[ Home ] [ Speeches & statements ]

10 February 2006

We begin this year with a clear mandate arising out of the State of the Nation Address that we should move faster to address the challenges of poverty, underdevelopment and marginalisation confronting those caught within the Second Economy.

We must sustain and improve the effectiveness of our social security system targeted at providing a cushion of support to those most exposed to the threat of abject poverty.

As the President said, Government is committed to respond with all necessary seriousness and determination to all these challenges and play its role to give new content to our age of hope.

We will achieve this by ensuring that the machinery of government, at all levels, discharges its responsibilities effectively and efficiently, honouring the precepts of Batho Pele and the Patients Right’s Charter.

Health infrastructure

While progress is being made to improve primary healthcare (PHC) and hospital infrastructure, we have to continue to pay particular attention to the expenditure on capital projects. While Treasury have noted significant improvement in this area this year compared to last year, we need to sustain our efforts to increase expenditure. This relates particularly to the hospital Revitalisation Conditional Grant where we need to ensure that we monitor and assist provinces that are struggling to optimally use the allocated resources.

We are also finalising the Hospital Improvement Plan, which should address issues of maintenance of buildings, the provision and maintenance of equipment and historical backlog as a result of neglect in psychiatric hospitals.

The Hospital Improvement Plan will also deal with issues of governance of hospitals and improvement of the quality of care. Working together with the provinces, we will determine additional authority that will be delegated to hospital management to ensure that they are held accountable for the functioning of hospitals by September this year.

We will also ensure that functional hospital boards support the hospitals in responding adequately to the needs of our communities. We are conscious of the fact that without a strong referral system with the PHC facilities as the main entry point into the health system, our hospitals will not be able to cope with the demand for services. The Plan will therefore seek to strengthen these referral systems and encourage outreach programmes at both clinic and hospital level.

Human resources

The functioning of the health system is dependent on the adequate supply and equitable distribution of health workers. On 7 April, which is the World Health Day, we will be launching the Human Resource Plan for Health. This document will illustrate training needs for the country and outline interventions that have to be made to improve the supply of health workers in the country.

We will be reopening some of the Nursing Colleges to improve output in this area and the list of these colleges to be reopened will be finalised in due course. The challenge we are addressing is the recruitment of tutors who exited the public service. We are discussing with the Department of Public Service and Administration to ensure that even those who took voluntary severance packages can be considered as part of this recruitment drive.

We will be extending community service to cover nurses as the last group of health professionals to participate in this programme.

The process of reviewing remuneration packages for healthcare professionals should be completed this year and we hope that it will go a long way in improving our ability to attract and retain health professionals in the public sectors and rural areas in particular.

Tuberculosis (TB)

After playing a leading role in World Health Organisation (WHO) Afro discussions on declaring TB a crisis and declaring 2006 as the year of accelerated HIV prevention, we are ready to lead by example in implementing these resolutions.

We have developed a TB Crisis Management Plan which will be formally unveiled during the World TB Day on March 24. The Plan identifies at least four districts that are facing the most challenges in terms of the prevalence of TB and low cure rates. We are mobilising extra resources to ensure tangible improvements in these districts while we strengthen TB control programmes in all provinces.

We will be issuing a new tender for our Communication and Social Mobilisation Campaign which is currently valued at R160 million. This campaign should focus on improving awareness and TB cure rates and have messages targeted at specific groups that still pose a challenge in terms of the prevalence of HIV.

HIV and AIDS

This year, we want to ensure that prevention reassumes its rightful position in the response to HIV and AIDS as we observe the year of accelerated HIV prevention. Our aim is to increase the number of facilities that provide Voluntary Counselling and Testing, Prevention of Mother-to-Child-Transmission programmes and the management of sexually transmitted infections, especially herpes.

We will continue the care and treatment of those who are infected and affected through the Comprehensive Plan for Management, Care and Treatment of HIV and AIDS. At least 374 000 people have benefited from the nutrition component of this programme. An accumulative number of people initiated on antiretroviral therapy in the 229 accredited sites in the country was more than 100 000 by the end of December 2005. Concerted efforts have to be made to strengthen our patient information system to ensure that we are able to track patient compliance and establish the impact of this programme.

The Department has increased the annual budget allocated for the support of non-governmental organisations (NGOs) involved in the response to AIDS and TB from R49 million in 2005/2006 financial year to R56 million in 2006/2007. Close to 70 organisations had applied for this funding by the closing date on 6 February.

These NGOs work in the following areas:
* Governance and Programme Leadership
* Community Home Based Care
* Treatment Adherence Counselling Including TB Directly Observed Treatment Strategy
* Voluntary Counselling and Testing Services
* HIV and AIDS Life Skills Programme including peer education.

We have had an honour of being invited by The Joint United Nations Programme on HIV/AIDS (UNAIDS) to be members of Global Steering Committee that is assessing global progress in responding to HIV and AIDS since the adoption of the UN Declaration of Commitment on HIV and AIDS in 2001. South Africa chairs the working group on sustainable financing of prevention, care and treatment within this Steering Committee.

Access to medicine

We will make additional resources available for the research and development of traditional medicines which have the potential to add much value in the management of HIV and AIDS and other diseases.

We will continue our efforts to make medicine more affordable. The Pricing Committee and the Department of Health has consulted extensively with stakeholders on the issue of the dispensing fee that can be charged by pharmacists.

I expect the Pricing Committee to make recommendations to me on the revised dispensing fee for medicine during the course of this month. After considering their recommendations, I will announce a draft dispensing fee which will be open to public comment. We will consider the comments and make final determination of the new dispensing fee.

We appreciate the co-operation we have received from the major players in the retail pharmacy industry in this process. We are determined to set a dispensing fee that meets the government objective of making medicines more affordable, but also ensure that the country maintains a viable retail pharmacy industry.

Consultation process is underway and we should be able to finalise the Charter for the Health Sector.  Improving access to health should also include efforts to reduce the overall cost of private health care including hospital fees.

Healthy lifestyle

Much work has been done to make South Africans to be more conscious of the importance of caring for their health. This has included efforts to promote regular physical activity and good nutrition while discouraging risky behaviours such as smoking, alcohol abuse and unsafe sexual practices.

Through the healthy lifestyle awareness campaign, we want to deal with most of the main causes of ill-health and death in the country which can be grouped into three categories:
- Communicable diseases (such as HIV and AIDS, TB and Malaria)
- Non-Communicable diseases (such as Diabetes, Cancer and Hypertension); and
- Violence and trauma

We will sustain this public health campaign by combining the use of the media for raising awareness and encouraging more utilisation of health screening services to enable the prevention, early detection and management of diseases such as diabetes, breast, cervix and prostate cancers. We will also extend these efforts to areas such as foot care and dental therapy.

We continue with our tobacco control efforts and South Africa has been selected to be the co-ordinator of the African group on health matters and in the WHO process of implementing the Framework Convention on Tobacco Control. We will also be tabling in parliament the amendments to the Tobacco Control Act aimed at tightening some of the loopholes in the Act and increasing fines for non-compliance.

We should be able to move ahead this year with our efforts to highlight the negative health social effects of alcohol by putting warning labels on the container of alcoholic products.

Work has already commenced to look at the state of readiness of our Emergency Medical Services to handle the 2010 Soccer World Cup event. We will be reporting further on this matter during the course of the year.

While we call on our people to take care of their health, the state has a responsibility to create a healthy environment and to improve access to basic services that enhance good health.

Access to safe water

Government is committed to ensuring that everyone in South Africa has access to functioning basic water supply services and that everyone has access to a functioning basic sanitation facility by 2010. Government is also committed to the eradication of bucket systems in formal settlements by 2007.

In 1994 15.9 million people out of a population of 39.8 million people did not have access to basic water supply. By April 2005 Government had provided clean safe water to a total of 15 million people (population growth of 1.98% per annum amounts to 48.1million total population), which include those served at higher levels than the basic level of service. Of this 10 million people were served with a basic water supply service to Reconstruction and Development Programme (RDP) level.

The current backlog for water supply as on 1 April 2005 is 3.7 million people who have no access to any form of water supply infrastructure plus 5.4 million people who have some access but who have to be brought up to a basic level of service (RDP level). The water supply target for 2006/07 is that 1.5 million people be provided with basic water supply.

In Minister Sonjica’s budget speech in 2005 she referred to a national survey, which reflected that 63 % of municipalities could not confirm whether they complied with drinking water quality standards. Following the outbreak of typhoid in Delmas Department of Water Affairs Forestry (DWAF) followed this up with a more detailed survey and the development of a monthly reporting system. This information will be audited by DWAF regional offices.

In cases where drinking water quality does not meet the standards DWAF will provide the necessary support. A most successful program is already running in the Free State where this program of monitoring, audits and support has rectified many problems and compliance has risen remarkably.

DWAF as the national regulator for water services will report on the performance of all municipalities through a report to be published in April which will tell the public where we stand with Drinking Water Quality as well as other performance indicators.

The Free Basic Water programme is making a huge difference to the poor, (defined as households with less than R 800 income/month). 15.2 million poor people are receiving Free Basic Water (FBW) via formal infrastructure, some with infrastructure slightly below the basic level. A further 4 million have infrastructure and although they do not yet have a formalised FBW administrative system in place, are getting their water free. Thus in total 19.2 million of the 22.4 million, (85%), poor are getting their water free of charge. In total 35,3 million people or 73,46% of the population (48 081 483) are receiving free basic water. 

Proper sanitation

With regards to Sanitation services, in 1994, 20,4 million people out of a population of 39.8 were without adequate sanitation services. 

By April 2005, with an estimated population of 48,1 million (population growth of on average 1.98 % per annum), the backlog is estimated at 16 million people (3.9 million households). The target for 2006/07 is to provide 300 000 toilets serving an estimated 1.2 million people.

2,3 million people have been reached through the health and hygiene programme. The sanitation backlog in schools has been reduced from 4300 in September 2004 to 2505 by December 2005.

By 2007 the bucket system will be eliminated in formal settlements in the country.  This amounts to approximately 231 000 bucket toilets that need to be replaced with adequate sanitation.

The Sanitation Job Creation Programme was officially launched in Limpopo in December 2005.  Training of the Limpopo Municipal Managers and DWAF District Water Services/Sanitation Managers on Sanitation Planning within the context of Health and Hygiene is soon to take place.

Support to municipalities

The Department’s support to the municipalities comprises the following:

* Planning support with regard to Integrated Development Plans (IDPs) and the Water Services Development Plans (WSDPs)
* Monitoring of the water purification and wastewater treatment works operations
* Facilitation of project selection, feasibility studies and service level options
* Support with regards to implementation of the tariff structure and FBW policy
* Support for Section 78 process (division of powers and functions for water services between district and local municipalities) and selection of Water Services Providers
* Training of councillors and officials in water services and water demand management
* Resource mobilization to support municipalities.

Forestry

Forestry’s contribution to the second economy is through the facilitation of small growers into the forestry sector as well as the facilitation of new afforestation especially in the Eastern Cape and KwaZulu-Natal. The growing of trees in these areas will add to the economy, as well as providing employment and entrepreneurial opportunities to the local people.

The Department has been involved in planning for the expansion of forest areas in the Eastern Cape, where most forestry opportunities are available and where the local rural economy needs stimulation very badly. A Strategic Environmental Assessment has been conducted in the Eastern Cape and it shows areas for new afforestation, which is being pursued.

It is estimated that at least an initial 30 0000 hectares of land could be afforested and that possibly this could be increased to more than 150 000 hectares of land once the project gains momentum.  The areas could accommodate small growers and community afforestation if correctly planned and it could expand the broad base of black people engaged in forestry.  Within KwaZulu-Natal, options for new afforestation also exist and conservative estimates shows between 30 000-40 000 hectares suitable for this purpose. This will create substantial employment opportunities in the Eastern Cape and KwaZulu-Natal.

The Forestry Broad Based Black Economic Empowerment Charter process was launched in 2005 and the final charter should be completed in the first half of this year.

The core business of the Working for Water programme is to contribute to the sustainable prevention and control of invasive alien plants. In doing so, it addresses poverty relief and promotes economic empowerment and transformation within a public work’s framework, therein seeking to further develop the second economy. 

Since Working for Water’s inception in 1995 it has cleared more than one million hectares of invasive alien plants providing jobs and training to approximately 25 016 people per annum from among the most marginalised sectors of society. Of these, 52% are women. 

Working for Water currently runs 303 projects in all nine of South Africa’s provinces. Short-term contract jobs created through clearing activities are undertaken, with the emphasis on endeavouring to recruit women (60% target), youth (20%) and disabled (5%).  

Government will continue with its programme of ensuring all South Africans have access to basic services including health, water and proper sanitation.  No group should be excluded.  Free Basic Services play a vital role as it ensures that all South Africans have access to basic necessities. 

Issued by: Ministry of Health
10 February 2006