Question No. 14
Mr MJR de Villiers (Democratic Alliance, Western Cape) to ask the Deputy President:
(1) Whether the commitment that was signed by African countries in 2001 in Abuja, Nigeria, to increase their expenditure on health with up to 15 percent, was an agreement document between these countries; if not, what is the position in this regard; if so, what is the status of this agreement as an implementation document;
(2) Whether South Africa formed part of the African countries that committed themselves to this agreement; if not, why not; if so, what are the relevant details;
(3) (a) What percentage of this 15 percent that was committed to will be spent on HIV and AIDS, (b) what percentage is currently spent on HIV and AIDS, (c) where does the South Africa National AIDS Council fit into the (i) planning and (ii) decision making on how the 15 percent is spent and (d) how is this expenditure implemented?
Reply:
In order to address the exceptional challenges of HIV and AIDS, tuberculosis (TB) and other related infectious diseases, the Heads of State of the then Organisation of African Unity held a special summit in Abuja, Nigeria from 24 to 27 April 2001 specifically devoted to this issue. The summit adopted a declaration in which the Heads of State and government pledged to set a target of allocating 15 percent of their governments' annual budgets to the improvement of the health sector.
No specific amount was pledged for HIV and AIDS. The declaration merely stated that an appropriate and adequate portion of this amount should be put at the disposal of the National Commissions or councils for the fight against HIV and AIDS, TB and other related infectious diseases
Although the declaration is not a binding document and the 15 percent of the annual budget was a target, this government is close to achieving this goal in that health expenditure as a percentage of total government spending excluding the public entities is currently in the region of 13 percent.
In 2009/10, over 11 percent of the health budget was spent on HIV and AIDS in the public health sector. However, this may be an underestimate as it excludes the hospitalisation costs of people with HIV and AIDS.
The operations of the South African National AIDS Council (SANAC) secretariat are currently funded through the national Department of Health's budget. In addition, provinces allocate funding to support provincial AIDS councils and many municipalities support local AIDS councils. It is difficult to quantify the total amount of funding that is spent on the functioning of the national, provincial and district AIDS councils.
The total amount of funds set aside in the National Department of Health budget for SANAC operations for the 2010/11 financial year is R4,7 million. Decisions regarding the SANAC programme of action and therefore expenditure are taken at many levels; at the strategic level decisions are taken by the SANAC plenary which is chaired by the deputy president and co-chaired by a member of civil society (currently Mark Heywood).
At an operational level decisions are taken by the Chief Executive Officer of SANAC (Dr Nono Simelela). At present the Secretariat is working with the national Department of Health to determine its budget requirements for the next medium term expenditure framework (MTEF) period. The department therefore is a conduit for funds for SANAC until it becomes an independent legal entity with its own board.
Public sector HIV and AIDS expenditure is spent at all levels of the health system (district, province and national). In addition, all government departments have programmes aimed at HIV prevention these programmes are co-coordinated by the Department of Public Service and Administration on behalf of government and the Department of Public Service and Administration represents all government departments as a sector in SANAC.
I thank you.
