Date: 26/11/2003
Source: Department of Health
Title: Tshabalala-Msimang: Launch of National Health Laboratory Service


SPEECH BY THE MINISTER OF HEALTH, DR MANTO TSHABALALA-MSIMANG, AT THE LAUNCH OF THE NATIONAL HEALTH LABORATORY SERVICE, 26 November 2003

Programme Director, Distinguished Guests, Ladies and Gentlemen

It is a privilege and an honour for me to address you at this launch of the National Health Laboratory Service.

I sincerely apologize for being late. This was due to compulsory Parliamentary duties, which take precedence above everything I do as a Minister of Health. I had to defend my budget in Parliament, and if I had not done so, I would not have the money to pay for the laboratory services provided by the NHLS.

We established the National Health Laboratory Service to provide a comprehensive network of laboratory services throughout the country in support of the National Health System.

This could not be done through the fragmented services and inequitable services that we inherited when we came to government, hence we had to amalgamate the various state laboratories with the South African Institute for Medical Research.

The amalgamation process was not an easy one and I am sure that there are many issues that are outstanding, however, I m convinced that we have established a sound platform of which to launch the National Health Laboratory Service.

Some of you may recall that on May 1973, the then Minister of Health, Dr van der Merwe, appointed Dr Meiring Naude to investigate a comprehensive national state laboratory service for health services and the justification for the continuation of the South African Institute for Medical Research in its present format.

Two similar commissions led by Professor Jan van den Ende in 1995 and the late Professor Mini Kallichurum in 1999, which were appointed by the new democratic government, came to the same conclusion that there needs to be a single body to provide comprehensive laboratory services in South Africa.

In 2002, Parliament passed the National Health Laboratory Services Act, which established the NHLS into law.

I am proud of both the physical and human resources and capabilities of the NHLS because it is the backbone for providing accessible, affordable and quality health services to all South Africans, and the SADC Region.

I am proud of the Board and the Executive Management that are running the institution and I hope that they will always bear in mind that this institution belongs to the people of South Africa and the Government has put them as stewards over this prized precious asset.

I am sure you have all heard by now that Cabinet has approved a programme for the Comprehensive Care, Treatment and Management of HIV and AIDS.

Some short-sighted people see this only as a plan to roll out antiretroviral drugs.

I can assure you that when we met in Cabinet, we deliberated seriously on the implementation of this programme, in particular the monitoring of patient safety and the impact of the programme.

The programme will be implemented in at least one service point in every health district across the country. For those who do not know, a health district is equivalent to district council or metropolitan council.

I am sure you will appreciate that we rely on the NHLS to provide services in all these district, not only to support the implementation of the programme for the Comprehensive Care, Treatment and Management of HIV and AIDS, but to strengthen the whole healthcare system and infrastructure, especially in the historically disadvantaged areas which do not have a good network of laboratory services.

The NHLS will have to jerk up and expand laboratory tests such as CD4 counts and viral load testing, which are critical in the diagnosis and treatment of HIV and AIDS.

This includes strengthening general chemistry, microbiology and hematology testing, which is necessary for the holistic monitoring of patients.

Therefore, the challenges that lie ahead for the NHLS in implementing this programme are:
* Affordable and competitive pricing of laboratory tests;
* Making testing accessible at the facilities close to the sites;
* Improving quality control and turnaround times for tests; and
* Investing in the training and skills development of staff.

The health department has a robust research programme in which the NHLS should also participate. This is not confined to the HIV and AIDS programme. Our research programme includes many communicable and non-communicable diseases to which the NHLS can provide support.

You will recall, for example, that the origins of the National Institute for Communicable Diseases (the NICD) go back almost exactly 50 years - to the 14 November 1953, when the Institute began s the laboratories of the Poliomyelitis Research Foundation.

The Poliomyelitis Research Foundation had collected about 600,000 Pounds to build an Institute to develop poliomyelitis vaccine. Some 300,000 Pounds was spent on the building of the laboratories of the Institute.

In 1976, the then Department of Health purchased the Institute from the Poliomyelitis Research Foundation and renamed it the National Institute for Virology (NIV).

The maximum security P4 laboratory was opened in 1979 and the MRC AIDS Virus Research Unit was established in 1987.

In 2002, with the formation of the NHLS, the NICD came into being by adding on the public health microbiology laboratories to the NIV and creating a new division of epidemiological surveillance.

The NICD now serves as the country's national reference facility for providing intelligence on communicable diseases.

It also acts as the regional reference laboratory to provide laboratory support to the WHO for the AFRO Region. It is responsible for diagnostic and reference functions to a number of African countries, and provides training as well as external quality assurance.

Having the only Bio-Safety Laboratory - P4 laboratory in the continent, it is also responsible for diagnosis and management of many of the African Viral Haemorrhagic Fevers and also consults widely on this to several Middle Eastern Asian countries.

I have picked just one research and reference facility of the NHLS to demonstrate the important work that is taking place at this institute.

I am sure there are similar Units, which are doing work that is just as important. For example:

I know that Prof Valerie Mizrahi's group has been doing some sterling work on Tuberculosis.

Prof Keith Klugman, the former Director of the SAIMR, used to run a very important unit of pneumococcal bacteria. I hope this work is still being pursued.

I hope that the research work is not only confined to head office and that peripheral laboratories also have an opportunity to contribute towards research, over and about routine laboratory diagnostic work.

I want to challenge the NHLS to train more African researchers, not only from the continent, but also to train indigenous young people to boost the numbers of African research scientists.

You will recall between November 2002 and July 2003 that the world experienced one of the strongest communicable disease outbreaks - SARS, and in particular, China, Hong Kong, Vietnam, Singapore and Canada.

Many lessons were learnt from the SARS epidemic:

SARS brought home to the world that it remains unpredictably vulnerable to the emergence of new, and sometimes strange infectious diseases;

The rapid response and good public health interventions in most countries demonstrated the value of good surveillance and effective and rapid response systems;

The outbreak was an important rehearsal of emergency responses to a future influenza pandemic; and

Mechanisms for international cooperation as well as clinician-laboratory-epidemiology collaboration have now been established and field-tested.

I hope that the NHLS is building its capability in disaster management to be able to contain such disease outbreaks.

Besides the scientific and technical challenges that will face the NHLS, it will also have to brace itself to deal with the management and economic challenges.

With time, the NHLS has to become more and more competitive, which means that we are looking forward to a situation when the unit cost of tests cannot continue to climb year on year.

At some stage, the cost of laboratory services to the health system must be realistic and affordable, especially when large volumes are handled, as the case will be with laboratory tests to buttress the Comprehensive Care, Treatment and Management of HIV and AIDS.

Therefore the NHLS has to think serious about issues of efficiency, improving turnaround times and competitiveness.

I also expect improved quality of services especially in rural and remote areas, especially in historically disadvantaged areas such as the former Homeland areas. Very soon you will have to upgrade the services in Butterworth to be the same as in East London, almost a hundred kilometres away.

You will have to improve the turnaround times of tests such as TB microscopy in rural areas, if we are to tackle the scourge of TB and Multi-Drug Resistance TB in this country.

Finally, one of your biggest headaches will be to integrate people from different services, different corporate cultures and backgrounds into a single organization with a mission to improve efficiency, performance and client satisfaction and in a globally competitive environment.

I am aware that currently there are problems in the human resource area, which involve the conclusion of negotiations on remuneration packages as well as other issues, which relate to the broader transformation agenda in the NHLS.

However, I am confident that the executive management, the board and the employees of the NHLS will work through these challenges and come to a pragmatic and an amicable solution as soon as possible.

In conclusion, Programme Director, I am here to congratulate the NHLS on its achievements, and I am looking forward to bigger and bigger accomplishments from this sleeping giant.

I would like to give my special thanks to the Department of Health for overseeing the transformation of laboratory services and giving birth to the NHLS.

I wish to that Dr Nicholas Crisp who worked with all of you as a facilitator for the integration of all the laboratory services on my behalf.

I want to thank the board of the NHLS to taking good care of this asset of government and in particular, its chair, Ms Sesi Baloyi.

I would also like to congratulate the CEO of the NHLS, Mr John Robertson, and to wish him all the success in piloting this organization through its opportunities and challenges.

Finally, ladies and gentlemen, thank you for your presence at this important occasion and please join me in congratulating this new organization and to wish the NHLS a very bright future.

I thank you!

Source: Department of Health (http://www.doh.gov.za)