Regionalism in the Southern African Development Community: Integration for better health?

The paper examines the intersection of health and regionalism within the Southern African Development Community (SADC). It finds that while SADC has established frameworks like the Protocol on Health (1999) and the Regional Indicative Strategic Development Plan (RISDP), the SADC Secretariat has a limited role, acting primarily as a facilitator for member states and international donors. Policy implementation is left to individual governments, often outsourced to NGOs and CBOs via donor funding. Case studies in Swaziland and Zambia reveal a lack of regional policy embeddedness at the national level. However, specific cross-border initiatives targeting HIV/AIDS, malaria (E8), and tuberculosis in mining have shown progress through dedicated funding and political commitment.

• The SADC Secretariat does not independently implement health policies; it operates on a bottom-up basis, providing limited technical assistance while member states identify and implement policies themselves.
• National health policy agendas in SADC member states are frequently shaped by international donors and multilateral organisations, who provide the necessary funds and expertise, often bypassing the SADC Secretariat.
• SADC views health and poverty as bidirectionally linked, treating socio-economic development and social justice as the primary responses to health inequalities, though it avoids the specific term 'pro-poor' in its official treaties.
• Regional health frameworks, such as the SADC Protocol on Health (1999) and the RISDP, lack effective national embeddedness, as evidenced by case studies in Swaziland and Zambia where national health plans make little to no mention of SADC.
• The SADC Cross-Border HIV and AIDS Initiative has successfully implemented a fleet of 29 mobile 'Wellness Centres' across 12 member states to provide free primary healthcare to mobile populations.
• The SADC Pharmaceutical Business Plan aims to address critical regional gaps, including an 85% import dependency for ARVs from India and a lack of regional research and development.
• The E8 initiative represents a successful cross-border collaboration among eight Southern African states to transition from malaria control to total elimination through harmonised surveillance and treatment.
• The SADC Declaration on Tuberculosis in the Mining Sector addresses the high risk of TB among migrant mineworkers, though implementation is hindered by the fact that many mines provide their own private healthcare.
• SADC's overall budget is heavily reliant on external funding, with donor spending projected to be approximately 61% of the total budget in 2015.

APA

Penfold, E. (2017). Regionalism in the Southern African Development Community: Integration for better health? South African Institute of International Affairs. https://saiia.org.za/wp-content/uploads/2018/03/Regionalism-in-the-Southern-African-Development-Community.pdf

Chicago

Penfold, Erica. Regionalism in the Southern African Development Community: Integration for better health? South African Institute of International Affairs, 2017. https://saiia.org.za/wp-content/uploads/2018/03/Regionalism-in-the-Southern-African-Development-Community.pdf.

Wikipedia

{{cite report |last1=Penfold |first1=Erica |title=Regionalism in the Southern African Development Community: Integration for better health? |publisher=South African Institute of International Affairs |date=2017 |url=https://saiia.org.za/wp-content/uploads/2018/03/Regionalism-in-the-Southern-African-Development-Community.pdf |access-date=23 October 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{penfold2017regionalism, author = {Penfold, Erica}, title = {{Regionalism in the Southern African Development Community: Integration for better health?}}, institution = {South African Institute of International Affairs}, year = {2017}, url = {https://saiia.org.za/wp-content/uploads/2018/03/Regionalism-in-the-Southern-African-Development-Community.pdf}, urldate = {2026-10-23}, note = {Indexed by Climate Insights Directory} }