of the Social Cluster, Minister Tshabalala-Msimang
26 September 2006
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
