N Madlala-Routledge: South African Medical Association presidential
dinner

16 September 2006

Distinguished guests, it is an honour for me to address your presidential
dinner. First let me congratulate the newly elected President of South African
Medical Association (SAMA), Professor JP van Niekerk and the new executive. I
also wish to congratulate the outgoing executive for their work in guiding your
association over the past year. As you assume your new mandate, I hope we can
form a close partnership between the Department of Health and all its partners
in the public and private medical spheres. The central task which brings us
together is that of improving the quality of care for all our people.

In the Health budget vote this year I called on South Africans to set aside
our differences and to find common ground in the interest of health for all.
Our country is in pain and in need of healing. We are losing people in the
prime of their lives. We are losing our children and youth, the future of our
nation. We are losing mothers and fathers and seeing a growing number of
orphans and child-headed families. Our health professionals are in pain, facing
a pandemic for which medical science has not as yet come up with a cure. We are
in pain also because of the deep perceived divisions on the issue of treatment
of HIV/AIDS. The issue is a perceived battle between modern and traditional
medical science, where people are made to think there is a choice.

The Department of Health must advise on the basis of latest available
medical research, but can also promote the scientific development of potential
traditional therapies and treatment by investigating scientifically medicinal
claims made by alternative and traditional health practitioners. Government has
created the legal and institutional environment for this to happen in an
orderly fashion. In fulfilling our responsibility to protect our people
especially the most vulnerable, we need to put more resources into the research
and development of traditional medicine while taking very strong action against
charlatans who rob our people and expose them to unnecessary early death by
luring them away from the established health system and promising them instant
cures.

This evening I have been requested to address you on the role of South
African doctors in improving the delivery of healthcare in South Africa, the
Southern African Development Community (SADC) region and the African continent.
It is commendable and insightful that you are considering your role in the
reconstruction and development of not only South Africa but also the African
continent as a whole. This is in line with the agenda for Africa's renewal
embodied in the SADC Health Protocol and the New Partnership for Africa's
Development (NEPAD). Prior to the dawn of our democracy in 1994, we were
isolated from one another and from our brothers and sisters on the African
continent. Now we have an opportunity not only to contribute our skills and
resources but also to learn from one another. In addition to gathering medical
knowledge here in South Africa you could join with your colleagues at African
universities and research institutes to tackle the health priorities facing the
African continent. In doing this we must link our efforts with the rest of the
world and position Africa at the forefront of scientific development. SAMA can
play a leading role in developing partnerships with other medical associations
in Africa and thereby contribute to developing a vital SADC and continental
medical association.

Through the National Medical and Dental Association (NAMDA) and the
progressive students' organisations, some of you were at the forefront of the
liberation struggle. I remember the role some of you played in taking out the
bullets and fixing broken bones of the victims of apartheid violence. You
risked your lives to liberate our country. Now it is time to wage a new
struggle to free our people from the grip of disease and poverty, with the same
vigour and energy we needed to defeat apartheid. We have now made a break with
our painful and divided past and have committed to transforming our country and
contributing to Africa's development. We have developed health care policy
based on fairness and equity. We have established a health system aimed at
catering for all and the medical profession has been transformed into a single,
united, non-sexist and non-racial body. We must now vigorously address the
vestiges of the negative legacy of apartheid and under-development. Although we
have made significant progress in the first decade of our freedom to tackle the
huge health infrastructure backlogs, we now face new challenges of staff
shortages and the increased disease burden. The Human Resource Plan for Health
aims to address the problems of recruitment, training and retention of health
professionals. We do this cognisant of the global phenomenon of migration of
health professionals from developing to developed countries.

Partnership between the private and public health sectors is crucial.

As part of addressing problems of skills migration, we have agreed to train
significantly larger numbers of health professionals to cater for our domestic
needs and for the export market. If a small country like Cuba is able to
produce enough doctors for its own needs and export so many to different parts
of the world why can't South Africa do the same and tackle our problems of
unemployment at the same time? A trained health professional acquires the basic
skills to be successful in many other fields. Our country needs planners,
project managers and facilitators as well as evaluation and monitoring
experts.

The Department of Health is expected to assist in post conflict
reconstruction in the Democratic Republic of Congo (DRC) and Sudan. This role
cannot succeed without your participation and involvement. Through the South
African National Defence Force(SANDF), South Africa has contributed to the
peace processes in Africa, in support of the United Nations (UN) and the
African Union (AU). With the help of the Council for Scientific and Industrial
Research (CSIR), the SANDF has been looking into developing a holistic
peacekeeping model that takes into account developmental needs during and after
violent conflict. Health is one of the key services that are disrupted or
destroyed by war. Health professionals have the potential to contribute their
skills in peacekeeping and humanitarian missions.

As a professional medical association, you come from a long and rich
tradition of imparting knowledge mainly to other health professions. We need
this to happen on a larger community scale. The community sees you as role
models and leaders. It is this that places you in good stead to lead in their
full and sustainable development. Your close interaction with patients and your
medical knowledge and experience can enrich national initiatives and policy
around health. You can assist government to identify and address policy gaps
and implementation failures. You can assist with monitoring and evaluation
expertise. As influential people in society, you have a role in policy
advocacy. In terms of the Health Act, the national and provincial health forums
must engage all role players in the development and implementation of health
policy. Your association has a crucial role to play on these structures.
Through dialogue and joint action on agreed priorities we can advance the
nation and Africa's health agenda.

There are examples we can look at like that of Canada where the medical
association plays a crucial and complementary role to that of government.
Having identified policy development as an area of need, I would see a need for
SAMA to direct some of your resources and skill towards establishing a policy
resource centre like some of your colleagues have done in other countries.

SAMA could help mobilise resources and support for this work to extend to
SADC and the rest of Africa. Your challenge is to strengthen the initiative of
your Chief Executive in forming and nurturing the relations with other medical
associations in the region. I am pleased to learn that you are helping build
the African Medical Association (AMA). The SADC Health Protocol and NEPAD
Health Strategy need your contribution and support. Amongst you are academics
and heads of departments. You can assist the government mobilise the
professions for the advancement of science. SAMA can make a huge contribution
to youth development by mentoring the youth and partnering with them in their
programmes.

In my opening remarks I touched on the huge challenges facing the health
system, posed by the growing burden of disease. We need to put our energies
together to find ways to tackle the health challenges faced by our country, the
SADC region and Africa. According to the 2006 report of the Medical Research
Council (MRC), there are now an estimated 5,54 million HIV-positive South
Africans. More than a quarter of a million South Africans died of AIDS related
illnesses in the past year.

We must unite behind the comprehensive plan on HIV prevention, treatment and
care. This plan was developed through a participatory process and it provides a
useful platform for united action in the campaign to reduce new infections,
provide treatment and care and conduct research. This places us in a good
position to give patients the best available scientific information about
prevention, treatment and care.

I wish to pay a special tribute to medical science for helping us find
solutions to our medical problems. While there is as yet no cure for HIV/AIDS,
scientific advances have been made in treatment and care.

When combined with good nutrition and a healthy lifestyle, treatment with
antiretrovirals (ARVs) for those who need them and qualify has been shown
scientifically to prolong lives. So far, the only effective method of stopping
people getting infected who have been exposed to HIV either from needle pricks
or after rape is prophylactic treatment with ARVs. Post-exposure prophylaxis is
the only hope for rape survivors and needle prick victims. ARVs have also been
found to be effective in the prevention of mother to child transmission from
HIV positive mothers. This is the basis for the message of hope that must go
out to people who are trying so desperately to live.

The Department of Science and Technology has a crucial role in this work in
partnership with the Department of Health. Under the Department of Science and
Technology, government has established the Academy of Science of South Africa,
a statutory independent, merit-based "activist" body committed to assisting the
nation to find science-based solutions and create science-based opportunities
for growth and prosperity. I hope that your scientists are active and playing a
leading role in the academy.

The academy is constituted to ensure that leading scientists, acting in
concert and across all disciplines, can promote the advancement of science and
technology, can provide effective advice and can facilitate appropriate action
in relation to the collective needs, threats, opportunities and challenges of
all South Africans. Its mission statement states, "The function of science is
to create in a disciplined and systematic way, a continuum of coherent,
rational and universally valid insight into observable reality in all its
various facets. Scientific thinking and knowledge are fundamental to the best
work done in the applied natural sciences and in technology".

The academy networks with academies in other countries. I wish to stress the
importance of evidence-based research especially in medical science where
people's lives are at stake and our policy decisions must be always guided by
the best available scientific knowledge, derived from credible, peer reviewed
research.

Health is everyone's concern and is more important than individual and party
political differences. We must acknowledge our differences and bring the
creative power in all of us to create light and not heat. We must draw on the
spirit of the negotiated settlement and joint problem-solving as well as the
evidence of research so that we can reach consensus on how to provide optimal
health care with the limited resources available. Together we need to
strengthen the public-private partnerships (PPP), nurture these relationships
and ensure that comprehensive care networks are established and maintained. We
need to co-ordinate the use of limited resources so that optimal care services
are provided. We need to empower our patients and their families and strengthen
community support by providing information on how and where to access the
required services.

I believe that working together in the spirit of co-operation and effective
communication, affirming each other's achievements, correcting and supporting
one another with compassion when we fail we can find much common ground to help
us achieve the goal of comprehensive and quality health for all. SAMA can play
an important role in creating an environment to air our differences, identify
the necessary research and find the way forward so that we can together tackle
the challenges that face us most effectively and efficiently.

I look forward to working with you and listening to you to ensure quality
care for all South Africans. I also look forward to getting a copy of the
resolutions you adopted at your council meeting.

I thank you!

Issued by: Department of Health
16 September 2006