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Tshabalala-Msimang: Social Cluster Media Briefing (26/09/2006)

26th September 2006

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Date: 26/09/2006
Source: Department of Health
Title: Tshabalala-Msimang: Social Cluster Media Briefing


Social Cluster briefing document delivered by the Chairperson of the Social Cluster, Minister Tshabalala-Msimang

Good morning ladies and gentlemen,

It gives me great pleasure to brief you on progress made by the Social Cluster in implementation of Government's Programme of Action. As you will recall the last time that we reported back on the Cluster's work was before the July lekgotla.

This report will focus on progress in key aspects of our comprehensive social security system, on extreme drug resistant (XDR) tuberculosis (TB), on improving access to education, on second economy interventions and on youth development. I will conclude by covering a number of issues that have arisen around HIV and AIDS since the International AIDS Conference in Toronto.

Social security issues

As you know we have a number of pillars to our social security system. I will focus today focus mainly on child support grants and general social assistance.

The target set three years ago to extend the child support grant to 3,2 million children by March 2006 has been exceeded by 300 000. By June 2006, 3 550 940 children were registered as beneficiaries of the child support grant. If we include other forms of social assistance this figure increases to 7,4 million. In addition, many more children benefit from free health care services as well as free basic education.

A detailed study which profiles all child beneficiaries and their access to the various forms of government services has been completed with a view to consolidate all services provided by government to children. This report will be presented to Cabinet during October.

Extreme Drug Resistant TB

In March this year the Department of Health launched a National TB Crisis Management Plan which prioritises four health districts with the highest TB caseloads. This Plan was developed to raise awareness about TB to improve detection and deal with the large TB case load and poor treatment outcomes.

We learned during the past few weeks of the emergence of what is called extreme drug resistant TB in a few provinces. Cabinet has been briefed about this new challenge. In addition, I held a consultative meeting with TB researchers, clinicians as well as laboratory scientists and we agreed that they will keep me briefed on a continuous basis with regard to the extent of the problem and what can and is being done to contain the problem.

I have also been in touch with the World Health Organisation (WHO) as well as Ministers of Health in the region. I have requested an urgent meeting with experts from the WHO so that we can get assistance to develop a national as well as a regional strategy to deal with XDR TB.

Expanding access to education

More than 7 000 schools have implemented a voluntary no fee policy. This means that 2,6 million learners need not pay school fees, thus increasing access to education. Policies will be in place at the beginning of the 2007 school year to ensure that fees for the poorest primary schools are eliminated.

In order to provide good quality classrooms for our learners, the Department of Education has been conducting an audit of all schools. As of August 2006, 63% of the 30 000 institutions were audited and an interim report on the first 15 000 institutions that were audited has been prepared. Proper classrooms were made available to those learners who were found to be learning under trees in 2004. However, recent storms have resulted in damage to some schools. Whilst the damage is being repaired, some learners are unfortunately forced to learn under unfavourable conditions.

Second economy interventions

The Social Cluster's second economy interventions have focussed on the Expanded Public Works Programme. A plan has been developed to expand the Early Childhood Development Programme. The challenge is to find ways of balancing expansion and the provision of quality early childhood development services.

Plans are also being finalised to increase the numbers of community caregivers. We are planning to increase in number the 11 182 community caregivers (at the beginning of the financial year) to 25 000 by the end of this financial year. A key challenge is our capacity to adequately train the new recruits into this programme.

Youth Development

There are still too many graduates who are unable to find employment. Government received 2 490 requests for placement and from our database we sent more than 2 500 curriculum vitas (CVs) to various companies.

The National Youth Service reports that more than 4 800 young people will be working in various projects over the year. Examples of these projects are: the maths and science project in Ekurhuleni, the Expanded Public Works Programme in the Western Cape as well as the Kraaipan Heritage Project.

HIV and AIDS

As a result of a series of reports on the issue of HIV and AIDS since the International AIDS Conference in Toronto, I would like to address this matter as extensively as possible with the hope that it would clear any alleged confusion. There have been complaints about confusing messages. What is the message of government on HIV and AIDS?

What we are saying as Government is that we have this major challenge of HIV and AIDS, let us make sure it does not worsen by first and foremost preventing further infections. We thereafter say that for those who may be living with HIV, let us prolong for as much as we can, the progression from HIV infection to development of AIDS-defining conditions. Let us maintain good health. We do this by promoting healthy lifestyles ? regular physical activity, avoiding health risk behaviours like smoking, alcohol and substance abuse and unsafe sexual behaviour.

We acknowledge the serious challenges with regard to nutritional status of our population and approved various interventions such as food fortification, school nutrition, vitamin supplementation for pregnant women and children. HIV in particular, puts additional nutritional demands on the body and we have to make extra efforts to meet these demands. That is where we emphasise the use of a number of fruit and vegetables that provide particular vitamins and other micronutrients necessary in dealing with conditions associated with HIV and AIDS.

We treat opportunistic infections because many of them can be successfully treated even in the presence of HIV and AIDS.

We make antiretrovirals (ARVs) available for those with a CD4 count of 200 and below in facilities that have been accredited to provide this treatment. These facilities are available in all districts and have been extended to more than 70% of local municipalities to ensure that there is equitable access to this service.

Some have asked why do we advocate the use of particular fruits and vegetables, and whether this is an alternative to treatment? There has been extensive research on the Mediterranean diet and its health benefits particularly with regard to garlic and olive oil. Garlic has antiviral and antibacterial properties, lemon is a source of selenium and vitamin C and the benefits of beetroot with regard to anaemia are also well documented.

The message should not be lost that we want every person in the country to eat a balanced and nutritious diet and maintain good health. For those living with HIV, we are saying that good nutrition will help in prolonging progression from HIV infection to the development of AIDS-defining illnesses. It is not a substitute for medical treatment, but it helps in maintaining optimal health. It is also a foundation for effectiveness for many medical interventions.

There have also been questions about why we emphasise that it is HIV and AIDS and not HIV/AIDS.

We have used the phrase HIV and AIDS because we think it helps clarify the specific challenges we confront. These are, first, to prevent the transmission of HIV; second, to slow progression to AIDS-defining illness once transmission of HIV has occurred; and third, to treat and support HIV-infected patients to the best of our ability when they present themselves with AIDS-defining illness.

Some have alleged that there is no support the use of ARVs.

Our view is that ARVs play a role when the CD4 count reaches 200 or below and they can prolong life. As government, we are determined to make them available through accredited health facilities and there 262 of these in the country currently, including four Correctional Services facilities. At least 178 635 people had been initiated on antiretroviral therapy by June 2006.

The most important thing is to ensure that our facilities and the health system are able to provide this treatment in a safe manner. We should be able to monitor patients and respond accordingly to issues of adverse drug reaction and resistance. We are working on strengthening the patient information system and pharmacovigilance programme.

Medicines are registered with accompanying information on their contra-indications. Health professionals responsible for implementing this programme need to be aware of these and be able to advise the patients accordingly. Patients also have to know the challenges they may face and the need to seek medical advice on these.

Co-ordination of activities on HIV and AIDS

Cabinet has taken particular decisions to ensure that the co-ordination of activities on HIV and AIDS is strengthened. The Ministry of Health is part of those structures tasked with co-ordinating these efforts. We are determined to make our contribution to ensure that they work.

We need to move away from the perception that HIV and AIDS is just a medical or health issue. We want to ensure that all sectors are co-ordinated and that they contribute to the country's comprehensive response to this challenge. I hope all role-players will also be constructive in their approach. We need to strengthen partnerships and move forward as a country, guided by the Comprehensive Plan.

The Health Department is responsible for implementation of most of the programmes covered in the Comprehensive Plan. We are accountable for health facilities that deliver most of the HIV and AIDS services.

I will therefore continue to account to Cabinet and Parliament and speak to the general public and the media (as I have done this afternoon) about these programmes and the rest of our efforts to improve the health of our population.

Conclusion

In conclusion, I would like to report that meetings are now being held between provincial social cluster chairpersons and the co-chairs of the national Social Cluster of Directors-General. These meetings aim to synchronise the activities of the national and provincial spheres of government.

Whilst only selected activities have been reported on during this briefing, the rest of the report is on the government website. It is clear that progress is being made on a number of fronts.

Thank you

Issued by: Department of Health
26 September 2006
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