25 May 2004
Mr President, Madame Speaker, honourable members
1. I rise on behalf of the African National Congress to respond to the President, the Honourable Mr Thabo Mbeki's State of the Nation address. The speech has received national acclaim for its clarity of vision, incisiveness, clear targets and focus on delivering an economy and package of social services that will restore the dignity of our people.
2. The ability of the ANC led government since 1994 to deliver on its election mandates was clearly felt by the majority of South Africans who voted the African National Congress into power for a third term with a huge majority. Not only have we delivered social services but also the World Cup in 2010. We have and will continue to make South Africa, Africa and the world proud of this government.
3. Let me provide a small sample of what we have achieved in health in the past decade.
4. Madame Speaker, our mass immunisation campaigns and the dedication of our health workers and mothers to ensure that our children get immunised has resulted in our immunisation coverage increasing from 63% in 1998 to 74% in 2003. As a result no child has died from measles since 1999. This is a major achievement of this government. In addition, our surveillance efforts will ensure that South Africa is declared polio free in 2005.
5. Malaria in three of our provinces, KwaZulu-Natal, Limpopo and Mpumalanga causes much suffering and death. I am pleased to announce that as a consequence of our strengthened malaria control programme, which includes efforts of the governments of Mozambique and Swaziland as part of the Lebombo Spatial Development Initiative, we have had decreasing cases of malaria and significantly smaller numbers of deaths. The World Health Organisation's target is a case fatality rate of 1%. We are currently just below this target and will endeavour to reach 0.5% case fatality in the next five years. In addition, as was announced by the President we will deliver on the 10% reduction of malaria cases per year.
6. Madame Speaker and honourable members, we have contributed to a range of regional strategies on health in line with our commitments to NEPAD. I am proud to report that for the first time at the World Health Assembly, African ministers of health spoke with one voice on all policy issues.
7. We are currently implementing the SADC Health Protocol and the SADC HIV and AIDS programme. Our work in malaria control with our neighbours is one concrete example of our joint success.
8. In February 2003 the President announced that people with disabilities will get health care free of charge in public health institutions. We have successfully implemented this programme in all provinces. We are currently working with the Department of Social Development to ensure that there is a seamless process in accessing disability grants and free health services regardless of which department is first approached by people in need of these services. In addition, by the end of this financial year, the backlog in wheelchairs and hearing aids that we inherited will have been eliminated.
9. The comprehensive HIV and AIDS Care, Management and Treatment Plan for South Africa is being rolled out. Facilities have been identified in all provinces and selection of patients who qualify for the programme, and in some cases treatment has commenced. We will have at least service point per health district by the end of the first year of the Plan. Allow me Madame Speaker to reiterate however that this Plan is more than just about anti-retrovirals. The African National Congress and this government's response to HIV and AIDS has and will continue to emphasise the need for a comprehensive response on three levels: (1) prevention and care are as important as treatment; (2) government action alone will not curb the epidemic - all sectors of society, every community, every family and every individual must take responsibility for ensuring that the incidence of HIV and AIDS decreases in the second decade of our democracy; and (3) our response must be intersectoral - all government departments must have strong HIV and AIDS programmes.
10. We have increased access to primary health care for all our people. Since 1994 we have built more than 1300 new clinics in under-served areas of the country. This means that primary health care facilities are more accessible for millions of South Africans. More recently, since 1 July 2003, we implemented a scarce skills and rural allowance to ensure that we are able to attract and retain health workers in rural areas of the country. This policy complemented the phased introduction of community service for health professionals that has resulted in especially pharmacists, speech and occupational therapists and physiotherapists being available in rural and other previously under-served areas of our country. Our people have seen these improvements in health service delivery - therefore we are not surprised that they voted for the African National Congress in such large numbers.
11. There have been suggestions that we have neglected hospitals in the past 10 years in favour of primary health care. Off course we have prioritised primary health care - any sensible government will do this because the majority of the population require this level of care in the first instance. Let me state categorically however that we have not neglected our public hospitals. We have made billions of rands available to revitalise our hospitals and build new ones. Since 1999 we have commissioned 16 new hospitals. Amongst them are Inkosi Albert Luthuli in KwaZulu-Natal and the Nelson Mandela Academic Complex in the Eastern Cape. These are flagship hospitals, comparable with the best in the world. However, we must and have also focussed on upgrading existing hospitals and have 27 hospitals in a revitalisation programme which will ensure that their infrastructure, management and quality of care are all significantly improved.
12. The public health sector will contributed to the expanded public works programme initiated by the President. We will expand our community health worker programme in every province to ensure that communities are provided with health information to prevent them from getting sick and to support individuals and families when they are ill. We have developed, in consultation with community health workers, NGOs and academics, a new framework for the selection, training and remuneration of community health workers which we are in the process of implementing. These community health workers will play a major role in ensuring that communities are able to access health and other public services as easily as possible. I must add that whilst some of the community health workers are paid stipends, there are many who volunteer their services freely. In addition, we have encouraged retired nurses to also volunteer their services and many have done so.
13. Besides volunteering their services to become community health workers, community members participate in structures established to ensure that their influence on how the health services are managed is felt. Communities participate through clinic committees and hospital boards where they present community concerns about health issues. I also encourage communities, especially the youth to adopt healthier lifestyles. Proper nutrition, exercise, avoiding risky behaviour like alcohol and drug abuse are issues that in partnership with communities and other stakeholders we shall endeavour to strengthen in the next five years.
14. I have dealt extensively with the public health sector. However, the private health sector in South Africa is equally large and in some ways more complex. This government will work with the private sector to ensure that we develop synergies between these two sectors. We must, in line with the World Health Organisation's recommendations provide stewardship of the entire health system in this country. We cannot allow an unregulated private health sector which is both inequitable and I believe unsustainable. I held a meeting with senior representatives of the private health sector in April at which we agreed that there was much common ground between ourselves as government as the private sector and agreed to develop a health charter. I will ensure that this process is completed by the end of this year and that the charter clearly sets out the role of the private health sector in our country.
15. One of the key strategies to make health care more affordable is to reduce the cost of drugs. We are doing this by introducing a single exit price and ensuring that those who dispense the drugs only charge a professional fee.
16. This brings me to the issue of dispensing licenses. We must ensure that health professionals who dispense drugs are adequately trained to do so. Thus we expect them to do a course and apply for a licence. It is a very simple process and we encourage all health professionals who wish to dispense to apply for a license.
17. Lastly permit me Madame Speaker to provide a few examples of the leadership role South Africa plays in the World Health Organisation. This role is exemplified by the fact that I have been chosen as one of the vice presidents of the World Health Assembly last week. In fact I returned from Geneva only yesterday where I must say how proud I was at the influence that we bring to bear on public health policies that affect the world. We adopted a range of resolutions that will in the years to come ensure better health for the world's people. For example South Africa played key roles in the adoption by the World Health Assembly of a range of resolutions including:
18. In conclusion Madame Speaker, permit me to salute all South Africans for their contributions to making the first decade of democracy such a special one for our country in particular but also for Africa. Under the leadership of our President and the African National Congress the next 10 years will be even better for all South Africans.
I thank you!!!