Key points from a speech at the Gauteng Nepad Summit by Skhumbuzo Ngozwana
Joint Deputy CEO, CIPLA MEDPRO (PTY) LTD

I prefaced my talk with the quote “Health is the first wealth” (Ralph Waldo Emerson)

This is my view highlights the critical issues that any attempt to eradicate poverty should first address health, the most basic of essential services. Failure to do this will end in disastrous consequences.

General Recommendation for future NEPAD Summits:

* Health is the first wealth, as Emerson said. Thus, it is imperative that within the proposed program for future summits, Healthcare in Africa should have its own separate track / breakaway session, which would cover issues as diverse as Health financing, disease burden, pharmaceuticals and local production, supply chain systems, HR issues and so forth.
* Further, I would propose that any “secretariat” or organizing body needs to have input and representation from people well versed in these issues.
* Lastly generic pharmaceutical companies on the continent are organizing, and will shortly form a cross border Association, and it is only right that pharmaceutical feature prominently in future summits to accommodate this emerging spirit of cooperation.

Summary of my talk

* The challenge for Africa is to create the foundation for self reliance in the provision of safe, affordable, quality healthcare on the continent
* Therefore Africa needs Capacity Building not perpetual aid: Africa should learn to fish instead of depending on the caught fish …. For example, flows of money to assist with HIV, TB & Malaria to buy drugs from outside the continent, should assist local formulators to acquire WHO / FDA accreditation / certification so they can supply PEPFAR & Global fund programs on the continent
* Public Private Partnerships the solution

The detail of my talk: Health in Africa & Economic development–
o Challenges
* Institutional
* Inefficiencies at borders, ports etc
* Lack of good investment incentives
* Poor tax regime & compliance requirements for exports
* Skills shortage
* Policies incongruent
* Unhealthy tension between Industrial and Health Policies
* Socio- Economic (Increasing cost of care)
* Aging population – chronic care
* Increasing unemployment – fewer insured
* Unique diseases – Poverty related
* Global financial meltdown… but
* Increasing health insurance premiums & increasing co-pays
* Significant Political & Policy shifts & challenges
* Sector specific
* Local Production challenges
* Lack of skills & technological base
* Little focus on manufacturing by tertiary institutions
* Small market
* Expensive sourcing of API
* Lack of economies
* Entry into Africa - lots of Non-tariff barriers
* Knowledge of local customs & practices
* Political connection
* Access to supply chain
* Language issues
* Trust issues
* Corruption
o The need (Opportunity)
* Safe, affordable, quality efficacious medicines
* Building local capacity
* “African solutions to African problems – learning how to fish instead of being given caught fish”

Background Stats I quoted

o Sub-Saharan Africa has about 11 percent of the world’s people, but it carries 24 percent of the global disease burden in human and financial costs. To name a few:
* 1 Million malaria deaths
* ~ 600 000 deaths due to TB
* ~ 70% of the worlds’ AIDS deaths and HIV burden
* Almost half the world’s deaths of children under five take place in Africa.
o Three percent of the world’s health workers deployed in Sub-Saharan Africa.
o In a region where public resources are limited, the private sector is already a significant player. Around 60 percent of health care financing in Africa comes from private sources, and about 50 percent of total health expenditure goes to private providers.
o Just as important, the vast majority of the region’s poor people, both urban and rural, rely on private health care