NPPHCN has been known as 'The Network' since its inception in 1987. The network structure helped it to play an important role in mobilising and educating people in disadvantaged communities around health care as a fundamental right. In the process it shaped the thinking of many of the current leaders in the health sector and was influential in ensuring that primary health care was a cornerstone of the new health care system after 1994. By the late 1990s it was clear that sustainability requirements called for a change from a centralised to a decentralised structure. The restructuring process saw the closure of four provincial offices that were unable to generate their own funding. Others that had ongoing funding and projects were assisted in forming autonomous legal entities during the period from 1999 to 2001. The PPHC Centre for Learning and the Media and Training Centre for Health in the Western Cape, and the KwaZulu-Natal PPHC formed section 21 companies, while the Free State PPHC formed a trust. With the formal process of restructuring complete, NPPHCN will be able to concentrate in 2003 on building a consortium approach with these independent entities and other organisations in the health sector.

NPPHCN continued its advocacy work on primary health care policy and its implementation, with the focus on sharing information and transferring skills to communities and other projects and activities that promote primary health care.

Although there was no funded project work in this area, NPPHCN made use of its participation in a range of workshops and forums to advocate the values and approaches that it stands for. This included work on food security as part of the Church Youth HIV / AIDS project. Advocacy work also continued on health rights and on promoting the Health Rights Charter and the use of the health rights booklets, which continue to be ordered by universities and nursing colleges training health care providers. Financial constraints forced the untimely closure of the Public Health Initiative for Legislative Advocacy (PHILA), a key focus area. Since then the organisation has not had the financial resources to maintain work on monitoring health and related legislative and policy developments and keeping the public informed. Other opportunities for continuing this commitment to participative democracy have opened up and are being pursued at the time of writing this report.

The organisation has a long history of working with young people in the field of sexual health and HIV/AIDS in collaboration with faith based organisations. This rich history has been incorporated in the planning and development of the Church Youth HIV/AIDS project. NPPHCN appreciates the ongoing support of the Japan International Cooperation Agency (JICA) as the major funder for the third year of the project. The project works through churches in Ekurhuleni in Gauteng, and Engcobo in the Eastern Cape on an HIV/AIDS awareness and food security programme in collaboration with government, community leaders and other stakeholders. The role of local volunteers, particularly in the food security project, and of the peer educators in the schools, churches and communities, and the impact of pastors in their churches has had a big influence on the community response to HIV / AIDS and on willingness to talk about sexuality and the prevention of infection. The involvement of faith based organisations has helped to promote their role in the project areas. NPPHCN produced a video on the project, which has helped to influence the views of target groups and inform them about the possibilities of activities like food production. The intersectoral approach has been important here, bringing in the organic gardening skills of the Food Gardens Foundation. As a result communities are learning about the role that organic vegetable gardening can play in contributing to household food security. NPPHCN would like to thank the communities and traditional leaders for the allocation of land to the project, particularly in Engcobo. We also value the partnership and support that the project has received from local government, the minister's fraternal and the volunteers under the capable leadership of the programme manager, George Kgatshe.

NPPHCN, as the health sector representative on SANGOCO, participated in the civil society process leading to the World Summit on Sustainable Development in 2002. The task of coordinating the diverse range of health sector organisations and providing coherent input into the Global People's Forum at NASREC challenged the organisers. Unfortunately, opportunities for interaction with delegates from international and regional organisations were limited by widely separated and diverse venues and accommodation, communication delays and lack of coordination between the Global People's Forum at NASREC and the WSSD at Sandton. However it provided a platform for an exchange of views and for voicing concerns about sustainable development that should, if there is appropriate action and implementation, contribute to improvements in health and the environment and to sustainable development.

The difficult funding environment after 2000 led to increased staff turnover, which affected the key position of director. In 2001 Ms Khathatso Mokoetle left for local government and was replaced as director by Mr Hazzy Sibanyoni, who left early in 2002 for the corporate world. Frayne Furniss Mathijs, a long standing member of the National Executive Committee (NEC) took over the reins as director in March 2002. The stability of the NEC has been important in maintaining the purpose and direction of the organisation during these changes.

The NEC Members are commended for their commitment and support to NPPHCN over the years despite their own busy schedules. To the staff and partners I would like to express gratitude and appreciation for our relationship and I look forward to working together in the years to come.