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Date : 05/05/2005
Source: Ministry of Health
Title: Tshabalala-Msimang: Parliamentary Media Briefing, May 2005


Media briefing by the Ministry of Health on the Programme of Action of the Social Sector Cluster

I am presenting this report to the nation-building on the progress reports of the 2004 Programme of Action, and will therefore focus on those programmes of the Cluster that were raised by the President in his State of the Nation Address 2005 as needing acceleration and strengthening.

For the period under review, government committed to: examining the implications of the macro social state of our nation research on public policy and service delivery; launching the National Social Security Agency during the course of this year and implementing systematic plans against corruption. We worked hard to finalise the definitions of disability and allocations of the foster care grant. We continue our campaigns to address non-communicable and communicable diseases as well as non-natural causes of death, through the promotion of healthy life-styles and increased focus on tuberculosis (TB), AIDS, malaria, cholera and other water-borne diseases, and generally increasing the standard of living of the poorest among us.

COMPREHENSIVE SOCIAL SECURITY

Definition of disability

I am proud to announce that Cabinet has approved a common definition of disability for the implementation of the Free Health Care for Disabled Persons programme in the Department of Health and for the Disability Grant administered by the Department of Social Development. As both programmes are targeted to serve lower income disabled people, Cabinet was concerned that the two programmes were not well coordinated.

The newly adopted definition brings key policies and procedures in line, thus simplifying the eligibility processes and eliminating some of the current duplication of efforts that frequently create barriers for disabled persons applying for benefits in each programme respectively. More importantly, it makes the distinction between eligibility for a disability grant where the emphasis is on the applicant being unfit to work and participate in economic activity and eligibility for the free health care programme which focus more on the applicants functioning within society as a whole.

We will continue to work on policies addressing eligibility of persons with chronic diseases so that we can make a clear distinction between disability grants and possible grants related to the impact of chronic illness.

Social grants

The improvement of the integrity of the social grants administration system continues to be a priority in our Programme of Action. We have therefore instituted a number of projects that will assist us in ensuring that the system does not exclude people who qualify, while also ridding the system of elements of fraud and corruption.

In a recently completed verification process of all beneficiaries, government has made savings of close to R500 million by picking up a total of about 121 000 cases of temporary disability grants that had lapsed.

Through the fraud hotline, over 19 000 cases of potential fraud have been reported and these are being investigated. In addition, we have also established that over 41 000 public servants were in receipt of grants, and these are now being investigated.

The indemnity offered in December 2004 by the Department of Social Development, provided ineligible beneficiaries an opportunity to apply for indemnity before the end of March 2005. This campaign was a huge success in that during this period, nearly 90 000 applications for indemnity were received. Structures are being put in place in the provinces to process these indemnity applications.

Basic Services

The government’s undertaking to provide free basic water for the poor is currently being implemented, with the support and monitoring by the Department of Water Affairs and Forestry. Currently, potable water is accessible to 75% of people with infrastructure, which is 69% of the total population.

With regard to sanitation, the National Sanitation Task Team and Sector Monitoring and Evaluation system are in place. We have replaced the bucket system of 12 000 households. We have also developed guidelines and a strategy to eradicate buckets in the next 3 year cycle using the available budget of R1,2 billion.

COMPREHENSIVE HEALTH CARE

Non-communicable diseases and diseases of lifestyle

With regard to comprehensive health care, the Social Sector Cluster was tasked with strengthening its programmes and promoting healthy lifestyles which meant that non-communicable diseases such as diabetes, obesity, asthma and hypertension should remain a major focus area.

We have mobilised the support of various partners including the private sector and civil society in promoting healthy lifestyles. While disseminating messages on the need for good nutrition and physical activity, the programme has also focused on health screening during Izimbizo which has seen thousands of people being screened for diabetes, hypertension, oral health, sight defects, and where possible, cervical and prostate cancer.

I would also like to use this opportunity to alert the nation to the importance of 10 May, as the World Physical Activity Day and all citizens of this country are encouraged to host programmes emphasising the need for physical activity and proper nutrition. I think it is opportune, here, to acknowledge the continued participation and valuable contributions from pharmaceutical companies, fitness organizations and medical aid schemes towards the department’s Move for Health Campaign.

Our anti-tobacco campaign also continues to gain momentum. This year, South Africa became one of the few countries to have ratified the Framework Convention for Tobacco Control, which is a global initiative of the World Health Organisation.

Communicable diseases

Comprehensive Plan on HIV and AIDS

The Cluster was also tasked with continuing the implementation of Government’s Comprehensive Plan on HIV and AIDS, which focuses on prevention; care and support; treatment; and voluntary testing.

In this regard, we are pleased to report that during the first year of implementation, we have improved access to services and all 53 districts have a facility that provides comprehensive treatment for HIV and AIDS. The HIV prevention component of the Plan has been strengthened, specifically on STI treatment and partner notification and efforts this year, are geared at stepping up door-to-door social mobilisation.

The care and support component will focus on the integration with the community health worker programme. There are 1 700 projects nationally offering home-based care, a service that is critical to avoid situations where patients would develop drug resistance due to non-compliance. The treatment programme includes better follow-ups and improved treatment of opportunistic infections, but it still needs improvement with regard to patient monitoring mechanisms. Drug procurement processes were successfully completed within the first year of implementation and no stock-out has been reported.

We also continue to emphasise the importance of good nutrition and the use of essential nutrients as part of the comprehensive treatment to ensure that the immune system is not unnecessarily compromised. Clinical protocols now require micronutrients to be part of the treatment protocols. Our strong emphasis on nutrition, as an important element in the prevention and treatment of diseases and illnesses as well as the fight against HIV and AIDS, received a major boost when the World Health Organization hosted a conference on the role of nutrition in fighting HIV and AIDS in Durban. We will continue to spread this message.

Perhaps the biggest challenge that we face in implementing the Comprehensive Plan is the availability of laboratory facilities in under-served areas for voluntary testing. The capacity of laboratory services for CD4 count and viral load tests exists in most urban areas but there are certain areas that do not have such services readily available.

Another challenge relates to the integration and strengthening of workplace programmes within government and the President tasked the Cluster with addressing this. In response, the Cluster is strengthening its integrated programme focusing on increasing awareness on the importance of nutrition in building the immune system. Various government departments have incorporated messages focusing on nutrition in their programmes. Partnerships with civil society and the private sector have also been revived especially through the South African National AIDS Council (SANAC).

Through the Khomanani social mobilisation campaign, we are strengthening the provincial effort by deploying two people per province to work directly with communities. We started this programme in February and have already covered six. We have also implemented programmes that are mobilizing our people to act and earlier this year, a number of young people came out and declared that they were choosing to wait before engaging in sexual activity. We have been working in this context with religious leaders to promote abstinence.

During this reporting period, we have held successful social mobilisation events starting with STI/ condom week in Upington, in February which was attended by about 3 000 people. We also mobilized communities in Mpumalanga on World TB day in March to rise and act against the spread TB. Our collaboration with sectoral and faith-based organizations is also bearing fruit. The 600-strong group of traditional leaders that were trained on HIV and AIDS issues has also been embarking on a community mobilization process of their own, with the support of the Department of Health.

We are proud of our mobilisation campaign and the request by the United Nations to reproduce our Khomanani materials for distribution in the rest of Africa. We have also implemented programmes that are mobilizing our people to act. A number of young people came out and declared that they were choosing to wait before engaging in sexual activity. We will continue with similar mobilization campaigns.

TB

With regard to TB, we are reporting that our detection rate has increased thus leading to a better understanding the burden of TB in the country. However, our recent assessment of the prevalence of TB in the country shows that the cure rate remains a big challenge because of treatment default amongst other things. There are indications of an increase in multi-drug resistant TB cases, which is a great cause for concern and we have sought the assistance of the World Health Organization in this regard. The Department of Health is also working with provinces to develop centres for multi-drug resistant TB treatment, to conduct research to understand the causes for the increase in multi-drug resistant TB cases and to develop the necessary programmes for interventions such as increasing capacity to deal with the challenges of the TB programme.

Pig tapeworm in the Eastern Cape

There is currently an outbreak of Pig tapeworm in the Eastern Cape. The province is embarking on a massive mop up campaign to contain the outbreak and other provinces have been requested to assist the Eastern Cape with outbreak control.

Measles

We are working hard to contain the measles outbreak affecting KwaZulu-Natal, Gauteng and the Eastern Cape and to a lesser extent, the Western Cape. Mop up campaigns were conducted in all affected provinces where the immunization campaign coverage and routine immunization coverage was poor. The National Outbreak Response Team will present a report to me this month about the possible causes for the current measles outbreaks and the progress of the Expanded Programme on Immunisation.

Malaria

The control of malaria has been one of the major achievements of government over the past few years. The prevalence rate has decreased from 120 per 100 000 in 1999 to 28 per 100 000 in 2004. The case fatality has also declined from 0.8% in 1999 to 0.6% in 2004.

Cholera

Good collaboration between the Departments of Health, DPLG and DWAF in particular, has resulted in the containment of cholera cases and deaths nationally. The last case was reported in October 2004.

INTEGRATED FOOD SECURITY AND NUTRITION

About 245 000 households benefited from the National Food Emergency Scheme (NFES) of the Social Safety Nets and Food Emergency Programme during the last cycle of the scheme. The year 2005/6 is the final year of the R1.2 billion three-year allocations for the Food Emergency Scheme.

The Scheme ended, in its current form, with the 2004/5 allocation following concerns about its unintended consequences. The 2005/6 allocation has therefore been redirected to a new programme on Integrated Development Services focusing on the same beneficiary target groups. The funds will be transferred to provinces as a conditional grant in the current year and expected to form part of the base line from 2006/7. The intention is to enable provinces to support and provide appropriate welfare services and development interventions, and for immediate and appropriate short term relief to vulnerable individuals and households who are not eligible and not receiving any form of assistance in terms of the Social Assistance Act, 1992 or the Social Assistance Act, 2004 when it becomes operational.

With regard to the National School Nutrition Programme, the process of getting communities involved in school nutrition is ongoing – a number of School Governing Bodies (SGBs) have started taking charge. The vegetable garden programme have seen a number of schools, clinics and hospitals developing community food gardens in support of the Cluster programme of greening our communities with vegetable gardens to ensure food security.

Apart from work that has been done through the National School Nutrition and vegetable garden programmes, communities continue to develop their own gardens. The role of government has largely been around advocacy. Certain provinces have allocated some funds in support of the community gardens.

EXPANDED PUBLIC WORKS PROGRAMME (EPWP)

In the context of the programmes of the Social Sector, the Cluster was required to introduce steps to increase the numbers of Community Health Workers, having harmonised training standards and increased resources allocated to the programme. In this regard, the Cluster can report that the process of harmonising training standards is under way and the qualifications framework for Community Health Workers has been completed. The Cluster is currently working on developing learning materials and skills programmes in partnership with Umsobomvu and the Health and Welfare SETA.

Community Health Workers are being trained to deal with broader societal issues rather than just HIV and AIDS. The training programme is undertaken across various departments and by the three spheres of government.

The Cluster was also tasked with expanding the Expanded Public Works Programme (EPWP) through the provision of Early Childhood Development (ECD) services. The Department of Education has established task teams to plan and monitor the delivery of these services. At least seven provinces have drafted their social sector plans for implementing the EPWP and a team of consultants have been appointed by the Department of Public Works to assist in drafting Action Plans for the EPWP projects. The ECD Integrated Plan which is crucial to the delivery of the ECD EPWP has been amended and distributed to the members of the ECD Interdepartmental committee and the consultants as a resource for the development of the Action Plan.

Conclusion

I would like to end here and hope that we will be able to elaborate on some of these issues during the question and answer section of this session.

Thank you.

Issued by: Ministry of Health
5 May 2005

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