SPEAKING NOTES FOR MINISTER OF HEALTH HON. DR ZWELINI MKHIZE

THE ROTARY FAMILY HEALTH DAY EVENT

Wednesday, 14 October 2020

  • Programme Directors, Dr Nonhlanhla Makhanya and Dr Thembisile Xulu,
  • Deputy Minister of Health the Honourable Dr Joe Phaahla
  • Director General Department of Health Dr. Sandile Buthelezi
  • CEO of Action Group for Family health and AIDS Prevention, Ms Sue Paget
  • Deputy Chairperson of SANAC, Ms Steve Letsike
  • Executive Stakeholder Manager SANAC Rev. Zwoitwaho Nevhuthalu
  • Country Director for Center for Disease Control and Prevention, Dr John Blandford
  • Global Rotary CEO, Dr Ian Burton
  • Chairperson of the SABC Mr Bongumusa. Makhathini
  • Rotary International President Elect Mr Shekhar Mehta
  • Members of the Media
  • Partners, Colleagues, Ladies and Gentlemen

Today marks the beginning of the 7th annual Rotary Family Health Days’ outreach programme- a massive humanitarian community health initiative that began in 2012. I am honoured to launch this programme for 2020. This programme achieves the goals of primary health care through public private partnership which aims to provide an enabling environment for communities to proactively seek health and be afforded the opportunity to practice preventative health care.

 

The timeliness of this year’s programme could not be more critical as we emerge out of the COVID-19 surge and refocus our energy towards the attainment of Universal Health Coverage. As a programme that has established a broad footprint in our communities, we as the Department of Health welcome this opportunity to kickstart a campaign of rebuilding rapport with our community members and attracting them back to our facilities to test for and manage various conditions such as HIV, TB, hypertension, diabetes and cancer.

 

Prior to COVID-19, we were already facing a triple burden of HIV, TB and non-communicable diseases. However, just as we were making inroads through various programmes that sought to implement the tenets of National Health Insurance, at least in practice if not in law, the COVID-19 storm descended upon as and disrupted the inroads we were making in building confidence in the health reform.

 

We have quantified these disruptions and I would now like to take this opportunity to share with the public: we are aware that, due to the combination of lockdown regulations and the fear of contracting COVID-19 in facilities, our people shied away from seeking what may have been deemed to be non urgent or non essential health services. We are very concerned by the significant declines in numbers of patients who sought medical assistance for the common conditions we have outlined above: Between April and June 2020 HIV testing fell by 46%; and medical male circumcisions had to be suspended and resumed on July 1 2020. Screening for TB fell nationally by 9% for adults and 14% for children; and Primary Health Care utilization rate by children (for example access to immunization) fell by 20%. But not only that COVID-19 has wreaked havoc on the socioeconomic situation across the country- increasing inequalities and causing acute suffering and a humanitarian crisis.

 

It is therefore imperative that we embark on an aggressive “catch-up” drive to ensure that we capitalize on the infrastructure gains made during the COVID-19 pandemic and get our people back to our facilities and our services back into the communities to continue the good work that was being done as we moved towards the attainment of Universal Health Coverage through our National Health Insurance.

 

As you may be aware, on the 12th December 2012, the United Nations unanimously endorsed Universal Health Coverage as a pillar of sustainable development and global security. These commitments were sealed in political solidarity at the High Level Meeting on Universal Health Coverage during the United Nations General Assembly of September 2019

 

The principle behind Universal Health Coverage is that no one should be denied access to quality health care because of socio-economic circumstances- whether it be of the individual, or the state- we must not leave anyone behind

 

Prior to the COVID-19 pandemic, COVID-19 saw us making great strides towards the implementation of NHI- we had introduced the Bill to Parliament in July and the public hearings had been concluded towards the end of 2019, with the vast majority of South Africans welcoming the public health reform as a long overdue intervention to eliminate the current unjust two-tiered system. Just as we were to begin the Parliamentary hearings, a storm brewed in China with the winds blowing in our direction, forcing us to avert our gaze from those goals and attend to a global health disaster.

However, we were determined not to let the proverbial crisis go to waste, ensuring that we took every opportunity to adopt the mechanisms and proposals contemplated in the Bill to manage COVID-19 and stay on the path towards Universal Health Coverage.

May I therefore take the opportunity, to revisit the principles of the NHI and I hope that there will now be more familiarity in our experience during the COVID-19 surge.

 

The NHI is a health care financing system that is designed to pool funds such that there will be one national purchaser of health goods and services for all South Africans. There will be no distinction between a private or a public facility and every South African will expect to receive the same standard of care regardless of their social standing. All South Africans will share the responsibility of financing the system and we will cross-subsidise one another in an exercise of social solidarity- those who are young, healthy and working will contribute towards the fund for the benefit of those who are too elderly, sick or disabled to be able to work. This is the principle that operates globally.

 

We are currently working on a package of primary health care services that will be provided under the NHI. Our starting point is to ensure that all services currently provided in the public sector are included. We are also working with the Council for Medical Schemes (CMS) to ensure that every medical scheme pays for the same package of primary health care services as that provided by the public sector – this is part of the process to revise the prescribed minimum benefits that the CMS is working on.

Programme Director, let us reflect on government`s partnership with the Rotarians and how it neatly dovetails into our ambitions of attaining Universal Health Coverage.

The main objective of our partnership is to provide an enabling environment for health seeking behaviour. This objective is usually realised through bringing services to the people in an outreach format over 3 days. In addition, the Rotarians are well known for their fight against Polio and for the promotion of immunisation of children. And we must say we appreciate the contribution to the point where Africa has been certified as free of Polio.

 

These services are available in public health facilities for free on a daily basis. Today I would like to call on all individuals, families and communities to take this opportunity and go to their nearest health care facility to screen and test for HIV, TB, high blood, sugar and other ailments. If you do test positive for HIV, or screen positive for TB, STIs, or non-communicable diseases, you will be able to treat these illnesses early and enjoy good quality of life despite the diagnosis.

 

We therefore urge that if you are started on treatment for any chronic condition during this programme, that you continue to use the services that government has made available for you so you do not become sick or disabled. This is why we came up with the campaign called Cheka Impilo (Know Your Health Status). This campaign is designed to remind you that the power of healing in in your hands and that we are here to reach out, guide and assist you in every way so you can reach your full life potential.

 

As we approach World AIDS day, we need to remind ourselves that HIV/ AIDS is still a pandemic in this country, more threatening than COVID-19. Therefore, I believe we all know why testing for HIV is so important! Firstly, knowing one’s HIV status will assist in management of the disease if one is HIV positive. You can get treatment and live a long and healthy life. Also, if one is HIV positive, one should take care not to transmit the virus to others, by adhering to their medication in order to stay virally suppressed. Last year, we introduced a wonderful new drug called TLD which is much better tolerated and supresses the virus even quicker. If you take your treatment well without defaulting, you will remain virally suppressed with a strong immune system and this plays a crucial role in protecting you from contracting other diseases, including COVID-19. I must say that in the who clinician community in South African we were really concerned about the prevalence of HIV as a potentially dangerous co-morbidity for COVID-19 but we have not seen a significant impact of co-infection of HIV and novel Coronavirus and we look forward to research that will explain why we have been relatively spared in this regard.

 

Furthermore, consistent and correct use of male and female condoms will also reduce HIV transmission. Both male and female condoms, MAX and MAXIMA, and a compatible lubricant, are distributed for free in public health facilities and non state facilities so there is no excuse for not using a condom. In addition to condoms please continue to reach out to public health facilities for other sexual reproductive health interventions such as other contraceptives, ante-natal Clinics, and counseling for Termination of Pregnancy.

 

As I alluded to earlier there was a noticeable decrease in caretakers and children seeking health care because of lockdown or fear of contracting COVID-19. South Africa is one of the countries that is recognised globally for the expanded programme of immunization which contributed to the reduction of childhood diseases such as pneumonia and diarrhoea and the elimination of Polio, of which we have been recently certified. So once again, I call all on mothers, fathers, grandmothers, grandfathers and caretakers not to fear our facilities and ensure that your children are taken for immunisation.

 

I implore our nurses and doctors to warmly welcome all children who may have missed their immunizations during the lockdown period so that no-one is deterred from visiting the facilities to catch up their immunizations.

 

We remind caregivers that it is very important to always have the child’s road to health booklet (also called the clinic card) when you go to the facility, so we can track the progress of your child and quickly pick up any failure to thrive.

 

A full package of services for women, which includes contraceptives, cervical cancer screening (PAP smear) and testing for pregnancy, are also available.

 

For brothers and fathers out there we also provide Medical Male Circumcision (MMC) for free in facilities and selected sites. We know from research that men who are circumcised are less likely to contract HIV by 60%. However, this does not render you immune to contracting HIV and other sexually transmitted infections. This is why we still recommend consistent and correct use of condoms even in circumcised men every time they have sex.

 

The Rotary family health days have contributed to the 90-90-90 targets through provision of outreach testing and referral to treatment initiation with adherence counseling. Whilst we have reached the target of the first 90 nationally, we will need to prioritize our targeting in other areas and take the services to the people in order to achieve the second and the third targets.

 

To all health care workers, let me take this opportunity to express appreciation for your efforts during one of the toughest public health care eras in history. You have persevered, fought and prevailed- many times going beyond your call of duty to ensure that we emerge victorious and for that I thank you. Along the way, we lost some 247 of our frontline workers in the war against COVID-19: I wish to convey my sincerest condolences to the families, friends, colleagues and communities who lost these precious members of our society. May the souls of our soldiers forever rest in eternal peace and may we never forget the men and women who laid down their lives in the line of duty.

In our midst we have the leadership and ground forces of the Rotary, their partners and our own hard working officers of the Department of Health. I would like to congratulate Rotary and an all those involved in this great people driven initiative. I do hope that we will continue the partnership in the years to come and that next year, your services will not be disrupted by any novel disease- indeed, we believe that through such initiatives we become more adept at handling any public health threat that could present itself in the future. We do hope we will have had access to the vaccine and therefore will have built herd immunity and resumed our normal lives. We remain proud partners and I assure you of my utmost support for you and confidence in the wonderful services that you continue to render for our people.

 

Finally it is my privilege and honour, as delegated by the Honourable Deputy President of the Republic of South Africa, Hon. David Mabuza in his capacity as the Chairperson of the National AIDS Council, to launch the theme for the commemoration of World AIDS Day 2020.

 

The global theme as set by UNAIDS for this year is ‘Global Solidarity, Shared Responsibility.’ It calls for greater solidarity and collective responsibility among nations to take measures that end HIV and AIDS as public health threats. This theme also suggests that, unless we work together for a common good, our efforts will forever be in vain. This is one lesson that we have learnt during COVID-19, particularly as we seek to access vaccines we have made the call that no-one should be left behind.

 

It is against this backdrop that South Africa will commemorate World AIDS Day under the theme, “We’re in this together, Cheka Impilo!”

This is an earnest call to all South Africans to make responsible health choices.

Both the national and global themes acknowledge that the success of any public health system depends on the collaborative effort and a joint responsibility where individuals, communities and authorities work together.

Ending AIDS requires communities to be placed at the centre of the response so they can help address challenges specific to them.

Communities need tailored and targeted interventions and not a one-size-fits-all approach.

As we countdown to World AIDS Day 2020, we call on community leaders, faith based organisations and leaders, traditional leaders, traditional healers, nurses, doctors, pharmacists, allied health professional, mothers, fathers, grandparents, learners, teachers political leaders, businesspeople, teenagers, academics and scholars- all members of society in the roles they play to say: “We’re in this together, Cheka Impilo!”

We can eliminate HIV and AIDS, together.

With that partnership we will be formidable and be able to conquer any challenges we can come across.

I thank you.