1. Influencing Public Health Policy by national and sub-regional PHAs – AFRICAN FEDERATION OF PHA PERSPECTIVE Dr.Mathias SOME ABSP, RASPAF, AFPHA At PHASA Policy Workshop during WCPH Addis Ababa, Ethiopia, 23 April 2012 African Federation of Public Health Associations

2. WHY INFLUENCE PUBLIC HEALTH POLICY? (1) In most of the African countries, health policies are hospital oriented one, aimed to provide mostly reparative care interventions to restore health  The great majority of people live in conditions that constantly threaten their health:  unhealthy living environment,  poor access to essential social services (drinking water, education, etc..)  insufficient access to balanced and sufficient,  very high risk factors (accidents, alcoholism, smoking, pollution, etc..)

3. WHY INFLUENCE PUBLIC HEALTH POLICY? (2) Health facilities, even curative, are not affordable to all for following reasons: - Geographic inaccessibility, - Cultural incompatibilities, - Economic barriers, Care services, are often poorly equipped, lack of qualified personnel; Communities are considered as passive consumers of health care and not as potential actors

4. IN WHAT DIRECTIONS INFLUENCE PUBLIC HEALTH POLICY? To make sure that health is a real factor of social and economic development, health policies must have the following characteristics: ▫ be focused on actions insuring healthy and empowered communities, ▫ be focused primarily on disease prevention through protection of vulnerable groups (women, newborns, young children, elder persons, workers, etc.) and promotion of healthy lifestyles, ▫ promote equity of access to quality services, ▫ require more responsiveness and accountability towards communities.

5. WHY PHAs MUST INFLUENCE PUBLIC HEALTH POLICY? Apart from Government and Governmental Agencies of Health, only PHAs look at the totality of Public Health on a continuous basis PHAs are multi-sectoral and multi-disciplinary PHAs have an institutional memory which is specifically and eternally focused on Public Health People expect an independent authoritative voice on issues of Public Health

6. WHICH PHAs CAN REALLY INFLUENCE PUBLIC HEALTHPOLICY (1) To influence health policy in a public health vision, the PHAS shall: – Be known by the main health actors in their country, – Be recognized for their relevant positions, – Accepted as interlocutors, – Respected because of their seriousness. All these characteristics make them visible and credible!

7. WHICH PHAs CAN REALLY INFLUENCE PUBLIC HEALTHPOLICY? (2) PHAs that can fulfill these conditions are those that are able: 1.To exploit the evidence based data of research institutions to build advocacy strategies or campaigns, what means be able to work closely with them, 2.To develop strategies and advocacy campaigns on issues of public health, 3.To mobilize other potential actors (politicians, civil society organizations, scientists) in advocacy and lobbying campaigns, 4.To share the results of their actions with other actors, 5.To intervene in communities to mobilize them to be involved in the implementation of health programs.

8. WHAT IS THE CONCRET SITUATION IN OF AFRICAN PHASs Regarding these requirements? Many PHAs are very young, inexperienced, There is a large difference between PHAs in Anglophone countries others, particularly regarding: – Collaboration capacity with research institutes in order to draw evidence based data to build advocacy campings, – Capacity to successfully develop and conduct advocacy campings.

9. SOME FEW EXAMPLES FROM WESTERN AFRICA However, we can mention some experiences that have been initiated and conducted by national PHAs, in Western Africa by the Network for Governance, Equity and Health (GEH) that had included Benin, Burkina, Côte d’Ivoire, Mali, Senegal, In Burkina, ABSP has successfully conducted a campaign that lead to pass the law on tobacco control. If we compare these to what is done in Anglophone African countries, it is a little drop in the ocean!

10. HOW TO MOVE FORWARD? (1) Our Federation is of course young, but it must very quickly demonstrate its efficiency by enabling national PHAs to influence health policies. The following axes of actions can be considered: 1.Take measures for a rapid strengthening of capacities of existing national PHAs so that they can be visible and credible, 2.Enable them to be really multidisciplinary, and mobilize key national stakeholders on health priority issues. For this purpose, the reduction of maternal and neonatal mortality in African countries must be seen as a major concern where African national PHAS must prove their leadership capacity, 3.Every event happening in any country by the initiative of national PHA ( Public health workshops, Congresses, scientific activities, etc..)must be an opportunity to exchange experiences, regardless to language barriers

11. HOW TO MOVE FORWARD? (2) The Federation encourage national PHAs: – To promote frameworks and mechanisms of interaction between researchers and policy makers and health programmes officials, – To become familiar with the internet facilities to benefit from the experiences of other countries; To meet these challenges, the Federation must establish strong and lasting partnerships with – United Nations agencies and especially with WHO, – African organizations of regional integration, – Networks of PHAs from other continent (Europe, America, Asia) who are more experienced than we are

12. MERCI POUR VOTRE AIMABLE ATTENTION I THANK YOU FOR YOUR KIND ATTENTION!