Shanghai Declaration on Promoting Health

See the Shanghai Declaration on Promoting Health in the 2030 Agenda for Sustainable Development, the link is here:

What is new in this Declaration is the focus on “health literacy” – a term which encompasses the use of information and knowledge in healthcare, and particularly the application of health information and knowledge in education at all levels.  

A clear set of commitments is set out, including the following:

“We commit to:

  • recognize health literacy as a critical determinant of health and invest in its development;”
  • develop, implement and monitor intersectoral national and local strategies for strengthening health literacy in all populations and in all educational settings;”
  • increase citizens’ control of their own health and its determinants, through harnessing the potential of digital technology;”
  • ensure that consumer environments support healthy choices through pricing policies, transparent information and clear labelling.”

Unveiling the Burden of Dengue in Africa

Mosquito sucking bloodMost travelers to Africa know to protect themselves from malaria. But malaria is far from the only mosquito-borne disease in Africa. Recent studies have revealed that dengue, a disease that is well recognized in Asia and the Americas, may be commonly misdiagnosed as malaria in Africa. So if you’re traveling to Africa, in addition to taking anti-malarial medications you should also take steps to avoid dengue…..more

Scientific Animations Without Borders (SAWBO) has a Dengue Prevention animation in multiple languages for use here:

How South Africa can beat its sugar-fuelled diabetes epidemic

Four times as many people have Type II diabetes today as 36 years ago, according to the World Health Organisation. In 1980, 108 million people were diagnosed with diabetes worldwide. By 2014, the figure was 422 million writes Dr Sundeep Ruder. In South Africa, 7% of adults aged 21 to 79 – 3.85 million people – have diabetes. A large proportion of these remain undiagnosed. The global prevalence of adult diabetes has nearly doubled – and is rising more rapidly in middle- and low-income countries. Globally, about 1.5 million people died as a direct result of diabetes in 2012. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. Stringent glucose control has reduced some small-vessel complications such as blindness and kidney failure. The residual risk of large-vessel complications such as heart attacks and stroke remains high…..more

Office of Health Standards Compliance still not up to scratch after 5 years: DA

Office of Health Standards Compliance still not up to scratch after 5 years: DA.

DA spokesman on health matters Dr Wilmot James said on Sunday he had written to the Chairperson of the Parliamentary Portfolio Committee on Health‚ Mary Ann Dunjwa‚ to request that Health Minister Aaron Motsoaledi and the Acting CEO of the OHSC‚ Bafana Msibi‚ come and explain to Parliament why it (OHSC) is incapable of measuring the quality of maternal (or any other health care) matter after five years since its establishment.

James said that a “breathtaking admission” to the Sunday Times‚ Motsoaledi had stated that the OHSC was‚ after five years‚ still “on a learning curve”‚ unable to design a robust health assessment model and therefore in no position to exercise oversight.

Asked if it took a simple organisation like the OHSC five years to figure out its job‚ how long would it take to establish National Health Insurance (NHI)‚ Motsoaledi‚ “with supreme arrogance”‚ had replied: “The problem with you people is that you are so impatient. This is grossly unfair. It shows a hatred for NHI.” more

Too poor to care? The call for a minimum wage has exposed a sick system

This week, a panel of experts released its recommendations for a proposed minimum wage of R3 500 per month. In its report, the panel noted that care workers were by far the most likely to earn significantly below this threshold with wages so low that workers were in effect “subsidising the cost of these services through low-wage or no-wage work”.

This is hardly news to many of the country’s community health workers who continue to battle for regularised pay and benefits.

Gauteng community health workers recently marched to the department of health. The march was prompted by, in part, the department’s decision this year to summarily change the conditions of employment. These workers, who were paid directly by the department until March 2016, have been forced into contracts with Smart Purse, an outsourced payment management system. Essentially outsourced workers, they are not eligible for benefits such as paid maternity leave, state-subsidised pension payments and a myriad of other benefits afforded to government employees…..more and more

Who’ll deliver all our babies?

Sky-high medical negligence claims are forcing obstetricians out of private practice – so much so that the gynaecological society has warned that there won’t be any left in the private sector by 2020.  Medical insurance premiums are rising steeply, making it impossible for many doctors to stay in business. This year private-practice obstetricians had to pay R650000 in medical insurance premiums and this is expected to hit R850000 next year, forcing more of them to stop delivering babies and work only in gynaecology.

The SA Society of Obstetricians and Gynaecologists suggests that about 50 obstetricians quit helping women give birth this year, leaving about 450 obstetricians in the private sector. They need to charge a minimum of R13000 a delivery to cover their costs, including rent and staff, but medical aids pay them less than this. About R5000 of the fee is to cover medical insurance…..more

ADRIAN GORE: Focusing on the negative blinds us to SA’s gifts

At Discovery, we are deeply patriotic and believe our beautiful country is deserving of our best efforts to build it. It is my view, however, that we underrate SA and ignore its sizeable potential. Because of this, we limit our future and affect our ability to lift our country for the benefit of all South Africans. We think being negative about SA is an appropriate, conservative and sophisticated response. But it is not. My thinking is neither naive nor emotional — it is grounded in science. Evolutionary biology teaches us that we evolved on the savannahs over millions of years in conditions that were extremely challenging. Life expectancy was about 30 years and infant mortality was high, with one in three babies dying. We faced scarcity and physical threats, necessitating seeking out negative indicators in order to survive because these signals presented imminent harm. As such, we are deeply coded. Our predecessors who failed to read those cues faced the ultimate risk: death. Today, the opposite is true. The challenges we face are not about scarcity and physical threats, but about abundance, and threats of systemic failure…..more

National Health Act is holding back development of SA’s healthcare

The government’s National Health Insurance (NHI) proposals have dominated the headlines in recent months. The Free Market Foundation’s health policy unit too, has focused on that misdirected and flawed policy. But the NHI is not the only problem in our national health regime. The National Health Act (61 of 2003) is also holding SA back in terms of medical and healthcare development. The Good Law Project’s Principles of Good Law report, published in 2015, contained an introduction to the metalegal concept of “the rule of law”. In brief, the rule of law means that objectively ascertainable principles of law govern society, rather than the arbitrary discretion or whims of politicians and bureaucrats. This is why “the rule of law” is distinguished from “the rule of man”, which finds its expression in dictatorship or absolute monarchy…..more

JOHANN SERFONTEIN: NHI will live or die on the competence of managers in public healthcare

Professional management in the public health sector is a key factor if the implementation of a National Health Insurance (NHI) is to stand any chance of success. Ailing state facilities can be turned around by proper management, as shown by the shining example of Frere Hospital in the Eastern Cape, where a new hospital manager turned a shambolic institution into something that resembles the Department of Health’s proposed ideal clinic model. But what if it is the provincial department that is incompetent? The negative effect of poor management is then spread over a much larger area…..more

Free education and healthcare for poor, same side of the coin

Education and healthcare are the two issues in which the state has to provide the resources, writes Aaron Motsoaledi.  The Department of Health will invest R17bn over the next three years into upgrading public clinics to “workable” levels, in line with a broader preparation for introducing the National Health Insurance (NHI) system. The government has concluded an investigation into the amount required to upgrade the clinics into facilities capable of delivering services to their communities. This figure is insufficient for high-level services, but would hopefully provide key medication and the infrastructure medical staff demand. NHI and the #FeesMustFall campaigns are the same side of the coin, rather than diametrically opposed initiatives…..more

DA has a plan to fix healthcare shortfalls

The DA is expected to unveil its alternative vision for universal healthcare on Wednesday, promising a better deal for patients in half the time of National Health Insurance (NHI) and at no extra cost to the fiscus. It proposes scrapping medical aid tax credits, which are valued at R17.4bn for the current fiscal year, and using the resources to improve public healthcare and subsidise medical scheme membership. The government promised to deliver NHI within 14 years when it published its green paper in August 2011, but progress has been slow despite Health Minister Aaron Motsoaledi’s drive to get it going. The plan has also been criticised as unaffordable, and based on unrealistic expectations of economic growth….more

EXCLUSIVE: NHI pilot projects fail to reach targets

The public health system is in crisis, and its flagship programme does not offer a better deal for patients.  Hospitals and clinics in the government’s flagship National Health Insurance (NHI) pilot programme are failing to improve any faster than those in the rest of the country, according to inspection records obtained from the Office of Health Standards Compliance. The records reveal a public health system in crisis. Among the 1,427 facilities inspected in the four years to March, just 89 of them scored a pass mark of 70% or more. Facilities fell short on matters ranging from the availability of medicines to infection control…..more

See list here

Hotline for patients to expose poor treatment and shoddy hospitals, clinics

Patients will soon be able to report negligence‚ long queues and shoddy hospital and clinic facilities to the health police.

The office of health safety compliance will launch its complaints management call centre on Monday to record and investigate complaints properly.

Through this centre, the watchdog body would be able to protect and promote the health and safety of health service users and vulnerable people exercising their right to healthcare, said spokesman Ricardo Mahlakanya.

He said a team would be ensure calls were not missed…..more

How BEE gives sweet riches to an inner hive

A coterie of politically connected black businesspeople has amassed extraordinary wealth, but the state remains outside the circuits of production, write Jeremy Seekings and Nicoli Nattrass.  The ANC took office committed to increasing the ownership and control of business by black people. Considerable effort went into the formulation and implementation of the black economic empowerment (BEE) legislation and regulations that compelled business to co-operate in the transfer of large shares of ownership and control to a new, black corporate elite. The close, informal links between black political and economic elites contrast with the mostly strained formal and informal links between ANC leadership and government ministers and the established white economic elite…..more

‘No will to drive NHI in SA’

File image: Independent MediaJohannesburg – Falling state revenue collections and warnings from the finance minister that South Africa has a very constrained package and tough choices have to be made might drive a rift between National Health Insurance (NHI) hard liners and those seeking other funding options to improve health services for more South Africans.

The keynote speaker of this year’s SA Medical Association conference, which opened at the Sandton Convention Centre on Friday, Olive Shisana, blamed the lack of political will for the lack of progress in implementing the proposed NHI.

“The political will is just not there. Nine years after the ANC Polokwane resolution to implement NHI, we still do not have the legislation to introduce NHI,” she said.

She was adamant that there was enough money in the fiscus to fund NHI, as the 8.5 percent of gross domestic product that South Africa currently spent in both the private and public sectors was more than the amount spent by some countries with universal health coverage. …more

Fed-up NHI doctors say they are nothing more than glorified nurses

GPs working in the National Health Insurance’s biggest pilot site say they won’t stay because of drug stock-outs, staff shortages and long queues. Fewer than one out of three general practitioners contracted by one of the National Health Insurance (NHI) scheme’s pilot sites believe that the scheme will have a “discernible impact” on giving “previously underserved communities” better access to healthcare, according to a study published in the South African Medical Journal in November. Researchers interviewed 55 of the 75 GPs who worked at one of 17 clinics in the NHI’s biggest pilot district, Tshwane, between April and June last year. Many of the doctors said they wouldn’t be staying on “for a long time” because drug stock-outs, staff shortages and the “pressure of long queues” had reduced them to nothing more than “glorified nurses”. ….more

Full article

Call for Applications: Alan Magill Fellowship 2017

Seeking Applicants for the Alan J. Magill Fellowship

$50,000 – Open Only To Low/Low-Middle Income Country ASTMH Members [Angola  / Benin  / Burkina Faso / Burundi  / Cameroon  / Cabo Verde  / Central African Republic  / Chad / Comoros / Congo / Côte d’Ivoire  / Democratic Republic of the Congo  / Djibouti  / Equatorial Guinea  / Eritrea / Ethiopia  / Gambia / Ghana  / Guinea / Guinea-Bissau  / Kenya / Lesotho / Liberia / Madagascar / Malawi / Mali / Mauritania / Morocco  / Mozambique  / Namibia / Niger / Nigeria 2 / Papua New Guinea / Rwanda / Senegal  / Sierra Leone  / Somalia / South Sudan / Sudan  / Swaziland  / Timor-Leste  / Togo / Uganda / United Republic of Tanzania / Yemen / Zambia / Zimbabwe

We are proud to launch the Alan J. Magill Fellowship, created in partnership with the Bill & Melinda Gates Foundation to honor the life, example and legacy of Alan J. Magill, MD, FASTMH, a widely recognized and respected leader in the global tropical medicine community.

In keeping with the prominent roles displayed throughout Alan Magill’s life, the Magill Fellowship:

Will provide funding of $50,000 for a period of up to two years to one recipient

Will support mentorship, career and/or leadership development projects for early- to mid-career ASTMH members in low/low-middle income countries focusing on leadership development in tropical medicine

Stipulates that the selected Magill Fellow will work closely with a mentor (ideally an ASTMH member, but not required) who will play a prominent role in developing and executing the Fellow’s two-year plan of activities

While the award will recognize achievement in tropical medicine, it is not intended to extend current research or clinical activities. Instead, it is designed to support career-broadening experiences to enhance professional development and leadership opportunities beyond those traditionally available from within the applicant’s home organization?and in so doing, equip awardees to later assume leeadership and mentoring roles in various aspects of tropical medicine.

For further details, review Call for Concept Papers here.

Deadline for submission is February 1, 2017.

HIFA profile: Lady Velarde Murrugarra is Coordinator, e-Prevencion in Latin America and Caribbean, and is currently Vice-President of the Association of Peruvian Telemedicine and Telehealth (2015-2017) and Director of Relations Internationals Association Peruvian Bio-Informatics (APIM).  ladymurrugarra AT

BMJ: New models of working risk throwing the baby out with the bathwater

A strong case is being made in many countries that the traditional model of general practice needs to change. Critics claim that practices are too small and too isolated, that they are increasingly unable to meet their patients’ needs and expectations, and are unfit to lead the necessary redesign of health systems.1 2 As general practice in the UK in particular struggles with a demoralised workforce and inadequate resources,3 these criticisms are being taken on board. Quietly but rapidly, and in a largely ad hoc fashion, general practice is changing; small practices are closing or merging with other practices, practice networks are forming, the primary care workforce is becoming increasingly multidisciplinary, and new integrated models of care that bring together community and hospital based services are being developed.

Many of these changes may be good for patients and for the health system, but insufficient attention is being paid to the possible unintended consequences. One substantial risk should be exercising policy makers but is not doing so: that the emerging new models may not deliver the same benefits to patients and the health system as the traditional model. ….more

Clubfoot training in Africa

At the University of Oxford we have been developing clubfoot training materials for healthcare professionals in Africa, to strengthen care for children born with clubfoot. Working with CURE Clubfoot and Global Clubfoot Initiative, and over 70 clubfoot practitioners from the UK and 18 countries in Africa, we are excited to be in the final stages of producing an instructor training course, a Basic Clubfoot Treatment Provider course (using the Ponseti method), and an Advanced Non-Surgical Clubfoot Treatment Provider course.

We’ve piloted the materials in French and English, and during November 2016 we are raising funds to support further clubfoot training in Africa next year, and further translation.

We’d love to hear from colleagues interested in building up clubfoot services in Africa.

Grace Le

Africa Clubfoot Training project, NDORMS, University of Oxford

In response to a message from earlier today about Clubfoot training in Africa, I would like to make everyone aware of SAWBO’s educational clubfoot animation.  Here is the link where you can view and download the video in its various languages:

This video is free to use for any educational purposes.  If you would like to work with us to translate this video into another language, please email me at


Ben Blalock


Scientific Animations Without Borders™

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