Manilla

The decision to monitor equity in South Africa goes back to a meeting held in Manila during July 1997, supported by the Henry J. Kaiser Family Foundation, which brought together a group of about 25 top level South African policy makers and managers with a similar contingent from a number of South East Asian countries. These countries were selected because of their experience in implementing over the past decade, far reaching efforts to establish more equitable national health systems.

One of the most crucial discussions that occurred during this meeting focussed on the importance of being able to measure progress towards equity as prerequisite for countries becoming actively involved in placing equity in the forefront of their agenda.

A key outcome of the meeting was the enthusiasm on the part of legislators in accepting the function of monitoring the move towards equity as central to their legislative function as stipulated in the constitution and the acts of parliament. In terms of these stipulations, legislators, particularly through the various portfolio committees have the responsibility to "monitor, investigate, enquire and make recommendations relating to any aspect of the legislative programme, budget, rationalisation, restructuring, functioning, organisation, structure, personnel, policy formulation…of government". A solid foundation for subsequently developing this work in South Africa was thus established.

Arlington, Virginia

In 1999, the Rockefeller Foundation's Global Health Equity Initiative was assembled to discuss the problem of health inequalities between and within countries, evidenced by increasing documentation of inequalities, and to consider what the ethical mandates in responding to that evidence might be.

The next year, a follow-up meeting was held, where informational needs for monitoring population-level health inequalities were clarified and strategies presented for effective intervention. One such strategy was the Health System's Trust Equity Gauge project, begun as a monitoring and advocacy effort to support South African legislators in the development of effective health policy.

In August 2000, proposals for Equity Gauges from developing countries in three continents were considered for implementation. Participants in the meeting, which included many of the original participants of the GHEI as well as experts in various areas of health equity and the project representatives of the proposed Gauges, called for the establishment of an alliance that could provide various forms of support to the projects and be active in the international arena. GEGA was developed in response to that call.

Twelve Gauges have taken up the task of implementing the Equity Gauge Strategy. In February of this year, GEGA held a meeting to support these Gauges clarify and shape the structure, form, and activities of both individual gauges and of GEGA as an active international organization. It became clear that a strong enthusiasm to continue and expand the work was driving GEGA members. The conference accomplished much conceptually and practically, including identifying next steps for continuing and strengthening the impact of Gauges and for securing the future success of the Alliance. A longer report of this meeting is included in the Appendices.