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Final Declaration of the 25th Meeting of Ministers of Health of the Movement of Non–Aligned Countries held in Johannesburg, South Africa, 26 – 27 March 2001 Preamble 1. The Ministers of Health and Heads of Delegations of the Movement of Non-Aligned Countries, met in Johannesburg, South Africa from 26 – 27 March 2001, to deliberate and reach consensus on health policy issues under the general theme, "Health, Trade and Development; Aligning Policy for a Common Goal." 2. The Ministers of Health and Heads of Delegations reaffirmed the views expressed by Heads of State and Governments at the XII NAM Summit in Durban 1998, wherein they emphasised their commitment to the principles and commitments of the 1995 World Summit for Social Development, recognised health as a resource for sustainable development and expressed their commitment to overcoming the obstacles to good health through international collaboration including, more effective South – South co-operation. 3. The Ministers of Health and Heads of Delegations welcomed the revalidation of the principles and commitments of the 1995 World Summit for Social Development by the 24th Special Session of the UN General Assembly entitled "World Summit for Social Development and beyond: achieving Social Development for all in a globalising world," (Geneva, June 2000) and endorsed the health related elements of the further actions and initiatives proposed by this meeting. 4. The Ministers of Health and Heads of Delegations recognised that solidarity, sovereignty, dignity, equity, and the fostering of national capacity and knowledge in the areas of health and sustainability, are pivotal principles for the Technical Co-operation amongst Developing Countries (TCDC), and they are fully valid today. Putting into practice these principles to make the TCDC run effectively will require the implementation of different co-operation forms and modalities, especially in terms of reciprocity amongst Participating States, joint exchange and co-operation, as well as the unconditional contribution of those having the resources and possibilities to do it especially, but not exclusively developing countries. They emphasised the relevance and importance of South–South co-operation as a strategy in support of the development efforts of developing countries and as a means of ensuring their equitable participation in the emerging global economic order. 5. The Ministers of Health and Heads of Delegations noted that, while globalisation and continuing rapid technological advances offer unprecedented opportunities for social and economic development, they continue to present serious challenges, including widespread financial crises, insecurity, poverty, exclusion and inequality within and among countries and societies. They further noted that unless the benefits of social and economic development are extended to all countries a growing number of people in all countries and even entire regions will remain marginalised from the global economy. 6. Noting that the primary determinants of ill health (poverty, the lack of education and environmental degradation) are also amongst the critical causes for underdevelopment, the Ministers of Health and Heads of Delegations underscored the central role that health plays in development, by being both a necessary precondition to and an outcome of the overall development process. 7. Further noting that the attainment of good health is often realised through actions outside the health sector, the Ministers of Health and Heads of Delegations committed themselves to strengthening and enhancing multisectoral action at all levels. They also urged regional and international organisations, as well as development agencies, to ensure that the health dimension is integrated into their policies and programmes and co-ordinated at the country level. 8. In order to achieve the highest possible standards of health for their people, the Ministers of Health and Heads of Delegations reaffirmed the crucial role of Government in:
<<Back to Top>> Health for All and Health Sector Reform 9. The Ministers of Health and Heads of Delegations reaffirmed their commitment to the objectives of the health for all strategy, in particular the achievement of equitable, affordable, accessible and sustainable health care systems based on primary health care, whilst recognising that it is the sovereign right of each country to develop national policies appropriate to the specific needs of its people. 10. The Ministers of Health and Heads of Delegations noted that, to achieve progress towards these objectives, health systems would need to be strengthened, through inter alia the following measures:
11. Noting that there are important lessons to be learnt from the experiences of individual countries in the area of health sector reform and that the developing country perspective has often been absent from international discourse on this subject, the Ministers of Health and Heads of Delegations reiterated the need to formalise the mechanisms for sharing such experiences through for example, supporting the work of the evolving network of academic institutions within NAM countries. 12. Recognising that current debt relief efforts could potentially free up considerable resources for use in the development of health infrastructure and services and that the yield from current processes has to date been disappointing, the Ministers of Health and Heads of Delegations urged the international community, including creditor and debtor countries and relevant international financial institutions, to identify and implement development orientated and durable solutions to alleviate external debt and to solve the debt servicing problems of developing countries. 13. The Ministers of Health and Heads of Delegations recognised the potential of the private sector and non-governmental organisations to complement the efforts of the public sector in the delivery of health services, but emphasised that this goal could only be achieved in the presence of a common vision and shared values, supported by an appropriate government regulatory framework and stewardship. <<Back to Top>> Building social capital: Addressing the major health challenges. 14. Whilst the developmental impact of ill health is fairly universal, the causes thereof may vary considerably between and within countries. The Ministers of Health and Heads of Delegations reaffirmed the sovereign right and responsibility of countries to mount the appropriate responses based on their specific public health needs, available resources and cultural and social values and norms. 15. The Ministers of Health and Heads of Delegations recognised the particular challenge posed by the HIV/AIDS epidemic in a number of developing countries, impacting as it does, on all facets of life. By its predominant effect on the young and economically active, the epidemic threatens to impede and even reverse development gains, whilst increasing the long term vulnerability of the orphans that it creates in its wake. They committed themselves to leading and coordinating the multisectoral response necessary to combat this epidemic. 16. The Ministers of Health and Heads of Delegations welcomed the prominence afforded to HIV/AIDS on the international political agenda and expressed support for the forthcoming Special Session of the UN General Assembly on HIV/AIDS (June 2001). They, however, emphasised that to be effective, such commitment by the international community must be translated into increased resources and intensified action at the national and international level. They renewed their commitment to develop and intensify South-South co-operation in this area of HIV/AIDS. 17. Recognising that HIV/AIDS, Malaria and TB constitute a major development challenge in many NAM countries and as such require a response that surpasses that which countries are able to mount individually, the Ministers of Health and Heads of Delegations welcomed the mobilisation of international consortia by WHO and UNAIDS, in support of national and regional efforts to address the vulnerability to and the treatment of these diseases. 18. Recognising the importance of advocacy in countering ignorance, stigma and discrimination associated with HIV/AIDS, the Ministers of Health and Heads of Delegations welcomed the expressions of political commitment at both the national and international levels. 19. In the light of the particular vulnerability of women and girls, the Ministers of Health and Heads of Delegations urged that increased efforts be made to provide them with equal access to education, social and health services. Such health services should address reproductive health including the challenges posed by high levels of maternal mortality and morbidity and the challenges of violence against women. 20. The Ministers of Health and Heads of Delegations further emphasised the need for the involvement of men as partners to women in these reproductive health programmes. 21. Noting that communicable diseases continue to represent the major cause of morbidity and mortality in developing countries and that these diseases are readily transmitted across national boundaries, the Ministers of Health and Heads of Delegations pledged to intensify their efforts at all levels to prevent, monitor and treat these conditions. 22. Concerned about the projected population increase in less developed countries from 4.9 billion in 2000 to 8.2 billion by 2050, the Ministers of Health and Heads of Delegations urged the international community to honour its commitment to providing the resources necessary to address critical population issues such as reproductive health and rights; wider choices towards fertility regulation, improvements in the status of women; longer life expectancy; lower infant mortality and closing the gender gap in education. 23 The Ministers of Health and Heads of Delegations further recognised that non-communicable diseases including mental conditions, already constitute a serious health problem in many NAM countries as a consequence, inter alia of lifestyles and ageing populations. Since many countries may in future be faced with the double burden of disease related to both communicable and non-communicable diseases, they emphasised the importance of a comprehensive approach to health problems especially health promotion. 24. The Ministers of Health and Heads of Delegations aware of the problems facing many adolescents in developing countries due to violence, risky sexual behaviour, drug use and delinquency; agree to promote the development of participatory programmes of advocacy and resourcefulness which will enable them to improve upon their integral health and well-being. 25. The Ministers of Health and Heads of Delegations noted that a healthy and productive workforce is a prerequisite for the socio-economic development of any country and that the working conditions of the majority of working people does not meet the minimum standards set by the ILO for safety, health and social protection. They were of the view that this contributed significantly to health and economic losses and urged that occupational health and safety concerns should be integrated into efforts to expand the skills of workers and provide decent work - (Amended from 26th International Conference on Occupational Health) <<Back to Top>> The access to safe and affordable essential medicines 26. The Ministers of Health and Heads of Delegations reaffirmed the right of everyone to the enjoyment of the highest attainable standard of physical, mental and social health and recognised that the access to safe and affordable essential medicines constituted an important factor in the realisation of this right. 27. Whilst acknowledging the contribution of intellectual property rights to the promotion of research and development of new drugs, the Ministers of Health and Heads of Delegations noted that the relevant international agreement also required that the protection and enforcement of these rights should contribute to the transfer and dissemination of technology, to the mutual advantage of producers and users of technological knowledge and in a manner conducive to social and economic welfare, and to a balance between rights and obligations. 28. The Ministers of Health and Heads of Delegations, therefore, urged that countries should not be hindered in their efforts to exercise the options available to them under international agreements, including compulsory licensing and parallel importation, to protect and advance access to life saving and essential medicines and consistent with national laws and international agreements acceded to. 29. The Ministers of Health and Heads of Delegations supported the call for the provision of greater support and assistance to developing countries in the fields of vaccines, medicines and public health, thereby strengthening local capacity, improving control and treatment of communicable diseases such HIV/AIDS, malaria and tuberculosis as well as assisting in making vaccines and medicines for the control and treatment of these diseases widely available at affordable prices. In this connection, the need for the formation of a global drug facility for HIV/AIDS and associated infections, as is proposed for TB, was strongly stressed. 30. The Ministers of Health and Heads of Delegations encouraged arrangements and incentives to mobilise commercial enterprises, especially in the area of pharmaceuticals, to invest in research aimed at finding remedies that can be provided at affordable prices for diseases that particularly afflict people in developing countries and supported the efforts of WHO to foster partnerships between the public and private sectors in the area of health research. They also emphasised the need to encourage the use of proven alternative and traditional systems of medicines as a means for providing affordable solutions to many diseases. 31. The Ministers of Health and Heads of Delegations emphasised that to be successful, these partnerships would have to be based on genuine consultation and co-operation with affected countries, mutual trust, clear terms of reference and a transparent method of work. 32. The Ministers of Health and Heads of Delegations welcomed the offer from technologically advanced developing countries, to explore and expand the opportunities for South-South collaboration with particular reference to HIV/AIDS-related drugs. <<Back to Top>> Health as a Human Right 33. Recognising that the interdependent nature of rights determines the extent to which any single right may be enjoyed, the Ministers of Health and Heads of Delegations undertook to reaffirm, promote and strive to ensure the realisation of all rights set out in relevant international instruments and declarations, including those relating to education, food, shelter, employment, health and information, particularly in order to assist people living in poverty. 34. The Ministers of Health and Heads of Delegations recognised that women and girls suffer additional discrimination and are, therefore, disproportionately represented amongst the poor, the uneducated, the marginalised and the excluded. They urged the elimination of such discrimination and the empowerment and full participation of women in all areas of life as an intrinsic part of social development. 35. The Ministers of Health and Heads of Delegations noted the progress made in the ratification and implementation of the International Convention on Children’s Rights and reaffirmed the importance of health in the provisions of the Convention. They renewed their commitment to intensify their efforts to pursue concrete measures for its implementation and requested that the international community supports their efforts and their initiatives in this regard. 36. The Ministers of Health and Heads of Delegations urged the international community to avoid and refrain from any unilateral or coercive measures not in accordance with international law and the Charter of the United Nations that impedes the full achievement of economic and social development by the population of the affected countries, in particular women, children, the elderly and persons with special needs, that hinders their well-being and that creates obstacles to the full enjoyment of their human rights, including the right of everyone to a standard of living adequate for their health and well-being. They further urged that food and medicines not be used as tools to apply political pressure. 37. The Ministers of Health and Heads of Delegations noted with concern the deteriorating political situation in the occupied Palestinian territories as a result of Israeli expansionist policies and the extensive use of force against Palestinian civilians and the embargo and isolation which has led to a marked deterioration in the health and well-being of the Palestinian people They have, therefore, urged an intensification of the efforts to put an end to this policy of aggression and to achieve a just, comprehensive and lasting peace on basis of the UN resolutions in particular Security Council resolutions 194 (1948), 242 (1967) and 338 (1973). 38. The Ministers of Health and Heads of Delegations further noted with grave concern the displacement of peoples and the deterioration of health conditions and well-being of the affected peoples, due to the continuing and rising levels of armed conflict in various parts of the world. They, therefore, called for stronger commitment to end such conflicts as well as the mobilisation of resources to restore the health care delivery services in affected areas <<Back to Top>> Trade and Health 39. Noting that the proposed services sector negotiations within the World Trade Organisation, will include the consideration of possible liberalisation of the trade in health services, the Ministers were of the view that such liberalisation should support national health policies and advance health equity. They requested WHO and other concerned international organisations to strengthen the capacity of developing countries to analyse the possible impact of such agreements on health equity and the ability to meet the health needs of people living in poverty and to develop policies to ensure the promotion and protection of national health services. 40. Recognising the health burden caused by the use of tobacco products, the Ministers of Health and Heads of Delegations reaffirmed their support for more effective control of tobacco products and in particular, their support for the proposed elaboration of a Framework Convention on Tobacco Control to co-ordinate trans-national action in this respect, [as contained in Resolutions WHA52.18 and WHA53.16]. They, however, recognised that the economies of many developing countries were reliant on tobacco and tobacco products and urged that assisting such countries to diversify their economies should be an important focus of the proposed framework convention. 41. As ever increasing amounts of food and feed and food products for human and animal consumption, circulate in international trade, the Ministers of Health and Heads of Delegations urged that the safety of such products should be a foremost concern. They, therefore, welcomed the collaborative work of WHO and FAO within the Codex Alimentarius but cautioned against the adoption and use of unrealistic standards, as a means of restricting the access to products from developing countries. They also urged that a surveillance and analytical system be put in place to respond to the interests and needs of non-aligned countries. 42. The Ministers of Health and Heads of Delegations noted the progress being achieved in the areas of human genetics and biotechnology. They urged that the accumulation and utilisation of knowledge in respect of the common human endowment, should at all times be subject to accepted scientific, moral and ethical standards and to the potential benefit of all, especially the poor. <<Back to Top>> Future steps 43. The Ministers of Health and Heads of Delegations endorsed the contents of this declaration as a basis for their future collaboration and undertook to ensure that these views were reflected at the appropriate fora including, the 54th World Health Assembly and the XIII NAM Summit. 44. Consistent with the Havana Declaration (June 1998), the Ministers of Health and Heads of Delegations stressed the importance of ensuring that the Non-Aligned Movement Health Consultative Group, (comprising the NAM Troika) functions more effectively in following up the Movement’s health strategies. 45. The Ministers of Health and Heads of Delegations and all participants expressed their profound appreciation and thanks to the Republic of South Africa for successfully hosting and organising the 25th meeting of Ministers of Health of the Non-Aligned Countries.
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