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16 September 2006

Distinguished guests, it is an honour for me to address your presidential dinner. First let me congratulate the newly elected President of South African Medical Association (SAMA), Professor JP van Niekerk and the new executive. I also wish to congratulate the outgoing executive for their work in guiding your association over the past year. As you assume your new mandate, I hope we can form a close partnership between the Department of Health and all its partners in the public and private medical spheres. The central task which brings us together is that of improving the quality of care for all our people.

In the Health budget vote this year I called on South Africans to set aside our differences and to find common ground in the interest of health for all. Our country is in pain and in need of healing. We are losing people in the prime of their lives. We are losing our children and youth, the future of our nation. We are losing mothers and fathers and seeing a growing number of orphans and child-headed families. Our health professionals are in pain, facing a pandemic for which medical science has not as yet come up with a cure. We are in pain also because of the deep perceived divisions on the issue of treatment of HIV/AIDS. The issue is a perceived battle between modern and traditional medical science, where people are made to think there is a choice.

The Department of Health must advise on the basis of latest available medical research, but can also promote the scientific development of potential traditional therapies and treatment by investigating scientifically medicinal claims made by alternative and traditional health practitioners. Government has created the legal and institutional environment for this to happen in an orderly fashion. In fulfilling our responsibility to protect our people especially the most vulnerable, we need to put more resources into the research and development of traditional medicine while taking very strong action against charlatans who rob our people and expose them to unnecessary early death by luring them away from the established health system and promising them instant cures.

This evening I have been requested to address you on the role of South African doctors in improving the delivery of healthcare in South Africa, the Southern African Development Community (SADC) region and the African continent. It is commendable and insightful that you are considering your role in the reconstruction and development of not only South Africa but also the African continent as a whole. This is in line with the agenda for Africa's renewal embodied in the SADC Health Protocol and the New Partnership for Africa's Development (NEPAD). Prior to the dawn of our democracy in 1994, we were isolated from one another and from our brothers and sisters on the African continent. Now we have an opportunity not only to contribute our skills and resources but also to learn from one another. In addition to gathering medical knowledge here in South Africa you could join with your colleagues at African universities and research institutes to tackle the health priorities facing the African continent. In doing this we must link our efforts with the rest of the world and position Africa at the forefront of scientific development. SAMA can play a leading role in developing partnerships with other medical associations in Africa and thereby contribute to developing a vital SADC and continental medical association.

Through the National Medical and Dental Association (NAMDA) and the progressive students' organisations, some of you were at the forefront of the liberation struggle. I remember the role some of you played in taking out the bullets and fixing broken bones of the victims of apartheid violence. You risked your lives to liberate our country. Now it is time to wage a new struggle to free our people from the grip of disease and poverty, with the same vigour and energy we needed to defeat apartheid. We have now made a break with our painful and divided past and have committed to transforming our country and contributing to Africa's development. We have developed health care policy based on fairness and equity. We have established a health system aimed at catering for all and the medical profession has been transformed into a single, united, non-sexist and non-racial body. We must now vigorously address the vestiges of the negative legacy of apartheid and under-development. Although we have made significant progress in the first decade of our freedom to tackle the huge health infrastructure backlogs, we now face new challenges of staff shortages and the increased disease burden. The Human Resource Plan for Health aims to address the problems of recruitment, training and retention of health professionals. We do this cognisant of the global phenomenon of migration of health professionals from developing to developed countries.

Partnership between the private and public health sectors is crucial.

As part of addressing problems of skills migration, we have agreed to train significantly larger numbers of health professionals to cater for our domestic needs and for the export market. If a small country like Cuba is able to produce enough doctors for its own needs and export so many to different parts of the world why can't South Africa do the same and tackle our problems of unemployment at the same time? A trained health professional acquires the basic skills to be successful in many other fields. Our country needs planners, project managers and facilitators as well as evaluation and monitoring experts.

The Department of Health is expected to assist in post conflict reconstruction in the Democratic Republic of Congo (DRC) and Sudan. This role cannot succeed without your participation and involvement. Through the South African National Defence Force(SANDF), South Africa has contributed to the peace processes in Africa, in support of the United Nations (UN) and the African Union (AU). With the help of the Council for Scientific and Industrial Research (CSIR), the SANDF has been looking into developing a holistic peacekeeping model that takes into account developmental needs during and after violent conflict. Health is one of the key services that are disrupted or destroyed by war. Health professionals have the potential to contribute their skills in peacekeeping and humanitarian missions.

As a professional medical association, you come from a long and rich tradition of imparting knowledge mainly to other health professions. We need this to happen on a larger community scale. The community sees you as role models and leaders. It is this that places you in good stead to lead in their full and sustainable development. Your close interaction with patients and your medical knowledge and experience can enrich national initiatives and policy around health. You can assist government to identify and address policy gaps and implementation failures. You can assist with monitoring and evaluation expertise. As influential people in society, you have a role in policy advocacy. In terms of the Health Act, the national and provincial health forums must engage all role players in the development and implementation of health policy. Your association has a crucial role to play on these structures. Through dialogue and joint action on agreed priorities we can advance the nation and Africa's health agenda.

There are examples we can look at like that of Canada where the medical association plays a crucial and complementary role to that of government. Having identified policy development as an area of need, I would see a need for SAMA to direct some of your resources and skill towards establishing a policy resource centre like some of your colleagues have done in other countries.

SAMA could help mobilise resources and support for this work to extend to SADC and the rest of Africa. Your challenge is to strengthen the initiative of your Chief Executive in forming and nurturing the relations with other medical associations in the region. I am pleased to learn that you are helping build the African Medical Association (AMA). The SADC Health Protocol and NEPAD Health Strategy need your contribution and support. Amongst you are academics and heads of departments. You can assist the government mobilise the professions for the advancement of science. SAMA can make a huge contribution to youth development by mentoring the youth and partnering with them in their programmes.

In my opening remarks I touched on the huge challenges facing the health system, posed by the growing burden of disease. We need to put our energies together to find ways to tackle the health challenges faced by our country, the SADC region and Africa. According to the 2006 report of the Medical Research Council (MRC), there are now an estimated 5,54 million HIV-positive South Africans. More than a quarter of a million South Africans died of AIDS related illnesses in the past year.

We must unite behind the comprehensive plan on HIV prevention, treatment and care. This plan was developed through a participatory process and it provides a useful platform for united action in the campaign to reduce new infections, provide treatment and care and conduct research. This places us in a good position to give patients the best available scientific information about prevention, treatment and care.

I wish to pay a special tribute to medical science for helping us find solutions to our medical problems. While there is as yet no cure for HIV/AIDS, scientific advances have been made in treatment and care.

When combined with good nutrition and a healthy lifestyle, treatment with antiretrovirals (ARVs) for those who need them and qualify has been shown scientifically to prolong lives. So far, the only effective method of stopping people getting infected who have been exposed to HIV either from needle pricks or after rape is prophylactic treatment with ARVs. Post-exposure prophylaxis is the only hope for rape survivors and needle prick victims. ARVs have also been found to be effective in the prevention of mother to child transmission from HIV positive mothers. This is the basis for the message of hope that must go out to people who are trying so desperately to live.

The Department of Science and Technology has a crucial role in this work in partnership with the Department of Health. Under the Department of Science and Technology, government has established the Academy of Science of South Africa, a statutory independent, merit-based "activist" body committed to assisting the nation to find science-based solutions and create science-based opportunities for growth and prosperity. I hope that your scientists are active and playing a leading role in the academy.

The academy is constituted to ensure that leading scientists, acting in concert and across all disciplines, can promote the advancement of science and technology, can provide effective advice and can facilitate appropriate action in relation to the collective needs, threats, opportunities and challenges of all South Africans. Its mission statement states, "The function of science is to create in a disciplined and systematic way, a continuum of coherent, rational and universally valid insight into observable reality in all its various facets. Scientific thinking and knowledge are fundamental to the best work done in the applied natural sciences and in technology".

The academy networks with academies in other countries. I wish to stress the importance of evidence-based research especially in medical science where people's lives are at stake and our policy decisions must be always guided by the best available scientific knowledge, derived from credible, peer reviewed research.

Health is everyone's concern and is more important than individual and party political differences. We must acknowledge our differences and bring the creative power in all of us to create light and not heat. We must draw on the spirit of the negotiated settlement and joint problem-solving as well as the evidence of research so that we can reach consensus on how to provide optimal health care with the limited resources available. Together we need to strengthen the public-private partnerships (PPP), nurture these relationships and ensure that comprehensive care networks are established and maintained. We need to co-ordinate the use of limited resources so that optimal care services are provided. We need to empower our patients and their families and strengthen community support by providing information on how and where to access the required services.

I believe that working together in the spirit of co-operation and effective communication, affirming each other's achievements, correcting and supporting one another with compassion when we fail we can find much common ground to help us achieve the goal of comprehensive and quality health for all. SAMA can play an important role in creating an environment to air our differences, identify the necessary research and find the way forward so that we can together tackle the challenges that face us most effectively and efficiently.

I look forward to working with you and listening to you to ensure quality care for all South Africans. I also look forward to getting a copy of the resolutions you adopted at your council meeting.

I thank you!

Issued by: Department of Health
16 September 2006