Zambia
is enjoying a good, positive spotlight in health matters in the United States
of America. What more with the recent visit of former President George W Bush
who visited the country for the second time in June, 2013
President
Bush and his wife Laura Bush were in Zambia last June and specifically in Livingstone
to promote their cancer fighting initiative, the Pink Ribbon Red Ribbon Campaign and to help
refurbish the Mosi-o-Tunya clinic.
In
March this year, Kristie Mikus the President’s Emergency Plan for AIDS Relief
(PEPFAR) Country Coordinator in Zambia was in Washington DC and noted, at a
Center for Strategic and International Studies panel discussion that work
already accomplished through US government sponsored HIV programs has paved the
way for broader women’s health gains in Zambia
Last
May, First Lady Dr. Christine Kaseba
Sata was in New Orleans to attend the 61st Annual Collage of
Obstetricians and Gynaecologists (ACOG) Conference.
She
took time to appeal for support projects aimed at supporting projects aimed at
improving maternal health with ACOG President Dr. Breeden James.
Meanwhile,the
Center for Strategic and International Studies (CSIS) also joined in the
accolades and applauded the new level of political will and leadership on
women’s health issues in Zambia. This was at a high powered panel discussion of
distinguished discussants and health experts who were joined by Zambia’s
Ambassador to the United States of America Palan Mulonda.
In
introducing the discussion entitled “Strengthening Women’s Global Health
Through Partnerships: Challenges and Opportunities, moderator and Senior
Associate of the CSIS Global Health Policy Center, Ms Janet Fleischman, first
gave an overview of roundtable discussion and noted that in March 2013, a CSIS
delegation had undertaken a trip to Zambia to explore the opportunities and
challenges in women’s health.
She said CSIS chose to visit because of the
new level of political will and leadership on women’s health issues and also
cited the First Lady Dr. Christine Kaseba Sata as one of the women leaders who
“are driving the country forward in issues related to women.”
Ms.
Fleischman further said the CSIS delegation while in Zambia examined programs
focused on three women’s health issues, that is maternal mortality, cervical cancer
and access to voluntary family planning.
The
delegation also explored the opportunities and challenges on how the United
States leverages the President’s Emergency Plan for AIDS Relief (PEPFAR) and
how it works with its partners to prioritize women’s health.
Particular
attention was focused on two recent public private partnerships (PPP) – Saving
Mothers, Giving Life (SMGL), which addresses maternal mortality and Pink Ribbon
Red Ribbon (PRRR), which integrates cervical cancer screening and treatment
with HIV/AIDS services and increases breast cancer awareness.
Contributing
to the debate, Ambassador Mulonda stated that Zambia recognized the need to
partner with the private sector in order to fight against disease to improve
women’s health noting that with the scarcity of resources, the Zambia
government would have to partner more to use other resources.
He
observed that Zambia was looking to strengthen partnerships with partners who
could support the country’s agenda and stressed the need to work towards the
right culture in as far as women’s health was concerned.
“The
two new initiatives, that is the SMGL and PRRR have considerable promise to
improve women’s health in Zambia, he said.
This
is evident when one considers their roll out plans and the results already
registered in the short space of time that the initiatives have been in
existence. The two initiatives make use of existing platforms under PEPFAR and
are already established institutional frameworks thereby guaranteeing
sustainability in the long term,” he said.
Answering
to a question by the moderator as to how Zambia has seen the value and the
challenges of PPPs, Ambassador Mulonda went on to explain that the traditional
thought in Zambia had been that the delivery of health services was done by the
government alone but with the recent HIV epidemic this had been proved wrong –
help in delivering health services had come from the outside, particularly from
the United States.
“Following
the PEPFAR example, we recognize that in order to fight against disease to
improve women’s health, in addition to bilateral programs, our government needs
to partner at the bilateral, international level and with other sectors as well.
Going forward with the scarcity of resources, the Zambian government will have
to partner more to use other resources,” he concluded.
Another
panelist Jeffrey Blander, the Acting Director of Private Sector
Engagement, Office of the Global AIDS
Coordinator said the public-private partnerships was an area which the Office
of the Global AIDS Coordinator (OGAC) and the President’s Emergency Plan for
AIDS Relief (PEPFAR) started in 2006 in order to leverage more resources from
the outside.
He
said, “For example, we have had over 150 partners that leverage more than
US$800 million dollars and resources, but this is not about monetizing the
financials, this is about what do partnerships bring to the table. These
partnerships bring academia, technology and management expertise. It is
important to recognize that these partnerships bring tremendous value.”
Other
discussants included Asiak Brun, the Director, Department of Climate, Global
Health and Sustainable Development of the Norwegian Ministry of Foreign Affairs
who stated that his country had put
particular focus on women’s health globally as part of the government’s policy.
John
Kraemer who is a member of the Pink Ribbon Red Ribbon Secretariat who noted
that PEPFAR had a large partnership in the public and private sector whose
coordination was taken seriously. He said the coordination was done in two
ways, coordination of substance and coordination of the work the partners do.
“For
substance coordination, focus is on the national ownership aligning under the
country’s own policies. Our model has been to look at the country’s priorities
and gaps, and using our partnership to fill the gaps. At the coordination of
work level, we use country coordination mechanisms with their specific teams
and other partners on the ground,” said Kraemer.
And
Ms. Celina Schocken, the Head of the Secretariat, Saving Mothers, Giving Life
and Director, Policy and Government Relations, Merck for Mothers noted that the
governments of Zambia and Uganda were by far their most important partners as
there were huge amounts of money coming from Merck, the United States
Government and other partners.
To
support her statement she said, “One of our goals is to show that our program
works. For example, we had a 15 percent increase in pregnant women receiving
ART in Uganda and we will show better results at the end of this year. It is
important for PEPFAR to know that our initiative is showing good results and
that we are delivering services that work.”
All
said and done, public private partnerships are absolutely essential for the
continuing viability of our health systems in beyond current donor funding. A
good example is the HIV and AIDS response which is funded by donors in excess
of US$400 million per year.
According
to Dr. Mannasseh Phiri, a HIV/AIDS and Health Activist, in the past the public
private partnerships existed in Zambia although they were named such. The
mining industry had an extensive private health system running parallel to
public services and of a much better quality and standards, catering for large
sections of the population in the mining towns and relieving pressure from the
public sector.
He
observes that the private sector has in the past led the way in HIV and AIDS
treatment. Luckily, a forthcoming collaboration between Barclays Bank and the
drug company Glaxo-Smith Kline has been announced but is yet to take off.
“It
will aim to provide a private distribution system for drugs that can supplement
public systems. The new system will include small private pharmacies and drug
stores in the remote parts of the country,” he says. It is a model that has
been tried in other parts of Africa and has great potential.
Another
example is Cola-Life, an upcoming initiative aiming to use the very extensive
Coca-Cola distribution network to distribute Oral Rehaydration Salts for
diarrhea in infants. If it works, it could be extended for distribution of
other medicines such as anti malarials, mosquito nets and condoms.
The writer is Deputy Chief
of Mission at the Embassy of the Republic of Zambia in Washington DC.
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