2013年11月5日-7日，第三屆金磚國家衛(wèi)生部長會議在南非開普敦舉行。中國、南非、印度、巴西、俄羅斯等金磚5國衛(wèi)生部長、以及聯(lián)合國艾滋病規(guī)劃署和世界衛(wèi)生組織國家組織的代表參加了會議。衛(wèi)生計(jì)生委副主任馬曉偉率團(tuán)出席。
馬曉偉在發(fā)言中表示，金磚國家在全球衛(wèi)生事務(wù)中發(fā)揮著越來越重要的作用，在衛(wèi)生領(lǐng)域的合作前景廣闊，在國際事務(wù)中的聯(lián)系日益加強(qiáng)，對全球衛(wèi)生的影響不斷增強(qiáng)。過去三年間，金磚國家衛(wèi)生部長定期會晤機(jī)制已經(jīng)形成，為有關(guān)各國分享經(jīng)驗(yàn)、形成共識、開拓合作提供了制度平臺。他指出，全民健康覆蓋是金磚國家衛(wèi)生合作的重要議題，全面健康覆蓋的目標(biāo)與中國醫(yī)改的目標(biāo)是高度一致的。中國愿繼續(xù)與金磚各國加強(qiáng)交流合作，開展研究，更好地實(shí)現(xiàn)全民健康覆蓋，共同提高人民健康水平。
本屆會議是根據(jù)2013年3月金磚國家領(lǐng)導(dǎo)人會晤《德班宣言》以及2013年1月在印度召開的第二屆金磚國家衛(wèi)生部長會議有關(guān)倡議舉辦的，由南非主辦。會議發(fā)布了《開普敦公報(bào)》，并決定于2014年在巴西舉辦第四次金磚國家衛(wèi)生部長會議。
公報(bào)中英文全文如下：
第三屆金磚國家衛(wèi)生部長會議開普敦公報(bào)
南非 2013年11月7日
1. 按照金磚國家領(lǐng)導(dǎo)人《三亞宣言》、《德里宣言》和《德班宣言》要求，金磚國家衛(wèi)生部長于2013年11月7日在開普敦共同出席第三屆金磚國家衛(wèi)生部長會議。部長們：
2. 憶及承諾為促進(jìn)金磚國家人民健康而加強(qiáng)內(nèi)部合作的金磚國家衛(wèi)生部長會議2011年《北京宣言》、2013年《德里公報(bào)》，以及2013年5月20日于第66屆世界衛(wèi)生大會期間在日內(nèi)瓦發(fā)布的《聯(lián)合公報(bào)》，重申公眾健康是社會和經(jīng)濟(jì)發(fā)展的基本要素，并承諾將對影響健康的經(jīng)濟(jì)、社會和環(huán)境決定因素采取行動。
3. 重申致力于在以下重點(diǎn)專題領(lǐng)域合作，加強(qiáng)衛(wèi)生監(jiān)測體系、通過預(yù)防和健康促進(jìn)降低非傳染性疾病危險(xiǎn)因素、全民健康覆蓋、重點(diǎn)關(guān)注傳染病和非傳染病的戰(zhàn)略性衛(wèi)生技術(shù)、醫(yī)療技術(shù)和藥品研發(fā)。
4. 重申就與世界衛(wèi)生組織議程相關(guān)的關(guān)鍵問題進(jìn)行協(xié)調(diào)、合作和磋商的承諾。
5. 重申在以下領(lǐng)域開展合作以有效控制傳染性和非傳染性疾病的承諾，包括分享現(xiàn)有資源信息、開發(fā)風(fēng)險(xiǎn)評估工具、風(fēng)險(xiǎn)緩解措施、轉(zhuǎn)診系統(tǒng)、生命全過程健康管理、提高社區(qū)能力，以及在國家、區(qū)域和國際各級監(jiān)測公共政策對健康的影響等。
6. 認(rèn)識到非傳染性疾病已成為影響不同經(jīng)濟(jì)收入水平國家的全球重點(diǎn)。承認(rèn)非傳染性疾病可預(yù)防并影響發(fā)展，金磚國家可通過與非傳染性疾病高發(fā)病率相關(guān)的社會經(jīng)濟(jì)決定因素研究等多種合作活動攜手降低疾病負(fù)擔(dān)。
7. 認(rèn)識到金磚國家面臨著艾滋病、結(jié)核等傳染性疾病的挑戰(zhàn)。決心在開發(fā)能力和基礎(chǔ)設(shè)施方面進(jìn)行協(xié)作與合作，降低結(jié)核病的患病率、發(fā)病率，抗擊艾滋病。措施可包括監(jiān)測系統(tǒng)，創(chuàng)新藥物、疫苗、診斷技術(shù)，促進(jìn)結(jié)核病研究人員在藥品、疫苗的臨床試驗(yàn)方面開展合作，加強(qiáng)可負(fù)擔(dān)、高質(zhì)量、有效和安全藥品的可及性，以及提供高質(zhì)量的衛(wèi)生服務(wù)。
8. 認(rèn)識到千年發(fā)展目標(biāo)的重要性和相關(guān)性，特別是與衛(wèi)生相關(guān)的千年發(fā)展目標(biāo)。呼吁聯(lián)合國會員國在2015年后發(fā)展議程的討論中，將健康作為一個重要問題予以充分考慮。
9. 強(qiáng)調(diào)婦幼健康作為優(yōu)先領(lǐng)域的重要性，旨在實(shí)現(xiàn)千年發(fā)展目標(biāo)，應(yīng)逐步降低孕產(chǎn)婦死亡率，新生兒、嬰兒和5歲以下兒童死亡率。重申承諾致力于進(jìn)一步提高服務(wù)和能力建設(shè)，以確保改善婦幼安全和健康，并通過交流最佳實(shí)踐加強(qiáng)合作。
10. 認(rèn)識到有效的衛(wèi)生監(jiān)測體系是實(shí)現(xiàn)控制傳染性和非傳染性疾病的關(guān)鍵，對實(shí)施《國際衛(wèi)生條例（2005）》至關(guān)重要。進(jìn)一步認(rèn)識到，各國根據(jù)實(shí)際情況和最佳實(shí)踐采用不同監(jiān)測模式，承諾將在疾病防控活動的規(guī)劃、監(jiān)測和評估機(jī)制以及衛(wèi)生監(jiān)測體系能力建設(shè)方面加強(qiáng)合作。
11. 認(rèn)識并且贊賞實(shí)現(xiàn)全民健康覆蓋的勢頭，支持世衛(wèi)組織行動計(jì)劃的領(lǐng)導(dǎo)作用和大方向，進(jìn)一步強(qiáng)調(diào)為全民提供優(yōu)質(zhì)的初級衛(wèi)生保健服務(wù)和監(jiān)測全民健康覆蓋進(jìn)展的重要性。為此，部長們聯(lián)合制定了監(jiān)測框架，用于幫助各國跟蹤在實(shí)現(xiàn)全民健康覆蓋方面的進(jìn)展。部長們認(rèn)識到在衛(wèi)生人力資源的政策、戰(zhàn)略和國際合作方面加強(qiáng)合作的重要性，以促進(jìn)實(shí)現(xiàn)全民健康覆蓋。
12. 認(rèn)識到循證衛(wèi)生政策的價值與重要性，進(jìn)一步認(rèn)識到金磚國家需要長期合作，通過交流信息而分享知識和最佳實(shí)踐，以便加強(qiáng)衛(wèi)生體系的績效。
13. 回顧2011年首屆金磚國家衛(wèi)生部長會議《北京宣言》，強(qiáng)調(diào)通過技術(shù)轉(zhuǎn)讓加強(qiáng)發(fā)展中國家能力的重要性和必要性。為此，部長們強(qiáng)調(diào)確?？韶?fù)擔(dān)、高質(zhì)量、有效、安全的通用名藥、生物產(chǎn)品和診斷試劑等醫(yī)療產(chǎn)品之可及在實(shí)現(xiàn)健康權(quán)中的重要作用。重申加強(qiáng)衛(wèi)生國際合作的承諾，特別是南南合作，支持發(fā)展中國家努力促進(jìn)人人享有健康，并決心建立金磚國家技術(shù)合作網(wǎng)絡(luò)。
14. 重申支持全面實(shí)施世衛(wèi)組織《公共衛(wèi)生、創(chuàng)新和知識產(chǎn)權(quán)全球戰(zhàn)略和行動計(jì)劃》，及依此成立的研究與開發(fā)籌資和協(xié)調(diào)問題磋商性專家工作小組，并提請注意世界衛(wèi)生大會66.22號決議和65.24號決議關(guān)于設(shè)立示范項(xiàng)目的內(nèi)容。認(rèn)識到經(jīng)驗(yàn)和知識分享的重要性。敦促金磚國家通過建立網(wǎng)絡(luò)和專家委員會的形式全面參與示范項(xiàng)目的實(shí)施。
15. 關(guān)注金磚國家的獨(dú)特優(yōu)勢，例如可負(fù)擔(dān)衛(wèi)生產(chǎn)品的研發(fā)和生產(chǎn)、開展臨床試驗(yàn)的能力等。呼吁在生物技術(shù)應(yīng)用領(lǐng)域加強(qiáng)合作，為金磚國家人民和其他發(fā)展中國家人民帶來更多健康效益。
16. 承認(rèn)世衛(wèi)組織在推動全球衛(wèi)生議程中的獨(dú)特作用，重申支持關(guān)于世衛(wèi)組織改革的持續(xù)討論，以更好地應(yīng)對世衛(wèi)組織未來籌資等全球?qū)用嬉?guī)劃、組織和執(zhí)行方面的挑戰(zhàn)。歡迎開展籌資對話，對話以世衛(wèi)組織會員國通過有條理且透明的進(jìn)程共同設(shè)定的重點(diǎn)為基礎(chǔ)。
17. 注意到在落實(shí)北京和德里衛(wèi)生部長會議決定方面的進(jìn)展，通過了“金磚國家衛(wèi)生領(lǐng)域戰(zhàn)略項(xiàng)目合作框架”。
開普敦
2013年11月7日
3rd Health Ministers MeetingSouth Africa 7th November 2013
Cape Town Communiqué
1. Consistent with the mandate of the BRICS Leaders as stated in the Sanya, Delhi and eThekwini Declarations , the BRICS Health Ministers met in Cape Town on 7th November 2013 at the 3rd BRICS Health Ministers’ Meeting. The Ministers:
2. Recalled the Beijing Declaration and Delhi Communiqué of the BRICS Health Ministers Meetings in 2011 and 2013 and Joint Communiqué of the BRICS Health Ministers in Geneva on 20th of May 2013 on the sidelines of the 66th session of the World Health Assembly respectively, where they committed to strengthen intra-BRICS cooperation for promoting health of the BRICS populations. They reiterated that public health is an essential element for social and economic development and committed to act on economic, social and environmental determinants of health.
3. Reiterated their commitment to collaborate on key thematic areas focusing on strengthening health surveillance systems; reducing Non-Communicable Disease (NCD) risk factors through prevention and health promotion; Universal Health Coverage (UHC); strategic health technologies, with a focus on communicable and non-communicable diseases; medical technologies; and drug discovery and development.
4. Reaffirmed their commitment to coordinate, cooperate and consult on key issues pertaining to the agenda of the World Health Organisation (WHO).
5. Renewed their commitment to the effective control of both communicable and non-communicable diseases through cooperation in sharing of existing resource information, development of risk assessment tools, risk mitigation methods, referral systems, life course approaches, community empowerment, monitoring health impact assessments of all public policies at national, regional and international levels.
6. Recognised that NCDs are now a global priority that affects low, middle and high income countries. They acknowledged that as NCDs are preventable and impact on development, BRICS countries can partner in reducing the burden of diseases through various collaborative initiatives including research on social and economic determinants that contribute to a high incidence of NCDs.
7. Recognised that BRICS countries face challenges of communicable diseases including HIV and Tuberculosis. They resolved to collaborate and cooperate in the development of capacity and infrastructure to reduce the prevalence and incidence of TB and combating HIV/AIDS. This can be improved through a surveillance system and innovation for new drugs/vaccines, diagnostics and promotion of consortia of researchers to collaborate on clinical trials of drugs and vaccines as well as strengthening access to affordable, quality, efficacious and safe medicines and delivery of quality health care.
8. Noted the significance and relevance of the Millennium Development Goals (MDGs), in particular health-related MDGs. They called upon the Member States of the United Nations to give due consideration to health as an important issue in the discussions of the post-2015 development agenda.
9. Emphasized the importance of maternal and child health as a priority with the aim of achieving the MDGs, through progressive reduction in maternal mortality, neo-natal, infant and under-5 mortality. They reiterated their commitment to further enhance services and capacity building so as to ensure improved maternal and child safety and outcomes, and to strengthen collaboration through exchange of best practices.
10. Recognised that effective health surveillance is key to controlling both communicable and non-communicable diseases and also central to the implementation of the International Health Regulations (2005). Further recognising that the countries use different models for surveillance based on their realities and best practices, they committed to strengthen cooperation in the mechanisms for planning, monitoring and evaluating disease prevention and control activities and capacity-building for effective health surveillance systems.
11. Recognised and expressed appreciation for the momentum built with regard to Universal Health Coverage and expressed support for the leadership role and broad direction of WHO’s Action Plan and further emphasized the importance of providing access to, in particular, quality Primary Health Care services for all. They emphasized the importance of monitoring progress towards Universal Health Coverage. To this end, they jointly developed a monitoring framework that would help countries track their progress towards achieving Universal Health Coverage. In this regard, the Ministers recognized the importance of strengthening policies and strategies, as well as international cooperation on human resources for health in order to achieve UHC.
12. Recognised the value and importance of evidence-based health policy. They further recognized the need for long term collaboration amongst the BRICS Countries to share the knowledge and best practices through information exchange in order to strengthen the performance of the health systems.
13. Recalled the Beijing Declaration of the 1st BRICS Health Ministers’ Meeting in 2011 emphasizing the importance and need of technology transfer as a means to empower developing countries. In this context, they underlined the importance of ensuring access to affordable, quality, efficacious and safe medical products, including generic medicines, biological products, and diagnostics for the realization of the right to health. They renewed their commitment to strengthening international cooperation in health, South-South cooperation in particular, with a view to supporting efforts in developing countries to promote health for all and resolved to establish the BRICS network of technological cooperation.
14. Reiterated their support for the full implementation of WHO Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property, which gave rise to the Consultative Expert Working Group on Research and Development, and, in this context, drew attention to WHA Resolutions WHA66.22 and WHA65.24 with specific reference on demonstration projects. Acknowledged the value and need for experience and knowledge sharing. Urged BRICS countries to fully participate in the process of implementation of the identified projects through the establishment of networks and expert committees.
15. Focussed on the unique strength of BRICS countries such as capacity for R & D and manufacturing of affordable health products and capability to conduct clinical trials. Called for enhanced cooperation in application of bio technology for health benefits for the population of BRICS and other developing countries.
16. Acknowledging the unique role of WHO in advancing the global health agenda, they reiterated their support to the continued discussions on the process of reform of WHO to better respond to global challenges in programmatic, organizational and operational terms, including the future financing of WHO. They welcomed the initiation of the financing dialogue based on priorities collectively set by WHO Member States in a structured and transparent process.
17. Taking note of the progress made on the implementation of the decisions taken at the Health Ministers’ Meeting in Beijing and Delhi, adopted the “BRICS Framework for Collaboration on Strategic Projects in Health”.
Cape Town
November 7th, 2013
