ANC Today

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Volume 5, No. 28• 15-21 July 2005

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THIS WEEK:

* Letter from the President: The privilege of trusteeship 
* Health Charter: Partnerships towards better health care for all 

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LETTER FROM THE PRESIDENT

The privilege of trusteeship

From its very beginning, the African National Congress was established as an
inclusive parliament of the African people. Its founders saw the Congress as a
repository and spokesperson of the hopes and aspirations of the black millions
who had been colonised by Britons, the Boers and the Portuguese.

Since then, the ANC has worked and continues to work further to build itself as
the repository of the aspirations of all our people, black and white.

On 24 October 1911, the newspaper 'Imvo Zabantsundu' published the well known
article, "Native Union", written by Pixley ka Isaka Seme, in which he explained
why it was necessary to establish the ANC. He said:

"The South African Native Congress is the voice in the wilderness bidding all
the dark races of this sub-continent to come together once or twice a year in
order to review the past and reject therein all those things which have retarded
our progress, the things which poison the springs of our national life and
virtue; to label and distinguish the sins of civilisation, and as members of one
house-hold to talk and think loudly on our home problems and the solution of
them.

"The Natives everywhere now and to-day know that a South African Native
Congress.will give them the only effective means whereby they will be able to
make their grievances properly known and considered both by the Government and
by the people of South Africa at large. Through this Congress the Natives will
have the opportunity and means with which to influence the public opinion of
this country and to greatly assist the South African Statesmen who are working
for the peace, prosperity, and the development of this land.

"(The day of the formation of the Native Congress) will certainly be an
important day in the annals of our Native history; we shall have come together
to bury forever the greatest block to our security, happiness, progress and
prosperity as a people. We shall have come together truly, as we are, the
children of one household to discuss our home problems and the solution of
them."

In this article, Seme reported that, "A great Paramount Chief accepting that his
name be included in the honourable list of Native princes who endorse and
support this movement, writes that:

"He however wishes to point out that whilst the objects and the aims of a
Congress appear to be good and reasonable, much of the success depends upon the
attitude of the members.

"There should be among other things a firm resolve on the part of every member
to eliminate factors which have in the past proved fatal to the continued
existence of such Societies. They should set their faces strongly against the
jargon of racial feeling, the ebullition (heated incitement) of the element (of
tribalism), and the excessive display of political partisanship."

Pixley Seme saw the South African Native Congress, the ANC, as a common home not
only for our people, but also as the household of the people of "this sub-
continent". Accordingly when it was established just over two months after the
article "Native Union" was published, the Congress spoke in the name of the
colonised African natives from as far a-field as present-day Zambia.

The internationalist posture adopted by the founders of the ANC represented the
entrenched understanding of the shared destiny of Africans everywhere, including
the Diaspora, which had been expressed by such early modern African
intellectuals as the Rev Tiyo Soga.

In an article entitled "What Is The Destiny Of The Kaffir Race", published by
the 'King William's Town Gazette and Kaffrarian Banner', on 11 May 1865, almost
half-a-century before the ANC was established, Tiyo Soga said: "Africa was of
God given to the race of Ham. I find the Negro from the days of the old
Assyrians downwards, keeping his 'individuality' and 'distinctiveness', amid the
wreck of empires, and the revolution of ages.I find him enslaved.I find him in
this condition for many a day - in the West Indian Islands, in Northern and
Southern America, and in the South American Colonies of Spain and Portugal.
Until the Negro is doomed against all history and experience - until his God-
given inheritance of Africa be taken finally from him, I shall never believe in
the total extinction of his brethren along the southern limits of the land of
Ham."

Tiyo Soga was convinced that "history and experience" confirmed that, whatever
our travails, including our enslavement, as Africans we would never lose our
"God-given inheritance of Africa.(even) amid the wreck of empires, and the
revolution of ages".

He foresaw that even in our country, then in the grip of the colonial wars waged
by British imperialism, colonialism would fail to achieve "the total extinction
of (Africans) along the southern limits of the (African continent)".

By chance, as we concluded the 2nd National General Council (NGC) of the ANC,
various events took place in and relevant to Africa, which vindicated the
confidence and optimism that Tiyo Soga proclaimed concerning the future of our
continent, 140 years ago.

In 1993, the democratically elected President Ndadaye of Burundi was killed in a
military coup d'etat. The government was overthrown and a military dictatorship
established. During the resultant conflict and civil war sparked by these
developments, over 300,000 baRundi were killed. This was in addition to others
who had died before this, as a result of massacres that claimed the lives of
Hutus and Tutsis in a seemingly intractable 'ethnic' conflict.

And yet, as we concluded our 2nd NGC, the people of Burundi held peaceful
democratic elections to choose their national parliament. Remarkably, after a
long period of violent conflict, everybody has accepted that these elections
were democratic and that their outcome truly represents the will of the people
of Burundi.

All of us are justly proud of the role our country has played and is playing,
which has contributed to Burundi's advance to peace and democracy. This has
included the sustained and critical mediation efforts of leaders of our movement
and country, Nelson Mandela and Jacob Zuma, and the vital peacekeeping
contribution of members of our National Defence Force.

Not many days after these historic events in Burundi, the Republic of Sudan
inaugurated a new government with the swearing in, in Khartoum, of the President
and Vice Presidents appointed on the basis of a Constitution representing the
outcome of negotiations that ended a 50-year war between the northern and
southern parts of this multi-racial, multi-ethnic, multi-cultural and multi-
religious African country.

By decision of the erstwhile Sudanese belligerents and the African continent, we
have the responsibility to convene and chair the Sudan Post-Conflict
Reconstruction Committee of the African Union. In this capacity, we have the
responsibility to help ensure that Sudan achieves the lasting peace and unity in
diversity which eluded this sister African country for a long time.

In addition to this, we have men and women of our National Defence Force and
Police Service deployed in Darfur, as part of the African Union (AU) Mission
charged with the responsibility to bring about peace in this part of Sudan.

Once again, we have every reason to be proud of what we have done and are doing
to bring hope to the sister people of Sudan, which, as in the case of Burundi,
included deployment of some of our compatriots to provide expert support to the
peace negotiators.

Soon after the conclusion of our 2nd NGC, we were privileged to join leaders of
Africa and the South to engage the leaders of the G8 countries at the annual G8
Summit Meeting at Gleneagles, Scotland.

Also present at this meeting were other important world leaders, namely, the
Secretary General of the UN, the President of the European Commission, the
President of the World Bank, the Managing Director of the International Monetary
Fund (IMF), and the Director General of the World Trade Organisation (WTO).

Among others, this engagement addressed the three critically important issues of
African development, climate change and world trade, the latter within the
context of the WTO Doha Development Agenda.

The discussions on the development of our continent focused on the interlinked
obligations of Africa and the G8 arising out of the New Partnership for Africa's
Development (NEPAD), and the G8 Africa Action Plan.

In this regard, we must pay tribute to Prime Minister Tony Blair and Chancellor
of the Exchequer, Gordon Brown, for the initiative they took to establish the
Africa Commission, the members of the Commission, and others, including the
business community in Africa, the UK and elsewhere in the world, who acted to
advance the African agenda.

We must also express our sincere appreciation for the enormous effort made by
the artists, Bob Geldof, Bono, and others, to mobilise the masses of the people
globally, to take up the cause of the poor of our continent, as they and others
had acted to help us end the apartheid crime against humanity.

As a country we are privileged that we had the possibility to contribute to the
elaboration of NEPAD, its adoption by the OAU and the AU, and the establishment
of the partnership with the developed countries of the North, as expressed
through the G8 Africa Action Plan and the Africa Partnership Forum.

The Gleneagles Summit adopted concrete decisions involving the commitment of the
necessary financial and other resources, to implement the integrated programmes
identified in NEPAD and the G8 Africa Action Plan.

Among others, these firm commitments encompass the critically important issues
of peace on our continent, debt, trade, development assistance, economic growth,
and the modernisation of the physical African infrastructure.

The Gleneagles decisions mark an historic new step in fundamentally redefining
the relationship between Africa and the countries of the North. They vindicate
the hopes and conviction that Tiyo Soga took to his grave, that Africa would
triumph, despite "the wreck of empires, and the revolution of ages".

We must also take this opportunity once more to extend our sympathy and
solidarity with the government and people of the United Kingdom, and the peoples
of the world, for the human and material losses they and we suffered as a result
of the heinous terrorist outrage perpetrated against residents of, and visitors
to London.

This happened as representatives of 24 important countries and international
organisations met in Great Britain to address matters of vital relevance to the
pursuit of the goal of a better life for the billions of human beings who occupy
our common globe, including the suffering people of Palestine.

As members of the ANC and as South Africans, we must draw great inspiration from
the fact that we were not passive observers but active participants in the
historic events we have mentioned - the parliamentary elections in Burundi, the
inauguration of a new Government of Sudan, and the adoption of the Gleneagles
Africa programme of action.

These successes constitute a few more critical steps towards the renaissance of
our continent and our country. However, as a movement and a country, we still
have a long journey ahead of us to achieve the objective we and the rest our
continent set ourselves, to realise the goal of a better life for all.

Among other things, this means that we must ensure that the ANC continues to
maintain its strength, its unity and its historic character as a repository of
the aspirations of the masses of our people. In this regard, members of the ANC
must always remember that their membership of our organisation means they have
the honour and privilege to run and manage the ANC in trust for our people.

For example, all our members must remember what one of our founding Patrons, the
"Paramount Chief" quoted by Pixley Seme, advised about what is required of
members of the ANC.

As he said, "There should be among other things a firm resolve on the part of
every member to eliminate factors which have in the past proved fatal to the
continued existence of such Societies. They should set their faces strongly
against the jargon of racial feeling, the ebullition (heated incitement) of
the element (of tribalism), and the excessive display of political
partisanship."

All this requires that all our members should know that whatever they do will
always be subject to the intense and critical scrutiny of the masses of the
people. The masses will not permit us, members of our organisation, to weaken or
put their movement, the ANC, in disrepute.

This is because, as Pixley Seme said, these masses are convinced that through
the African National Congress, their common "household", they "have the
opportunity and means with which to influence the public opinion of this country
and to greatly assist the South African Statesmen who are working for the peace,
prosperity, and the development of this land."

As we observed the 75th Anniversary of the ANC, on 8 January 1987, our late
President, Oliver Tambo, said:

"The people have daily been expressing their allegiance to the premier
instrument of liberation they have created, the African National Congress, the
democratic parliament of the people of South Africa.

"In the 75 years of its fighting existence, our movement has established its
place as the force that has led the people as a whole under widely different
conditions, but always correctly and consistently, towards final victory. In the
new situation with the new tasks ahead of us, we are certain that your movement,
the ANC, will live up to its responsibilities."

This "force that has led the people as a whole under widely different
conditions, but always correctly and consistently, towards final victory", must,
as before, live up to its responsibilities during this highly favourable period
for the further advance of the national democratic revolution and the African
renaissance.

Thabo Mbeki

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HEALTH CHARTER

Partnerships towards better health care for all

A draft health charter, released for comment this week, aims at building
partnerships between the private and public sectors to ensure equitable, quality
health care for all South Africans.

The draft charter addresses transformation of the health sector in the areas of
access to health services, equity and quality in the health services, and the
promotion of black economic empowerment in the sector.

The publication of the draft charter comes just days after the ANC National
General Council identified health for all as a major priority. The council
identified the need to continue to strengthen the health care system at public
sector clinics and hospitals, and called on government to investigate ways of
bringing down the cost of private hospital services. Attention needed to be paid
to ensuring appropriately staffed and resourced facilities, especially in rural
areas, including measures to address the training, recruitment and retention of
additional health professionals. Proposals to address these matters are among
the issues raised in the charter.

Presenting the draft charter this week, Minister of Health Manto Tshabalala-
Msimang said one of the objectives of the charter would be to significantly
contribute to rectifying the wrongs of the past, and in particular the grossly
inequitable access to and distribution of health care and ownership of health
establishments.

"We need to ensure that our health system reflects the diversity of our society
and meets the various health care needs of the total population of South
Africa... The Charter requires us to achieve the most effective, economic and
efficient utilisation of all resources within the health sector so as to
adequately address the health needs of all the people of South Africa," she
said.

One of the major challenges the country needs to address is the inequality in
access to health care. This inequality of access is reflected in the financing
of health care, where a large proportion of overall health care financing goes
towards the private sector, which services only a small proportion of the
population.

Between 15 and 20 percent of South Africans have a high degree of access to
health services, while between 75 and 80 percent have either limited or no
access to health services. Tshabalala-Msimang cited figures that indicate that
the state spends some R33.2 billion on health care for 38 million people while
the private sector spends some R43 billion servicing seven million people.

These financing anomalies, together with the spiralling cost of medical scheme
contributions and expenditure, are not something which government can tackle
alone. They require a partnership across all components of the health sector to
establish a more sustainable and equitable approach to managing the country's
health.

"The Charter commits all of us to move towards a coherent, unified health system
offering financial protection for all the population in accessing a nationally
affordable package of health care at the time of need and to improve access to
health care services in general," Tshabalala-Msimang said.

It provides, according to the draft charter, for a relationship between the
public and private sectors "of mutual cooperation, trust and respect in order to
improve the scope, accessibility and quality of care at all levels of the health
system".

Access

Among the proposals for improving access to health care is to investigate the
creation of a category of "independent practitioners" who would be contracted to
the state to improve access at the primary level. The range of health services
available to under-serviced communities would be increased, and solutions would
be tailored to the needs of particular communities.

The draft charter also proposes public-private initiatives to use resources more
efficiently and reduce inequities. The parties would also agree not to refuse
anyone emergency medical treatment irrespective of whether or not they are able
to pay.

Resources will be directed towards education, training and development within
the health sector, including using existing resources like the skills
development levy more effectively to provide financial support to students
studying in the health field. Efforts would also be made to market the health
professions to introduce students to work opportunities within the national
health system, and to attract qualified South Africans back from abroad.

Equity

Steps to improve equity in health services would include developing a minimum
defined basic package of care that is available to all patients in both the
public and private sectors regardless of the ability to pay.

In addition to working to eliminate all inefficiencies from health service
delivery, the draft charter also proposes the development and implementation of
a programme that meets the human resource requirements of the sector over the
next 15 years. It would also support existing initiatives to increase the number
of black people and young women matriculating in higher grade science,
mathematics and computer science.

Annual targets would be set for recruiting, training and retaining health care
personnel, and a code of practice on the ethical recruitment of health
professionals would be developed.

Importantly, the draft charter proposes programmes that result in the broader
representation of black people in the health sector, with a target of 60% black
and 50% women personnel at all levels by 2010. By 2014 this should have
increased to 70% black and 60% women personnel.

Quality

To improve the quality of health services, in addition to the improvements
already proposed, the draft charter proposes regular and sustained training
programmes for health care personnel on the rights of patients and the
principles of Batho Pele.

It could also include the development of low cost health service and financing
options that are accessible to middle-income groups and that "assure value for
money in terms of health outcomes". These health outcomes would be measured by
quality assurance programmes.

The draft charter also makes provision for the consideration of complaints by
users of the national health system, and "the creation of mechanisms whereby
such complaints are used to inform the planning and delivery of health services
so as to be able to continually improve the quality of health care".

Black economic empowerment

Alongside the empowerment measures already mentioned, including human resource
development and employment equity, the draft charter also proposes that by 2010
each of the companies in the health care sector should be at least 35% owned or
controlled by black people. This should increase to 51% by 2014.

Procurement policies and programmes that are favourable to firms controlled or
owned by black people will be implemented. At least 60% of all procurement
should be from black owned firms by 2010, increasing to 80% by 2014.

In terms of the draft charter, the private sector would commit themselves to
spending a fixed proportion of their annual income on social responsibility
projects. Parastatal funding institutions would be approached to help with
funding black economic empowerment transactions in the health sector.

The draft charter proposes the establishment of a non-statutory Health Sector
Council or Health Charter Committee, funded by and representing all
stakeholders, which would monitor the implementation of the charter.

Government's view is that the implementation of the charter must be flexible
enough to allow for changes and adjustments to be made as circumstances change.
The deadline for comment is 15 August.

MORE INFORMATION:

Draft Charter of the Private and Public Health Sectors
http://www.doh.gov.za/docs/misc/healthcharter.pdf

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