The full budget speech it is available at http://www.doh.gov.za/docs/sp-f.html

 

Tuesday, 13 April: National Minister of Health, Dr Aaron Motsoaledi, presented the Health Budget which had experienced 16% growth to R21.5 billion for 2010-2011.

 

KEY POINTS

·         Action to be taken against high price SA charged for ARVs

 

SUMMARY

 

Motsoaledi reiterated the Cabinet’s commitment to an outcomes-based approach for improving service delivery and identified four concrete outcomes which “must emerge from our interventions to transform the health sector over the next four years”,

1. Increasing life expectancy;

2. Combating HIV and AIDS;

3. Decreasing the burden of diseases from Tuberculosis; and

4. Improving health systems effectiveness, by strengthening Primary Health Care and reducing the costs of health care.

 

The Health Minister identified a further 20 specific outcomes for 2010-2014:

1. Increased life expectancy at birth;

2. Reduced child mortality;

3. Decreased maternal mortality;

4. Managing HIV prevalence and improving the quality of life of people living with HIV and AIDS;

5. Reduction of new HIV infections;

6. Expanding access to the Prevention of Mother To Child Transmission programme;

7. Improved TB case finding;

8. Improved TB treatment outcomes;

9. Improved access to antiretroviral treatment for HIV-TB co-infected patients;

10. Decreased prevalence of drug resistant TB;

11. Revitalisation of Primary Health Care;

12. Improved physical infrastructure for healthcare delivery;

13. Improved patient care and satisfaction;

14. Accreditation of health facilities for quality;

15. Enhanced operational management of health facilities;

16. Improved access to human resources for health;

17. Improved health care financing;

18. Strengthened health information systems (HIS), including strengthening Information, Communication and Technology (ICT);

19. Improved health services for the Youth; and

20. Expanded access to Home Based Care and Community Health Workers.

 

 

HIV AND AIDS

 

This is a time of great change for health policy, with the roll out of expanded HIV testing and treatment campaigns happening now. However amidst these significant policy changes the Health Minister reiterated President Zuma’s World AIDS Day message that the mainstay approach continues to be a focus on prevention.

 

The Health Minister outlined the objectives and policies for the following focal areas:

PMTCT: Maternal Mortality Ratio must decrease from the estimated 400-625 per 100,000 to 100 or less per 100,000 live births over the next 4 years – PMTCT will be enhanced so that by 2014/15, less than 5% of babies born to HIV positive mothers are HIV positive

 

Child Mortality: Must decrease from the current 69 deaths per 1,000 live births to not more than 30-45 deaths per 1,000 live births. Government is introducing a national measles and polio vaccination campaign as well as targeting this group for the H1N1 vaccination.

 

TB: Must increase our TB cure rate from the current 64% to 85% by 2014/15. We willtrain 3,000 health workers in the management of TB. We will also expand our TB DOTS programme and train 2,500 Community Health Workers as DOTS supporters. The Kick TB 2010 will integrate TB awareness with soccer.

 

HIV and AIDS: Target is toreduce by 50% the number of new HIV infections by 2011/12andinitiate on Antiretroviral Treatment (ART) 80% of eligible people living with HIV and AIDS.

 

-PMTCT to pregnant women with CD4 ≤350 (not ≤200)

-Pregnant HIV+ women receive dual therapy from 14 weeks of pregnancy (not 28 weeks as was previously the case) until post delivery

-ART to TB/HIV co-infected with CD4 ≤350 (not ≤200)

-All 4,333 public health facilities will be accredited to provide ARVs – already an additional 519 facilities are providing ARVs since 1 April 2010

 

HCT Campaign: Provide HIV counselling and testing to 15 million South Africans by the end of June 2011. The HCT will also provide a chance to screen for blood pressure, blood sugar, anaemia and TB. This campaign was driven by the findings of The Lancet that South Africa faces a quadruple burden of disease: HIV & AIDS and TB, high maternal and child mortality, non-communicable diseases and violence and injures.

 

 

CHALLENGES

 

Motsoaledi cited the challenges of human resource capacity as well as supply and logistical problems in some facilities, especially in rural areas. He also stated that he was fighting the higher prices South Africa is charged for ARVs; South Africa “must be able to purchase ARVs at the lowest prices as we are the largest consumers of ARV in the world and must benefit from economies of scale” or else risk failure of the expanded ART.

 

The Health Minister said further strengthening was needed to the following interventions:

 

Finally, the Health Minster spoke about improving the effectiveness of the health system, which included refocusing on primary health care and a review of health legislation. He again spoke of his support for a National Health Insurance (NHI) system to reduce the ever escalating costs of health care in South Africa.

The full budget speech it is available at http://www.doh.gov.za/docs/sp-f.html