TAC Statement on new cabinet appointments and resources for health

The Treatment Action Campaign is an Atlantic grantee. TAC E-Newsletter The Treatment Action Campaign (TAC) welcomes the appointment of Dr. Aaron Motsoaledi as the Minister of Health, and the re-appointment of Dr. Molefi Sefularo as the Deputy Minister of Health. Both the Health Minister and the Deputy Health Minister have an immense responsibility to protect the health and human rights of people in South Africa, and to achieve the targets laid out by the National Strategic Plan for HIV/AIDS 2007 2011. TAC will support the ministry in its responsibility to rebuild the health system and to implement progressive policies and programmes. TAC will also continue to closely monitor health policy development and implementation, and resource allocation for health under the leadership of Minister Motsoaledi and Deputy Minister Sefularo to ensure that government commitments to healthcare delivery are achieved. This is particularly important in the current economic climate. As of May 2009, about 700,000 people have been initiated onto ARVs in South Africa’s public health sector. But at least double the current number of people who are on ARVs need treatment urgently to survive. It is government’s responsibility to make ARVs accessible and sustainable, as stated in the NSP and enshrined in the constitutional right to the progressive realization of health care. A severe lack of funding threatens the achievement of the NSP targets. Department of Health officials have admitted that the budget allocation for ARVs through the current HIV/AIDS conditional grant to provinces will not be nearly sufficient to treat 220,000 people this year. There is also a drastic shortage of money to fund the other NSP target interventions and coverage. A Statistics South Africa report indicates that South Africa’s official unemployment figure has increased from 21.9% in the last quarter of 2008, to 23.5% by March 2009, with economists estimating that the real unemployment rate exceeds 30%. A recent report by the World Bank details the negative effects that rising unemployment and reduced earnings have on health outcomes. Reduced income makes people less likely to seek medical attention when they are sick as they can no longer afford to travel. It also forces people to buy cheaper, less nutritious food which leads to an increase in malnutrition. Poor households are likely to be the worst affected because they have less room to re-adjust their expenditure. Despite the fact that clinic visits may contract in times of economic recession, the actual demand for these services increases as people face greater difficulties in accessing adequate food and housing. Minister Motsoaledi and Deputy Minister Sefularo will have to confront the serious health challenges resulting from the economic downturn and to implement policies that cushion the poorest sectors of society from the effects of the downturn, as these communities bear the brunt of decreasing access to public health services. TAC’s support for the previous Health Minister, Barbara Hogan, was premised partly on Hogan’s extensive background in financial management as the chair of parliament’s Finance Portfolio Committee, but also on her commitment to engage in and understand the severity of the problems of healthcare delivery. During her time as Health Minister, Hogan worked tirelessly to improve the South African health system. After the enactment of an antiretroviral ‘moratorium’ in the Free State province a four month period during which no new patients were initiated onto ARVs as a result of poor fiscal planning and management in the province Hogan planned for the establishment of a team of budgeting experts to monitor the budgeting processes of provincial Departments of Health. TAC is therefore disappointed that Minister Hogan was not reappointed as the Minister of Health, but congratulates the Minister on her appointment to the Department of Public Enterprises. TAC is confident that her leadership and expertise will have a positive impact on her important new position. Minister Motsoaledi and Deputy Minister Sefularo must continue the decisive work done by Minister Hogan. Specific attention must be given to reforming the Department of Health, implementing measures to alleviate the critical shortage of human resources in the public health sector, scaling-up the ARV roll-out and achieving the targets of the NSP, and vastly improving the implementation of TB control measures and treatment.