Statement of the SADC Health Ministers' Meeting
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SADC Health Ministers and the Health Minister of Rwanda met in a spe-
cial meeting held in the Chris Hani - Baragwanath Hospital, South Af-
rica on the 4th and 5th November 1999.
The meeting was convened to specifically review some elements of the
HIV/AIDS response in the Region. Prominent scientists and senior of-
ficials from Member States, including representatives from the World
Health Organization and UNAIDS participated in an open and frank
sharing of information.
The Ministers wish at the outset to express profound appreciation to
His Excellency, the Deputy President of the Republic of South Africa
- Mr Jacob Zuma for opening this meeting and reaffirming the support
of the political leadership of the Region.
The Ministers reviewed an HIV/AIDS strategic plan, which had been
prepared by a Task Team they had established in their meeting in
April 1999 and led by Zambia with the aim of providing a framework
for a coordinated response in the Region for the period up to 2003.
It remains the firm view of the Ministers that the most urgent chal-
lenge of the regional and national programmes is the implementation
of multi-sectoral interventions aimed at primary prevention of the
spread of HIV/AIDS.
The Health Ministers also reviewed ongoing work aimed at the reduc-
tion of mother to child transmission particularly the use of Zi-
dovudine (AZT) and Nevirapine. It was noted that current evidence
still suggests that around 75% of HIV positive women will give birth
to an HIV negative child without the use of any of the antiretroviral
agents. It was also noted that the administration of either Zi-
dovudine (AZT) or Nevirapine may increase the number of children born
HIV negative to HIV positive mothers to around 85-90%.
Whilst encouraged by these results, the Ministers expressed grave
concern over the possible side effects as a result of their toxicity
and the potential development of resistance to these compounds. The
Ministers felt that there was a need to research the effects of un-
necessary exposure of children and mothers to these drugs. The Minis-
ters charged the SADC scientists to work in a coordinated manner to
address these concerns as well as establish the effects on breast-
feeding of some of the strategies to prevent MTCT in developing coun-
tries.
The Ministers also noted that, to be successful, any programme of
antiretroviral drug use has to be built on the solid foundation of
other important interventions such as voluntary counselling and test-
ing; overall strengthening of the health systems and the primary pre-
vention of HIV infection of all women and the protection of HIV nega-
tive breastfeeding women from the risks of HIV infection.
The Ministers committed themselves to immediately step up efforts to
implement programmes in Member States aimed at promoting and support-
ing voluntary counselling and testing as well as strengthening the
capacity of the health systems to effectively deliver these services.
This will also include improving the capacity together with other
sectors and communities to provide care and support for those af-
fected and infected and the growing number of children orphaned as a
result of AIDS. It is important to stress that these key programmes
would require enormous resources.
The Ministers were encouraged by and support the initiatives cur-
rently underway aimed at finding a vaccine that would provide some
protection against HIV strains common in our Region. They stressed
the need for coordinated action by scientists in the speedy develop-
ment of effective and affordable vaccines.
The Ministers agreed to work together and share information on legis-
lative frameworks on blood safety as well as support the WHO
Collaboration Centre on Blood Transfusion Technology in Harare. The
centre should carry out periodic audits and quality assurance
programmes as part of ensuring the availability of safe blood and
blood products throughout the Region. The Ministers charged the drug
regulatory authorities in the Region to meet as a matter of urgency
and work on a framework for harmonization of drug regulation under
the auspices of SADC to be presented to the Ministers by April 2000.
The Health Ministers further remain concerned about the un-afford-
ability of drugs that would help improve the quality of life of peo-
ple with HIV/AIDS. In this regard Member States will work together to
ensure provision of affordable packages for the treatment particu-
larly of opportunistic infections. The measures to be undertaken in-
clude bulk purchasing as well as continuing to explore the appropri-
ate use of other cost reducing interventions such as parallel import-
ing and compulsory licensing. In this regard the Ministers agreed on
the need for a joint meeting between the Ministers of Health, Trade &
Industry and Finance within SADC.
Furthermore they called upon WHO to forcefully advance public health
interests in all international fora especially the World Trade Or-
ganization. Ministers expressed serious concerns about the implica-
tion of the Trips Agreements on the availability and affordability of
pharmaceutical supplies in the Region. The Ministers were concerned
about the inequality between the various actors in the provision of
drugs in the Region, particularly with regard to the excessive
strength and influence of the international pharmaceutical giants.
The Health Ministers invited other partners to work together to curb
the spread of this virus and counter the disastrous impact of this
epidemic, which has become an emergency which requires both national
and regional actions.
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