Public Health Association & International Association of
Health Policy Conference 2004

PHASA Conference Resolution

The second annual conference of the Public Health Association of South Africa (PHASA) was held in Durban from the 5-7th June 2004 in conjunction with the 13th International Conference of the International Association of Health Policy (IAHP).

The conference was attended by almost 200 public health professionals working in all spheres and at all levels of government, academic and research institutions and non-governmental and worker organisations and coming from over 20 countries.

The theme of the conference was "Challenging Health Inequalities: Forging Progressive Partnerships for Public Health", with sub-themes of health inequalities, health systems development, and addressing HIV/AIDS and other priority health problems.

Plenary addresses and oral and poster presentations by both South African and international experts provided compelling evidence of the health crisis in South and Sub-Saharan Africa, and its national and global determinants. In South Africa, and indeed globally, health inequalities are rapidly widening, with an increased burden of mortality and morbidity resulting not only from the "traditional" communicable diseases - "diseases of poverty" but also from non-communicable disease, violence and injuries and, more recently, HIV/AIDS. This increasing quadruple burden of disease threatens progress towards the realization by Sub-Saharan African countries of the Millenium Development Goals.

Moreover, it is apparent that both nationally and globally, economic and social factors are increasingly influencing this alarming picture. For example, unhealthy diets are linked to the growing monopolization of the food industry at a global level as well as trade patterns regulated by the World Trade Organisation: in short, obesogenic diets are being promoted by economic globalisation in both under-developed and industrialised countries.

Similarly, there is increasing recognition that both HIV/AIDS and violent injury are strongly associated with both poverty and social dislocation and their consequences. This includes reported engagement by young poor women in unsafe commercial sex, as well as the accelerating rural impoverishment and urban migration, both driven by economic globalisation.

In terms of health systems, discussions centred on the challenges facing their financing and functioning, especially regarding the crisis of human health resources. Many presentations drew attention to the opportunities provided by partnerships with non-governmental, faith-based and community-based organisations, particularly in relation to strengthening community level infrastructure, recognized to be crucial in addressing the therapeutic, preventive and caring dimensions to both HIV/AIDS and TB.

Global and national factors adversely affecting the functioning and sustainability of health systems were analysed. These were noted to include reduced public sector health budgets, fragmentation of funding of programmes as a result of many new donor initiatives, and human resource scarcity. The latter is a result of underproduction by training institutions, migration out of the public sector or abroad, and losses due to HIV/AIDS. International speakers, drawing on European, Latin American and US experiences, warned of the threats posed by privatization of services, to equity of access to health services and resources.

Delegates resolved to contribute to actively building PHASA as a forum in which the above issues can continue to be discussed and further researched. It was further agreed that PHASA has the potential to both influence all sectors of government to increase their focus on public health and build capacity in this area. Through this PHASA hopes to strengthen government's ability to achieve its mandate of not only treating the large and increasing disease burden of South Africa's population, but also in protecting and promoting its health.