SUSTAINING HEALTHCARE THROUGH REGIONAL INTEGRATION

Shylet SanyangaSADC Committee Chairman and CEO: AHFoZ

Presentation Outline• BHF - SADC members• SADC Protocol on Health• Strategic objectives of the BHF-SADC Committee• Regional integration opportunities• Challenges• Where to?

BHF Membership [1]• The map on the next slide highlights the 15 current members of SADC• The goal of BHF is one of regional inclusivity of all SADC member

states . It is hoped that the rest of the countries in the region will join this grouping for us to achieve collective growth as a region.

• Current members of BHF are:-– Botswana– Lesotho– Namibia– Moçambique– Swaziland– Zimbabwe– South Africa

BHF Membership [2]SADC member countries

SADC Protocol on Health - Agreement • Signed by 14 Heads of State on 18 August, 1999, in Maputo Mozambique.• “State Parties shall co-operate in addressing health challenges facing

them through effective regional collaboration and mutual support under this protocol for the purposes of achieving the following objectives”:

SADC Protocol on Health- Objectives • to identify, promote, co-ordinate and support those activities that have

the potential to improve the health of the population within the Region; • to co-ordinate regional efforts on epidemic preparedness, mapping,

prevention, control and where possible the eradication of communicable and non-communicable diseases;

• to promote and co-ordinate the development, education, training and effective utilisation of health personnel and facilities;

• to facilitate the establishment of a mechanism for the referral of patients for tertiary care;

SADC Protocol on Health Objectives[2] • to foster co-operation and co-ordination in the area of health with

international organisations and co-operating partners; • to promote and co-ordinate laboratory services in the area of health; • to develop common strategies to address the health needs of women,

children and other vulnerable groups; • to progressively achieve equivalence, harmonisation and

standardisation in the provision of health services in the Region; and • to collaborate and co-operate with other relevant SADC Sectors.

Strategic Objectives BHF-SADC Committee

Strategic objectives [1]• Recognition of regional stakeholders and medical schemes• To provide an enabling environment for all stakeholders in the

region.• To promote the common interests of health funders in the SADC

region.• To promote regional cooperation in development of regional

healthcare policies and programmes.• To promote sustainable, affordable and quality healthcare in the

SADC region.

Strategic objectives [2]• To achieve these objectives BHF has formed a Working Group

tasked with specific duties to undertake on behalf of all members.• The Working Group will be responsible for the following areas

that will all support the strategic objectives outlined above:-– Lobbying and advocacy initiatives– Marketing initiatives; and – Healthcare developmental initiatives

Strategic objectives [3]The BHF Working Group

Working Group

Marketing service

Policy influence

Development

Regional integration opportunities

Regional integration opportunities [1]• Concentrate on maximising our use of ICT to enable our product

to become borderless throughout SADC.• Review the issue of study permits and need for separate medical

aid coverage in the country of study despite the student having existing coverage in the country of domicile.

• Country recognition through an accreditation process to facilitate acceptance of member funders from the SADC region.

Regional integration opportunities [2]• Continue to assess the impact of any National Health Insurance

Schemes, in South Africa and other countries within the region, on levels of access to public hospitals and levels of service provision for the poor.

• Harmonising of tariffs with the aim of a regional tariff structure• As a region, we must reverse the impact of lower costs charged by

countries such as India by becoming more competitive in terms of price and quality of service.– Consider the following graph which shows that the cost of treatment

in India is almost half that of costs in the region!

Regional integration opportunities [3]Comparison of medical costs for certain procedures (extracted from AHFoZ study)

0

5,000

10,000

15,000

20,000

25,000

ZIMBABWE SOUTH AFRICA INDIA

Regional integration opportunities [4]• If we, as members, can work towards reducing this cost disparity

there will be regional health care opportunities for all member countries through:-– Reduced number of patients opting for treatment and procedures

outside the region and who in turn will be supporting local hospitals and practitioners; and

– An opportunity to boost medical tourism into the region by becoming a global centre of excellence known worldwide.

• A SADC help desk or website with access to a regional online database with details of, inter alia, tariffs, costs , location of hospitals, and other service providers for ease of reference by patients from the region.

Regional integration opportunities [5]• Adoption of WHO ICD-10 methodologies by all members states

working with and learning from the early adopters such as South Africa.– This will improve the collection of statistics, harmonise tariffs and

provide limitless data analytic opportunities to healthcare funders to identify trends and opportunities. This is important for policy formulation at country or regional level.

• Becoming innovative in creating new products for older members of our community.

Challenges

Challenges [1]• The mobility of people within Africa and the SADC region for

many reasons.– BHF needs to recognise this fact and address it by designing

innovative medical aid packages to cater for foreign nationals, asylum seekers and illegal immigrants that often are denied medical care in their new host country or are required to pay for services in advance.

– We need to create a borderless region, in a medical aid sense, to provide support to migrant populations through regional medical aid packages payable electronically from anywhere in the world.

Challenges [2]• Harmonise barriers to entry in the sector

– Regional health care funders need access to the region’s larger markets which are presently closed to them through protectionist legislation. Other markets cannot be penetrated at all whilst some players from other countries have had to enter some markets through local firms in those countries.

– Competition should be based on service and not regulation.

Challenges [3]• The disease burden within the SADC countries in particular HIV/AIDS and

its impact on funders– Work with global researchers to improve the affordability of drugs.– Consider any relevant interventions that member countries can take to further

reduce the risks of HIV/AIDS that are not currently in place.

Where to?

Where to? [1]• Keep moving forward

– To achieve and sustain any of the objectives and opportunities discussed today it is essential for us to:-• Keep moving forward by consulting regularly with all our stakeholders;• Have the explicit support of the Board to empower the members of the

Working Group to ensure these strategic objectives are achieved; and• To actively pursue the opportunities and the challenges listed in this

presentation to create a conducive environment and promote a sustainable healthcare system in the region.

Where to? [2]• Seek the support of all the SADC Ministers of Health

– Some challenges involve issues of sovereignty and regulatory frameworks and Ministerial support will be vital in solving these matters

• Access the variety of strengths that each country in the region is endowed with in order to improve our own local products through knowledge transfer.

• Attract new members from the SADC region by proving the value of being part of BHF to the existing members.

• This requires support and commitment by existing members.

Where to [3]• On the political front there is talk about introduction of a common Visa for

the region, similar to the Schengen Visa for European countries.• Whilst we are from the private sector; we operate in political

environments and we cannot dissociate ourselves from developments on the political front.

• Medical schemes’ authorities should therefore be proactive to avoid being taken by surprise by the “winds of change” as the world fast becomes a global village with no borders!.

THANK YOU