The World Health Organisation describes health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity [1]. Most Ministries of Health focus on treatment of infirmities and yet there are various factors including those of social and economic influence that play a part in one’s complete well-being. Aspects of health as described by the WHO must be embraced for a healthy population and that the team in-charge of ensuring good health recognizes the link between all factors that have an influence on the total health of any being. The Ministry of Health in Zambia has taken recognizance of the fact that all determinants of health must be taken into account when dealing with disease prevention and control. Since 1995 the government of Zambia has developed national policies in specific aspects of health provision [2, 3]. The Ministry of Health as part of its transformational agenda has undergone yet another reform in its bid to improve health at all levels. A new directorate called the Directorate of Health Promotion, Environment and Social Determinants of Health has been included in the Ministry of Health Structure to ensure a holistic approach is utilised when managing the health of the Zambian population. The Health Press – Zambia had an opportunity to meet with the Director of the new Directorate Dr Kennedy Malama who shares his views in the following excerpt:

Zambia’s Health sector has undergone a number of reforms including the Strategies and Plans of 1991/1992 followed by the 1995 reforms anchored on the National Health Services Act which led to formation of Boards [4]. However, the reorganisation of the Health Sector in 2016/2017 is unique as it has been premised on a transformational agenda of prioritising Promotion of Good Health, Preventing and Controlling Disease. This shift has been necessitated by the fact that our disease burden has generally continued to rise despite the massive investment from Government and its Cooperating Partners in the Health Sector especially in the treatment platform. It is very clear that our health budget shall continue to increase if we continued at this trajectory. This scenario has called for rethinking in terms of where we want to go as a country.
Service delivery is made up of Health Promotion, Disease Prevention & Control, Treatment and Rehabilitation. As a country, our top priority should be on ensuring that people don’t fall sick and those that slip through the cracks are treated and rehabilitated accordingly. We need to take those high impact community interventions to the Households.
It is evident that the majority of determinants of health lie outside the health sector and ignoring this fact is at the peril of the Zambian people’s health. This mandate to navigate the determinates of Health makes the new directorate better placed to spearhead the prevention, and controlling of diseases; of course working closely with other directorates particular Public Health and Clinical Care & Diagnostic Services.
It is from the above background that Ministry of Health made a bold decision to amplify its emphasis on promoting health and preventing and controlling diseases. To ensure that this declaration does not remain rhetoric, a Directorate of Health Promotion, Environment and Social Determinants of Health has been created at the Ministry Headquarters.
The new directorate’s mandate include: promoting good health, preventing and controlling disease, coordinating environmental health, occupational health and food safety, fostering intersectoral collaboration within the framework of Whole Government and Whole Society, buying into the Principles of Health in All Policies (HiAP). In addition the new directorate shall spearhead legislation and policy formulation and review, setting of standards and guidelines, resource mobilisation and health Communication. Other roles include; provision of supervision, technical support, mentorship and monitoring & evaluation at all levels.
Zambia continues to be besieged by emerging and re-emerging infectious diseases. From 2016 through to 2017 Zambia has experienced two outbreaks of cutaneous anthrax associated with eating meat from anthrax infected hippopotamus and buffalo in Chama district of Muchinga province and beef in Limulunga, Nalolo, Kalabo, Shangombo districts of Western Province. The outbreaks have reoccurred in both provinces within 5 years despite varied interventions such as health education and vaccination of domestic animals. We also note persistent diarrhoeal disease in our communities despite various interventions. There is need to revise and input appropriate and effective health promotion and disease prevention and control interventions. A holistic approach to health promotion, prevention and control of disease remains a priority. Evidence from the anthrax and diarrhoeal diseases suggests engaging all stakeholders in preventing and controlling these and other diseases is the way to go. The community needs to be engaged at all levels in order to mitigate the high burden of many preventable diseases. Borrowing from the late President J.F Kennedy of the USA, “Let’s not ask what government can do for us but what we can do for human kind”
With this unprecedented prioritisation of health promotion, prevention and control of disease, the strength of this paradigm shift will greatly enhance Primary Health Care and expedite Zambia’s attainment of a healthy and productive population contributing to the socio-economic development of the country. This new focus shall be catalytic in Zambia’s attainment of the Universal Health Coverage. It’s expected that all these interventions targeting the community particularly the households shall significantly contribute to reduced incidence and prevalence of communicable and non –communicable diseases including maternal, New-born, child and adolescent morbidity and mortality.
We need to rush to that tap and close it rather than mopping the floor expecting the floor to become dry!

Dr. Kennedy Malama, Director Health Promotion, Environment & Social Determinants. Ministry of Health Headquarters Lusaka, Zambia.

1. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948. URL:
2. Ministry of Health [Zambia]. National Health Policy: a nation of healthy and productive people. Lusaka: Ministry of Health; 2012. URL:
3. Ministry of Health [Zambia]. National Health Strategic Plan 2011 – 2015: towards attainment of health related Millennium Development Goals and other national health priorities in a clean, caring and competent environment. Lusaka: Ministry of Health. URL:
4. Bossert, Thomas, Mukosha Bona Chitah, Maryse Simonet, Ladslous Mwansa, Maureen Daura, Musa Mabandhala, Diana Bowser, Joseph Sevilla, Joel Beauvais, Gloria Silondwa, and Munalinga Simatele. Decentralization of the Health System in Zambia. Major Applied Research 6, Technical Paper No. 2. Bethesda, MD: Partnerships for Health Reform Project, Abt Associates Inc. December 2000.

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