1. NATIONAL DEPARTMENT OF HEALTH PRESENTATION TO NCOP COMMITTEE MAY 2003

2. Health Portfolio Committee. April 2003 2 OVERVIEW STRATEGIC PLAN WHICH HIGHLIGHTS MEASURABLE OBJECTIVES, INDICATORS AND TARGETS FOR THE NEXT THREE FINANCIAL YEARS TABLED. TEN POINT PLAN PERIOD ENDING DURING THIS FINANCIAL YEAR. WILL REPORT ON CHANGES IN EPIDEMIOLOGY AND ACHIEVEMENTS.

3. Health Portfolio Committee. April 2003 3 CHANGING EPIDEMIOLOGY FOR IMR, UNDER 5 MORTALITY AND MMR NO NEW FIGURES SINCE SADHS (IMR - 45, 2 DEATHS PER 1000 LIVE; UNDER 5 - 59,4/ 1000; MMR – 150/ 100 000). INTESTINAL INFECTIOUS DISEASES, INFLUENZA AND PNEUMONIA AND ‘UNSPECIFIED UNNATURAL’ WERE THE TOP THREE UNDERLYING CAUSES OF DEATHS IN 1997-2001 AMONG CHILDREN AGED 0 – 14 YEARS AS COMPARED TO PERINATAL CONDITIONS, ILL-DEFINED/UNKNOWN AND INTESTINAL INFECTIOUS DISEASES IN 1995.

4. Health Portfolio Committee. April 2003 4 CHANGING EPIDEMIOLOGY FOR THE PERIOD JANUARY TO AUGUST 2002, ONLY 1 CASE OF TETANUS NEONATORUM WAS REPORTED. DURING THE SAME PERIOD 5 CASES OF WHOOPING COUGH WERE REPORTED COMPARED TO 24 CASES FOR THE SAME PERIOD IN 2001.

5. Health Portfolio Committee. April 2003 5 CHANGING EPIDEMIOLOGY OF THE 406 SUSPECTED MEASLES CASES REPORTED IN 1998, 27 WERE CONFIRMED BY LABORATORY TESTS AND IN 2001 THE NUMBER OF CONFIRMED CASES WERE EVEN LOWER, ONLY 8 OF 1 166 SUSPECTED CASES WERE CONFIRMED. CLEARLY THE MASS CAMPAIGNS AND ROUTINE IMMUNISATION IS HAVING THE DESIRED EFFECT.

6. Health Portfolio Committee. April 2003 6 CHANGING EPIDEMIOLOGY THE OVERALL HIV PREVALENCE RATE WAS 22.4% IN 1999, 24.5% IN 2000 AND 24.8% IN 2001. THE PREVALENCE OF HIV AMONG ADOLESCENTS AGED BELOW 20 YEARS DECLINED FROM 21% IN 1998 TO 16.5% IN 1999, STABILISING TO 16.1% IN 2000 AND 15.4% IN 2001.

7. Health Portfolio Committee. April 2003 7 CHANGING EPIDEMIOLOGY THE STI RATE DROPPED FROM 9% IN 1998 TO UNDER 3% IN 2001. THE INCIDENCE TB CASES FOR 2001 WAS 423 PER 100,000 POPULATION. IN TERMS OF CASES NOTIFIED, THIS TRANSLATES TO MORE THAN 188 000 TOTAL TB CASES OF WHICH MORE THAN 83,000 WERE NEW SMEAR POSITIVES (INFECTIOUS).

8. Health Portfolio Committee. April 2003 8 CHANGING EPIDEMIOLOGY THE MALARIA CASES AND DEATHS FOR 2002 TO 30 NOVEMBER 2002 WERE 14 468 AND 86 RESPECTIVELY. THIS IS A 42% DECREASE IN MALARIA CASES AND A 23% DECREASE IN DEATHS COMPARED TO THE PREVIOUS YEAR (MALARIA CASES 24 951, MALARIA DEATHS 112 IN NOVEMBER 2001). THE TOTAL NUMBER OF CHOLERA CASES IN THE COUNTRY WAS 106 389 AND THERE WERE 229 DEATHS (CFR = 0.22%) – LESS THAN THE WHO RECOMMENDED FIGURE OF 0,5%.

9. Health Portfolio Committee. April 2003 9 ACCOMPLISHMENTS ALL PROVINCES ARE IMPLEMENTING THE PERINATAL PROBLEM IDENTIFICATION PROGRAMME (PPIP) WHICH HELPS PROVINCES TO IDENTIFY CAUSES OF PERINATAL DEATHS. IN 2000 27 PUBLIC SECTOR FACILITIES IMPLEMENTED PPIP INCREASING TO 91 IN 2002. THE BABY FRIENDLY INITIATIVE HAS RESULTED IN 58 OUT OF 480 MATERNITY UNITS BEING DECLARED AS BABY FRIENDLY.

10. Health Portfolio Committee. April 2003 10 ACCOMPLISHMENTS THE NUMBER OF FUNCTIONING DESIGNATED TOP FACILITIES HAS INCREASED FROM 109 TO 159 IN 2002.

11. Health Portfolio Committee. April 2003 11 ACCOMPLISHMENTS IN 2002/3 2,5 MILLION FEMALE CONDOMS AT A COST OF R18,5 MILLION WERE DISTRIBUTED. THE NUMBER OF SITES AT WHICH FEMALE CONDOMS ARE DISTRIBUTED HAVE INCREASED TO 200 FROM 114 IN THE PREVIOUS FINANCIAL YEAR. 358 MILLION MALE CONDOMS AT A COST OF R 71 MILLION WERE IN 2002/2003. THIS IS UP FROM THE 267 MILLION CONDOMS PURCHASED AND DISTRIBUTED IN 2001/02.

12. Health Portfolio Committee. April 2003 12 ACCOMPLISHMENTS SINCE LATE 2000 VCT SERVICES HAVE BEEN ESTABLISHED IN 691 CLINICS NATIONALLY. FOOD FORTIFICATION IS A MAJOR NATIONAL PRIORITY AND REGULATIONS WERE PUBLISHED FOR COMMENT IN OCTOBER 2002. EDUCATIONAL AND PROMOTIONAL ASPECTS BEGAN IN FEBRUARY 2003 WITH FULL IMPLEMENTATION BY THE END OF 2003. THE PROGRAMME WAS FORMALLY LAUNCHED BY THE MINISTER ON APRIL 1.

13. Health Portfolio Committee. April 2003 13 ACCOMPLISHMENTS SINCE DECEMBER 1998, R1,6 B HAS BEEN SPENT ON THE DESIGN AND CONSTRUCTION OF 966 PROJECTS AT 240 HOSPITALS. A TOTAL OF 492 PROJECTS AT 141 HOSPITALS HAVE BEEN COMPLETED. NELSON MANDELA ACADEMIC HOSPITAL WITH 460 LEVEL 2 & 3 BEDS HAS BEEN COMPLETED, THE FIRST PATIENTS ARE EXPECTED TO BE ADMITTED IN SEPTEMBER WITH FULL OPERATIONS IN MID TO LATE 2004.

14. Health Portfolio Committee. April 2003 14 ACCOMPLISHMENTS INKOSI ALBERT LUTHULI ACADEMIC COMPLEX WITH 846 LEVEL 2, 3 AND 4 BEDS HAS BEEN COMPLETED, HAS STARTED ADMITTING PATIENTS ON A PHASED BASIS AND WILL BE FULLY OPERATIONAL BY AUGUST 2003. THE PRETORIA ACADEMIC HOSPITAL WITH 777 LEVEL 2 & 3 BEDS IS EXPECTED TO BE COMPLETED BY NOVEMBER 2003 AND IS EXPECTED TO BE FULLY OPERATIONAL BY APRIL 2004.

15. Health Portfolio Committee. April 2003 15 HEALTH MONITORING & EVALUATION BUDGET (R’000) 2003/042004/052005/06 R 183 130R 185 019 R 197 365 (NOTE: INCLUDES QoC) BUDGET FOR MRC: R 156 695R 163 388 R 173 304 INFORMATION SYSTEMS FOR MONITORING & PLANNING 2 ND SOUTH AFRICAN DEMOGRAPHIC AND HEALTH SURVEY ANNUAL HIV ANTENATAL SURVEY STRENGTHEN NATIONAL PATIENT COMPLAINT SYSTEM MONITOR CONDUCT OF PATIENT STAFISFACTION SURVEYS AND IMPLEMENTATION OF CORRECTIVE MEASURES INTRODUCE CLINICAL AUDITS

16. Health Portfolio Committee. April 2003 16 MATERNAL, CHILD, WOMEN’S HEALTH & NUTRITION BUDGET DETAILS (R’000): 2003/042004/052005/06 INP C/GRANTR 808 660R 950 418R1 041 543 OPERAT. BUD.R 20 261R 23 323R 24 677 TOTALR 828 921R 973 741R1 066 220 IMPROVE IMMUNISATION COVERAGE & IMCI COVERAGE EXPAND THE BABY FRIENDLY HOSPITAL PROGRAMME IMPROVE SERVICES TO DECREASE MATERNAL MORTALITY INCREASE THE NUMBER OF FACILITIES THAT OFFER TERMINATION OF PREGNANCY SERVICES EXPAND THE INTEGRATED NUTRITION PROGRAMME

17. Health Portfolio Committee. April 2003 17 MENTAL HEALTH & SUBSTANCE ABUSE BUDGET (R’000): 2003/042004/052005/06 R 6 221R 6 989R 7 408 IMPLEMENT MENTAL HEALTH CARE ACT INTEGRATION OF MENTAL HEALTH INTO THE HEALTH SERVICES TO PROVIDE COMPREHENSIVE CARE IMPLEMENT REGULATIONS ON WARNING LABELS ON BOTTLES CONTAINING ALCOHOLIC BEVERAGES REDUCE ADVERTISEMENTS OF ALCOHOL

18. Health Portfolio Committee. April 2003 18 HIV/AIDS & STIs BUDGET (R’000): 2003/042004/052005/06 COND. GRANTSR333 556R 481 612R 535 108 OPERATIONSR332 165R 369 356R 368 236 TOTAL R665 721R850 968R903 344 (NOTE: INCLUDES BUDGET FOR TB) IMPROVED STRATEGIES TO DEAL WITH THE HIV/AIDS EPIDEMIC: –EXPAND VCT –EXPAND PMTCT SITES –IMPROVE STI SURVEILLANCE & MANAGEMENT –INCREASE CONDOM DISTRIBUTION –IMPROVE USE & MONITORING OF CONDITIONAL GRANTS

19. Health Portfolio Committee. April 2003 19 TUBERCULOSIS STRENGTHEN THE TB CONTROL PROGRAMME: –EXPAND DIRECT OBSERVED TREATMENT SHORT COURSE TO ALL HEALTH DISTRICTS –IMPROVE TURN AROUND TIME FOR SPUTA (48 HRS) –IMPROVE CURE RATE (FIRST ATTEMPT)

20. Health Portfolio Committee. April 2003 20 PHARMACEUTICAL POLICY AND PLANNING BUDGET (R’000): 2003/042004/052005/06 R 23 937 R 23 246R 25 521 IMPLEMENT PHARMACY ACT REVISION OF ESSENTIAL DRUG LISTS ESTABLISH PRICING COMMITTEE LICENSING OF PHARMACIES

21. Health Portfolio Committee. April 2003 21 MEDICINES REGULATORY AUTHORITY BUDGET (R’000): 2003/042004/052005/06 R 23 012 R 23 691 R 25 112 IMPLEMENT MEDICINES AND RELATED SUBSTANCE ACT IMPROVE SYSTEMS & PROCESSES TO ENSURE SAFE DRUGS: –IMPROVE PROCESSES FOR REGISTRATION OF DRUGS –ATTAIN MEMBERSHIP OF THE INTERNATIONAL PHARMACEUTICAL INSPECTION SCHEME & INSPECTION –DEVELOP CENTRE FOR EXCELLENCE FOR GMP AND QUALITY SYSTEMS FOR SADC AND NEPAD

22. Health Portfolio Committee. April 2003 22 DISEASE PREVENTION AND CONTROL BUDGET (R’000): 2003/042004/05 2005/06 MEDICO-LEGALR 52 000R 86 600R 91 796 OPERATIONSR 73 013R 73 575R 77 209 TOTAL R 125 013 R 160 175R169 005 EXPAND THE CATARACT SURGERY PROJECT & ELIMINATE BACKLOG IN ASSISTIVE DEVICES CREATION OF SINGLE BLOOD TRANSFUSION SERVICE SAPS MORTUARIES HAVE BEEN TRANSFERRED

23. Health Portfolio Committee. April 2003 23 HOSPITAL SERVICES & EMS BUDGET (R’000): 2003/042004/052005/06 R 6 291 730R 6 781 638R7 245 173 REVITALISATION OF PUBLIC HOSPITALS –PHYSICAL FACILITIES –DECENTRALISED MANAGEMENT –QUALITY OF CARE STRENGTHEN USE & MONITORING OF CONDITIONAL GRANTS NATIONAL EMERGENCY MEDICAL SERVICES PLAN DEVELOPMENT & IMPLEMENTED

24. Health Portfolio Committee. April 2003 24 HUMAN RESOURCES BUDGET (R’000): 2003/042004/052005/06 R6 651 R7 328 R7 768 DEVELOP & MONITOR IMPLEMENTATION OF HR PLAN BASED ON THE PICK REPORT FACIILTATE TRANSFORMATION OF HEALTH PROF COUNCILS DEVELOPMENT & IMPLEMENT ORGANISATION DEVELOPMENT PLAN FOR THE NDOH IMPROVEMENTS IN RURAL ALLOWANCES FROM 1 JULY 2003

25. Health Portfolio Committee. April 2003 25 NON-PERSONAL HEALTH SERVICES BUDGET (R’000): 2003/042004/05 2005/06 R60 741 R68 432R68 705 IMPROVE ENVIRONMENTAL HEALTH SERVICES (E.G., USE OF NATIONAL WASTE MANAGEMENT STRATEGY NATIONALLY) EXPAND OCCUPATION HEALTH SERVICES (E.G., INCREASE NUMBER OF MEDICAL BENEFIT EXAMS) EXPANDING HEALTH PROMOTION SERVICES

26. Health Portfolio Committee. April 2003 26 HEALTH & WELFARE BARGAINING COUNCIL & INDUSTRIAL RELATIONS BUDGET (R’000): 2003/04 2004/05 2005/06 R1 770 R2 699R2 861 IMPROVE MANAGEMENT OF EMPLOYEE RELATIONS WITHIN THE NDOH IMPROVE WORKING CONDITIONS OF EMPLOYEES THROUGH PARTICIPATION IN BARGAINING COUNCIL

27. Health Portfolio Committee. April 2003 27 CONCLUSIONS MUCH WORK HAS BEEN DONE BUT MUCH MORE REMAINS FOCUS WILL CONTINUE TO BE ON POLICY AND LEGISLATION DEVELOPMENT BUT INCREASINGLY THE FOCUS WILL BE ON MONITORING AND STRENGTHENING IMPLEMENTATION