Health Budget Vote Speech in the NCOP by the Deputy Minister of Health Dr Mathume Joe Phaahla
Honourable Chairperson;
Honourable Minister of Health, Dr Aaron Motsoaledi; Honourable
Ministers and Deputy Ministers
Honourable MEC'S and Members of the Select Committee on Social Services,
Honourable Members of the NCOP
Distinguished guests,
Ladies and gentlemen,
Thank you very much honourable chairperson for this opportunity to participate in the 2014/15 budget vote for The Department of Health. Our 2014-2019 Strategic Plan and the 2014/15 Annual Performance Plan are firmly anchored in the implementation of the National Development Plan (NDP).
The implementation of these plans will go a long way in realising the commitments we made as the ANC in our election manifesto.
Honourable members, we are all familiar with the fact that as a country we have a challenge of diseases such as HIV and AIDS, TB and high rates of maternal and child morbidity and mortality, but we must always be aware of the growing problem of what is now globally known as the new “emerging epidemic of non-communicable diseases”.
Currently in the 30 - 70 year age group non-communicable disease (NCDs) account for 43% of total deaths. Cardiovascular diseases (including hypertension), cancer, diabetes, chronic respiratory infections, mental disorders and other diseases have been part of our health landscape for decades but until recently due to high levels of infectious diseases have tended to play second fiddle to communicable diseases in low and middle income countries. With increased urbanisation and industrialisation we are already seeing growing trends of these diseases in South Africa. These diseases are often called silent killers because many people that have diabetes or hypertension for example are not aware that they have a problem at all.
The NDP is clear in this regard. “South Africa’s health challenges are more than medical. Behaviour and lifestyle also contribute to ill-health. To become a healthy nation, South Africans need to make informed decisions about what they eat, whether or not they consume alcohol, sexual behaviour, levels of physical activity, among other factors”.
In 2011 the UN General Assembly passed a resolution recognising the challenge of NCDs. Two weeks ago the General Assembly reviewed progress made in implementing the Political Declaration for the Prevention and Control of NCDs. I am pleased to report that South Africa was acknowledged as a leading country in taking serious steps towards addressing the major risk factors for NCDs.
We were recognised as a leader in areas such as tobacco control, trans-fat and salt regulation and also on our proposals to restrict alcohol advertising and sponsorships. Since 1995 we have brought down our smoking rates by around 30% including amongst school going children.
Our salt regulations, which industry is now beginning to implement ahead of the compulsory targets set for 2016 and 2019, are projected to result in 7 400 fewer deaths due to cardiovascular disease and 4 300 fewer non-fatal strokes per year.
Alcohol consumption amongst drinkers remains far too high at 27 litres of pure alcohol per annum in people 15 years and over. Amongst men this is a very high 33 litres. This is significantly higher than both the African and World average intake of 21 litres.
We realise that these figures will not dramatically drop by restricting advertising alone, but it is well established from several studies that alcohol advertising influences behaviour - it brings about positive beliefs about drinking and encourages young people to drink alcohol sooner and in greater quantities.
The integrated approach to managing all chronic diseases whether they are communicable or non-communicable will go a long way in improving effectiveness. The establishment of National Health Commission will enhance intersectoral collaboration.
We must reduce premature mortality from NCDs by 25%; reduce tobacco use by 20%; reduce alcohol consumption by 20%; reduce salt intake to less than 5g per day; reduce the percentage of obese or overweight people by 10%; increase physical activity by 10%; ensure that women receive cancer screening as per our policy on screening.
The number of people within South Africa who are overweight or obese has been rising yearly in the past few decades.
A survey done in 2012 found that the prevalence of obesity in those 15 years and older was 65.1% in females and 31.2% in males. This is a crisis for the individuals affected and for our health services and the economy.
Drinking just one sugar sweetened beverage a day increases the likelihood of being overweight by 27% for adults and 55% for children.
One 330 ml of carbonated soft drink contains an average of 8 teaspoons of sugar and the same size sweetened fruit juice an average of 9 teaspoons.
The Ministerial Advisory Committee on Cancer has now been functioning for a little over a year.
The introduction of the Human papillomavirus (HPV) vaccine is a critical step forward and we are confident that it will go a long way in reducing cancer of the cervix. The South African Cancer Control strategy will be launched this year and will be providing additional impetus and direction for both the prevention and care and treatment of cancer.
Increasing cataract surgeries and preventing avoidable blindness is another area that the Department of Health will be focusing on in immediate to medium term.
One of the growing public health challenges is the Road Traffic Crash Injuries. These place a heavy burden, not only on the national economies but also household finances as many families are driven deeply into poverty by the loss of breadwinners and the added burden of caring for members disabled by road traffic injuries.
The total medical costs for violent injuries is estimated at R4,7 billion /pa , while the total costs of traffic crashes and injuries are estimated at R110 billion p/a to the South African economy. Many of these car crashes end violent injuries are related to alcohol use and abuse.
Road traffic crash injuries can be prevented and our role as government is to take action and address road safety and prevention of violence in a holistic manner. This requires involvement from multiple sectors (transport, police, health, education sectors) and that addresses the safety of roads, vehicles, and road users themselves.
Honourable chairperson we are taking steps to improve our emergency medical services to make sure we provide timeous and efficient services to the communities.
i) Regulations governing emergency medical services are being reviewed which will improve efficiencies by setting high industry standards and providing minimum norms.
ii) A national policy on National Emergency Care Education and Training is being developed in conjunction with the Health Professions Council of South Africa in order to improve the skills of emergency care personnel.
With regard to malaria South Africa has made positive strides to controlling malaria: In the year 2013, 8 820 malaria cases and 100 deaths were reported compared to 64 622 cases and 458 deaths that were reported in the year, 2 000. This represents an 86% reduction in malaria cases and 78% decrease in malaria deaths in South Africa.
The country is now shifting its approach from control to elimination of malaria by 2018.
South Africa and Cuba entered into a historic agreement called "Cooperation Agreement in the Field of Public Health" in 1995 to enable Cuban doctors to come and work in South Africa. This agreement was amended in 1996 to include the training of South African Medical Students in Cuba.
The medical training programme has over the years grown from strength to strength with good support from most of the provinces. In 2011, the Cuban government offered to train up to 1000 medical students in Cuba using a different funding model. Some of the highlights of the Cuban agreement are:
- 2733 students have been recruited to the medical training programme since 1997 inclusive of those who did not complete the course for various reasons.
- 402 students have graduated and are serving in various public institutions.
- 63 students returned last year and are doing the final year of the 18 months programme.
- 65 students are to begin the 18 month programme in July 2014.
- 2132 students are currently in Cuba.
- 607 students have been recruited in 2014 and will commence with their studies in Cuba in September.
Honourable Chairperson, the Department of Health has number of entities operating under its authority, but I will only refer to one entity:
The National Health Laboratory Service (NHLS) provides diagnostic laboratory services to all state clinics and hospitals. It also provides health science training and education, and supports health research. The entity provides valuable service but it is currently facing number of challenges in terms of financial stability which is largely related to the business model under the current NHLS Act. This matter is receiving attention from the ministry and department.
Honourable members we are indeed on the march to a Universal Health Coverage for all South Africans and together we will move South Africa forward to a healthy nation.
I thank you all.
