AFRO-NETS> WHO Press Release - World Health Assembly

[Dieter Neuvians MD <neuvians@harare.iafrica.com>]

WHO Press Release - World Health Assembly
-----------------------------------------

FINDING THE MONEY, HOSPITAL INVESTMENTS, HIV/AIDS AND PRIORITY SETTING 
ARE HOT TOPICS AT MINISTERIAL ROUNDTABLES

Geneva, 20 May, 1999 - Over 110 Ministers of Health from all over the 
world participated in roundtable discussions on a series of key topics 
during the World Health Assembly, with well-known journalists serving 
as moderators of lively, wide-ranging debates focusing on "Lessons 
learned in world health."

Each debate was introduced by a technical expert who framed the issues 
and presented questions, and moderated by well-known media personali-
ties from around the world. They included Dr. Jean Daniel Flaysakier, 
head of France TV Channel 2's health service; Jeremy Laurance, health 
editor of The Independent in London; Lynette Lithgow, CNBC anchorwoman, 
and Jean-Paul Hoareau de Montrose of Deutsche Welle Radio.

One session, on the dilemmas ministers of health face in finding the 
money for health activities, featured a strong emphasis on economic 
factors in relation to health and development. As the Minister of 
Health from the Maldives, A. Abdullah noted, " Yes, finding the money 
is a problem, but even more important is to make good use of it." 
Ghana's Minister, S. Nuamah Donkor, emphasised equitable distribution 
of resources, and suggested putting all funds from different sources 
such as government, donors, and the private sector into a common fund 
without being earmarked for particular activities.

Ecuador's Health Minister, E. Rodas, cited the need to "convince prime 
ministers and finance ministers to act as health ministers," adding 
that "The government should not pay the health care for those who can 
afford to pay - health should not be free for everyone." Indonesia's 
F.A. Moeloek noted a major budget increase for health expenditures in 
year 2000, with a rise from less than 3% to 5% of the total government 
expenditure. And Nicaragua's minister, M. McCoy Sanchez, in whose coun-
try 20% of central government budget is allocated for health, said 
"Strengthen Primary Health Care. It is seven times cheaper to provide 
care at that level compared to hospitals." She also called for a focus 
on prevention and reduction in referrals. Indian Health Minister D. Ez-
hilmalai, when asked how his country could spend money on nuclear bombs 
when health needs were so great, told participants it was equally im-
portant to protect the population against external threats. He noted 
that life expectancy had risen markedly in the last five decades, dem-
onstrating that funding was adequate for health.

The discussion on setting priorities in the health sector focused on 
critical choices ministers must make on such matters as the proportion 
of revenues allocated to different levels of health services and to 
specific disease control programmes, their geographic distribution, 
public funding and eligibility for various types of treatments, and 
similar thorny issues. The Health Minister from the Netherlands, Dr. E 
Borst-Eilers, said, "We all have a common top priority sitting around 
this table...that is a good public health system for all." The Domini-
can Republic's Dr. S. Sarita stated it simply: "Who sets the priori-
ties? The bank."

In a session on Investment in Hospitals, Professor N. Luo, Minister 
from Zambia said, "We live in a global society where less developed 
countries want to be like developed countries. We need to look at where 
we are and where we want to be realistically. If a country like Zambia 
wants a health system like Switzerland, we will only feel frustration 
and not ever reach that goal." The minister from Cook Islands, T. 
Fareika, said "If you force people to pay for their health, then they 
will do something about their health. If you charge someone for eating 
too much then they will not overeat."

A session on HIV/AIDS drew an overflow crowd and spirited debate. Thai-
land's Dr. D. Sukaromana said, "We have developed three new vaccines 
against AIDS, free and available to all. These are social vaccines: 
education, 100% condom coverage, and teaching life skills to children." 
He added, "We must not medicalise AIDS. It is a social issue."

Uganda's Dr. C. Kiyonga said that his country, with two million sero-
positive cases, decided to be open and educate the population. "We have 
broken through customs, particularly, in talking about condom use. It 
was embarrassing at the start, but there has been an exponential in-
crease. Now the number of condoms sold is more than those given away", 
he indicated.

Zambia's N. Luo said that "We should be very worried in Africa because 
of the level of the epidemic. It is getting out of hand. Why is this so 
despite very good interventions? One reason is the problem of section-
alization. You need a holistic approach. Some countries deny they have 
a problem. Even one infection in a country is a problem." Ministers 
also touched upon the sensitive issue of the unavailability of exorbi-
tantly expensive drug cocktails to patients in poor countries. Kenya's 
J. Kalweo said, "WHO should lobby for medicines. If technology is 
available, no one should be denied it."

Kakou Guikahue, Minister of Health from the Cote d'Ivoire, said "Why do 
we have UNAIDS? We don't have UN-DIABETES or UN-STROKE. This is because 
AIDS is a war which will decimate the human race if left unchecked."

UNAIDS' Peter Piot said that five goals were crucial: Political mobili-
zation, well-coordinated programmes, resource mobilization, new part-
ners including industry, NGOs, and religious groups, and more technical 
resources. He said there were two important human rights aspects which 
should not be forgotten: Good counselling on living with HIV/AIDS and 
the importance of education in fighting stigmatization.

For further information contact:
Daniel Epstein (AMRO)
Public Relations, WHO, Geneva
Tel: +41-22-917-874 (during WHA52)
or   +41-22-791-2584
Fax: +41-22-791-4858
mailto:epsteind@paho.org

All WHO Press Releases, Fact Sheets and Features as well as other in-
formation on this subject can be obtained on Internet on the WHO home 
page at:
http://www.who.ch

--
Send mail for the `AFRO-NETS' conference to `afro-nets@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to:  `owner-afro-nets@usa.healthnet.org'.