.

The challenges that we face to strengthen our individual and collective efforts to reduce NCDs are immense given that many of the drivers of this new epidemic are social in nature. However; legislating, regulating and campaigning against the four risk factors for NCDs, i.e, poor diet, tobacco, alcohol abuse and lack of physical activity, is not beyond the reach of any country. All that is needed is political will and leadership, partnerships and commitment at global, regional and national levels.

I thank you.