Early in the COVID-19 pandemic WHO’s @DrTedros highlighted the problems of access to health services by millions of people living with NCDs+ in his tweet. His tweet certainly mirrors what the SA NCDs Alliance and our allies have been saying since 2007 when the SA Human Rights Commission (SAHRC) held its first public hearings into the right access to health services.
COVID-19 changed the parameters of vulnerability to include NCDs+, mental health, and reemphasised disability in all its shapes and forms.
SAHRC report 2007
15 years ago the primary focus was understandably on access to HIV/AIDS and TB services. It was the height of the communicable disease epidemic. And amidst our homegrown “AIDS-denialism”. It was also the midpoint of the Millenium Development Goals (MDGs) where vast amounts of funding were channelled into communicable diseases and maternal-child services. That pattern of expenditure and funding remains in place today.
Executive summary
The report’s executive summary is salutary: it fits today’s health service access issues in the COVID-19 pandemic. Just substitute NCDs+ for communicable diseases. And, we have a similar complaint today.
The report’s opening quote is ironically, but not surprisingly, from The AIDS Law Project, the early version of Section 27:
“We don’t yet have a definition of essential health services. This means we don’t have a base line for the right to health and it is impossible to cost the health service and thereby determine objectively what can be
afforded.”
We still don’t have the definition. But HIV unlike NCDs+ is a National Development Plan priority. As for the rest of the conclusions, they mostly are unmet PLWNCDs+ The main change to health services is that HIV/TB services dominate primary health care. We beg for evidence-based inclusion of NCDs + throughout the life-course. And, more not just a tack on to HIV, TB and STI services.
That is why we fight on. Read the SAHRC 2007 report on access to health services SAHRC 2007Health Report
The newly appointed Health Department Director General Sandile Buthelezi will take the reins from 1 June 2020.
Buthelezi, whose appointment was announced a fortnight ago, will take office at a critical time with the country and the world at large in the throes of the COVID-19 pandemic.
His first day in office will coincide with the country’s move to alert level 3 of lockdown.
“I wish to take this opportunity to congratulate Dr Buthelezi and believe that he is certainly up to the task,” said Health Minister, Dr Zwelini Mkhize, upon welcoming Buthelezi.
A medical doctor, Buthelezi brings a wealth of experience having worked in the implementation and rolling out of government’s strategy to fight HIV and TB in our country. He has also worked with international organisations that have over the years given support to South Africa in its health programmes.
Dr Buthelezi, also carries direct knowledge of challenges faced by public health facilities, having worked as a superintendent of hospitals at a young age.
While welcoming Buthelezi, the Health Minister expressed appreciation to the Acting Director General, Dr Anban Pillay who has been acting since the departure of the former DG.
“We also wish to bid farewell to Dr Yogan Pillay, the DDG for Communicable and Non-Communicable Diseases prevention, treatment and rehabilitation who is going into early retirement after working for the national Department of Health for 23 years,” said the Minister.
Under Pillay’s leadership South Africa’s HIV treatment programme grew to become the largest in the world, new vaccines were introduced as part of the expanded programme on immunisation and infant, under five and maternal mortality rates have declined significantly.
In December 2019, Dr Pillay requested to take early retirement in order to join the Clinton Health Access Initiative (CHAI) as Country Director for South Africa and senior advisor on Universal Health Coverage for CHAI globally. CHAI began working with the South African government in 2003 and has operated in the country since 2008.
South Africa anchors many global pricing deals that reduce the costs of essential health products and allows other countries to save on the same products.
CHAI has over the years been one of the organisations that have supported the department to improve access to lifesaving treatment, diagnosis, and prevention of HIV, tuberculosis and malaria as well as maternal and neonatal health, sexual and reproductive health, non-communicable diseases including cancer as well as health financing. “We wish Dr Yogan Pillay well in his future endeavours,” said the Minister.
Reading the Auditor General’s report 2018-19 is not the way to finish off a week. It is a dismal tale of woe which adds another distressing layer to the state capture saga. What is truly distressing is that this information is in plain sight and very little is done from one year to the next. The Citizens version candidly spells it out: “overall audit outcomes take a turn for the worse over five years.” For me, it is much clearer that the boffins’ version of the report which sugar coats the message as “audit outcomes regressed since 2014/15.”
Provincial departments of health are in a bad state and need urgent intervention to prevent collapse. An exception is the Western Cape.
Serious weaknesses in the financial management of national & provincial government unaddressed in the last five years. (Section 4)
The quality of the performance reports slightly regressed since 2014/15 from 66% to 62% (auditees publishing credible reports).
Little improvement on key government programmes according to the National Development Plan Section 6 district health services (HIV/AIDS, TB &maternal & child health) box below water infrastructure development, housing development finance, school infrastructure delivery expanded public works programme.
72% of the auditees materially did not comply with legislation similar to the previous year & slightly higher than the 70% in 2014/15.
What does this mean for National Health Insurance Bill and sweeping changes needed for the financing of health care? The National Department of Health is not among those that received a clean (unqualified) audit.
Reading the Auditor General’s report 2018-19 is not the way to finish off a week. It is a dismal tale of woe which adds another distressing layer to the state capture saga. What is truly distressing is that this information is in plain sight and very little is done from one year to the next. The Citizens version candidly spells it out: “overall audit outcomes take a turn for the worse over five years.” For me, it is much clearer that the boffins’ version of the report which sugar coats the message as “audit outcomes regressed since 2014/15.”
Provincial departments of health are in a bad state and need urgent intervention to prevent collapse. An exception is the Western Cape.
Serious weaknesses in the financial management of national & provincial government unaddressed in the last five years. (Section 4)
The quality of the performance reports slightly regressed since 2014/15 from 66% to 62% (auditees publishing credible reports).
Little improvement on key government programmes according to the National Development Plan Section 6 district health services (HIV/AIDS, TB &maternal & child health) box below water infrastructure development, housing development finance, school infrastructure delivery expanded public works programme.
72% of the auditees materially did not comply with legislation similar to the previous year & slightly higher than the 70% in 2014/15.
What does this mean for National Health Insurance Bill and sweeping changes needed for the financing of health care? The National Department of Health is not among those that received a clean (unqualified) audit.
os highlighted the problems of access to health services by millions of people living with NCDs+ in his tweet. His tweet certainly mirrors what the SA NCDs Alliance and our allies have been saying since 2007 when the SA Human Rights Commission (SAHRC) held its first public hearings into the right access to health services.
