Debate on the State of the Nation Address 2023 Minister of Health Dr Joe Phaahla, 15 February 2023
Madam Speaker / Chairperson of the NCOP;
H.E. President Ramaphosa;
H.E Deputy President Mabuza;
Colleagues in the Executive;
Honourable Members;
Distinguished Guests;
Ladies and Gentlemen;
I appreciate the opportunity to participate in the debate on the SONA 2023 delivered by President Ramaphosa on the of 09 February 2023.
A year ago, when President delivered his 2022 SONA we were still in the grip of high levels of the Covid-19 pandemic just having gone through the fourth wave driven by the Omicron Variant.
Few months earlier South Africa and SADC countries had been isolated from the world through travel bans. Today this sounds a long time ago.President made a commitment that we would end the State of disaster and lift restrictions when the situation was right - doubting Thomases did not believe him … it sounds déjà vu. Indeed before the end of April we had ended the State of Disaster and by the 22nd June we lifted all restrictions. Interestingly yesterday we were in court with an organisation which opposed the State of Disaster but now is arguing it was illegal to terminate it.
On the one extreme were people who wanted the State of Disaster gone by January 2022 in the midst of the wave while when we lifted all restrictions in June there were those who said it was risky. It is now accepted that our cautious approach was prudent as we have had no major flare ups since June - so the electricity disaster will also pass.
Thanks to the leadership of the President and Cabinet colleagues during the difficult time we all went through. While the virus is still in our midst, no doubt the most is behind us. We again thank our Health workers for their gallant service to the nation.
When we see serious flare ups in the countries like China, Taiwan, Japan and South Korea it is a reminder that it is not really over. Here at home, we are still getting localised outbreaks but manageable with no pressure on health facilities.
Our best protection remains vaccination. Total doses administered now is 38.5 million with 51.1% adult coverage. We still have enough stock for first time vaccination and boosters.
Adults between 18-50 years can get boosters after 90 days of last dose of either J&J or Pfizer and those 50+ can get booster 1,2 and 3 after 90 days intervals - visit your nearest public service site as many private sites closed due to low uptake.
The leadership of President Ramaphosa in the fight against Covid-19 and his campaign for equity to tools such as vaccines and therapeutics is recognised in Africa and beyond. During the whole 2022 I had to represent him at many world forums including United Nations where his input was desired. On 18 and 19 February I will accompany him to the AU Summit where he will give a report as the AU Covid Champion.
The pandemic and the steps we took in mitigation resulted in setting back our established public health programmes and childhood vaccinations. One of the results is the recent outbreak of measles starting in Limpopo in October 2022 and spreading to Mpumalanga, North West, Free State and Gauteng. So far 506 cases have been confirmed.
Vaccination is being rolled out in all provinces with mass vaccination in outbreak areas for children 6 months – 15 years. We call on parents and guardians to check the road to health cards for 1st dose at 6 months andsecond dose at 12 months. If not sure take child your for vaccination. On Sunday 5 February 2023 we confirmed that the two sisters from Diepsloot in Johannesburg were confirmed by laboratory test to be suffering from Cholera after travelling to Malawi where there is a major Cholera outbreak which has killed more than 1 200 people. Since then, the husband of one of the women also tested positive for Cholera. Almost 10 days after these 3 cases there has been no other clinical and laboratory confirmed cases and therefore we have no reason for alarm as the
incubation period is 2-5 days. Nevertheless we still have to practice good hand hygiene as the spread is through water and food contamination. At this stage there is no need for Cholera vaccine which as President mentioned in SONA is being produced here in RSA.
Another negative impact has been on our programmes to combat HIV and Aids, TB and STIs. The number of people tested for HIV went down and so was the number of people initiated on treatment and we therefore lost some who already started treatment. Under the auspices of SANAC we have developed catch-up plans including a welcome back campaign for those who had left treatment.
TB containment also suffered the same fate for reduced testing, diagnosis, treatment and especially completion of treatment which results in cure. Remember that TB is curable, unlike HIV and AIDS. A TB Recovery plan is being implemented with SANAC partners with its pillars being:
(a) Find the estimated 120,000 missing TB positive people per year;
(b) Strengthen linkage to treatment
(c) Strengthen Retention to complete treatment
Use improved methods of diagnosis and also shorter time treatments including for MDR-TB and for children. We call on this Parliament to revive the TB Caucus as part of Global TB Caucus consisting of 130 countries united in raising awareness and
supporting efforts to eradicate TB.
We remain committed to achieving the 90-90-90 targets of 90% people knowing their status, 90% put on treatment, and 90% virally suppressed. We missed these targets due to Covid-19 but we commit to 2023 and want to reach the 95-95-95 by 2025 as agreed globally. We are currently at 94-76-92 – big challenge being initiating clients on treatment and retaining them. Treatment is prevention.
SANAC partners are at an advanced stage of finalising the new 2023-2028 National Strategic Plan for HIV, TB and STIs, which will take us to agenda 2030 for elimination of both HIV and TB as Public Health Threats. The NSP will be launched at the World TB Day on 24 March 2023.
Reproductive Health Services, commonly known as Family Planning, also suffered under Covid-19. With the addition of schooling disruption we have seen serious rise in teenage pregnancies and increased HIV infection in young people. In response, in June 2022 we launched the Youth HIV Prevention Strategy called Zikhala Kanjani, whose central theme is messages by young people and programmes driven by young people. We are also increasing youth zones in Primary Health Care facilities where young health professionals attend to their peers.
Prevention of Non-Communicable Diseases (NCDs) such as High Blood Pressure, Diabetes, Obesity, cancers, have been brought to sharp focus due to the risk of serious illness and death from Covid-19. We welcome collaboration by various NGOs in this battle. We will continue to also regulate for healthy diets and against harmful tobacco products. Working with other departments we need to get back to curbing access and advertising of alcohol as it is destroying our youth.
On 4 February we were pleased to join the NGO Pink Drive in promoting awareness but also screening and testing for various cancers on World Cancer Day in Johannesburg.
With reduction in Covid-19 pressure we are again able to focus on improving the quality of health services. Key amongst our intervention is upgrading of infrastructure. We support provinces through direct and indirect Infrastructure grants amounting to R7.5 billion per financial year supporting Primary Health Care facilities and all levels of hospitals. In the first quarter of this year construction of the long awaited Limpopo Academic Hospital will commence in Polokwane. This state of the art teaching hospital will provide specialist services such as specialised surgery, oncology, neonatal and paediatric ICU and cardiac care, just to mention a few – services over and above teaching medical students, post graduate doctors and other health professionals. The necessity of
referring patients will be drastically reduced.
In the Eastern Cape:
Zithulele and Bambisana in the OR Tambo District – construction of new hospitals has started.
In Free State:
Dihlabeng Hospital starting soon this year.
Again in Limpopo:
Siloam Hospital: Few months already in construction.
Tshilidzini Hospital: New construction before end of 2023.
We are aware that backlog of infrastructure is big so we are discussing with Infrastructure SA and National Treasury about innovative financing. In Human Resources for Health, we are pleased that all medical Interns and Community Service doctors are placed in hospitals with no hassles. Due to limitation of funds there are doctors who completed community service who could not be employed, we are looking at plans to employ 424 of those before end of March 2023. We are working with the Minister of Finance to find ways to retain health professional employed under Covid-19 stimulus.
Loadshedding is a major obstacle to quality health services and we continue to strive for exemption of all health facilities. On the medico-legal litigation side, we are pleased with the ruling of the High Court in Bisho on 7 February which ruled that future medical care of litigants can be done in public health facilities, thus reducing a claim from R35 million to R2,1 million and agreeing that most of this money ends up in lawyers’ pockets. We will continue to improve services to reduce
possible litigation.
We urge members of the National Assembly to approve the NHI Bill when it comes to the House, and similarly the NCOP later on. We owe it to ordinary South Africans to transform our health services for the better. President Ramaphosa has been a pillar of strength in the efforts for South Africa to reach Universal Health Coverage and improvement of quality. Your role Mr President is recognised in the Continent and beyond and we appreciate your commitment.
I thank you!!
