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.
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
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 SANCDA developed this list to guide integrated person-centred care.
NCDs Atlas of the NCD Alliance has recently been published. This showcases advocacy by civil society groups from around the globe. Four of the reports published in the Atlas became award winners at the Sharjah NCD conference in the areas of:
Coalición Latinoamérica Saludable – Rapid Regional Response to Strengthen and Defend National NCD Policies in Latin America
East African NCD Alliance – Benchmarking to Track and Advance Regional NCD Action
Healthy Caribbean Coalition – Building Civil Society Capacity to Improve Access to Cancer Services for Underserved Populations
Tanzanian NCD Alliance – Creating a Journalists’ Forum to Raise Awareness on NCDs
The SANCDA report titled “Crafting a Collective Advocacy Agenda in Support of a Sugar-Sweetened Beverages Tax in South Africa”, is contained in the document.
This goes to highlight the journey, problems and lessons learnt in the collective creation of a sugar tax in South Africa.
The journey to getting the tax to work for South African’s has barely begun. The areas of work coming from its implementation in April will be to ring-fence money from the tax collected to help fund civil society in prevention, awareness and care.
The SANCDA is honoured to have been published in the NCDs Atlas and look forward to the next publication and furthering the movement to a sugar-free South Africa.
Download the report here
How long have you been at the head of SADAG?
I started SADAG in 1994, at the encouragement of Prof Michael Berk, who was my psychiatrist. I had had massive Panic attacks for ten years without the right treatment, but when I got the treatment, (medication from the psychiatrist,) I became well within four weeks. It just goes to show what the right treatment can do for patients.
SADAG held its first meeting at Sandton Library on a Thursday morning and SADAG over filled the Sandton Library, at 11am.
I have been the founder from the beginning. Have a fabulous, small, active board who make quick decisions. Some have been with me for 18 years. Have a strong committed team of six staff.
What have been the biggest achievements for the organisation over the last 20 years?
- SADAG fought to get Bipolar registered as a PMB
- SADAG opened the first ever Counselling Container in Diepsloot, with over 200,000 people and two counsellors, subsequently SADAG has started 3 support groups, working in the clinics (2), have three schools SADAG are wo, king on in Suicide prevention, Bullying, Exam Stress, Substance Abuse, and work with the police station, churches, other stakeholders and the big local Diepsloot mall.
- SADAG has trained just under a million children, teens, on Teen Suicide prevention and Depression. Class by Class and school by school. SADAG also train the teachers. All nine provinces and send 12 trainers for the day to each school. Leave three pieces of info for the youth, what symptoms to look out for; what are their local resources, what are our emergency numbers and contacts where SADAG can help them.
What is SADAG’s biggest focus at this current moment?
SADAG would like to further develop our partnerships with the Department of Health, and education, instead of doing a huge volume of work on their behalf with no recognition or support. SADAG would like to establish an ombudsman on Mental Health with toll free lines, to investigate drugs not being available, as they currently are not at Helen Joseph or Tara, or Eastern Cape
How would you change current practise to best serve the greater country in regards to mental health?
- Put back psychiatric nurses in rural clinics, where they previously were. Give them more prescription writing permission in the more rural areas.
- Put more beds in place for mental health particularly for children and youth.
- Put all the interns and community psychologists in place in rural hospitals and clinics, not in the Johansseburg, Cape Town and Durban, etc.
- Put more pilot counselling containers in place in rural large townships. They are economical, effective and build wonderful community relationships.
What does the future hold for the organisation and what do you hope achieve?
The organisation will continue to develop more support groups, currently SADAG has 200 groups, and they put in place community skills and access to better treatment is very important. SADAG are aiming for 300 in the next 3 years. SADAG need more brochures in various languages and funding for speaking books on Bipolar and Schizophrenia for rural communities, very hard topic to understand. These books can be distributed, played, and replayed by patients, family members, and community groups.