Salutations

• Your Excellency, the Right Honourable Prime Minister Dr Sibusiso B. Dlamini

• Honourable Minister of Health Make Sibongile Ndlela-Simelane

• Honourable Ministers present here

• Regional Administrator

• Members of Parliament from both Houses

• Your Excellency the American Ambassador

• The RC and Other Heads of UN Agencies

• Senior officials from Government Institutions

• Development Partners   

• Representatives of Non-Government Organisations

• Health Researchers

• Media houses

• Distinguished Ladies and Gentlemen

Good Morning

I bring you warm greetings from the World Health Organization Regional Director, Dr Luis SAMBO. Personally, it is my pleasure to be here this morning to present a key note address on behalf of RD/AFRO at this very important occasion of the official opening of the 2014 National Health Research Conference.

I am so delighted to come back to this beautiful country after nearly 9 years.  My family and I have fond memories of our stay here, and we forever remain grateful for your generous hospitality.

As a matter of fact, when we left here and transferred one of our children to a secondary school in Kenya, he was asked to sing a song before the school assembly in a foreign African language, as a way of expressing diversity in the school. The only song he knew in a foreign African language was the Swazi national anthem. He sang the anthem with perfection. Thank you for making us feel and act like one of you.

Your Excellences,

Ladies and Gentlemen,

I recall that in November 2012, the country held the second and very successful National Health Research Conference during which WHO Regional Director was represented by the Deputy Regional Director, Dr Matshidiso Rebecca MOETI.

WHO’s continued participation in your national meetings on health research is not random, but a recognition of your efforts and a demonstration of our commitment to support research for development in countries.

WHO’s commitment to research is explicit in its Constitution which came into force in 1948, namely “to promote and conduct research in the field of health” (Article 2(n)).

Indeed, 3 of the 6 core functions of the Organisation directly reflect this commitment:

01. Shaping the research agenda and stimulating the generation, translation and dissemination of valuable knowledge

02. Setting norms and standards, and promoting and monitoring their implementation, and

03. Articulating ethical and evidence-based policy options

In response to resolution WHA58.34 on the Ministerial Summit on Health Research, the Secretariat drafted a position paper describing WHO’s role and responsibilities in the area of health research on the basis of an initial assessment of WHO activities in this area.

As a result, the WHA in May 2007 adopted Resolution WHA60.15 on WHO’s role and responsibilities in health research. This resolution requested the Director-General to submit to the Sixty-second World Health Assembly a strategy for the management and organization of research activities within WHO.

The WHO Research Strategy was presented to the Executive Board in January 2009 and at the 62nd World Health Assembly in May 2009.

The priority given to research aimed at solving health problems of developing countries is based largely on the historic report of the Nobel Conference held in Sweden in 1990.

The Commission on Health Research for Development noted that only 5% of the funds invested in health research in the world were devoted to illnesses which account for 95% of the world’s disease burden.

In the African Region, ministers of health agreed that we need a common vision for health research if we are to guarantee sustainable health development with particular emphasis on the Millennium Development Goals.

The fifty-sixth session of the WHO Regional Committee for Africa adopted a programme of action for research and strategic guidelines for knowledge management in health.

In April 2008, the African Conference on Primary Healthcare and Health Systems adopted the Ouagadougou Declaration which, among other things, urges the Member States to strengthen health information and surveillance systems, promote operational research on health systems; and create centres of excellence in research that would generate evidence for decision-making.

Undoubtedly, WHO will continue to promote the message that research is fundamental to generating knowledge to improve health outcomes and contribute to achievement of the Millennium Development Goals (MDGs).

It will continue to promote the message that evidence must inform the design and implementation of health programmes as well as all attempts to reform and strengthen health systems.

However, in order to contribute to health development and achieve the internationally agreed health-related development goals, including those contained in the MDGs, Member States are urged to accelerate efforts to mobilize and allocate more resources for strengthening their national health research systems and also create mechanisms to translate the outcomes of research into actions.

Specially, we should all be reminded of the commitments made at the Ministerial Conference on Research for Health in the African Region in June 2008, commonly referred to as the Algiers Declaration. In these commitments Member States were urged to allocate at least 2% of national health expenditure and at least 5% of external aid for health projects and programmes to research and research capacity building, and to invest more in research aimed at improving health systems.

Distinguished Ladies and Gentlemen,

Given that we have a strong research constituency in this meeting, I wish to touch on two aspects of critical importance:

(i) Ethics of Research on human subjects:

Pursuit of research on human subjects must of necessity take into consideration internationally recommended ethical and human rights principles such as the Siracusa Principles on research; the 1947 Nuremberg International Guidelines on Ethics for Research on human subjects; the 1964 World Medical Association Declaration of Helsinki; and the 2002 Council for International Organization of Medical Sciences pronouncements.

Collectively, all these conventions call for:

- voluntary and culturally sensitive informed consent as an absolute essential;

- conduct of a risk/benefit analysis;

- scientific soundness of the research activity;

- respect for participants’ life, health, privacy and dignity; and

- ensuring access to standard of care for all study participants.

The level of scientific rigor stipulated above is meant to prevent exploitation of study subjects and safeguard their rights, safety and well-being. Subjects of health research must be protected from harm related to the research procedures and freely choose whether to participate or not.

National Health Research Ethical Review bodies made up of experts qualified to represent a range of community, cultural and moral values should be part of the backbone of national regulatory mechanisms for the conduct of health research.

It is also international practice that for externally initiated research, ethical standards should meet those of initiating country as well as the host country. 

(ii) Moving from research to policy:

Research should not be an end in itself. Rather, it should seek to feed into policy and improved quality of life for targeted beneficiaries.

Some common challenges in moving from research to policy include:

• lack of or minimal ownership of the research agenda and findings; limited human and infrastructural capacity for research;

• limited financing; and

• long lead time for the availability of results from research activity.

In this regard, Government should facilitate processes that accelerate translation of research findings into national health policies. 

Researchers on the other hand should anchor their research appetite on national needs and strategic directions.

Your Excellences,

Ladies and Gentlemen,

Without a doubt, the theme for this National Health and Research Conference “Investing in Health for Development” is very befitting. This theme is supported by the following sub-themes;

a) Universal Health Access and Coverage

b) Mobilization and efficient use of resources for health

c) Improving Health Outcomes and

d) Health, equity and development from a human rights perspective.

Undeniably, health is essential for development as only healthy persons can fully and effectively contribute to national development.

Accordingly, investing in health is investing in development.

In fact, Health is an essential pillar in any national development strategy.

Mobilizing more resources for health and using the resources more efficiently are all important for the attainment of Universal Health Coverage.

Permit me, Distinguished Guests, at this juncture to commend the Government of the Kingdom Swaziland for maintaining health as a key priority area for government financing.

We commend the good work and results that have been achieved in health in Swaziland. The Antiretroviral Therapy (ART) coverage at over 90% based on CD4 count of 350 is one of the highest in sub-Saharan Africa.

The PMTCT coverage is also very good with over 95% of pregnant women attending health facilities receiving ARV prophylaxis to prevent transmission of HIV to the children.

The coverage of routine immunization has similarly been increasing to an average of 90%; and I am informed that you have also increased the smear positive treatment success rate for TB to 73%.

Yes, you have made good progress in these areas, but there is need to continue to work hard to sustain and improve on these gains and also to address the remaining challenges that the country continues to face - such as:

• the high HIV/AIDS burden,

• drug resistant TB, high maternal mortality,

• high child mortality,

• increasing burden of non-communicable diseases, and

• limited numbers of skilled health workforce.

I am also aware that the goal of moving towards universal health coverage is gaining support at very high-level.

Since publication of the 2010 World health report on health system financing, more than 70 developing countries have requested WHO technical support for their plans to move towards universal coverage.

Countries that have already reached the goal are sharing their experiences.

Nonetheless, they are also making it clear, it entails long-term planning and phased implementation. It takes unwavering political commitment at the highest level of Government.

Your Excellences,

Ladies and Gentlemen,

There is no universal formula for reaching universal coverage. Each country must carve its own way forward. Any move towards universal coverage is an inherently country-owned initiative.

It must be home-grown, strongly rooted in the country’s culture, its domestic political institutions, the legacy of the existing health system, and the expectations of its people.

Universal coverage means quality health care for all delivered in ways that protect users from financial catastrophe or impoverishment. It is a powerful social equalizer, contributing to social cohesion and stability. It is not cheap. But when well-planned, universal coverage is affordable.

The challenge is to expand health services with constant attention to causes of waste and inefficiency that can be reduced through smart policies and wise decisions.

Research offers this guidance. It brings precision to the understanding of problems, and it offers proof of the solutions that work best. Research can also uncover ways to scale up services and control down spending.

The drive to universal health coverage should therefore take a centre stage during the discussions in the conference.

It is heartening to note that this conference places particular emphasis on investing in health for development, including the management of fiscal and macroeconomic policy concerns, and the effective use of financial incentives to promote efficiency, high-quality care, and results.

But I must caution that Social and Environmental determinants for health need to be addressed if we are to improve health and contribute to economic development. Most of these determinants lie outside the health sector.

That is to say, health sector alone cannot ensure universal health coverage. Input of other sectors is very important.

And although the focus of universal health coverage is on interventions whose primary objective is to improve health, interventions elsewhere in other sectors – agriculture, education, finance, industry, housing and others – may bring substantial health benefits.

Therefore, research on how actions and decisions in all these sectors affect health is also important.

To conclude my statement, I wish to once again thank you very much your Excellences, Honourable Ministers, partners and dear colleagues, for inviting me to share some ideas with you.

I can only assure you of WHO’s readiness and commitments to continue to support the local efforts here in the Kingdom, to help you address the health development challenges that the country faces.

Thank you for your attention, and I wish you a very successful Conference.