30.06.2009

Launching of the Health Sector Strategic Plan III

Swiss Cooperation is especially delighted about the fact that equity, governance and gender are cross-cutting issues in the Health Sector Strategic Plan III (HSSP III) launched on June 30, 2009. All three are considered as crucial in the improvement of the service delivery towards people.

Address by Adrian Schläpfer Ambassador of Switzerland in Tanzania, on behalf of DPG Health

Excellency Jakaya Mrisho Kikwete, President of the United <>Republic of Tanzania, Honourable Prof. David Mwakyusa, Minister of Health and Social Welfare, Ladies and Gentlemen, colleagues and friends,<>

On behalf of Development Partners involved in the Health Sector, it is both an honour and a pleasure for me to participate in this special event to launch the Health Sector Strategic Plan III. We commend the Government of Tanzania and all stakeholders on the release of this plan. HSSP III, as it is commonly referred to, is a comprehensive plan to respond to the health needs of all Tanzanians, with the aim of achieving the health related Millennium Development Goals.

Since 2000, Tanzania has made impressive health gains; recent data from the Tanzania HIV/AIDS and Malaria Survey indicate that between 1999 and 2007/8 under five mortality has declined by 38%. HIV/AIDS prevalence rate among young men and women has fallen substantially from 2004 levels. There have also been great strides in providing life-saving anti-retroviral treatment to those living with HIV/AIDS. And there are signs that malaria and tuberculosis are progressively being brought under control as well. These are impressive achievements which demonstrate that the strategies in place are delivering tangible results.

However the challenges we face remain daunting: With an estimated 8000 maternal deaths per year, maternal mortality remains high, too high. Many children, particularly those under five, are still suffering from malnutrition and anaemia, and are dying from preventable and treatable infectious diseases. The newborn situation analysis report notes that 140 newborns die every day in Tanzania, which is one every 10 minutes.  It also notes that most of these deaths occur in rural areas and in poor families where delivery at home is the norm. The causes of these deaths are directly linked to the low attendance for delivery at health facilities, a dramatic shortage of qualified human resources and the shortcomings of medical supplies such as delivery kits, and equipments in the health system.

The crucial challenge for the future is certainly how access to and quality of essential health care can be improved. The Health Sector Strategic Plan launched today is an important milestone in this endeavour because it emphasises the importance of quality essential health services, and highlights the importance of equity and governance.

The cost of delivering health care is increasing worldwide. That’s why it is crucial to develop a long term strategy for the financing of essential health services. In order to ensure the implementation of this ambitious plan and sustain the achievements, the increase of health funding is critical, as is the method by which the resources are allocated and managed, so that additional funding can produce substantial improvements in health outcomes.  

While the existence of effective strategies is a precondition for a well focussed and coherent approach, health is one of those public goods, whose financing cannot possibly be generated entirely by the users themselves. Public financing is thus inevitable and we Development Partners stand ready to support the Government accordingly. That is why a group of Development Partners, including the Netherlands, Denmark, Ireland, Germany, Switzerland, Norway, Canada, World Bank, UNFPA, UNICEF, WHO and One UN have recently confirmed their commitment to work with the Government of Tanzania and stakeholders to implement the HSSPIII and to continue to fund the sector through the so called health basket fund. For financial year 2009/2010 this amounts to approximately 60 million US Dollar in confirmed pledges, with the potential for millions more to come, as other development partners are currently working to secure their commitment. These funds will be pooled and together with funds from the government budget will pay for sustainable improvements in the health sector through the Medium Term Expenditure Framework of the Ministry of Health and Social Welfare, the Regional Health Management Plans and the Comprehensive Council Health Plans for each of the districts. This year, stakeholders have decided that an even greater proportion of this health basket funding will be provided to facilitate front line health services at the district level. Thus, from July 2009, the per capita Health Basket Fund contribution to district level health services will increase to $1.25, up from $0.5 when the Basket first started and $1.00 per capita last year. This is still a modest amount, considering the needs, but it’s our expectation that more Development Partners will join in the basket fund to support the implementation of this ambitious and comprehensive plan.

The ‘Health Basket Fund’ was established in 2001 and is meant to complement the government’s own efforts to improve the health system, especially in first-line facilities, district hospitals, health centres, and dispensaries.  The funding is used by the Government to address the priorities defined in its health sector strategies. It uses Government systems and in so doing it also aims at strengthening the planning as well as the procurement and financial management systems.  The Health Basket fund has been assessed by the external evaluation of the Health Sector, and acknowledged in the world’s leading medical Journal “The Lancet” as an effective way of providing aid and as having been one contributing factor to Tanzania’s remarkable drop in child mortality. In addition, non-basket funders like the US Government and Japan have participated significantly in the development of the Health Sector Strategic Plan and will continue to provide substantial support to the health sector that can be leveraged with these basket funds to achieve the ambitious objectives of the Plan.  The additional efforts that their funds support are intended to be complementary and harmonized with that of other donors.

Access to basic health care is a human right, which should be availed to all of us – here in Tanzania and globally. Unfortunately, this is not yet the reality in all countries: we find substantial differences in nearly all health indicators along urban-rural, regional and socio-economic divides. In Tanzania for example, rural poor children are much more likely than their urban peers to die, and when they survive they are more likely to suffer from the long term consequences of malnourishment. We also find inequalities in gender disaggregated data: an improved health care to women will not only reduce the maternal mortality rate and multiple pregnancies, but impact decisively and positively on Tanzania’s overall development, too, considering women’s crucial role as actors in society and the economy.

These challenges are global challenges. As long as basic needs are not met universally, no society can prosper, no economy grows and the world cannot live in peace. Your challenges are our challenges as well. That’s why we Development partners are committed to assist the Government of Tanzania in its joint efforts with all Stakeholders from civil society, faith based organisations and the private sector to make every effort necessary to reach the health related Millennium Development Goals. The regular dialogue with all stakeholders which has been so effective and instrumental in drafting the Health Sector Strategic Plan III should continue during its implementation. We Development Partners pledge our wholehearted support to the speedy, efficient, effective and equitable implementation of the Plan and wish you well in this ambitious endeavour.

Asanteni sana.