Medical aid societies (MAS) in Zimbabwe cover a tenth of the population, and about 80% of income to private health care providers in Zimbabwe comes from MAS. They contribute more than 20% of the country’s total health expenditure. This paper outlines the flows of private capital that lie behind the growth of the profit medical aid and insurance health care sector in Zimbabwe. It was implemented within the Regional Network for Equity in Health in East and Southern Africa (EQUINET) by Training and Research Support Centre and SEATINI, in a regional programme co-ordinated by the Institute for Social and Economic Research, South Africa. The report proposes measures for improving the functioning of and equity in the sector and to address the current exposure of beneficiaries. Strengthening the regulatory environment will help to address legal ambiguities on investment of the industry’s ‘surplus’ funds, to ensure the multiple relevant laws from finance and health are known and applied by MAS/ insurance providers, and to fairly and firmly enforce the law. The sector should ensure timely scheme reporting as required by law and maintenance of a database with basic information on schemes, as well as registration of all schemes, avoiding increasing segmentation of the sector into small fragmented risk pools from individual schemes and encouraging (for example through enforcement of regulation on registration and liquidity requirements), mergers into larger and more viable risk pools. Regulatory and scheme policy measures should be introduced that require and implement cross-subsidies necessary for equity and ensuring benefits packages cover personal care and personal prevention services. Other measures include taking up the shortfalls in coverage of medicines on existing plans, checking the degree of vertical integration in each scheme and unbundling any monopolies across the sector that are limiting patient choice (e.g. paying only for selected linked services), and improving the outreach of consumer information on schemes, benefits packages and consumer rights to members and organisations servicing members (e.g. the labour movement and employer organisations).
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This leaflet is a translation of EQUINET’s policy brief on trade and health. The summary information is shown here in Portuguese. O crescimento do comércio internacional tem conseqüências significativas para a saúde pública. A relação entre o comércio e a saúde não é simples, e não é unidirecional. Neste informe levantamos questões sobre porquê é que questões sobre o comércio têm que ser compreendidas e geridas com o intuito de promover a saúde e realçamos as principais preocupações em saúde pública decorrentes dos acordos sobre o comércio livre. Chamamos a atenção para as medidas que os governos e a sociedade civil na região podem tomar com vista a alcançar maior coerência entre o comércio e as políticas de saúde, de maneira a que o comércio internacional e as regras do comércio maximizem os benefícios para a saúde e minimizem os riscos em saúde, especialmente para populações pobres e vulneráveis.
The countries in eastern and southern Africa and the East African Community are at various stages of enacting laws to address counterfeiting. Substandard and fasified medicines are a problem for public health if they lack the active ingredients that make them effective, or if they are harmful. Yet making quality, safety and efficacy an intellectuual property issue, and defining counterfeiting so widely as to include generic medicines have even greater potential public harm, as they may make these essential medicines available as branded versions, at significantly higher cost. This policy brief draws policy makers attention to the need to ensure that counterfeit laws do not include generic medicines and that falsified medicines are dealt with under public health and not ntellectual propoperty law. It discusses the key issues in these laws and draft laws and how they are likely to affect public health and access to essential medicines in the region.
Leaflet on EQUINET: A Rede Regional para a Equidade em saúde na África oriental e austral (EQUINET) é uma rede de profi ssionais, membros da sociedade civil, formuladores de diretrizes políticos, ofi ciais do estado e outros dentro desta região que se juntaram como catalisadores de equidade, para poder promover e realizar os valores compartilhadas da equidade e justice social na saúde.
Briefing leaflet on EQUINET. Le Réseau Régional sur l’Equité en matière de santé en Afrique orientale et australe (EQUINET) est un réseau de professionnels, membres de la société civile, décideurs, employés gouvernementaux et autres personnalités de la région qui se sont réunis pour mettre en oeuvre une politique en matière d’équité, ce afi n de promouvoir et défi nir des valeurs communes en matière d’équité et de justice sociale au niveau de la santé.
EQUINET September 2009 Conference Resolutions translated into French: Plus de 200 employés gouvernementaux, parlementaires, membres de la société civile, professionnels de santé, chercheurs, universitaires et décideurs, mais aussi les membres des Nations Unies, d’organisations internationales et non-gouvernementales d’Afrique orientale et Australe se sont rassemblés à la troisième Conférence Régionale de EQUINET sur l’Équité en Matière de Santé en Afrique Orientale et Australe, qui s’est tenue du 23 au 25 septembre 2009 au complexe hôtelier de Munyonyo à Kampala. Les délégués ont reconnu des inégalités significatives, grandissantes, évitables et injustes en matière de santé et de ressources de santé dans nos pays, notre région et notre monde. Comme la Commission de l’Organisation Mondiale de la Santé sur les Déterminants Sociaux de la Santé, nous sommes conscients que cette injustice sociale est en train de décimer certaines populations à une grande échelle. Bien que nous ayons dans notre région les ressources de santé nécessaires, nous notons que beaucoup d’entre elles, dont les professionnels de santé, quittent l’Afrique. Nos ressources restantes atteignent par conséquent rarement les personnes les plus démunies. Ceux qui en ont le plus besoin n’y accèdent pas suite aux contraintes économiques, causée par cette inégalité.
This is a report of a workshop for a project that TARSC and Country Minders for People’s Development (CMPD), under the auspices of EQUINET, undertook as a pilot to explore options for participatory communications with the community-based organisations and some of the orphans and vulnerable children in Monkey Bay, Tanzania.
EQUINET September 2009 Conference Resolutions translated into Portuguese: Mais de 200 oficiais de governo, membros de parlamento, membros de sociedade civil, trabalhadores de saúde, pesquisadores, acadêmicos, e executores de política assim como pessoal das Nações Unidas, e organizações internacionais bem como não governamentais de Africa Oriental e Austral, encontraram na terceira conferência regional da EQUINET sobre Equidade em Saúde em África, realizado entre 23-25 setembro 2009, em Munyonyo, Kampala.
This report presents a detailed desk review providing the constitutional provisions of the right to health in 15 countries in east and southern Africa (ESA): Angola, Botswana, Congo-Brazzaville, Kenya, Lesotho, Madagascar, Malawi, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Uganda, Zimbabwe and Zambia. The review was carried out within the Regional Network for Equity in Health in East and Southern Africa (EQUINET) by the Center for Health, Human Right and Development. This paper used the six core obligations as spelt out in General Comment 14 to assess the inclusion of the right to health in the constitutional provisions of the ESA countries: to ensure the right of access to health facilities, goods and services on a non-discriminatory basis, especially for vulnerable or marginalised groups; to ensure access to the minimum essential food which is nutritionally adequate and safe, to ensure freedom from hunger to everyone; to ensure access to basic shelter, housing and sanitation, and an adequate supply of safe and potable water; to provide essential drugs, as from time to time defined under the WHO Action Programme on Essential Drugs; to ensure equitable distribution of all health facilities, goods and services; and to adopt and implement a national public health strategy and plan of action.
The countries in eastern and southern Africa and the East African Community are at various stages of enacting laws to address counterfeiting. Counterfeiting is a problem for public health if counterfeit medicines lack the active ingredients that make them effective, or if they are harmful. Yet laws that define counterfeiting so widely as to include generic medicines have even greater potential public harm, as they may make these essential medicines available as branded versions, at significantly higher cost. This policy brief draws policy makers’ attention to the need to ensure that counterfeit laws do not inadvertently include generic medicines. It discusses the key issues in these laws and draft laws and how they are likely to affect public health and access to essential medicines in the region.