9 November 2007
The National Health Council (NHC) held its regular meeting to discuss
various health policy issues in Cape Town today. The NHC is made up of the
Minister of Health, the MECs for Health from all provinces, the South African
Local Government Association (Salga) and South African Military Health
Services.
Security at hospital
The NHC discussed the challenges posed by crime on the delivery of health
services. This includes the shooting of a patient at Chris Hani Baragwanath
hospital in Gauteng and killing of the hospital chief executive officer and
three managers at Seshego Hospital in Limpopo by an employee who had been fired
from the hospital.
The NHC emphasised that the incident at Seshego Hospital in particular
should not be allowed to discourage hospital managers from taking appropriate
action to promote discipline and deal with cases of misconduct. Health
facilities are valuable institutions that should remain accessible to the
public at all times. The NHC calls upon all communities to assist in protecting
these institutions from crime.
Crime is a social challenge which requires an integrated community response.
Therefore, the security of public institutions like health facilities should be
one of the main issues on the agenda of Community Policing Forums. Provincial
health departments should ensure that security companies hired at hospitals
provide effective service including adequate entrance control to prevent entry
of weapons and the loss of hospital property. The Department of Health will
develop the standards for package of security services which should guide the
provision of security services in health facilities.
Tuberculosis (TB) control
The NHC endorsed the new Tuberculosis National Strategic Plan for 2007 to
2011 with changes that will be effected by the Minister. The plan was developed
through extensive consultation with local and international stakeholders in the
area of TB. The Plan is aimed at strengthening South Africa's response to the
challenges of TB as well as Multi-Drug Resistant and Extensive Drug Resistant
TB.
While the number of TB cases remains high, there is steady improvement in
successful treatment completion rates and in the cure rates. Both the cure
rates and successful treatment completion rates improved from 50% and 60%
respectively in 2001 to 57,6% and 70,8% respectively in 2006. During the same
five year period, the death rate has been fairly constant at between six to
seven percent and so was the treatment failure rate around 1,5%.
The plan will prioritise prevention of TB, health promotion and encourage
collaboration amongst Social Sector Cluster department to address the
challenges of poverty that compound the spread of TB. The plan directs that
routine culture and first line drug sensitivity testing be done for all high
risk groups and second line drug sensitivity testing will be conducted on all
confirmed MDR-TB patients.
All confirmed XDR-TB patients are referred to an MDR-TB Unit for
hospitalisation for a period of at least six months and thereafter discharged
for ambulatory care at the nearest health facility with ongoing treatment and
psychosocial support provided. This will require strengthening of community
based care and follow up systems at community level. Enforced hospitalisation
or quarantine of patients with XDR TB is only justifiable as a last resort
within a human rights framework after all reasonable voluntary measures to
isolate the patient have failed. The new TB Plan also acknowledges the
relationship between TB and HIV and AIDS and provides for interventions to deal
with the challenges posed by co-infection.
The plan requires that all TB patients be offered voluntary HIV counselling
and testing. Those who test HIV positive will be offered cotrimoxazole
routinely. Ongoing psychosocial support and early diagnosis and treatment of
other opportunistic infections will also be provided and anti-retroviral
treatment (ART) should be made available to all TB patients who are
eligible.
The plan also directs that a package of care for HIV positive patients
should include routine screening for TB, treatment for those with TB and TB
preventive therapy for those found not to have TB. We have made available to
provinces a total of R400m in this year's adjustment budget to deal with MDR
and XDR-TB and request for additional resources have been made in the budget
bid for 2008/09 to assist in the fight against TB.
The development of this plan and allocation of additional resources for its
implementation demonstrates the commitment of the Department of Health to
respond adequately to the challenge of TB. There is, however, a need for new TB
diagnostics and drugs to bolster the ability of all affected nations to succeed
in controlling TB. We hope that the 38th Union World Conference on Lung Health
that is currently underway here in Cape Town will discuss and take a firm stand
to address this dire weakness in the world's response to TB.
In conclusion, the NHC would like to take this opportunity to wish all those
celebrating Diwali a happy and wonderful celebration.
Contact:
Sibani Mngadi
Cell: 082 772 0161
Issued by: Department of Health
9 November 2007
Source: Department of Health (http://www.doh.gov.za)
