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Date
: 03/08/2003
Source: Ministry of Health
Title: Tshabalala-Msimang: South African AIDS Conference
INPUT BY THE MINISTER OF HEALTH, DR MANTO TSHABALALA-MSIMANG, AT
THE SOUTH AFRICAN AIDS CONFERENCE, Durban, 3 August 2003
Programme Director, Distinguished and Invited Guests, Ladies and
Gentlemen, it is a privilege and an honour for me to introduce to
you His Excellency, the Deputy President of South Africa, Mr Jacob
Zuma.
Director of ceremonies, His Excellency, The Deputy President of
South Africa, Mr Jacob Zuma, The Deputy Minister of Health, MECs,
Conference Chair, Members of SANAC and the Provincial AIDS
Councils.
The Deputy President is the leader of government, and in
particular, he is the champion of all our activities in government
relating to HIV and AIDS.
As we come to this conference today, government is accused of doing
nothing about the spread of HIV/AIDS in our country. Let me tell
you that nothing could be farther from the truth than this
statement.
Our achievements in our multisectoral response to AIDS speak for
themselves.
* We are implementing the 5-year strategic plan for AIDS which
emphasises prevention; treatment, care and support; fighting
against stigma and discrimination; and investing in research and
disease surveillance;
* We have reduced the prevalence of syphilis from 9% to 3% from
1999 to 2001
* To date we have introduced approximately 1,600 counselling and
voluntary testing sites throughout the country. Government
continues to expand these services to include other sectors
* In 2001, out of its own concern and initiative, government
introduced the programme for the
prevention-of-mother-to-child-transmission of HIV;
* A recent survey showed that there are approximately 450
home-based care programmes across the country
* We purchase and distribute condoms free of charge. In 2003, we
are spending R123m on this programme, which sees to the
distribution of approximately 22 million male condoms and 100,000
female condoms every month
* Recently, our health system has been accused of being in
Intensive Care Unit
* Our health care system is certainly better that the one we
inherited from the apartheid regime
* There are more people enjoying universal access to basic health
care services now, especially women and children
* We have built 701 new clinics, and expanded 249 existing
clinics;
* Yes it is true that those who had a first world health care
system while the majority of South African had nothing, are feeling
the squeeze
* Through our national drug policy we have expanded access to
quality and affordable medicines even to the private sector
* Government has set aside approximately R2.7 billion in the next 3
years for the Hospital Rehabilitation and Revitalisation
programmes;
* The establishment of the National Health Laboratory System in
2002 was an important step in consolidating laboratory
services;
* The NHLS recently developed a new CD4 testing method that would
cost approximately 10% of the current costs of CD4 tests;
* Where drug stock-outs was a reality only 3 years ago,
pharmaceutical managers in the provinces now report less than 5%
drug unavailability over a one-year period
* The opening up of our borders in 1994 meant new opportunities for
South Africans, and the health sector has certainly felt the effect
of this brain drain
* In an effort to counteract some of these trends, the government
dramatically increased the remuneration packages for health
workers
* The community service for a growing number of health worker
categories, but starting with doctors, aims to bring to the public
sector some of the benefits of the state subsidised health
professional training in our academic institutions
Yes, partly because of HIV and AIDS, there is pressure in the
system and our health workers are experiencing increased workloads,
and we are attending to that.
Earlier this year during my budget speech, I announced that
Government has set aside R500 million to attract and retain health
workers in rural areas of South Africa.
We are finalising the negotiations on how this money will be
distributed, but as much as we appreciate our medical doctors in
the public service, the money cannot be spent on one category of
workers.
We've got to think of the lone professional nurse that is running a
clinic at Kwadukuza and has no one to relieve her when sick or
during weekends.
Some say that providing ARVs is as simple as administering an
aspirin. We say, no, this is not true. Whilst ARVs have an
important role in the management of AIDS disease, their
administration needs one to take into account a whole variety of
factors.
For example, to provide a comprehensive PMTCT programme requires
the following interventions:
* Integrating PMTCT into antenatal care services;
* Providing counselling and voluntary testing;
* Setting up an infrastructure for HIV testing and quality
control;
* Counselling on safe infant feeding practices;
* Providing formula feed and managing its logistics;
* Providing multivitamins
* Treatment of all opportunistic infections;
* Providing the Nevirapine tablet; and
* Post-delivery follow-up on the baby-mother pair
* Training of health care workers on PMTCT and infant
feeding.
Another illustration, Programme Director, concerns the provision
antiretrovirals for post-exposure prophylaxis for survivors of
sexual assault.
This programme includes the following services:
* Psychological counselling;
* STI prophylaxis;
* HIV testing;
* Emergency contraception;
* Medico-legal assessment of injuries
* Data management and registry;
* ARVs containing triple therapy; and
* Follow up for those who chose to use ARVs
* Forensic training.
Therefore, I submit, Mr Programme Director, that the provision of
antiretrovirals in the public health sector is a subject that must
be considered soberly, and government is doing so.
For example, government is carefully considering a report that was
submitted by the Joint Task Team of the National Treasury and the
Department of Health on expanding treatment for people infected
with HIV, including the healthcare infrastructure requirements and
cost implications.
But certainly, if the truth be told, the provision of
antiretroviral drugs is not comparable to administering aspirin for
a headache.
This is why we consider the accusation that the South African
government is guilty of genocide very seriously.
This is an irresponsible statement and one that is also politically
dangerous. We have a vast number of people in our country who are
infected and affected by HIV and AIDS. We must engage each other to
find solutions to this problem but not to play political games on
such a sensitive and emotional subject.
Programme Director, I would like to express my appreciation for the
many partners who are working with us in bilaterals with the
Department of Health and through the South African National AIDS
Council.
Since the inception of the Partnership Against AIDS Programme in
October 1999, we have established partnerships with the following
sectors:
* faith-based organisations
* youth
* women
* business
* labour unions
* the mining sector
* the disabled
* traditional healers and leaders
* sports fraternity
* the hospitality and also
* people living with HIV/AIDS
I would also like to appreciate the work we are doing with our
international collaborating partners such as the UN system, and to
recognise the contributions of some of the major donors. For
example, during the year 2003, we received the following
donations:
Donor: USAID
Amount 25 million US Dollars
Period: 2003
Donor: CDC
Amount: 3 Million US Dollars
Period: 2003
Donor: KFW
Amount: 9 million Euros
Period: 2003 - 2004
Donor: DFID
Amount: 30 million Pounds
Period: 2003 - 2008
Donor: Belgium
Amount: 6.2 million Euros
Period: 2002 - 2007
Donor: Ireland
Amount: 4 million Euros
Period: 2001 - 2003
Donor: Japan
Amount: 1 million Rand
Period: 2003
Donor: EU
Amount: 26 million Rand
Period: 2002 - 2003
There is also the subject of political commitment of the government
of South Africa, which I would like to address.
I will not do so because I think the Deputy President would be the
most appropriate person to deal with the subject.
But I would like to inform you about the HIV and AIDS budget just
for Department of Health. In the National Department alone, we
budgeted R212m in 2001, R459m in 2002 and R666m in 2003. The total
budget for government is R3.3bn in this MTEF.
In the final analysis, Programme Director,
* We will know we have succeeded when we have provided all South
Africans with the information and tools to prevent them from
contracting the HIV virus;
* We will know we have succeeded when we have been able to prolong
the period from HIV to AIDS by supporting those who are infected
with nutrition, nutritional supplements and natural
medicines;
* We will know we have succeeded when we have mobilised all our
resources and every sector in society to provide treatment, care
and support to those who are infected and affected by HIV and
AIDS;
* We will know we have succeeded when we can prevent the
transmission of HIV from mother to child during childbirth;
* We will know we have succeeded when we society can treat people
who are infected and affected by HIV and AIDS with compassion and
to remove the stigma and discrimination associated with this
disease
* We will know we have succeeded when we can unite as South
Africans to discuss strategies to prevent and treat this diseases
without influence from external agendas
Government is willing to work with all the stakeholders to work our
pragmatic solutions to all the challenges confronting South Africa
with regards to HIV and AIDS.
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