Hon Deputy Chairperson and Chairperson for this sitting, hon Minister of Health, Dr Aaron Motsoaledi, Ministers and Deputy Ministers present, hon chairperson of the select committee, hon members, colleagues, MECs for health, distinguished guests, and our senior management, led by the director-general, I wish to join those members who have extended condolences to the family of Dr Mkhize, a young, 27-year-old doctor who was killed by a patient he was supposed to be assisting. Our condolences go especially to his daughter, who shared with me that she herself would like to become a doctor one day. It is important that the health sector work together with provinces to continuously look at, and relook at, the issue of security in our facilities, although indeed plans cannot necessarily be made to deal with some of the incidents. However, it is our duty and responsibility to continuously review the rigour of the security system, both for our patients and our health workers.
It is indeed my privilege to address this honourable House on this occasion in support of the Health Budget Vote for the 2011-12 Medium-Term Expenditure Framework, MTEF, as presented by the Minister.
In participating in this budget debate, I wish to acknowledge the significant turnaround the department has achieved under the visionary and passionate leadership of Minister Aaron Motsoaledi and through the contribution of my predecessor, the late Dr Molefi Sefularo, working with the MECs of various provinces on the National Health Council. I would also like to acknowledge the input of the director-general and senior management in the national head office and in the provinces.
This turnaround has been profound, especially with respect to investing in strategic partnerships and in research and innovation, and using knowledge to save lives, particularly in the HIV/Aids programme. This budget we are debating today will build on these successes and achievements as we advance towards "a long and healthy life for all South Africans".
Since the advent of democracy, the diseases of extreme poverty like kwashiorkor and marasmus are not as prevalent as before. South Africa is on course to eradicate malaria. The prevalence of oesophageal cancer in the Eastern Cape is on the decline as a result of our interventions. Access to primary health care has significantly improved, with over 40% of clinics built during this era.
In this current term we have already reported a 50% decrease in the mother- to-child transmission of HIV, and 12 million South Africans have come forward to respond to the HIV Counselling and Testing Programme. Over 1,4 million patients who would otherwise be in hospices waiting to die are now alive on antiretroviral treatment, ART. Through innovations in technology the time it takes to diagnose TB and multidrug-resistant TB has been greatly reduced, by about six weeks and almost three months respectively. These achievements that South Africa has made, especially in the fight against HIV, have been acknowledged widely as the world observes 30 years this year since the first Aids patient was diagnosed.
We have now reached a turning point, but it is not as yet uhuru. We dare not be complacent. This is just the beginning. We still have a long way to go in order to ensure that we do indeed push back the frontiers of HIV/Aids and TB in our lifetime.
One of the key lessons that we must learn during this period is that we need to be better prepared for new and emerging diseases. Above all, we must leverage the best available scientific knowledge and evidence, as well as appreciate the need to continuously innovate, looking at new and better ways to achieve health and wellness goals. We have also learnt that strategic leadership and effective partnerships are catalysts in tackling complex problems that humanity faces from time to time, problems of the magnitude of HIV and Aids.
The Minister has aptly outlined the quadruple burden of disease, the four epidemics that the country is facing now, with HIV/Aids, TB and maternal and child morbidity and mortality in the lead. On noncommunicable diseases, trauma and violence, we must not wait until we are overwhelmed, as was the case with HIV in our country, or as is the case in the developed countries with cardiovascular and metabolic diseases.
In preparation also for the National Health Insurance system we have prioritised interventions that promote wellness, prevent ill health and improve the effectiveness of treatment and care.
It is estimated that the indirect cost of hypertension and cardiovascular diseases alone to the South African economy and society is about R8 billion annually. What is more concerning is that 70% of these deaths are of economically active members of society who are younger than 55 years of age, and that almost 195 people a day die from these diseases. The good news, however, is that 80% of these diseases are preventable. I think we must really imagine this daily, so that we actually realise that we have a duty and responsibility to opt for prevention.
Our goal is to reduce the burden of noncommunicable diseases by 5% to 10% in this term and to ensure coverage of about 25% of districts in regard to integrated programmes in this financial year. The strengthened primary health care model, as announced by the Minister, with the district-based specialists, community health teams and school health programmes is a platform we will use to achieve this goal.
We believe that South Africa must be spared another massive wave of catastrophic epidemic, something which resulted in the doubling of the death rate in the past decade when we experienced the HIV/Aids epidemic. We will learn lessons from past failures and recent successes, as well as successes in combating malaria and hosting the 2010 Fifa Soccer World Cup Tournament, in the way that we manage the growing burden of noncommunicable diseases.
We aim to host a multisectoral national lekgotla on noncommunicable diseases, which will precede the global heads of state summit to be held in September this year. We must emerge from this summit with a strategic partnership similar to that of the SA National Aids Council, Sanac, ready to begin a social movement for promoting wellness and healthy lifestyles. Health must be a way of life, a choice that South Africa makes as a contribution to "a long and healthy life for all". We can no longer afford to be oblivious to the high price being paid by current and future generations socially and economically. The huge burden of ill health is a risk to sustainable development.
It is in this context, alongside the HIV/Aids Counselling and Testing Campaign, that we called on South Africans to be tested and screened and to know their status for diabetes, hypertension, obesity and cancers. We will work together in ensuring that a district and municipal ward-based disease surveillance system is in place to enable us to have targeted prevention and treatment programmes.
When I was in Ga-Rankuwa last month with the Move for Health Campaign, together with the Tshwane University of Technology community, the demand for testing in all these various screening programmes was very high. This necessitated the various service providers coming back the next day to assist the student community in getting to know their status and taking positive action. South Africans are responding positively.
Chronic disease care will also form an integral part of the National Health Insurance system. As part of strengthening the health system, we are rolling out a long-term care model for diabetes and hypertension throughout the health care system. This intervention aims to improve the quality of life of patients and also to reduce the high cost of complications like strokes, blindness, diabetic amputations and kidney failure. The chronic disease management register will be used as a monitoring tool for districts.
Regulations for organ transplants have already been published for comment in order to avoid the unethical conduct that was reported a few months ago.
We will continue to work with all stakeholders to achieve the World Health Organisation Vision 2020 goal of eliminating blindness through, amongst other things, cataract surgery.
We are in consultation with the Ministry responsible for water services to finalise investigations and consultation on water fluoridation for the prevention of tooth decay. As part of the school health programme, primary prevention oral health services will be implemented in schools, targeting a minimum of 10 primary schools per province in this financial year. We support the Minister in his ensuring that we implement the Mini Drug Master Plan that was approved by the National Health Council, NHC, earlier this year. We are concerned about the massive increase in alcohol advertisements, which seem to be targeting the populations at risk, especially young people. We will engage with the industry, the media, research institutions and society, as we aim to strengthen measures to protect society, and also to protect our economy, from the negative impacts of alcohol. We have already commissioned research to examine the impact of alcohol on TB outcomes. Such studies will also advise us on similar impacts on treatment outcomes for other diseases. Industry and the media cannot and must not be allowed to maximise profits from various commodities and from advertorials at the expense of our youth, society and the economy.
Tobacco regulations have yielded positive results. We are, however, concerned that there are about 7 million South Africans that still use tobacco, resulting in about 44 000 deaths annually. [Interjections.]
On mental health, we aim to strengthen the implementation of the Mental Health Care Act, Act 17 of 2002, by supporting and monitoring provincial incorporation of community mental health services as part of the primary health care, PHC, package. Interventions to reduce the turnaround time for forensic observations, including the recognition of forensic nursing as a registered speciality with the Nursing Council, are under way.
On injury prevention and emergency medical services, the high morbidity and mortality burden of injuries in South Africa is driven by a high rate of road accident injuries and interpersonal violence, the latter accounting for 46%. It has been estimated that around 3,5 million people per annum seek health care for injuries. The Medical Research Council of South Africa, MRC, reports that injury and violence is the second leading cause of death in South Africa after HIV.
The health sector is an important player in the attainment of the objectives of the five pillars of the United Nations-led Decade of Action for Road Safety, especially Pillar 5, which deals with post-crash responses. A report developed by the MRC setting out practical and cost- effective interventions will be released later this year.
Violence against women and children is still very high. The rate of female homicide by an intimate partner is 6 times the global average, with a woman killed every 6 hours. Chair, 25% of women in the general population have been a victim of physical violence by an intimate partner, and 40% of men have perpetrated violence against a female partner. As per an MRC report, 40% of all rapes reported to the police are of children under 18 years of age and 15% of those are under 12 years of age. The recent reports in the media on the brutal attacks on and killings of lesbian women, including that of a 13-year-old girl, are no less an indicator of this scourge in society than the daily reported cases of rape and domestic violence.
As we participate in the 365 Days of Activism for No Violence against Women and Children, we will work with the Social Development department, the police, and the National Prosecuting Authority under the Thuthuzela programme to strengthen the victim support services programmes and mainstream the treatment and support of survivors. Measures have also been put in place to reduce the backlog in forensic laboratories.
We will be releasing an e-Health policy and strategy, after extensive consultation. Currently, we are on the 19th draft of this process.
We will also leverage the experience gained from various panels, and specifically the 2010 Fifa Soccer World Cup Tournament last year, to introduce mobile health solutions.
Currently, priority will be given to developing electronically based surveillance systems able to deal with monitoring the Millennium Development Goals, MDGs, and the nationally negotiated service delivery agreements, which will be monitoring the prevalence and incidence of HIV/Aids, and also the risk factors.
Hon members, any effective health system must operate an effective, reliable, quality, expert-driven epidemiology and disease surveillance system. We need to identify new emerging diseases early on, track our successes in various interventions, and also remain vigilant for outbreaks and re-emerging diseases.
Next month, the National Health Research Committee will be convening a health and innovation summit, where researchers in the health sector will identify research and innovation gaps and priorities aligned to the mandate in the negotiated service delivery agreements that the Minister has signed with the President. The Department of Science and Technology, academics, research institutions, and the private sector have been invited to contribute to this task.
On health technology, the National Health Council has approved the Health Technology Strategy. This strategy includes the recruitment of bio- engineering and clinical engineering technicians to maintain the many pieces of equipment, some of which are highly complex and expensive, in hospitals and clinics. The Ministerial Advisory Committee on Health Technology has already begun to work on developing norms and standards for health technology. An essential equipment list for various levels of the health care system is already before them and will be released for consultation.
In his speech the Minister also referred to the reduction in price achieved through the central drug procurement approach adopted by the NHC. Learning from this achievement, we will establish a central drug procurement authority working jointly with provinces to act as an enabler towards affordable and reliable access to pharmaceuticals.
We want to thank the Minister for his leadership, and colleagues and MECs for their co-operation and the leadership they provide in their various provinces. Working together, we will consolidate our achievements, especially in fighting the scourges of HIV/Aids and TB, as well as improving mother and child health and ensuring that they live a long and healthy life.
I want to thank the House for this opportunity, and say that its support for this Budget Vote is support for contributing to the MDGs and the national renegotiated service delivery agreements. Thank you. [Applause.]