Hon House Chairperson, my colleague Minister of Health Dr Zweli Mkhize, Ministers and Deputy Ministers present, MEDs present, our chairperson of portfolio committee hon Dr Siboniseni Dhlomo, members of the committee, hon members of this , ladies and gentlemen, the debate on our Budget Vote takes place just six days before we celebrate Mandela Day, which this year marks 101 years since our icon was born. This is also 25 years since President Mandela led our country into a peaceful transition from apartheid to freedom and democracy. Over and above leading us into the establishment of our democratic state based on constitutionalism and establishing the key institutions which anchors the state, President
Mandela led in focussing on access to basic social services to the most vulnerable in society. In his first 100 days in office he introduced, amongst others, the feeding schemes at primary schools, free health services for children under six years and pregnant women. In his lifetime he also established the Nelson Mandela Children's Fund, and thanks to that initiative we today have a long- lasting memorial for him, the Nelson Mandela Children's Hospital.
Another impactful legacy of our icon is the Nelson Mandela-Fidel Castro Medical Training program which De Dlhomo spoke about earlier on, which is based on a co-operation agreement which he signed with President Castro in 1995. As of today, this programme has contributed 731 South African doctors trained in Cuba and also hundreds of doctors of Cuban nationals who are working in our health services mostly in rural areas. Just last Friday on 5 July, seven days ago, we witnessed the graduation of 87 young doctors conducted by the rector of the Medical University of Havana at Walter Sisulu University in Mthatha. The overwhelming majority of these graduates are serving in rural areas. One of the graduates of this program is Dr Lindiwe Sidali. She is the first black African female cardiothoracic surgeon operating at lnkosi Albert Luthuli Hospital in KwaZulu-Natal. She comes from rural Eastern Cape in Idutywa, and like many other families in the rural areas they migrated with their
mineworker father to Wonderkop in the North West near Rustenburg where she grew up and matriculated. If it was not for this programme Dr Lindiwe Sidali would have never a medical doctor not to mention a cardiothoracic surgeon.
We are currently in the process of bringing back 647 students to complete their integration. They will start the programme from 20 July and the last to start will be on 1 August. The two groups of these students have already landed and the second group has just landed yesterday at O R Tambo through an SA Aairways chartered flight from Havana. The last group will land on 15 July
The Cuban trained doctors will add a lot of impetus into the improvement of our health human resources with a major focus in primary health Care. They are going to be our building blocks on capacitating primary health care services in districts.
As we have stated many times nurses are the bedrock on which our health services are built. The process of restructuring nursing education is at an advanced stage. All public nursing colleges have been restructured into one main nursing college per province with subcampuses in the districts with a total of 76 subcampuses in the whole country.
Three national curricula were finalised and used to develop province specific curricula. The new three-year Diploma in Nursing as well as the one-year Advanced Diploma in Midwifery and selected postgraduate diplomas have been prioritised by all colleges. These programmes will be offered in a phased approach commencing with the three-year basic nursing diploma at the beginning of next year, January 2020. Prioritisation is aligned to the primary health care, re-engineering agenda and also to other national priorities. The Department of Higher Education is in the process of developing regulations for declaring nursing colleges as higher education colleges in terms of The Higher Education Act. These regulations will specify that nursing colleges, while established under the Higher Education Act, Act 101 of 1997, as amended, will operate under the administrative oversight and management of the national Department of Health. In terms of a protocol to be signed by the two directors-general, DGs, this will make possible for transitional mechanisms through which these colleges will be able to operate as of the beginning of next year even when the regulations might not have been concluded. The nine provincial colleges and campuses will commence with the diploma as I have mentioned earlier. Further other campuses will also start with other postgraduate diploma in critical care, trauma and other specialised postgraduate diplomas starting in 2021.
Hon Chairperson, noncommunicable diseases continue to outstrip infectious diseases in our country as illustrated by the report from the Statistics SA. A huge chunk of these deaths are due to cardiovascular diseases, strokes and diabetes. But cancer has also been a rising epidemic. These developments can be attributed to urbanisation, commercial determinants of health, risk behaviour such as tobacco use, harmful use of alcohol, unhealthy diets and lack of physical exercises. The challenge of noncommunicable diseases, NCDs, is also not just local, but global and as a result, in September 2018 a high level meeting of the UN General Assembly was convened by the Secretary-General, and our own President Ramaphosa was one of those who attended and we were also there as the Ministry and department to give support and to attend various parallel sessions and also civil society sessions.
The General Assembly passed a political declaration which amongst others expressed concern at financial and human cost of NCDs especially in developing countries which was estimated at over $7 trilion US dollars over the next 15 years. The assembly reaffirmed the primary role of governments in responding to the challenge by developing adequate national multisectoral responses.
Our leaders committed to, amongst others, and I quote:
Strengthen our commitment, as heads of state and government, to provide strategic leadership of prevention and control of NCDs by promoting greater policy coherence and co-ordination through whole of government and health in all policies as approaches and engaging stakeholders in an appropriate, co-ordinated, comprehensive and integrated, bold whole of society action and response.
So, our leaders made very bold commitments. They also committed the acceleration of the World Health Organisation Framework Convention on Tobacco Control without interference by tobacco industry. They also committed themselves to do everything to eliminate marketing of alcohol amongst young people. In this country as a department and also with our stakeholders will take some steps to make sure that this declaration can be a reality. Amongst others a draft legislation on tobacco control was published in May last year to advocates a zero-tolerance policy which will inhibit indoor smoking in public places , including removal of smoking areas in restaurants and bars; introduced regulations to restrict various categories of foodstuffs in terms of level salt; tax on sugar has already been implemented; the DTI is leading together with our department in enhancing visible health warning labels on alcoholic beverages and
also reduce the age of where you can purchase alcohol from 18 years to 21. These are some of the majors which we are taking.
As I have mentioned cancer is also becoming an epidemic, not only in our country but also all over the world. We have taken some steps in this regars. We have lanched a national cancer campaign in October 2018 in KwaZulu-Natal, the province of our chairperson; purchasing s number of linear accelerators to support our major hospitals, especially Charlotte Maxeke and Universitas Academic Hospitals in Bloemfontein; and the human papillomavirus, HPV, vaccine has also been rolled out as a form of prevention for cervical cancer. In the area of mental health, which is part of our noncommunicable epidemic, steps have been taken amongst others to secure more psychiatrists to the private sector to support the public health system, especially in the area of forensic where there is a clocking of the system due to the fact that many lawyers when they represents they put mental illness as part of the defence - this is clocking our system. So, we have to procure more psychatrisits to unlock the system.
In the area of malaria our country has prioritised elimination, and not just reduction of by 2023. We want to make sure that by this time we have zero malaria cases. This is a very strong aspiration.
We have made progress in terms of serouis reduction in incidences of malaria over the last 18 years by 73%. The death rate of malaria has come down by a rate of 74%. But we still have challenges. Amongst the challenges is the migration mobility across the countries of people and mosquitoes - mosquitos don't need passports, they move from one country to another. We have to work with our neighbouring countries and we are doing that with Mozambique, Zimbabwe and eSwatini. Also we want to work with our provinces to make sure that we can do indoor spraying very effectively. There are three in the country which are affected, Limpopo, Mpumalanga and KwaZulu- Natal. We have worked well with the National Treasury to procure an amount of R90 million to support these provinces. I can see our colleagues, the MECs of Limpopo and KwaZulu-Natal are sitting together. I am sure they are planning how to do the inddor residual spraying.
Just a few comments on some of our entities, we have very effective entities within our department. The SA Medical Research continues to produce excellent scientific outputs through the National Research Foundation, NRF-rated scientists including two of the A-rated NRF scientists in the leadership. I can see both of them in the gallery; the chair of the SA Medical Research Council and the CEO are here. Thank you very much.
Just to highlight some achievements, discovered new gene called, CDH2, which predisposes young adults and athletes to sudden cardiac arrest - done and identified with other global collaborators; the national TB prevalence survey with fieldworkers already working in the Eastern Cape; and collaborated with the Agricultural Research Council and a company called Afripex which deals in wellness products to produce a substance which is one of the actives ingridients of Rooibos - I hope you all take Rooibos tea. This product will help in managing cholesterol, blood glucose and insulin resistance. Thanks to the SAMRC for this work. It also Established the Centre for the study of antimicrobial resistance. This is becoming another problem in the country and in the world.
The SAMRC has also received R10 million to assist young South Africans scientists who are studying towards PHDs in clinicalhealth research in the National Health Scholars Program from the Public Health Enhancement Fund, which is a collaboration between us and various private sector companies. This scholarship programme has recently been renamed the Bongani Mayosi National Scholarship Programme, in honour of the late Professor Mayosi.
To comment to the hon member from the FF Plus, one of our entities is the councils for medical schemes which regulate medical schemes.
I want to bring to your attention a very relevant point. The medical schemes industry, in the last financial year, paid out a total of R172 billion to beneficiaries. But also had in reserves R62 billion. When you add these two together it means that the medical schemes were managing a budget in terms of paying claims and also reserves of R234 billion. In the same financial year, the total allocated budgets for national health and also provinces was just R242 billion -a difference of R8 billion. The R234 billion was used to service only 15,5% of the population. That difference of R8 billion accounts for funds which must service the rest of the 48 million South Africans - 85% of the population. The difference between the two budgets is just R8 billion - to service 15% and 85%.
While we must accept that there is a lot, as the Minister has indicated, but there are areas where we can be able to make savings. But the fact of the matter remains that this skewed funding cannot be sustainable; it can't work. Nowhere in the world can this be sustainable. That's why the universal health coverage is a key so that there can be equity in the ways funds are utilised for health services. [Time expired.]
Hon Chair, the national Health department is ready to implement the universal health coverage. We are ready for the "Thuma mina" [Send me] and we are ready for "Khawuleza" [Hurry up].