|Press Release WHA/7
20 May 1999
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 personalities 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 country 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. Ezhilmalai, when asked how his country could spend money on nuclear bombs when health needs were so great, told participants it was equally important to protect the population against external threats. He noted that life expectancy had risen markedly in the last five decades, demonstrating 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 Dominican Republic's Dr. S. Sarita stated it simply: "Who sets the priorities? 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. Thailand'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 seropositive 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 increase. 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 sectionalization. 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 exorbitantly 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 mobilization, well-coordinated programmes, resource mobilization, new partners 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, journalists can contact Daniel Epstein (AMRO), Public Relations, WHO, Geneva. Telephone (41 22) 917 6874 (during WHA52) or 41 22 791 2584. Fax (41 22) 791 4858. Email: firstname.lastname@example.org.
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