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Zambia 2015 | HEALTH & EDUCATION | VIP INTERVIEW

TBY talks to Hon. Joseph Kasonde, Minister of Health, on developments in the country's healthcare landscape.

The Director of the World Health Organization in Zambia recently voiced his satisfaction with progress in the country's health sector. What have been the main achievements of your Ministry since you assumed office in 2011?

One of the critical issues that we discovered when we came to power was the issue of healthcare delivery. At that point we identified certain diseases to target in order to reduce their impact on the population, specifically HIV-AIDS, Malaria, and other communicable diseases. We also recognized the emergence of non-communicable diseases. If we look back over the past four years, though we are certain that we have had an impact on Malaria control, we aim at nothing less than its total eradication. We have also had an impact on new cases of HIV transmission, particularly mother-child transmission, which has been greatly reduced. With regard to the healthcare system itself, we were concerned about pharmaceutical supplies, as this has long been a concern. In 2011 there was approximately 110-120 million in present day Kwacha, which in those days stood at a billion, allocated to pharmaceutical supply. Since then we have come to spend three times what we had previously spent on supplying drugs.

The vast majority of that supply comes from imports. What are your plans for trying to develop a drug manufacturing industry in Zambia?

It is difficult to ensure availability of drugs when you are dependent on sourcing them from abroad. There is a need for some production to be realized in Zambia, although manufacturing in terms of laboratory synthesis is not a realistic proposition for Zambia today. However, in the later stages of pharmaceutical processing and production there is the possibility of setting up local operations. We need to establish some incentives as part of the Zambian Development Agency, related to tax and other critical areas. Secondly, we should work with those who are interested in manufacturing and guide them in areas where they might have a maximum impact by producing locally. The concern about both money and distribution systems is that if you do not define the essential medicines, success is elusive as there are over 3,000 products worldwide, and Zambia cannot afford to purchase them all. We have to define essential needs, and there must be absolute availability of those essential medicines.

What is the status of your plan to build 650 health posts at an estimated cost of $50 million?

We are progressing steadily. In terms of the contract time that we have given to our contractors, we may set April 2016 as the completion date. People have been impatient ever since we announced the plan, but we will do our best to have it ready as soon as possible.

"We have promised that the distance, or the radius, around any institution that we can reasonably expect a person to travel when ill is 5km."

What will be the impact of this project once completed?

We have promised that the distance, or the radius, around any institution that we can reasonably expect a person to travel when ill is 5km. At present, the average distance is between 40 and 80km. These 650 posts are meant to address that issue by reducing the distances people travel before they reach a healthcare facility.

How will you address the shortage of healthcare professionals?

We aim to increase our intake by encouraging both the public and private sector to engage in training. As of today, the number of nurses trained by the private sector is almost the same as those trained by governmental institutions. Unfortunately, health workers also take a long time to train, so we need to persuade our people to be patient. Even if we increase the number of students today they will not be ready to work immediately.

You mentioned the increase in the balance of non-communicable diseases in Zambia. What does that mean for the Ministry?

We have been conscious of the issue for some time, but I do not think that we are even close to ready at the moment. Over the past two years we have taken several steps to address non-communicable diseases. The new Cancer Diseases Hospital that we hope to commission shortly exemplifies our efforts. The structure is intended to be more than a hospital; it will be a center of excellence for the prevention and management of cancer.

Medical and health tourism is on an increasing trend. Do you see any potential in Zambia?

The government is spending approximately $1 million a year to send patients outside of the country for treatment, because there are certain conditions that we cannot handle. We acknowledge that the exchange of health services between countries is important. We have much to offer and will shortly be accepting cancer patients from neighboring countries. At one time Zambia was utilizing Zimbabwe's services, but today we are set to become an international center.

What role do mobile technologies and other new technologies play in providing healthcare to rural areas?

We have adopted e-learning, and though our initial effort was perhaps small, we have established five nursing schools and a unit at the University Hospital. This unit is called Tele-Medicine, and will offer the chance for people to access health services remotely by sending images and being assessed online. The potential for ICT solutions is huge, especially in the supply management of drugs. A good control of drug stocks is essential as instant information will allow us to react instantly.

What are your expectations for the year ahead?

Our main objective is universal health coverage. We firstly need to raise the quality of care in general. After this we need to expand geographically to cover as much of the territory of the country as possible. We are also committed to the elimination method. We know that we can eliminate malaria and AIDS, perhaps even earlier than HIV itself. And turning to pharmaceuticals, we cannot accept any shortage of drugs identified as being essential. We must also begin to approach the issue of financing. Health financing is a problem everywhere, even in industrialized countries, so we have to start thinking about how to solve this. I am hopeful that a law will be passed within the coming period to create a social health insurance scheme. In that way we can increase our current budget. This year we have allocated 9.3% of the budget to health, and want to raise this to at least 15%. And meanwhile, we aim to pass the social health law within this year.