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SA: Motsoaledi: Address by the Minister of Health, at the World Health Assembly plenary, Geneva (17/05/2010)

17th May 2010

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Date: 17/05/2010
Source: The Department of Health
Title: SA: Motsoaledi: Address by the Minister of Health, at the World Health Assembly plenary, Geneva

Mr President
The Director-General, Dr Margaret Chan
Honourable members
Colleagues
On behalf of the South African delegation, I wish to congratulate you on your election and wish you all the best for the duration of your tenure. This year is a historic year for Africa. In 25 days time the first ever 2010 FIFA Soccer World Cup on the African continent will kick off in South Africa.
South Africa is ready to welcome the world. We wish those who will be joining us an enjoyable stay. The health sector has been preparing for years for this event and we have worked with World Health Organisation (WHO) and other partners.
I want to allay your fears regarding concerns that have been raised regarding Rift Valley fever. The recent case about a German tourist, which started pandemonium within some media circles especially in Europe, was really a false alarm. Both the Bernhard Nocht Institute for Tropical Medicine in Germany and our own National Institute of Communicable Disease (NICD) has confirmed that it was not Rift Valley fever viral infection. We are continually and effectively monitoring all diseases including Rift Valley fever, this is what any health system in any part of the world is expected to do anyway.
The World Health Assembly this year will review progress made towards achieving the millennium development goals (MDGs). Independent reviews have clearly shown that in Sub-Saharan Africa our goals will not be achieved by 2015; my country is one of those which were found to be lagging behind.
I am committed to changing this situation and I wish to share my hope and conviction with all my colleagues who have to meet these targets, that this situation can be reversed. We are hopeful that this will be within the five years we have until 2015.
We intend to introduce simpler, basic interventions to bring down the disgracefully high mortality rates. We will learn from the experiences of those countries and member states whose maternal mortality rates ranged from 250 and 450 in the 60's and have significantly dropped to below 25 by 1990.
The simple measures we are referring to are mainly about doing the right things at the right places and at the right time, these interventions have been well documented. Our commitment is also to the number of children who are under five who die each year.
Sadly, most of them die from conditions which can be prevented and which are treatable. Every one of these children deserves an equal chance of survival. We all have a responsibility to act and we are doing so in South Africa. That is why massive child immunisation campaigns in my country have been launched last month.
As a country, we also know that the main causes of maternal and child mortality are associated with HIV and AIDS and tuberculosis (TB). It is for this reason that our response to improve maternal and child mortality rates include effective measures to fight HIV and AIDS and TB. We are determined to launch ourselves on a trajectory that will dramatically bring about improvements in health.
HIV and AIDS is the most complex and the most devastating infectious disease that humanity has ever confronted. It has, and it still claims lives, it is a burden to the healthcare system and eats up resources. We have witnessed the devastating effects. We have seen the need to act. Our resolve is to turn the tide. We acknowledge that there are impediments, but they should not deter us from acting nor prevent us from responding effectively.
South Africa is responding aggressively to the HIV and AIDS pandemic and as with many of the most successful public health interventions in the world, we are certain that it is the simple, sensible things that will bring about results in the war against HIV and AIDS and these are namely: everybody knowing their HIV status, prevention against infection, prevention of mother to child transmission, early uptake of treatment, accessible and uninterrupted treatment, we will put emphasis on the proper management and treatment of HIV and TB co-infected patients.
With the help of the WHO and other United Nations agencies, we have adopted a totally new policy on HIV, AIDS and TB whereby we regard them as more or less one disease to be treated under one roof. Hence we are busy integrating HIV and AIDS and TB treatment facilities into one.
Mr President World AIDS Day 2009 was a historic day for South Africa in the fight against HIV and AIDS. On this day, which was also attended by the Executive Director of the Joint United Nations Programme on HIV and AIDS (UNAIDS), Mr Michel Sedibe, President Zuma made far reaching announcements whereby treatment was to be upgraded for certain categories of vulnerable people, consistent with WHO guidelines, but also that massive prevention strategies need to be undertaken with civil society.
I am happy to announce that as from 1 April 2010, following this announcement:
* All pregnant women started receiving treatment at the CD4 count of 350 or less
* All HIV and TB co-infected people are also receiving treatment at CD4 count of 350 or less and from July we will institute a massive INH prophylaxis for certain categories of HIV positive people
* All pregnant women who are HIV positive with CD4 count of 350 have started receiving treatment at 14 weeks
* Lastly, all children who are HIV positive have started receiving treatment regardless of CD4 status.
The history of HIV and AIDS response has been one of demanding action. It has changed the frontiers of public health. It is for this reason that the effectiveness and success of our response is underpinned by the deployment of the South African society itself, led by President Jacob Zuma and leadership from all sectors, political, social and economic.
This is bold and ambitious but it has public health safeguards. This way of responding by South Africa is a sign our commitment to improve the lives of our people, it is also an expression of the respect we attach to each life affected by the disease and our resolve to give every child a better life and every woman decent care.
Mr President, I am pleased to inform you that this has been precisely the launch of the biggest campaign ever by South Africa. Launched on 25 April, it involves testing 15 million South Africans for HIV by June 2011.
We have decided to include as part of this campaign a focus on non-communicable diseases and diseases of lifestyles. Hence all the 15 million South Africans who presented at testing stations, apart from being counselled and tested for HIV, will also have their blood pressure and haemoglobin checked, random blood sugar level determined, and TB oral screening undertaken. Any woman who tests positive is also being offered a pap smear. We hope this offer will be extended to all women as a matter of routine in due course.
Another major campaign which has also been launched recently is the massive male medical circumcision. To this end, in the province of KwaZulu-Natal alone, where the practice of circumcision was stopped more than 200 years ago, this decision has been reversed by the king of the Zulu nation himself, and a massive male medical circumcision is currently underway there.
The implication of the above initiatives means that resources will have to be increased. The South African government has recognised this and has committed additional funding whereby the antiretroviral budget alone increased by 33 percent over the allocation of the previous financial year.
The approach we have taken and the change of policy we have adopted are a tall order for any country, especially a developing country. But we are determined and we will wage this war to the bitter end. With your support and encouragement, we are beginning to make small positive gains, which are making significant strides. One day these will incrementally contribute to a quantum leap that will take South Africa out of its current situation.
It is on this basis that I sincerely believe we can turn the tide and that by 2015, where the WHO report of 2005 has recorded "No progress/worsening", it will record "progress, 20 to 40 percent decrease in measles, mumps and rubella (MMR)" or better still, it will record "on track". With political will, technical and financial support, collaboration and joint effort, I am convinced it can be done.
In conclusion Mr President, permit me to thank the WHO Director-General and other United Nations agencies and our development partners for their support in the past year. We will work in partnership with other countries in the African Region and beyond to improve the lives of our people.

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