President

In this issue we outline activities that should be part of the routine functions of the district health management team, led by the district manager. Given that there are four outcomes in the National Health Service Delivery Agreement (NSDA) that the Minister signed with the President and with all the MECs for Health, these priorities must be implemented at every level of the health system. These priorities are:

• Improve life expectancy

• Decrease the burden of disease from HIV and TB

• Decrease infant, child and maternal mortality rates

• Improve the effectiveness of the health system

Many of the world’s women are moving closer to gender equality, but substantial gaps remain between men and women in health, education and, particularly, political and economic participation in a number of countries, including some of the most developed, according to a new global report.

Measuring against 2010 rankings, for example, the Sixth Annual World Economic Forum’s Global Gender Gap Report 2011 found that New Zealand, South Africa, Spain, Sri Lanka and the United Kingdom showed slight declines in their overall gender equality rankings, while Brazil, Ethiopia, Qatar, Tanzania and Turkey posted gains.

A period of major change is unfolding in health and HIV services in South Africa, carrying opportunities and risks for delivering effective, integrated health services that improve health outcomes and save lives. South Africa is decentralizing HIV services to the primary health care level, paving the way for greater integration to address women’s health and to reduce maternal mortality. The United States can find feasible, flexible ways to support this process, even though its health program through the President’s Emergency Plan for AIDS Relief (PEPFAR) is scaling down.