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Date
: 28/06/2005
Source: Department of Health
Title: Tshabalala-Msimang: Monitoring and Evaluation media
briefing
Media briefing by the Ministers of Health and Social Development on
the Programme of Action of the Social Sector Cluster,
Pretoria
In this report, the Social Sector Cluster will outline progress
achieved since the briefing we made on 5 May 2005.
1. Comprehensive Social Security
The extension of the Child Support Grant is well on target with
close to 2.3 million children of ages 7 to 14 already benefiting
from the grants. These are in addition to the 0 to 6 year olds that
were initial beneficiaries of the Child Support Grant before the
Cabinet decision to extend the age of eligibility to 14.
Parallel to the extension of the Child Support Grant the Cluster
has put in place mechanisms of addressing inefficiencies and
unintended consequences of social protection as directed by
Cabinet. A research report on fertility rate in South Africa has
been completed and nothing in the analysis of the report indicates
that more teenagers are getting pregnant. To advance the research
work is ongoing is assessing potential perverse incentives,
including teenage pregnancies.
It is also the intention of government to encourage income
generation amongst those beneficiaries of social grants that can be
able to earn an income. In this regard, we continue to roll out
public works programmes and are pursuing various models of
cooperation with civil society, including faith based
organisations. We also continue to review the potential number of
beneficiaries against available budgets and to improve the
efficiency of the grant system and the targeting mechanisms. Since
the adoption of a common definition of disability last month by
Cabinet, we are now in the process of implementing simplified
administrative procedures that have to be followed to check
eligibility amongst beneficiaries.
The National Social Security Agency launched early this year, will
result in the implementation of a new model of grants
administration that will be piloted towards the end of this year.
Discussions are already under way with banks on the role that they
will play in the efficient delivery of the grants, especially in
reaching rural beneficiaries that did not have access to the formal
banking services. Basic Services
With regard to basic services, the Cluster is expected to deal with
the remaining challenges in sanitation and refuse removal,
especially in rural communities and areas of human settlement
– which is an ongoing programme. In May, we announced that a
budget of R1.2 billion had been allocated to the eradication of
bucket system over three years. It is expected that the budget will
cover the replacement of 233 000 buckets during the three-year
period. Work in this area is ongoing. The indigent policy has been
approved and a registration pilot has been started this month in
selected rural nodes and metros. The intention is to address the
challenges relating to targeting in the provision of free basic
services to those that are eligible, deal with the culture of
non-payment and improving the billing systems. 2. Promotion of
National Identity and Social Cohesion
The main intention of the Cluster’s programme on the
promotion of national identity and social cohesion related to the
review of the impact of socio-economic transformation on social
cohesion in communities and across society, including issues like
non-racialism and non-sexism as well as the role of the family,
value systems, identity and moral regeneration. The focus of the
review was on the changes in the material conditions and the
structure of society in South Africa in the past decade, and the
trends in the organisation of social life; trends in households and
families, community organisation and economic relations as well as
an analysis on how the diverse and overarching identities and value
systems affect the self-worth and aspirations of South Africans.
The Cluster is currently finalising a document on the policy
implications of the findings of that macro social analysis for
discussion at the July Lekgotla. The public will be informed of the
outcomes in due course. Parallel to that is the ongoing work of the
enhancing integration between the Security and Social Clusters to
deal with roots of many crimes that occur in communities, with a
special focus on areas identified as hot spots. 3. Comprehensive
Health Care
In promoting healthy lifestyles, the Cluster is working in
collaboration with the private sector and civil society in the
provinces in educating communities about risky behaviour and
importance of healthy living in the reduction of the diseases of
lifestyles such as hypertension and diabetes. The move for Health
campaign slogan: Vuka South Africa, Move for your Health was
launched on 30May 2005 in collaboration with the Departments of
Education, Sports & Recreation and private sector partners. The
key messages promote good nutrition and physical activity and
thousands of people were screened at various Izimbizo for diabetes,
hypertension and eyesight amongst others. HIV and AIDS
We continue our work in dealing comprehensively with the challenge
of HIV and AIDS. Our strategy operates at two levels. The first
level relates to a comprehensive strategic response to HIV and AIDS
as outlined in our HIV and AIDS/ STIs Strategic Plan for South
Africa. In this regard we are pleased to report that our prevention
strategies continue to form the backbone of our response to HIV and
AIDS. We have been pleased with efforts by all actors to begin to
put visibility into our abstinence message as recently demonstrated
by the abstinence marches in KwaZulu-Natal, which culminated in a
massive gathering at kwaNongoma recently. We continue to discuss
ways of intensifying this focus on abstinence with the Religious
Leaders Forum. Our condom distribution has also grown to higher
levels and the incidence of STIs has actually gone down. Another
element of prevention is the prevention of mother-to-child
transmission. In this regard we had requested three different
structures to look into the matter of the efficacy of moving to
dual or triple therapy in the context of our country, the Medicines
Control Council (MCC), The Medical Research Council (MRC) and the
EDL Committee. While we have received reports and suggestions from
the three institutions, we have not found conclusive support for a
change of our current policy in this regard. The Department of
Health has therefore been asked to do more work in this regard, in
preparation for a report and a proposal to Cabinet soon. Other
elements of the broad strategic response to HIV and AIDS include
research, monitoring and surveillance, and human rights issues. The
Strategic Plan is due for review this year, as it was meant to last
for five years, from 2000 –2005. The second level relates to
the Comprehensive Plan for Treatment Care and Support. Again in
this regard we are pleased to report that the implementation of the
plan is going very well, although we still face a number of
challenges. Voluntary Counselling and Testing sites continue to see
more people than before, while through the Khomanani social
mobilisation campaign we intensified efforts to spread messages
around voluntary testing and counselling as well as abstinence.
With regard to care and support for people who have tested positive
and those who are living with the virus, messages around positive
living and healthy lifestyles have also been intensified, including
the role of physical exercise and good nutrition in delaying the
development of Aids defining conditions. With regard to treatment,
143 sites in all the 53 districts have now been accredited to
provide comprehensive HIV and AIDS services, including ART. This is
in line with the targets that have been set for the programme.
Reports from provinces suggest that a total of 50 009 patients have
been started on antiretroviral treatment, in accordance with
current policy guidelines. Efforts to improve our monitoring
systems continue, to ensure that we can track these patients and
their response to such treatment. People continue to use
alternative treatment provided by various other groups of healers,
such as traditional healers, complementary medicine practitioners,
etc, and the department of health continues to monitor developments
in these areas, and to encourage research, especially around
traditional medicines. A few of these are now at clinical trial
phase. The South African National Aids Council (SANAC) has also
served as an effective forum for strengthening and integrating
programmes within government, and also between government and other
stakeholders. Other Communicable diseases
The prevalence of malaria has been decreased significantly and
substantially over the past 5 years from prevalence levels above
80% in some areas to current levels, which are below 10%. This can
be attributed to the success of in-door residual spraying using DDT
and the partnership with Mozambique and Swaziland. The total number
of malaria cases reported from January to May 2005 is 4 539, which
represents a 44.5% decrease from the 8 173 cases reported during
the same period in 2004. During the same period, 35 deaths were
reported compared to 55 in 2004, which represents a 36.4% decrease
on deaths related to Malaria. This means that we are slowly winning
the war against malaria. We are about to collaborate with
Mozambique in the use of residual spraying in the Libombo corridor.
Tuberculosis Last time we reported that we were facing some
challenges with regard to TB, as we saw some difficulties in the
reduction of cure rates as a result of non-adherence to treatment.
We also reported that the Department is working with provinces to
develop centres for multi drug resistance in an attempt to deal
with the tendency towards increasing drug resistance to TB
treatment. The Department will strengthen four components of the TB
programme. These include strengthening the DOTS programme,
improving laboratory services, fast tracking the appointment of TB
district coordinators and strengthening community mobilisation. We
are pleased to report that provinces continue to take further steps
to improve our TB control programme, especially as it relates to
the management and supervision of TB work. Reduction of cost of
medicines
The first phase of the Medicine Pricing Regulations has yielded a
19% reduction in the ex-manufacturer price of medicines when
compared to the previous blue book price. Savings of between 15 and
30% have also been reported by medical schemes. In summary, the
Cluster’s programme on Comprehensive Health Care is on
target. 4. Housing and Human Settlement
A comprehensive programme dealing with housing and human
settlements is well under way. The target or the Cluster was to
spend R14.2 billion in the next three years to ensure that the
people of South Africa had access to basic shelter. That target has
been exceeded with government’s approval for a R17.4 billion
over the same period being allocated. The National Treasury has
also approved a budget of R50 million to be spent on consumer
education, accreditation of local municipalities as well as
training on all human settlement policies and guidelines for
municipalities and provinces. The intention is to improve
institutional capacity and governance so that provinces and
municipalities are able to deal with rapid growth and urbanisation
that increase the demand for housing and basic services. 5.
Integrated Food Security and Nutrition
Since the start of the National Food Emergency Scheme in 2004 a
total of 245 000 households have benefited from the programme.
Agricultural Starter Packs to the value of R31 million have been
delivered to some 18 575 households in all provinces as a measure
of encouraging the development of sustainable food gardens.
Business plans and a financial model for financing the farmer
support programme have been finalised and the Department of
Agriculture is in the process of finalising a memorandum of
agreement with key partner institutions in preparation for the
implementation of the programme. The agricultural state and
state-supported community schemes have seen a significant increase
in the number of viable projects. With regard to the National
School Nutrition Programme and the social mobilisation for food
gardens, the Departments of Education and Health have worked
together in developing guidelines for quality assurance of food
products intended for use by the National School Nutrition
Programme. The programme is on track. 6. Expanded Public Works
Programme
The Social Cluster is progressively implementing labour intensive
methods in the delivery in the construction of housing, schools,
clinics and other community centres. The Cluster is developing a
clear resourcing strategy for expansion of social services such as
Early Childhood Development and the Community Health Worker
programme. With regard to the Community Health Worker Programme
unit standards have been developed. The Department of Social
Development as a coordinating department will create a dedicated
unit that will take charge in driving the programme. Government is
also exploring various partnerships with key institutions such as
the Development Bank of Southern Africa (DBSA), the Independent
Development Trust (IDT), the Business Trust, Umsobomvu, civil
society and religious leaders in various aspects of the EPWP
programme which will obviate some of the implementation challenges
that have been encountered. 7. ISRDP/URP
The Integrated Sustainable Rural Development Programme and the
Urban Renewal Programme are well under way. One of the main issues
that the Cluster had to address during the current cycle of the
Programme of Action was to develop a financing protocol for the
nodes to improve the effective coordination and financing of the
ISRDP and URP programmes by the three spheres of government. The
principles of the protocol are in place and the task is now at a
stage where the National Treasury is considering the feasibility of
budget allocation to line function departments to ensure that they
are able to implement programmes in support of the ISRDP/URP in the
nodes. 8. Conclusion
In conclusion, I would like to state that the Cluster is satisfied
with the progress in general. Areas that we have identified for
intensified efforts include the Expanded Public Works Programme and
the strong partnerships with key stakeholders that we are
establishing will assist in dealing with the blockages. A detailed
progress report on the Social Health Insurance will be outlined in
the next report of the Cluster. Issued by: Department of
Health
28 June 2005
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