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 Annual David Sanders Lecture in Public Health and Social Justice



The series honours Emeritus Prof David Sanders' legacy as founder of the SOPH and recognises his considerable contributions to UWC and to the field of public health, both locally and internationally. This was also recently acknowledged by the University of cape Town who awarded David an honorary doctorate. Each year an eminent speaker is invited to engage scholars, practioners, policy makers and activists in contemporary challenges and opportunities for public health research, teaching and practice, brining scientific excellence and implications for political and social action to bear on their chosen issue. In so doing, they will continue the vigorous, socially engage, scholarly debate and practice that has characterized much of David's engagement. 



2017 Annual David Sanders Lecture


Prof. Hoosen Coovadia addressed in his lecture the concepts of fairness, equality and equity with a focus primarily on the stratifcations based on race, gender and the private/public dichotomoies.

Prof. Coovadia is a Director at MatCH (Maternal Adolescent & Child Health) (Wits), Emeritus Professor of Paediatrics and Child Health and Emeritus Victor Daitz Professor of HIV (UKZN). He has devoted his life to the pursuit of justice, democracy and freedom -- chairing the Mandela government’s frst Commission on Maternal and Child Health and designing appropriate national policies. He has published more than 320 papers in national and international journals. The Lancet once described Prof Coovadia as "an icon of South African health", who "broke through the barriers of racist rule to establish himself as a top paediatrician and then became an international authority on HIV/AIDS, especially mother-to-child transmission". Continue reading


2016 Annual David Sanders Lecture



The Annual Lecture held at the UWC School of Public Health is in honour of Emeritus Prof David Sanders. The 2016 Lecture was delivered by Prof Sundararaman from the School of Health Systems Studies at the Tata Institute of Social Sciences, India. Dr Sundararaman, a former professor of medicine and activist in the People’s Health Movement in India, spoke on the topic “Public Health Systems. What Works – What does Not?” and the important challenges that face societies and governments alike in the Global South. 

He addressed a wide ranging set of issues covering the theoretical frameworks which determine health systems, their policy formulations and implementation successes and challenges. He drew comparisons from country experiences in Nepal, Thailand, India and South Africa on, among others, the delivery of private and public health services, community health workers, medicine stockouts and community engagement. The audience, drawn from government, students, academics and civil society, paid careful attention to his views on the South African initiative to launch its National Health Insurance and his advice to learn from other contexts.​ 

"There is a need to re-imagine and re-present the case for a National Health Services with or without a National Health Insurance – where it is the organization of service delivery that is the key- and method of financing it is but one component of it." Prof Sundararaman​​

Click here to download the presentation slides.    

Click here to listen to the podcast. 

 2015 Annual David Sanders Lecture


 

Prof Richard Laing: "Annual David Sanders Lecture 2014 “Access to Medicines: the Struggle Continues” Read more

Over forty years ago Richard Laing and David Sanders were medical students together in Zimbabwe, where they were both subsequently involved in various

capacities in the health services. During his last three years in the country (1987- 89) Richard developed the Zimbabwean Essential Drugs Programme (ZEDAP).

This set the direction for his professional career in pharmaceutical policy, notably at the World Health Organisation (WHO) and latterly back at Boston University’s School of Public Health as professor of International Health.

Prof Laing focused on critical issues influencing access to medicines. He commenced by reflecting on key moments including the first essential medicines list developed in 1977; the Nairobi conference on Rational Medicines Use which introduced a compromise by limiting the concept to the public sector; and the breakdown in 1998 of the compromise when 39 big Pharma companies sued the South African government.

While many have perceived patents and patent law to be barriers to the essential medicines concept, Kowalski et al (2011) quashed this assumption by showing that less than 6% of essential medicines were patent protected anywhere in the world. Besides patents, however, pricing remained a key issue with studies showing wide variations in prices both between countries and within the public and private sectors. Ironically, even though medicines in the public sector may be affordable, and even free in some cases, frequent poor availability results in patients reverting to high-priced medicines from the private sector.

Affordability of medicines is a critical issue in many countries with cumulative mark-ups between the manufacturers’ selling price and the final patient price varying considerably. Studies have revealed that in some countries the cumulative mark-up can be up to 600 times the manufacturers’ selling price.

Although generic medicines have been proposed as one answer to ensuring availability and affordability of essential medicines, available data show massive variations in use between countries. While the United States is a world leader in generic uptake by volume (almost 80%), Austria is at the other end of the scale with generics having just over a third of the market share and brand loyalty remaining high, even after patents end. The situation in South Africa falls between these two: in 2010 generics had 71% market share and brand erosion in the year after the patent ends varied between 60% to 90%.

Prof Laing concluded by pointing to several hopes and challenges in South Africa regarding access to medicines, including the National Health Insurance, which will hopefully include access to essential medicines; reform of the Medicines Control Council to speed up drug registrations; and lastly reform of patent legislation resulting in faster access to generics. He asserted that whilst South Africa has made significant progress in extending access to medicines in the past 20 years since democracy, ‘the struggle continues’.


 2014 Annual David Sanders Lecture


Picture: Emeritus Prof David Sanders, Dr Mary Bassett, Prof Helen Schneider


The 2015 Annual David Sanders Lecture was delivered by Dr Mary Bassett, Commissioner of Health of New York City. Dr Mary Bassett, moved by the recent attacks on Americans of African descent in the US, addressed the link between race and health in her lecture, entitled “#BlackLivesMater”. Can such a link be made? Most definitely, argued Dr Bassett in an earlier editorial in the prestigious New England Journal of Medicine (NEJM, March, 2015). Her article provides statistics on health disparities as they affect people of colour and refers to the dearth of scholarly research on this link.

Race and health are critical issues that South Africans can relate to, both in terms of this country‟s past injustices and its present challenges. With her long medical and research background of work in Africa, Dr Bassett was ideally placed to highlight the link between health disparities and inequities and race in the US and South African contexts.

Dr Bassett concludes her NEJM article with a plea:

"As a mother of black children, I feel a personal urgency for society to acknowledge racism's impact on the everyday lives of millions of people in the United States and elsewhere and to act to end discrimination. As a doctor and New York City's health commissioner, I believe that health professionals have much to contribute to that debate and process. Let's not sit on the sidelines.‟


Dr Mary Bassett: "#BlackLivesMatter: A Challenge to the Medical and Public Health Communities". Read more


2013 Annual David Sanders Lecture

Picture: Emeritus Prof William Pick, Prof Uta Lehmann, Emeritus Prof Shula Marks, Emeritus Prof
David Sanders, Prof Helen Schneider 


Shula Marks was born in Cape Town; she emigrated to the UK in 1960 and received her doctorate from the University of London in 1967. She has lectured and written widely on late-nineteenth and twentieth century South African history, including the history of health care in South Africa.

Apart from ten years between 1982 and 1992, spent as Director of the Institute of Commonwealth Studies, Prof Marks has spent her academic life at the School of Oriental and African Studies, where she is an Emeritus Professor and Honorary Fellow. She has honorary degrees from the universities of Cape Town, KwaZulu-Natal and Johannesburg, is an Honorary Emeritus Professor of the University of Cape Town, an Honorary Research Fellow of the School of Advanced Studies, University of London, and (now Emeritus) Fellow of the British Academy. Beyond the academy, she is currently on the Council of the Canon Collins Educational and Legal Assistance Trust, and spent thirty years on the Council for Assisting Refuge Academics, which she chaired for ten years.

She introduced her lecture on ‘Contesting Health Care,1930-2013: South Africa’s experience of social medicine in international perspective’ with the following points. While the miracles of modern medicine have never been more miraculous, the numbers of people dying of preventable diseases have probably never been higher than at the present time. Our television screens present an image of the most remarkable cures – alongside visions of human illness and despair, even in the mostaffluent countries of the world. Inequalities in health are not simply marked between societies but withinthem, and while the private and public expenditure on health care climbs ever higher, this is in general apoor guide to the health of the national population as a whole. This is as true in most of the ‘developed’ as it is in the ‘developing’ countries. Devising appropriate and affordable health care delivery systems is widelyacknowledged to be one of the crucial issues of our time, widely debated and contested. 

In this lecture, Prof Marks looked at South Africa’s experience of these contestations in an international context at those three ‘moments’: in the 1940s and1950s, the 1970s and 1980s, and since 1994.

Shula Marks: "Contesting Health Care, 1930-2013: South Africa's experience of social medicine in international perspective. Read more"

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