Deputy Speaker, hon President, hon Deputy President, Cabinet Ministers, hon Members of Parliament, ladies and gentlemen, as the Minister of Health, I would like to address you on the current situation faced by the country and the world at large because of the outbreak of influenza A: H1N1.
It is necessary for me to take this step because I believe we are all concerned by the recent rise in deaths in the country, particularly the deaths of pregnant women. The death of any individual is extremely painful and particularly regrettable, more so if that individual is a mother to be, who forms part of the foundation of any family and society as a whole.
As I've indicated in my personal letters to all of you, which I hope you have received, I wish to reiterate my message of my intention to use this opportunity to give you information that will assist you personally to deal with this disease and to request your assistance and personal involvement in effectively communicating the messages of influenza A: H1N1 2009 to our communities.
This is particularly important because whenever new diseases strike, rumours abound and take over the thinking process of citizens. These rumours will then inform the activities of the populace, which will usually be wrong activities. I'm happy that the letters I've written have reached all of you and hundreds of other people in all corners of this country. This is shown by the feedback we have been receiving on the letters.
Among those who have responded to the letters very positively, I wish to acknowledge the response of Prince Mangosuthu Buthelezi, Shenge. Thank you for your kind words indeed. I also wish to acknowledge the response received from Dr Wilmot James of the DA. I want to assure him that I will follow up on the proposals that he made in his response. Of course the continuous feedback and encouragement I received from comrades in the ANC and my colleagues in the Cabinet have also been extremely helpful in shaping our response to this pandemic. I also wish to thank Minister Manuel for responding on our behalf during yesterday's statements.
It is true that we have sent letters, not only to you, but to all members of the provincial legislatures, councillors, community development workers, principals of 30 000 schools, rectors of universities, ministers of religion, traditional healers and everybody who is a leader, including editors of newspapers, in trying to communicate this matter. What these responses and reactions indicate is the willingness and readiness of South Africans to hold hands in confronting common challenges.
Developments around this pandemic have been changing every week. So, since last week when I sent your letters, statistics have changed, and I wish to update them. At the moment the disease has spread to 170 countries globally and to 25 countries on the African continent. Today as I'm standing here in front of you, the virus has affected 182 166 people. These are laboratory confirmed cases. Globally we have 1 799 confirmed deaths, and in South Africa to date we have 5 118 infections with 20 deaths. As health officials globally and locally, we are worried by these deaths that have so far occurred, calculated globally as 0,9% of those affected, and as 0,3% of those people who are affected in South Africa.
It is worth noting that this virus affects people in the younger age groups, particularly between the ages of 10 and 29 years. Most of these individuals are in schools and institutions of higher learning. This is a very serious departure from what influenzas generally do. As you know, seasonal influenza typically attacks the elderly and kills between 250 000 to 500 000 people every year. But the H1N1 influenza, while it has killed very few people so far, has only affected 3% of people over the age of 65 years. This has never happened in the history of influenzas; it's a new phenomenon.
The World Health Organisation, WHO, has advised that countries must concentrate on mitigating the impact of the disease on their communities because containing it seems not to have happened. So, in mitigating, communication is the key. We have taken all the necessary steps to ensure that we are doing that. However, I want to mention to this House that more still needs to be done in the area of communication. That's why we are appealing for your assistance because you have constituencies and that is where communities are.
It is generally believed by experts, unfortunately, all over the world, including even those in the WHO, that at the end of this pandemic, 45% of humanity is definitely going to be affected. However, we wish to emphasise that while that is so, an overwhelming majority of people worldwide have mild symptoms and don't need any specialised attention and care.
The figures we are quoting here are for those who have been tested. We still believe that there are thousands and thousands out there who were not even aware that they had caught this influenza because it was very mild. So, people with very mild symptoms must just be treated as if they have any other common influenza which occurs on an annual basis, like I had last year and every other year in winter.
However, we are worried particularly about four categories of people: people with chronic heart or lung diseases seem to be succumbing; pregnant women, specifically; people living with HIV and Aids; and lastly, people with diabetes mellitus. We are particularly worried about these four groups of people.
We are emphasising once more that people who experience moderate and severe symptoms, which I've outlined in the letters and need not repeat here, must immediately seek medical attention. We are also saying that those who have mild symptoms, but fall within the categories that I've mentioned - chronic heart and lung diseases, pregnant women, HIV/Aids, and people with diabetes - must seek urgent attention, even if the symptoms are mild and seem like ordinary influenza
The distribution of letters in the provinces has changed since last week when I wrote you the letters. It indicates the following: the hardest hit province is Gauteng, with 49% of infected people; the Western Cape, with 21%; KwaZulu-Natal, with 12%; the Eastern Cape, with 6,4%; Limpopo, with 3,5%; Mpumalanga, with 2,5%; the North West with 2,3%; the Free State, with 2%; and the Northern Cape, with 1%.
I wish to warn members that this has nothing to do with the way the disease is spreading. It has a lot to do with where the testing facilities are. People are testing every day, even those who are not sick. The majority of laboratories are in Johannesburg. That is why 49% of the cases that are reported are there. That is followed by the Western Cape for the same reason. The death rate up to now is nine in the Western Cape, six in Gauteng, two in the Eastern Cape, two in KwaZulu-Natal and one in the Free State.
We will thoroughly investigate each death. However, present information shows that nine of the dead people were pregnant women, four had chronic heart diseases,one had diabetes and two had renal transplants. That is in keeping with all the risk areas that we have mentioned up to now. We are still trying our best to get more information on the other four.
Official testing is done by the National Institute of Communicable Diseases. In other words, you can test in a private laboratory, but if they reveal a death we will not communicate it until it has been confirmed by the National Institute of Communicable Diseases. This is because it is the only laboratory in Africa that has been accredited by the WHO. The fact that many countries on the continent don't seem to have the disease is simply because they don't have testing facilities. Most of them depend on South Africa for testing.
We want to appeal again to people that waking up at your home in the morning and rushing to the nearest private laboratory demanding to be tested simply because you can afford to do so financially does not help anyone. In fact, what it does is to clog up the health system as is the case now. This practice has disadvantaged people who really deserved to be tested.
Initially, when the pandemic started, laboratories could produce results within 24 hours. Now it takes up to seven days to produce results because people are just queuing up not because they have any symptoms, but simply because they just feel the need to be on the safe side. We do not know how testing puts you on the safe side anyway. Really, as one caller to SAFM said, there doesn't seem to be a breakdown of disease but a breakdown of testing, and we should not allow that.
The treatment of choice is Tamiflu, and we are only using it for moderate symptoms, severe symptoms and the categories of people that I've mentioned. Mass treatment with Tamiflu will lead to mass resistance. I want to warn members here today to be aware. We are not trying to hide treatment from them.
If you are attacked, hon Speaker, you defend yourself. Don't ever think viruses will also be attacked without defending themselves. They do so and in a cruel way. If you attack them continuously, even when it's unnecessary, they mutate. When they mutate, they become more dangerous. That's why we don't want to give every South African Tamiflu. If we start doing so, we'll be destroying ourselves. It's like that all over the world.
In line with the department's commitment to reducing maternal mortality, we have given instructions and directives to all doctors and health workers that whenever they come across a pregnant woman who shows any symptoms, they must give her Tamiflu immediately. They must not wait or try to do any testing, it's not necessary. They must just give her the treatment.
It is saddening to see pregnant women, in particular, who are dying because of this influenza. Unfortunately this phenomenon of pregnant women dying is a global one. I wish to announce to this House that because of this, the department is busy increasing the stock of Tamiflu by R30 million so that as we get very busy we can be prepared.
The closure of institutions of learning, workplaces, shopping complexes and malls has not proved to be helpful in the countries that have practiced that. We advise that if there are more people - learners or educators or even workers - absent from work or from school, institutions must consult the Department of Health and the Department of Education and we will take a joint decision on the correct course of action.
I wish to assure you and members of this House that everything is being done by scientists the world over, working together with the WHO, to try and produce a vaccine for this disease, because that is the only thing that will save humanity. If things go well, such a vaccine might be available within a few months. Over the last weekend I attended an international conference on this pandemic influenza in Beijing, China. Most of the Ministers from the heavily affected countries were at that conference.
The WHO briefed us that at the moment, 13 candidate vaccines have been collated and distributed to all vaccine manufacturers all over the world who must start the process of trials and production. However, producing a vaccine as it is going will not be completed in less than six months; that is not possible. So, it is estimated that if we are very lucky, the first acceptable vaccine from these candidates might be available by November 2009. If we are not very lucky, we might have to wait until April 2010.
Unfortunately, there is no capacity in developing countries to produce their own vaccines. At the moment, all vaccine production is being processed in Europe and America, with China also in the process of doing so. They are busy doing tests on 13 000 people within China.
However, the disturbing feature about today's world and the manner in which the world is arranged has been expressed by the Minister of Health for Cambodia in the conference, who noted that the developed world, after producing the vaccine, may prefer to cover their own population first before thinking about the developing world. China made it very clear in the conference that if they can produce a vaccine, they will first start with the 67 million people who are pregnant in that country.
I've spoken to my colleague, the Minister of Science and Technology, and we both think that ... [Interjections.]