Chairperson, I want to acknowledge the presence of the Minister and Deputy Ministers that are here, Members of the Executive Councils, MECs, members of the portfolio committee, members of the Select Committee on Health and distinguished guests, as well as leaders from the various institutions in the health sector that are here with us today. It is my privilege to address this august House on the occasion of the Health Budget Vote debate for the financial year 2011-12.
I want to start, lest I do not have enough time, by thanking the Minister of Health, Dr Aaron Motsoaledi, for his stewardship of the health sector. I also want to thank MECs, officials from both the national and provincial departments, and our various partners in the health sector for their contribution to ensuring that we set the health sector on course to provide a long and healthy life for our people.
I also want to acknowledge the contribution of my predecessor, the late Dr Molefi Sefularo. We are indeed building on the gains and the progress that has been made in the past years, led by the ANC government.
I want to remind members that although we have this high burden of disease, as outlined by the Minister, with the four epidemics that we are facing, South Africa has shown that it has what it takes to deal decisively with the problems that afflict it from time to time. I would like to remind members that we are building the health system for a better life for all South Africans.
We have to date almost done away with some of the diseases of extreme poverty, which medical students of today hardly see in their training. They include diseases like kwashiorkor and marasmus. We also hardly see measles, whereas before it was rife in our communities.
We have early reports that the policies for reducing the use of tobacco in our country are yielding results.
It is reported that oesophageal cancer in the Eastern Cape is also on the decline.
Forty per cent of the primary health care facilities that we have in our country have been built during this democratic era.
We are also on track to being recognised as having eliminated malaria during this period. The Minister has outlined what we are facing, these challenges before us.
I would also like to share with you that the burden of disease and death in our country is not only problematic at the social level, but is also strangulating our economy. It is estimated that the indirect cost to our economy and society due to cardiovascular diseases is about R8 billion annually.
What is of greater concern is that 70% of the deaths are of people younger than 55 years of age, and almost 195 people a day die from cardiovascular diseases. The good news, however, is that 80% of these diseases and deaths are preventable.
Our story line, therefore, is that we need to realise that our health is in our hands. As we move towards the end of the Move for Health, move to live campaign, which promotes the prevention of noncommunicable diseases, we expect every municipal ward and district in our country to know about the burden of noncommunicable diseases, and the burden of HIV/Aids and maternal and child mortality in their communities.
We expect every municipal ward and district in our country to understand the risk factors, and we have already begun programmes for reducing these risks. It is important, as member Dube has said, that we be methodical as we tackle these challenges that face us.
We recognise that people with HIV are also vulnerable to noncommunicable diseases, pregnant mothers may have underlying noncommunicable diseases, and our children are facing an increased risk of obesity. We have to realise that our collective efforts in dealing with the total disease burden in our communities is essential.
It is in this regard that we are leveraging the Soul City Aids campaign in order to encourage people to be tested for the various risk factors for noncommunicable diseases, such as high blood pressure, and raised glucose and cholesterol levels, as well as to know their body mass index, BMI.
We aim to reduce the burden of noncommunicable diseases and conditions in our country by 5% to 10% by 2014. We will focus specifically on hypertension, diabetes, obesity, mental illness, blindness and oral diseases.
Over the Medium-Term Expenditure Framework, MTEF, we will verify baselines of noncommunicable diseases per district, alongside those of communicable diseases, and aim to reach 25% of districts this year.
The strength and primary health care model, which the Minister alluded to, will be discussed later, led by the Minister himself. Also, the family teams that will be introduced in each of the 4 000 or so wards in our country, as well as the school health programmes, will serve as a platform that we will use to achieve these goals.
The health sector's Mini Drug Master Plan to deal with, amongst other things, alcohol abuse, has already been approved by the National Health Council on which MECs sit. We have also commissioned research to examine the impact of alcohol abuse on TB outcomes.
On the matter of mental health, we will adopt and implement strategies to improve Forensic Mental Health Services and assist provinces to build community mental health services as part of the Provincial Aids Campaign, PAC, package, including building partnerships with nongovernmental organisations and community-based organisations. The implementation of the Mental Health Care Act, Act 17 of 2002, will be closely monitored.
We will be hosting a multisectoral summit later this year, where we will launch the multisectoral strategy against noncommunicable diseases, as part of preparing for the health summit meeting on noncommunicable diseases in September.
A national healthy lifestyle programme with high-profile multisectoral leadership in society, similar to the South African National Aids Council, Sanac, under the Move for Health, move to live, campaign, will be built.
We will also identify research and innovation gaps, as well as priorities for surveillance, in order to enhance the effectiveness of preventing and treating lifestyle diseases.
It is clear that whilst we have a major programme to deal decisively with lethal communicable diseases, LCDs, we need more resources and must ensure that the resources that we do have are used efficiently. We should also ensure that the budget allocated by provincial departments is adequate and used efficiently. In this regard, prevention remains more affordable and better than cure. Any effective health system must operate an effective, reliable and quality- driven epidemiology and disease surveillance system, so that we identify new, emerging diseases early, track our success in various interventions and remain vigilant to outbreaks and re-emerging diseases.
Currently we are developing an electronically based surveillance system able to deal with monitoring the Millennium Development Goals, as well as the national service delivery agreements. We will also establish an on-time integrated surveillance system in the public health facilities and districts.
This system will not only be for monitoring LCDs, but also for leveraging the work we are already doing with monitoring the HIV counselling and testing, HCT, and antiretroviral treatment programmes. We will also include the burden of injuries in this regard.
We have adopted a three-tiered approach to strengthening our recording of and reporting on patients on ARVs. This approach takes into consideration the diverse access to information and communication technology in our facilities.
We have many pilot programmes that seek to use mobile technology in our country. Together with the Department of Communications, we are developing a strategy to use mobile technology applications to strengthen recording, reporting and support of patients who are on chronic medication.
One example is the use of cellphones by community health workers to report on their house visits so that we can have realtime information on health conditions in the families that they visit. This is building on the work that was started during the Fifa Soccer World Cup and is part of the legacy.
On research and development, we will support and monitor the functions of the National Health Research Ethics Council, NHREC, and the National Health Research Committee, NHRC, which act in an advisory capacity to the Minister, as well as institutions such as the Medical Research Council, MRC, and the Health Systems Trust, HST, in order to ensure that the research agenda is aligned to the priorities of the country.
It is our conviction that the alignment of all of us with the four priority areas for the country will indeed help us succeed in increasing the life expectancy of South Africans, and also achieving the MDGs and the Negotiated Service Delivery Agreement, NSDA, objectives.
In regard to health facilities infrastructure management, we have made an effort to ensure that health technology is enhanced. We will soon be publishing the essential health technology package for comment, and will be discussing this, not only with our sister departments at the provincial level, but also with the private sector.
The Minister has already alluded to the achievements we have had in reducing the cost of pharmaceuticals, particularly ARVs. We have set up a process of establishing a central drug procurement authority working with Treasury and the various provinces.
In this regard, we will ensure that we have an enabling system to help the South African purse to save resources, and also to afford South Africans reliable access to pharmaceutical products and medical devices. It will be part of our preparation for a more effective and sustainable national insurance system.
The registration of medicines will be improved. We know that there is a backlog in this regard, and we will reduce the time taken for them to reach the market by reducing the existing backlogs through training and aggressively recruiting evaluators, managing clinical trials and performing inspections on an ongoing basis. This will entail the recruitment of and retention strategies for pharmacists and other experts.
The Council for Medical Schemes will receive R4,194 million from this budget, and its primary objective is to protect the rights and entitlements of all members of medical schemes. With the leadership of the Minister, we are in communication with the medical aid schemes to invest in health promotion and disease prevention and not only in the treatment of diseases and their complications.
The National Health Laboratory Service will receive R82,167 million to provide quality, affordable and sustainable health laboratory and related public health services. We have already interacted with the laboratory services, and seen in this budget a reduction in essential laboratory services. This will be a relief to provinces and the various institutions that use the service.
I have already mentioned the eHealth programme and I would like to conclude by saying that in regard to making sure that we achieve our health objectives, we have ensured that we work not only with provinces, but also with various stakeholders. This is so that all of us can embrace these changes that we are coming up with for the health sector.
It is important as well to note that the burden of disease and death is not only a burden on individual families, but also a burden on breadwinners, mothers and fathers, and the workers of our country. It is a burden on our economy and any success in reducing the burden of disease and death - some members have alluded to the fact that it has doubled over the past decade or so - will bring relief to our economy. Thank you very much. [Applause.]