THE FEDERATION'S PAGES

Editorial Note

This issue of the Federation's Pages is devoted to some fascinating developments on the African continent: Public Health Associations present themselves as forerunners of national and international cooperation. We publish here for a wider audience the Kampala Declaration of March 2008 (as agreed by the participants 25 November 2005) on the health workforce in Africa and the model of regional cooperation in francophone Africa provided by the Association Burkinabé de Santé Publique (ABSP), Burkina Faso.

The Kampala Declaration on Fair and Sustainable Health Financing:

We, the participants in the Evidence Based Workshop on Health Financing in Kampala, held between the 23 and 25 November 2005, declare the following to be our common views of a way forward for the development of fair and sustainable health financing in low income countries:

1. Health is a fundamental human right, which must be supported by fair and sustainable health financing systems, based on equity and efficiency in promoting universal access to quality health care and protecting people, especially those living in poverty or in conflict areas, from financial risks and catastrophic health expenditures.
2. The transition of health systems to reach universal and equitable access to quality health care requires a sustainable financial resource base in meeting the health needs of the population, without causing impoverishment, and contributing to the attainment of national development goals and economic growth through improved health status.
3. The health financing system needs to be developed within the particular macroeconomic, socio-cultural, and political context of each country. It should create balanced incentives with regard to equity, efficiency, sustainability, and quality of care.
4. The collaboration between governments and development partners should follow internationally respected principles of the Paris Declaration of 2005 and thus ensure national ownership of the health development polices and processes, maximized use of limited resources, and reduced transaction and management costs.
5. Donor financing gradually needs to be replaced with nationally mobilized resources in line with the Abuja Declaration to ensure sustainability and country ownership of the health development process.
6. Out of pocket spending on essential health care should be minimized, while governmental spending on health should be increased and the scope for prepayments expanded in line with WHA resolutions 58:31 and 58:33 with a view to avoiding impoverishment of households and moving towards universal coverage.
7. Governments should ensure efficient and equitable allocation and utilization of human and financial resources in the health sector.
8. Implementation of fair and sustainable health financing reforms, strategies, and action plans should be based on the principles of accountability, transparency, non-discrimination and stakeholder participation.
9. All stakeholders should use evidence generated from the use of sound scientific methods in the development of health financing reforms and functions.
10. The development partners should provide adequate financial and technical support for capacity building in fair and sustainable health financing at the regional and national levels.

Report on the Creation of the Network of Francophone African Public Health Associations

Introduction

In 2004, alongside the workshops of Brighton World Federation Congress, the Executive Board of the World Federation of Public Health Associations (WFPHA) organized an ad hoc meeting on strategies to enhance the level of participation of francophone countries in World Federation meetings. On behalf of the francophone participants, the representative of the ABSP, Dr. Mathias Some, submitted a strategy. A few months later, by the end of 2004, ABSP proposed to organize an international workshop on the theme: "Strengthening national health systems, our responsibility". The workshop was to gather as many francophone public health institutions as possible. Unfortunately, it has not been possible to mobilize the necessary budget for such a meeting. The following steps were aimed at sensitizing more interested persons:

• Contacts with WHO regional Bureau for Africa (June and October 2005);
• Yaoundé meeting on health promotion in Africa (April 2006);
• Collaboration ABSP–CPHA–WHO to elaborate a strategic programme to promote public health associations (PHAs) in Africa;
• Ouagadougou meeting between national PHAs of Burkina Faso, Congo Brazzaville, and Niger (February–March 2007) to discuss on the necessity to set up a network;
• Ouagadougou workshop on network setting (27–28 April 2007).

The workshop

Three categories of participants were invited to workshop organized by ABSP with the financial support of the Canadian Public Health Association (CPHA):

• Beneficiaries from Cameroun, Congo Brazza, Côte d'ivoire, Burkina, Mali, Niger, and Tchad;
• Public health organizations from francophone countries: IRSP (Bénin), Maroc, RDC, France, Belgique, and Suisse;
• Regional organizations interested in health issues: WHO, West African health organization, and UEMOA;
• Health development partners: Canada, EU, Netherlands, France, and Belgium.

Why a network of francophone countries?

• They are facing the same regional socio-political and health circumstances
• Weak representation of francophone countries in international meetings on public health
• This workshop laid the foundation for PHAs to play their part
• Common vision, reality, and objectives

The main objectives of the workshop were the following:

• To create an environment favourable to the development of PHAs in African francophone countries;
• To organize a network of existing PHAs;
• To elaborate a two-year action plan for 2007 and 2008.

In order to achieve these results, the following main guidelines were adopted:

• To understand the African health context: panel of discussion on the theme "the main common challenges in public health in Africa",
• To agree on the priorities in the development of PHAs: presentation of different experiences by participant associations;
• To evaluate the challenges to face with: discussion on the theme "Potentials and constraints in the management of a network";
• To define a realistic plan of action.

On the basis of these discussions, the participants have adopted a constitution and internal regulation document, creating a network called Réseau des Associations de Santé Publique en Afrique Francophone (RASPAF).

Founding members

• ABSP, Burkina Faso,
• Association nigérienne pour la promotion de la santé publique (ANSP), Niger,
• Association congolaise pour la santé publique et communautaire (ACSPC), Congo Brazzaville,
• Association camerounaise de santé publique (ACASAP), Cameroon,
• Association tchadienne de santé publique (ATSP), Chad (emerging national association)
• Association ivoirienne de santé publique (AISP), Côte d'ivoire (emerging national association).

How is the network structured?

It is structured around the council of representatives (General Assembly), and an executive board including a President, a Vice-President, a General Secretary, and three persons responsible for the Thematic Committees. The thematic committees are a Scientific Committee, in charge of health research promotion and promotion of the utilization of its results, a Capacity Building Committee; and a Communication and Advocacy Committee.

The action plan:

• Ensuring the consolidation and the visibility of the network by:
• Enhancing experience sharing between members;
• Strengthening African PHAs influence in the world public health movement;
• Ensuring the good management of the network.
  
  
• Stimulating the maturity of the network by:
• Strengthening the technical capacities of the associations' members;
• Encouraging the expansion of the network;
• Monitoring and assessing the activities of the network and its action plan.

The challenges

• To get the thematic committees functioning, as the anchor of the network;
• To explore and encourage any opportunity facilitating experience sharing between members;
• To create and regulate a website for communication and exchanges;
• To mobilize international partnership to sustain the activities of the network.

What does the network expect from WFPHA?

• Support in advocacy for PHAs or countries that could bring complementary support to the national PHAs and the network;
• Facilitation of relationship with institutions to help with capacity building in communication and human resources development.

Contact:
Mathias Some
President, Association Burkinabé de Santé Publique (ABSP)
E-mail: mathias143@yahoo.fr