NCDs are a neglected priority in the National Department of Health (NDoH) Annual Performance Plan 2022/23 (APP) which expires at the end of March. Only 4 /18 outcomes in programme 3 are NCD-related.
The bottom 2 rows in the table, require the re-development of national policies for mental health and obesity. Transparency and an inclusive process are problematic.
Our Constitution calls for the meaningfu involvement of civil society and people living with NCDs. Together these conditions impact millions of South Africans and place increasing burden on the health system.
It would also be great to see the reviews of the existing policies which should come before a new policy.
The NCDs+ National Strategic Plan 2022-2027, launched in May 2023, (see the top row in the table) Implying that the provinces will have be close to publishing the impemetion plans for obesity, diabetes and hypertension. I know there is lots hard work getting the plans ready. The Medium-Term Strategic Framework 2019-24 makes it clear that NCDs budgets and implementation must happend in at the sumbnational or provinical level.
Today is the health budget speech at 14:00, and in the interests of transparency and inclusivity, it would be great if we, the people, had a look at it beforehand. The budget speech is a version of the Annual Performance Plan (APP) for the financial year to 31 March 2023.
So we are already into the financial year, and the APP23 s already in progress. Having asked for said APP23 PDF, and scouring government and parliamentary websites, we are still in the dark. The closest we came to is a presentation from the health portfolio committee.
The most positive aspect for NCDs+ is that NCDs+ are still in stream, branch or programme 3 along with communicable diseases. At least it hasn’t be shoved back in Programme 4 Primary Health Care where it languished without food or water.
Mind you it is unlikely to change much since the Medium Term Strategic Framework 2019-2024 (MTSEF24) does not prioritise NCDs+ or allocate funding. Except in the most peripheral way. I call this the legacy of 3M era: MDGs, Motsoaledi and Mkhize. Too bad that we are in SDG times and need different action to achieve universal health coverage (UHC target 3.8) and there is more than the target 3.4to achieve action on NCDs.
The MTSF 2019-2024 – a lasting legacy courtesy of the 3M era, MDGs, Motsoaledi and Mkhize. The absence of national budgets for NCDs+ is not the only issue. At the last count maybe one province had a sort-of-NCDs plan. Clear budget line items are awaited as an evolutionary step like the missing link. It would would great to have progress at the implementation level and within National Health Insurance budgets.
Joy there is a change to the number of outcomes and outputs covering NCDs+ in the APP23. That means a lot without a programme budget and an implementation plan.
The date of the review is August 2018. This is the first version. Later, in November 2018, a second version was circulated.
The NCDs National Strategic Plan 2013-2017 is also known as the 2nd NCDs NSP. It was reviewed in 2018 by a WHO country office contracted consultant on behalf of the NDoH.
It is grandiosely called The “Implementation Review of the NCDs NSP 2013-2017” The title is a farce since this plan was never implemented and unfunded. The review is supposed to imply an authentic evaluation of the plan, processes and outcomes. It does nothing of the sort
The WHO consultant Mel Freeman was also the NDoH official responsible for the development and implementation of the 2nd NCDs NSP during his tenure as Chief Director, NCDs
The NDoH official policy communication on vaccination 5 July outlines how the adjusted vaccination rollout. It differs from the original PHASE 2 rollout hence the use of “adapted.” It is not explicitly linked to phase 2 but it is hard to see where else it fits. Missing are those with comorbidities like NCDs, including diabetes and cancer.
1.4 Every vaccination site (public or private) must have a pro-active plan for managing walkins for vaccination.
Age group (+40) and congregate responsibilities government supported by private ;
Essential workers according to government sector “vertical” rollout
Workers by priority “economic” sector (mining, automotive industry, taxi operators) rollout via companies. Not clear if limited to the above sectors.
A general caveat about using EVDS to register all who are vaccinated.
NDoH & provincial DOH (PDoH) collaboration with private sector responsibilities
1.1 Vaccination registration & administration by age groups (5 subpoints around EVDS and reimbursement). 1.2 Working group 1: capacity analysis including underserved areas for the attention of PDoH, presumably with the prospect of solving problems (members NDoH/Business for SA). 1.3 Working group 2: NDoH equity monitor of demand in districts/municipalities to resolve coverage issues & look at rollout to 40+. 1.4 Walkins are OK & every vaccination site (public or private) must have a pro-active plan for walkins. (6 subpoints) 1.5 Congregate settings: homes for people with disabilities, old age homes and later on prisons (correctional facilities) remains PDoH / privates sector responsibility.
2 Roll-out of essential worker programme public sector
2.1 “Vertical” rollout with key government “sector” “projects” departments (9 subgroups) 2.2 PDoH not responsible for the above except “DBE project and around 220,000 people from 6 categories. 2.3 Vaccination of remaining health care workers (HCWs) according to V4HCW registration site and these also include “private employers.” (5 items) 2.4 Police (SAPS) is managing its own vaccination project. 2.5 Department of Defence and Military Veterans for the SANDF programme due to start on 8 July. 2.6 A number of government services still to be finalisied e.g. correctional services vaccination.
3 Prioritised sectors of the economy
3.1 President listed these previously mining, automotive manufacturing and taxi operators. 3.2 Many private sector companies have started vaccination of employees and contract workers. 3.3 Companies using in-house or outsourced health services.[/vc_column_text][vc_column_text]
4 EVDS-related issues
Four caveats about the importance of registering via EVDS in all circumstances.
