Speech by Minister Manto Tshabalala-Msimang in welcoming delegates to the preparatory meeting for the Kampala Forum on Human Resources for Health

Programme Director
Ministers of Health from the Southern African Development Community (SADC) region including the bureau countries
Executive Director of the Global Health Workforce Alliance, Dr Francis Omaswa
Chairperson of the forum organising committee, Dr Sigrun Mogedal
Officials from the Department of Health and fraternal bodies and institutes
Ladies and gentlemen

We are meeting here almost on the eve of the first major international conference to tackle one of the serious challenges facing our health systems, the challenge of human resources for health. We are gathered here to ensure that as a continent, we are able to speak with one voice and do everything we can to harmonise our approaches in tackling this challenge of human resource and thus ensuring that our healthcare systems are indeed geared to meet the expectations of the millions of our people.

It is a known fact that the shortage of skilled health professionals is crippling health systems of developing countries and this challenge is exacerbated by a number of factors, some of which are beyond the control of the developing countries.

Programme director, as we approach the 30th anniversary of the Alma Ata declaration on primary health care therefore, we need to realize that the majority of the countries faced with this challenge of human resources among others inherited serious health system challenges at the attainment of freedom and independence from colonial rulers. Although progress has been and continues to be, many challenges still lie ahead as efforts are made to make healthcare accessible to the millions of our citizens. The task then of ensuring that these challenges are properly dealt becomes our collective responsibility as leaders and as ministers responsible for health.

As most of you would know, many studies have been conducted looking at the reasons why health workers, notably medical doctors, nurses and pharmacists are in short supply within the public health system in developing countries. One of the most poignant factors that these studies have consistently alluded to has to do with the lack of effective long-lasting interventions to address these shortages.

It is worth noting that the African ministers of health have at several World Health Assemblies repeatedly called for urgent action to be taken at a global level to address what is now a very serious threat to the sustenance of health systems globally. The World Health Organisation (WHO) therefore has to be commended for ensuring that this matter is indeed.

Health workers are a fundamental and critical element of the provision of health services given the labour-intensive nature of the sector itself. The WHO estimates contained in the World Health Report 2006 that Sub-Saharan Africa faces the greatest challenge with the lowest concentration of health workers in the world bears testimony to this. In that report, the WHO estimates that the region has 11% of the world's population and 24% of the global burden of disease, but only 3% of the world's health workers and less than 1% of global health expenditure. This situation cannot be left unattended. It calls on us to provide decisive leadership, and we have to do it now, mindful of the disease and needless loss of life continuing to decimate our populations.

Programme Director, there are many things we have to do as developing countries in terms of gearing our health systems to meet the expectations of the millions of our people. Health workforce planning is critical but this has to be backed up by credible information systems so that we are able to know all aspects of human resources, the disease burdens and patterns to enable better planning and budgeting. Strengthening of health sciences education and training, deepening research that is relevant to the health needs, building capacity within ministries of health and entrenching regional cooperation are all critical aspects of our interventions.

It is in this context that I convey the appreciation, which I am sure we all have of the efforts of the Global Health Workforce Alliance (GHWA) to galvanise the global community to action. The principle upon which the agenda for action is premised is laudable. It simply states that the overall purpose, shared by everyone committed to this agenda, is that all people, in all places, shall have access to a skilled health worker who is equipped, motivated and supported.

I am sure therefore that as we gather here today as interested parties and participants, we do say mindful of this particular agenda. Its key interconnected strategies must serve to give more than meaning to the investments that our governments make in our countries healthcare systems.

Allow me, Programme Director, to briefly outline some of these key strategies:

* promoting focused and coherent national and global leadership
* scaling up health worker education and training and providing the appropriate mix of skills required for well-functioning health systems
* retaining a motivated, equipped, productive and better distributed health workforce
* making the national and international workforce market serve the goal of access to health care for all
* increasing domestic and external financing and making it more efficient, and
* achieving critical national capacity to inform and manage the response based on evidence and joint learning.

As we deliberate today, we must be guided by our common desire to effectively address the challenges faced by our continent. It is therefore crucial that the bodies that we have in the continent in the form of the forum of African Union (AU) ministers of health, SADC ministers of health and WHO AFRO continue to play an important guiding role in this regard. We have no reason to doubt their commitment in this regard.

Of equal importance is the role of the international community in ensuring that developed countries do what is right, that there is proper health workforce planning so that these countries too can produce for self-sufficiency. We can play our stewardship role of health systems as much as we can and within the means at our disposal, but it has to be recognized that it is difficult to compete with the richer health systems of developed countries.

SADC has been true to its resolution that countries within the region should not poach from one another. Although this has been effective to some extent, time has come for the continent to start thinking about how best to strengthen solidarity among its member countries. As mentioned previously, there are a number of areas where cooperation can best be achieved.

Education and training, research, academic exchanges and sharing of expertise are some of the areas we can explore. I therefore hope that today's deliberations, whilst preparing for a unified approach to Kampala, will lay a good foundation for development of a solid African solidarity. I am confident that with the commitment that we have shown over the years, we will indeed be able to find lasting solutions to the health challenges continuing to face our governments and millions of their citizens.

Allow me therefore Programme Director to welcome all the delegates to our country and to this gathering in particular. I am confident that indeed when the time comes for us to wrap on our deliberations, we will do so with a clear sense of what will happen in Kampala.

Issued by: Department of Health
12 January 2008