Published in 2021, this article presents EMERGENCY’s model of care and the clinical results of the Salam Centre for Cardiac Surgery in Sudan, in particular those obtained on paediatric patients under 15 years of age suffering from advanced rheumatic heart disease. The results demonstrate that building a hospital of excellence and offering free cardiac surgery and post-operative assistance can be a vector of positive change in the long term. Sharing these results means sharing our mission: allow African citizens to be recipient, like every other citizen in the world, of healthcare benefits coming from the best scientific developments in medicine, in the name of equality, dignity and human rights. 

After the International Workshop “Building Medicine in Africa. Principles and Strategies” hosted at San Servolo Island, Venice, Italy, on May 14 -15, 2008 and in accordance with the spirit and the principles of the Universal Declaration of Human Rights, stating that

“All human beings are born free and equal in dignity and rights” (art.1) “Everyone has the right…to medical care” (art.25)“ The recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world” (Preamble)

We hereby declare
the “Right to be Cured” as a basic and inalienable right belonging to each and every member of the human community.

We therefore advocate
the implementation of health systems and projects solely devoted to preserve, extend and improve the life of the people in need and based on the following principles:

Equality
Every human being has the right to be cured regardless his economic and social condition, gender, race, language, religion and opinions. Standards of health care, set by the progress of medical knowledge, must be delivered equally and without discrimination to all patients.

Quality
High quality health systems must be based on community’s needs, up to date with the achievements of medical science, and not oriented, shaped or determined by lobbies and corporations involved in the health industry.

Social responsibility
Governments must have the health and well being of their citizens as their priority, and allocate adequate human and financial resources.The services provided by health systems and humanitarian projects in the health sector must be accessible to and free of charge for all.

As Health Authorities and Humanitarian Organizations

We recognize
EQS (Equality, Quality, Social responsibility) based health systems and projects as respectful of human rights, appropriate to develop medical science and effective in promoting health by strengthening and generating human, scientific and material resources.

We commit
To plan and develop EQS based policies, health systems and projects.

To cooperate among us to identify common needs in the health sector and design joint programmes.

We appeal
To other Health Authorities and Humanitarian Organisations to sign this Manifesto and to join in promoting an EQS based medicine.To donors and to the international aid community to support, fund and participate in designing and implementing EQS

We, Ministers of Health and representatives of the health authorities of the Central African Republic, Chad, the Democratic Republic of Congo, Djibouti, Egypt, Eritrea, Ethiopia, Rwanda, Somalia, Sudan, Uganda, attending the first Annual Conference of the African Network of Medical Excellence, jointly organized in Khartoum, Sudan, by the National Ministry of Health of Sudan and the international NGO EMERGENCY,

Reaffirming the principle that the right to healthcare is a basic right of every individual, as stated in the Universal Declaration of Human Rights;

Recalling the principles of Equality, Quality and Social Responsibility stated in the ‘Manifesto for a Human Rights-Based Medicine’, which calls for high-quality and free-of-charge healthcare for all;

Acknowledging the urgent need for Centres of Excellence in Africa to provide high standards of medical treatment through secondary and tertiary facilities, thus strenghtening disease prevention and primary healthcare delivery;

Considering the Salam Centre for Cardiac Surgery, established by EMERGENCY in cooperation with the Ministry of Health of Sudan in Khartoum, as a replicable model in all our countries to provide high-quality care to our citizens and proper training to medical and non-medical professionals;

We commit to improving regional cooperation by establishing the African Network of Medical Excellence (ANME) in different medical specialities in order to strenghten our health systems on the national and regional level.

We jointly appeal to the international community of donors to support us and contribute to the successful implementation of this innovative, multi-disciplinary project by providing human and financial resources.

Signed on Thurday, 11 February 2010 – Khartoum, Sudan. On behalf of the Ministries of Health of: the Central African Republic, Chad, the Democratic Republic of Congo, Djibouti, Egypt, Eritrea, Ethiopia, Somalia, Sudan, South Sudan, Uganda.

We, Ministers of Health and representatives of the Health Authorities of: Burundi, Central African Republic, Chad, Djibouti, Eritrea, Ethiopia, Somalia, South Sudan, Sudan, Tanzania, Uganda, Zimbabwe, meet today at the “Building Medicine of Excellence in Africa” international workshop, jointly organised by the Republic of Uganda’s Ministry of Health, the Republic of Uganda’s Ministry for Foreign Affairs, and the international NGO EMERGENCY, on the occasion of the celebration of one year of activities at the Children’s Surgical Hospital in Entebbe, Uganda,

Bearing in mind that strengthening national health systems in middle- and low-income countries is a commonly recognised critical factor in striving to achieve the Sustainable Development Goals (SDGs);

Reaffirming the principle that healthcare is a fundamental right of every individual, as stated in the Universal Declaration of Human Rights;

Recalling the principles of Equality, Quality and Social Responsibility stated in the Manifesto for a Human Rights-Based Medicine, calling for the delivery of high-quality and free of charge healthcare for all;

Acknowledging the lack of facilities that can provide free of charge treatment to common complex diseases in our countries;

Recognising the need to establish Centres of Excellence in Africa to address relevant health priorities providing high standards of medical treatment through secondary and tertiary facilities, to complement disease prevention and primary healthcare delivery;

Appreciating that patients suffering from severe conditions require access to long-term continuity of care that will considerably improve quality of life;

Underlining the importance of developing future generations of health workforce to address the main epidemiological conditions in the African region, thus building more resilient health systems and mitigating brain drain;

Highlighting the fundamental role that Centres of Excellence can have in guaranteeing an adequate platform to provide specialist training;

Understanding that the management of complex systems delivering specialised care should be based on the principles of transparency and efficiency in order to provide effective and equitable services to all patients;

Embracing the crucial role of fruitful regional cooperation in order to ensure proper access to specialised care for patients, knowledge sharing, and guaranteeing the circulation of human resources;

Considering the experiences of the Salam Centre for Cardiac Surgery in Sudan and the Children’s Surgical Hospital in Uganda as an example that this model can be feasible, sustainable and replicable;

We hereby, commit to:

Promote the ANME model inside our own countries to build a deeper knowledge of the system and to foster a higher level of political endorsement;

Identify relevant health priorities that can be addressed by a cooperative and comprehensive response, and that allow for the referral of patients from across the region;

Improve regional cooperation amongst ANME countries and partners in order to reinforce the network and all its components;

Advocate jointly to promote the ANME model within the international community;

Join and strengthen efforts to mobilise resources from governments, international institutions, and donors to guarantee the long-term financial sustainability of the African Network of Medical Excellence.

Dated Friday 13th May 2022. Entebbe, Uganda

Ministers of Health and representatives of Health Authorities of:

Somalia: H.E Dr. Nur Fawziya Abikar
South Sudan: H.E Dr. Yolanda Awel Deng Juach
Sudan: H.E Dr. Heitham Mohammed Ibrahim Awadalla
Uganda: H.E Dr. Jane Ruth Aceng Ocero
Burundi: Dr. Jean Baptiste Nzorironkankuze
Central African Republic: M.me Chantal Manzibahi Nee N’droumokato
Chad: Dr. Francine Mbaidedji Dekandji
Djibouti: Dr. Saleh Banoita
Eritrea: Dr. Yohannes Teclegiorgis Tewelde
Ethiopia: Dr. Abas Hassen Yesuf
Tanzania: Dr. Januarius Joseph Hinju
Zimbabwe: Dr. Israel Dube

We, Ministers of Health and representatives of the Health Authorities of: Burundi, Central African Republic, Chad, Djibouti, Democratic Republic of the Congo, Egypt, Eritrea, Ethiopia, Niger, Nigeria, Somalia, South Sudan, Sudan, Uganda, Zimbabwe, attending the international workshop “ANME, Moving Forward” held at the Salam Centre for Cardiac Surgery. The event is jointly organized by the Republic of the Sudan Ministry of Health, the Republic of the Sudan Ministry for Foreign Affairs and the international NGO EMERGENCY.

Bearing in mind that strengthening national health systems in middle- and low-income countries is a commonly recognised critical factor in striving to achieve the Sustainable Development Goals (SDGs);

Understanding that Universal Health Coverage will be achieved only when access to safe, timely, affordable and equitable health services will be improved;

Reaffirming the principle that healthcare is a fundamental right of every individual, as stated in the Universal Declaration of Human Rights;

Recalling the principles of Equality, Quality and Social Responsibility stated in the Manifesto for a Human Rights-Based Medicine, calling for the delivery of high-quality and free of charge healthcare for all;

Recognizing the lack of facilities that can provide specialized free of charge treatment in our countries;

Appreciating that several diseases require access to long-term care to improve the outcome and their quality of life;

Drawing the attention that Non Communicable Diseases (NCDs), represent an emerging global health threat and are on the rise in Africa;

Strongly convinced that a patient-centred approach will improve the patient’s care and quality of life;

Underlining the importance of developing future generations of health workforce to address the main epidemiological conditions in the African region, thus strengthening health systems and mitigating brain drain;

Highlighting the fundamental role that Centres of Medical Excellence can have in guaranteeing specialized training;

Recognising the pivotal role of scientific and professional exchange to strengthen healthcare systems and research;

Considering the crucial role of regional cooperation to ensure proper access to specialised care, knowledge sharing, and promote the circulation of human resources;

Understanding that the highest political endorsement will be needed to strengthen ANME;

Fully aware that adequate recognition and endorsement from international and regional stakeholders will be necessary for the growth of ANME;

Emphasizing that investing in healthcare is a main contribution towards Countries development and economic growth;

Stressing the importance of finding feasible financial instruments that will enable resources mobilization to guarantee an adequate funding;

Considering the experiences of the Salam Centre for Cardiac Surgery in Sudan and the Children’s Surgical Hospital in Uganda as an example that this model can be feasible, sustainable and replicable;

We hereby, commit to:

1. Improve regional cooperation amongst ANME countries and partners to guarantee prevention, early diagnosis, timely treatment and adequate continuity of care;
2. Guarantee support for patients’ selection, movement and follow up in their home Country;
3. Foster the relations amongst ANME countries, regional training institutions and EMERGENCY in order to strengthen the training component and facilitate the sharing of knowledge;
4. Establish a collaborative research infrastructure including an IT platform to address health system’s issues relevant for the ANME Countries;
5. Gain the highest and broadest political endorsement in order to promote the ANME model inside our own countries;
6. Appoint a focal point that will be in charge to represent our own Countries within the Network;
7. Jointly advocate to promote the ANME model within the international community, especially towards regional bodies such as the African Union and the European Union;
8. Identify the most adequate tools that will provide sustainable financing for the network in the short-, medium- and long term;
9. Create and participate in a Coordination Mechanism that will provide guidance and improve the effectiveness of ANME implementation and planning;
10. To fully support and participate to ANME joint activities, meetings and conferences.

Dated Thursday 2^nd February 2023. Khartoum, Sudan

Ministers of Health and representatives of Health Authorities of:

Chad: H.E Dr. Abdelrahim Mahamat Abdelmadjid

Somalia: H.E Dr. Ali Hajiadam Abubakar

Sudan: H.E Dr. Heitham Mohammed Ibrahim Awadalla

Zimbabwe: H.E Dr. Amon Murwira

Uganda: H.E Anifa Kawooya Bangirana

Burundi: Dr. Olivier Nijimbere

Central African Republic: Dr. John Francis Onambele

Djibouti: Dr. Sahra Moussa Bouh

Democratic Republic of the Congo: Dr. Jules Biselenge Katusi

Egypt: Dr. Amer Samieh

Eritrea: Dr. Yohannes Teclegiorgis Tewelde

Ethiopia: Dr. Daniel Gebremichael Burssa

Niger: Mme. Aissa Hamma

Nigeria: Dr. Mukhtar Yawale Muhammad

South Sudan: Dr. Janet Kemisa Michael