Bilateral Agreements in the Field of Health: briefing

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25 March 2003
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Meeting Summary

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Meeting report

15 March 2003

Mr. L. Ngculu (ANC)

Documents handed out
- MoU between RSA AND Italy in the Field of Health in KwaZulu Natal
- MoU between RSA and Italy in the Field of Health in Gauteng
- Exchange of Notes between RSA and Japan on cooperation in KwaZulu Natal
- Basic Agreement between RSA and WHO for establishment of Technical Advisory Cooperation Relations
- Agreement between RSA and Nigeria on cooperation in the Field of Health and Medical Sciences
- Declaration of intent between RSA and Rwanda on cooperation in the Field of Health
- Declaration of intent between RSA and Senegal on cooperation in the Field of Health
- Declaration of intent between RSA and Angola on cooperation in the Field of Health
[email for documents]

The Department of Health provided information on the different types of agreements it had entered into with Japan, Italy, Nigeria, Angola, Rwanda and Senegal.

The Chair informed the committee that Dr. Simelela,
Chief Director: HIV/AIDS, who was to make a presentation on the compulsory HIV testing for sexual offenders had sent an apology to the effect that she could not attend due to prior commitments.

Bilateral Agreements on Cooperation in the Field of Health
Dr. T Balfour from the Directorate of International Relations explained that South Africa had entered into a variety of agreements with friendly countries. The Department of Foreign Affairs first establishes the relationship before other departments pick up the theme to craft specific engagements. She explained that there are various forms of agreements and that a Declaration of Intent was the lowest form of engagement followed by a Memorandum of Understanding (MoU) which then ushers in the highest form of engagement which is a Co-operation Agreement.

Dr Balfour noted that there has been an exchange of letters with Japan for the purpose of Japan contributing to a project to improve health facilities in KZN. The government of Japan has granted 1, 047,00,000 Yen to the project. The Japanese are very strict with the conditions of financial assistance but despite initial difficulties the community centre project was successfully implemented.

South Africa had signed a Memorandum of Understanding with Italy wherein the Italian government has undertaken to assist the Gauteng Department of Health to design and implement a comprehensive Health Information System in the province. The Italians are new comers in the area of financial assistance and the National Department is exploring ways of seeking their help to develop a comprehensive health information system.

South Africa had signed a Memorandum of Understanding with Italy to assist the KwaZulu Natal Department of Health with improvement of primary health care service delivery. It was signed on 25 June 2002 and the funding expires after three years. She pointed out that Italians are well established in matters of health information systems and their assistance in this area is vital. It will offer an opportunity for technical support and training in Italian institutions for health professionals.

South Africa has signed a basic agreement with the WHO for the establishment of Technical Advisory Co-operation relations with a view to implement the resolutions and decisions of the United Nations and related organisations. She pointed out that the Agreement was signed on the 5 December 2000 and that it extents diplomatic immunity to WHO officials present in the country. The Agreement outlines how the WHO would offer technical advice and provision is made for the WHO to organise seminars and other educational programmes for health professionals in the country

South Africa has entered a Co-operation Agreement with the government of Nigeria in the field of Health and Medical Sciences in pursuance of the goals of the Bi-National Commission established between the parties. The Agreement outlines areas of co-operation in a range of public health and medical science endeavours. South Africa has also signed a declaration of intent with the governments of Rwanda, Angola and Senegal based on institutional co-operation in the field of Health. This measure was in keeping with the government's desire to pursue close ties with key African countries.

Ms Madumise (ANC) wanted to know who pays for the staff that work for donor-assisted programmes such as the building a community centre in KZN.

Dr. Balfour explained that when provinces appeal for donor support they are presumed to be ready in terms of having the necessary capacity to implement the desired projects. She pointed out that such a province is expected to pay for its own staff.

Dr. Luthuli (ANC) asked if the donor is involved in the sustainability of the initiated projects and whether such a donor is inclined to engage with the country in future.

Dr. Balfour explained that donor assistance runs for the period specified in the Agreement. She noted that there were indeed many funding opportunities but that most provinces lack the necessary infrastructure to fulfil donor conditions to implement agreed projects.

Dr. Luthuli asked about the procedure followed in accessing donor funding.

Dr. Balfour explained that the application for donor funding is normally initiated at the provincial level and that all that the National Department does is to co-ordinate the process and eventually to sign the resultant agreement. She observed that some provinces are very active in securing donor assistance while others are not but that the National Department does at times intervene on behalf of poorer provinces.

Ms Tshwete (ANC) wanted to know whether there were trained people who take up the running of the facility once the donor disembarks.

Dr. Balfour pointed out that most of the personnel who run the facility are people already in the employment of the Department although additional staff may be recruited. Unless it is part of the agreement, the donor would not normally train such people.

Ms Tshwete noted that the Italian government undertakes to spend a sum of Euros 132,000 on training. She asked if this training targets only health professionals and whether the community benefits thereby.

Dr. Balfour pointed out that the envisaged training targets only health professionals but that the community does indeed benefit indirectly from services that would be rendered by these trainees.

Dr. Jassat (ANC) noted that some of the agreements have not been properly executed in that names of the signatories are missing. It was important to know who the link person is and the level of attention the agreement had received.

Dr. Balfour acknowledged the discrepancy and promised to look into it.

Ms Mathibela (ANC) referred to the scholarships which the WHO offers and wanted to know how these scholarships are awarded.

Dr. Balfour explained that the WHO indicates which vacancies are available. From there the Department's Human Resource section places appropriate advertisements and a selection committee is constituted to vet the applicants and select the successful candidates.

Mr. Gous (NNP) observed that the Co-operation Agreement with Nigeria obligates the Committee to visit that country.

The Chair noted that this was very important to the committee. Ms. Madumise added that a visit should not only apply to Nigeria but to all the other countries. The Chair agreed that the other agreements do not include a visit by the Committee as part of the deal.

Dr. Balfour acknowledged that the inclusion of a visit by members is vital and a deliberate one to ensure that there is activity in this area since most agreements gather dust once signed.

The Chair asked if managers in the Department are aware that there is no activity that is taking place regarding certain agreements.

Dr. Balfour said that they are aware. However there are many countries seeking to enter co-operation agreements with South African. This puts a heavy strain on the personnel component. Thus the Department is forced to prioritise on the agreements and give attention to some immediately and others must be shelved for the meantime.

Ms Tshwete (ANC) noted the declaration of intent with Angola and asked if the Department links up with the Department of Home Affairs when accepting referrals of patients from Angola and other countries.

Dr. Balfour admitted that it was important to ensure that those who come as referrals have their documents in order and that it is made clear who meets the cost of treatment and how the patient would be repatriated upon completion of the treatment regimen. She assured the Committee that the Department is always vigilant in this regard.

The Chair noted that agreements with friendly countries help to enhance the country's international relations. In particular, agreements with African countries are of immense important especially in view of the NEPAD initiative and the spirit of the African Union.

Meeting adjourned.


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