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					VOL 10 NO 14                                                                                16 - 22 APR 2010


CONDUCT AND SOCIAL COHESION                                                               WEEK IN REVIEW

                   At the meeting of the ANC’s National Executive Committee last
                   month, we spoke out strongly about the need for discipline among
                   the members of the organisation and more generally for all to          R5 billion set aside for retrenched
                   respect the rules of political engagement. As the organisation’s       workers | The Labour Department
                   leadership we were drawing the line, and that there would be           ministry released a statement
                   consequences for anyone who crossed that line.                         announcing that more than R5.1
                                                                                          billion is set aside to help workers
                  Matters relating to the conduct and statements of the ANC Youth         who lost their jobs during the
                  League which are totally alien to the culture of the ANC have           recession phase. The money will
made it necessary for us to emphasise a few fundamental principles today.                 benefit 700 000 people who are
                                                                                          retrenched, dismissed, on maternity
This is an appropriate moment to do so, particularly since it is the anniversary of the   leave, or ill during the 2010/11
brutal assassination of one of the outstanding heroes of our struggle, Comrade Chris      financial year. Some R42 billion in
Hani.                                                                                     Unemployment Insurance Fund
                                                                                          contributions and R23 billion from
On this anniversary, we recommit ourselves to uphold the values and traditions to
                                                                                          the Compensation fund would be
which he and scores of the country’s national heroes dedicated their lives. We
                                                                                          invested with the Public Investment
commit ourselves to continue working tirelessly to build a non-racial, non-sexist,
                                                                                          Corporation (PIC) in major
united and democratic South Africa, founded on the positive values that are
                                                                                          government and private sector
enshrined in the Constitution.
                                                                                          projects that would create jobs.
We urge all South Africans to work with us in achieving these goals. But ANC cadres
must lead in this process.

                                                                                          Firearm Amnesty | The nationwide
We also wish to underscore the following important points:
                                                                                          firearm amnesty campaign aimed at
FREEDOM OF THE MEDIA                                                                      reducing illegal firearms ended at
                                                                                          midnight on Sunday. Over 32 169
The country’s Constitution enshrines the principle of freedom of the media.               firearms were recovered. Of
An independent and free media is one of the cornerstones of democracy.                    this, 27% were illegal and 53% were
                                                                                          voluntary surrendered. Most of the
It is an important barometer of the extent to which the people are freely able to         guns were from Pretoria and
express themselves.                                                                       Gauteng was second. KwaZulu-
                                                                                          Natal was third and Western Cape
While in a democracy there will inevitably be times of contestation between the           was fourth in the number of firearms
media and other sections of society, the fundamental principles should be adhered         surrendered. A total of 2 500 people
to at all times.                                                                          used the opportunity to licence their
We must accord journalists the freedom to do their work unhindered. We should             firearms under the new act. South
engage them professionally and with dignity. Should there be a need to take issue         African citizens were given four
with anything that is being reported, it should be done in a manner that promotes         months since January to hand in
frank and open engagement.                                                                legal and illegal firearms, and 100
                                                                                          000 firearms were destroyed over
The manner in which a BBC journalist was treated at an ANC Youth League press             and above the recovered firearms.
conference is regrettable and unacceptable, regardless of any alleged provocation
on his part.

We place a high premium on order, stability and the rule of law in the country. That
is why the ruling party took the step this week of calling for restraint from all its
structures and members. Anyone who then goes against that statement is
undermining the leadership authority of the ANC, and that cannot be accepted.
When the ANC has made such a statement, it is totally out of order for us to
continue as if such a statement was not made.

Certainly there must be consequences for such behaviour.
                                                                                           WEEK IN REVIEW
We have done this because of the need to respect a high court ruling relating to a
particular liberation song. We also recognise that this song, in the current
environment, could be misunderstood by those not familiar with the context and
content of our struggle.                                                                   Zuma attended Nuclear Security
                                                                                           Summit | President Jacob Zuma
In making this call, we do not intend in any way to diminish the proud history of
                                                                                           concluded his two-day state visit to
struggle against apartheid. We do recognise that we have a responsibility to act in a
                                                                                           Washington DC. Zuma held a
way that reduces the potential for tension, and encourages unity.
                                                                                           bilateral meeting with US President
Our Constitution enshrines the independence of the judiciary and the rule of law.          Barack Obama at the US president’s
                                                                                           guest house, Blair House. The
We must recognise the role of the judiciary as the final arbiter in disputes in society.   summit covered a number of
The dignity and decorum of the institution must always be protected and defended.          bilateral issues, including nuclear
                                                                                           security, strengthening co-operation
There are procedures that one should follow to challenge court decisions.                  on areas like agriculture and HIV
Defiance of these procedures should not be tolerated. It would make mockery of our         and AIDS. The United States and
judicial system. It should be noted that to appeal a court decision is not to defy it.     South Africa signed a deal to boost
                                                                                           diplomatic exchanges, and the two
ZIMBABWE                                                                                   countries will work on areas such as:
                                                                                           health, education, food security,
South Africa is a respected member of the international community. The country has
                                                                                           public security, commerce,
certain responsibilities and obligations in the regional and broader international
                                                                                           investments, energy and nuclear
One of these is to facilitate the implementation of the Global Peace Agreement in          They also discussed the promotion
Zimbabwe. We undertake this task with the necessary seriousness and sensitivity,           of Africa peace and security within
and have to ensure impartiality at all times. We will continue to facilitate the           the ambit of the African Union and
resolution of the impasse in Zimbabwe and to treat all parties with respect.               United Nations. Obama praised
                                                                                           South Africa for voluntarily
We cannot and will not side with any one of the parties to the exclusion of others.
                                                                                           dismantling its nuclear weapons
We received a report from the last round of talks held last week. We will work with
the parties again to take the process forward.
The 21st of April will mark the 50 days until the start of the 2010 FIFA World Cup.                          th
                                                                                           Zuma attends 4 IBSA Summit in
Initial research indicates that South Africa is likely to receive 450 000 international    Brazil | President Jacob Zuma is on
fans between June 11 and July 11.                                                          a visit to Brasilia, Brazil to attend the
                                                                                           India-Brazil-South Africa Dialogue
South Africa remains ready to receive visitors from all walks of life and from all parts   Forum (IBSA) Fourth Summit.
of the globe. We are now putting final touches to our plans on security, logistics,        Business delegations from Brazil,
hospitality, transport and others.                                                         the Russian Federation, India, China
We urge international soccer fans to continue buying tickets and to prepare                and South Africa are expected to join
themselves to enjoy South African hospitality and experience the first African World       together to discuss issues related to
Cup ever.                                                                                  commercial interests of these major
                                                                                           emerging economies with a view to
SOCIAL COHESION AND UNITY                                                                  further integration and strengthening
                                                                                           their commercial ties. South Africa
Recent events have raised concerns in some quarters about social cohesion. Some
                                                                                           participates in the IBSA Summit
people have spoken of heightened racial tension. We should not be dismissive of
                                                                                           within the context of deepening
such concerns, and should be prepared to engage in dialogue to address them.
                                                                                           South Africa cooperation as one of
But we must acknowledge that South Africans remain united in their support for the         the mechanisms to advance the
Constitution, the values it enshrines, and the democratic institutions it has              interests of the developing countries
established.                                                                               on the global stage. The 5th IBSA
                                                                                           Summit is expected to take place in
South Africans are clearly committed to work together to address the legacy of our         South Africa in 2011.
divided past.
Our history tells us that there is no challenge we cannot overcome. Among other
things this requires responsible leadership. The ANC Youth League is not an
independent body. It exists within the umbrella policy and discipline of the ANC.
The organisation will deal with these matters internally as it deems fit. We reiterate
that leaders should think before they speak, as their utterances have wider
implications for the country.

                                                                                             WEEK IN REVIEW
We should spare no effort in
pursuit of peace and security                                                                Fifa launch World Cup tickets
                                                                                             cash sales | FIFA released a
                                                                                             statement announcing that South
                                                                                             African fans will be able to buy 500
                           The African National Congress was re-elected into power           000 unsold World Cup tickets in
                           in the last general election on the basis of its strong           cash. The decision came after Fifa
                           commitments to the people. Amongst these it was the               agreed to drop a ruling that they
                           resolve to combat serious and violent crime by being              could only be bought online or
                           tougher on criminals and organised crime syndicates.              through a ballot procedure. The final
                           In this regard, we will continue to increase the capacity of      phase of sales for the month-long
                           the South African Police Service through recruitment,             tournament beginning in June will
                           rigorous training and better remuneration. The culture of         see ticket selling points in shopping
                           human rights and the importance of upholding the law will         malls in the nine host cities plus a
                           at all times remain part of the training in the police college.   network of popular supermarkets.
                                                                                             Tickets are available for all 64
                           In December 2007, the ANC held its 52nd National                  matches except the final. Thousands
                           Conference in Polokwane, Limpopo. It highlighted the              of people queued outside Fifa
                           necessity of taking a tough stance against crime and              ticketing offices across South Africa
                           criminality, and the central role of communities in realizing     on Wednesday night and on
this objective.                                                                              Thursday morning, hoping to get
                                                                                             their hands on tickets for World Cup
The ANC-led government is accordingly taking a tough stance on the fight against
                                                                                             games. President Zuma thanked
crime. To realize these objective, certain steps have been undertaken amongst
                                                                                             thousands of soccer fans for their
these is the transformation of the police ranks to ensure clear lines of command and
                                                                                             concerted effort towards making
control and to instill a sense of discipline amongst the members.
                                                                                             Africa's 2010 World Cup a success.
This transformation should not be viewed in isolation of the other pillars of our
strategy - that is - strengthening partnerships with communities to make life difficult
for criminals to operate in our areas; utilising intelligence as a nerve centre of
policing; strengthening the legislative framework of the Independent Complaints              Sudan elections | Sudan held its
Directorate, the Civilian Secretariat for Police and the review of the entire criminal       landmark multi-party elections in 24
justice system.                                                                              years from 11 April to 15 April 2010 .
                                                                                             The Sudanese elections entailed:
It is important to emphasise that the change in police ranks is an operational matter
                                                                                             national presidential and
and has no constitutional implications. Section 199 (1) of the Constitution talks of a
                                                                                             parliamentary, the south Sudanese
police service, and so does Polokwane and other prior resolutions. Section 207 (1)
                                                                                             presidency, state governors, the
of the Constitution speaks of the National Commissioner. And, this will continue to
                                                                                             southern parliament and state
be so.
                                                                                             assemblies. The election brings
There is, therefore, no desire from anybody to tamper with the policy underpinnings          to an end the transitional period
that inform our approach to policing. The issue of how we mobilise and galvanise the         which began when the decades-long
material and attitudinal resources of the police to help to enhance discipline, instil       second Sudanese Civil War ended in
confidence and resolve, and uplift the morale within the ranks does not, and should          2005. The elections were extended
not be interpreted to mean or suggest a policy reorientation.                                from the original end date of 13 April.
It should furthermore be noted that when we, in the very early stages of our
democratic transition, spoke of demilitarisation of the police, we meant not only
rankings, but more importantly the issue of structures, equipment, and even uniform.
At the centre of this perspective, was the need to lay the foundation for community
policing, improved accessibility and accountability to the public.
Again, none of these fundamental aspects will be affected by the change in ranks.
The ANC-led government is consolidating partnerships across society, mobilising
our people to make life difficult for criminals in our midst in order to ensure that we
advance our cause to achieve the values of a caring society.
The Polokwane resolution on local police services refers to municipal and others, as
force multipliers. The use by conference, as well as ourselves, of the word ‘force’, is
not indicative of a particular preference of violence as a means to resolving
challenges, but a mere acknowledgement of the substantial content of the work of
the police. Our legal framework too, speaks of minimum and maximum force in
relation to the work of the police.
It should also be remembered that police use reactive force, only as a means to
suppress the violence generated by society against itself. The narrow and
unfounded assertion that a change in ranks could automatically lead to a decline in
crime is not part of our perspective. We are not naïve to think that criminals, by mere
sight or mention of an officer’s rank, will feel a cold shiver down their spines.

The prevalence of firearms and the widespread readiness to use them, together with
the availability of military expertise amongst criminals, have completely changed the        LATEST STATEMENTS
nature of crime in South Africa. Informed by practice, new and effective ways have
to be found.
It is either the police maintain a capability to meet this threat or, at some stage, as it   Joint ANC - COSATU media
was called for during 2006, the military would need to be called in. We must agree           statement
that using the military in a policing role in a democracy is something that should be        13 April 2010
avoided. A tactical and calculated physical, morale and skills-driven toughening of
the police appears to be a better and necessary option.                                      =ancdocs/pr/2010/pr0413.html
In the past the security forces including the police, were used deliberately to violate
human and civil rights. They were primarily used to defend the apartheid system. In
those days governance was largely defined by a national security doctrine with little
respect for the rule of law or constitutionality.                                            ANC welcomes World Bank
                                                                                             decision on Eskom
The use of force was a defining feature of the apartheid state, a state created as a         09 April 2010
social organisation directed against the majority of its people. The authoritarian 
nature of the apartheid state meant that it became more isolated, more corrupt and           =ancdocs/pr/2010/pr0409.html
more dependent on extra-judicial measures to sustain itself.
Under the apartheid system there were no institutions such as those referred to in
Chapter Nine of our Constitution, which are the State Institutions supporting
Constitutional Democracy. Section 181 of the Constitution deals with their                   ANC welcomes President Zuma
establishment and clearly lays out the governing principles of these institutions.           leadership in the fight against Hiv
                                                                                             and Aids pandemic
Section 181,1 lists all the institutions that are established under this clause. Sections    08 April 2010
181; 2, 3 and 4 give directives as to how Chapter Nine Institutions should conduct 
themselves, as well as other institutions of state be it Police, the Defence Force or        =ancdocs/pr/2010/pr0408b.html
any other organ of the democratic state. Furthermore the Constitution enjoins any
organ of state to assist these institutions in the fulfillment of their mandate. No
person or organ of state, police included, may interfere with their functioning.
These institutions are for the members of the public who may feel aggrieved by the           ANC condemns untoward
conduct of government or its agencies. Since 1994 these institutions have done               behaviour towards journalists
sterling work in defending and advancing human rights. They act as checks and                08 April 2010
balances against abuses by the state.                                              
Chapter two of our Constitution, Section 7; 1 and 2 states the following:
"This Bill of Rights is a cornerstone of democracy in South Africa. It enshrines the
rights of all people in our country and affirms the democratic values of human
dignity, equality and freedom. The state must respect, protect, promote and fulfil the
rights in the Bill of Rights."
Change, whether good or bad is bound to create a certain level of unease in society.
However, this natural unease is no justification for engaging publicly without first
grasping the objectives of proposed changes. Such behaviour is, sadly, common
amongst political opposition parties and some so-called ‘analysts’ and ‘experts.’
These ‘analysts’ and ‘experts’ have apparently taken a conscious decision to ignore
the institutions and measures that are there, or are being consolidated to ensure that
there are no human rights abuses by the members of the police or any other
government agency. For instance, we will before the end of June 2010 be tabling in
Parliament two pieces of legislation that are aimed at strengthening the Independent
Complaints Directorate (ICD) and the Civilian Secretariat for Police.
The new draft legislation on the ICD to be tabled in Parliament, amongst others,
changes the line of reporting, from the National Commissioner of Police to the
Minister of Police. The heads of the ICD and the Civilian Secretariat for Police have
been upgraded to the level of Deputy Directors General. This is done to attract the
right caliber of people to lead these institutions.
Some have likened the introduction of the rank structure to reversing our democratic
gains. If indeed being tough on criminals and crime in general, if improving our
capacity and instilling a sense of discipline is a return to the apartheid past, then
heavens help us all!
It has been observed that a police officer in South Africa has an eight times higher
probability rate of being killed than his counterparts in other parts of the world. In the
United States in 2005, 51 police officers were killed out of the total force of 700 000,
in the corresponding period in South Africa 95 out of 120 000 officers were killed.

There are many similarities between the Military and the Police forces. Among these
are the following:
Like the Military, the Police are vested with coercive powers, including the power to
use deadly force. The police, like the military, are exposed to dangerous working
conditions and have a type of organisation and discipline, very similar to that of the
military, which enable them to control their coercive powers and to survive in
dangerous conditions.
The police, like the military represent the right of the collective to use force against
an individual in pursuit of the common good. What they are allowed to do is at the
core of our understanding of democracy.
In recent years police have introduced a street survival course for all its members
outside of the specialized units, involving more advanced training in the use of
firearms and the handling of dangerous situations.
The re-introduction of the rank structure seeks to raise the consciousness of the
members of the police force by appealing to higher ideals and values such as liberty,
justice, equality, peace and humanitarianism, all of which are threatened by crime.
Alone, the issue of ranks cannot constitute militarization. One can call the
management of police by any other name, what is important however, is the
orientation of the police. We should instil a sense of pride in being a member of the
Police Service. The police must transmit to themselves and the public a sense of
mission and purpose.
Rank is an essential element of police supervision and leadership, enabling
individuals in each rank to form a homologous group. The basic mission for which
police exist is the prevention of crime and maintenance of law and order.
Section 205.3 of the Constitution places crime prevention on the shoulder of the
SAPS. It states the following:
"The object of the police service are to prevent, combat and investigate crime, to
maintain public order, to protect and secure the inhabitants of the Republic and their
property, and to uphold and enforce the law."
In the process of transformation, we have put more emphasis on managerial aspects
of the police at the expense of command and control. The police will remain
demilitarized, however, there is a need to instil a sense of urgency in the members.
And, without a clear sense of the chain of command, field accountability is at risk.
It is critical in South Africa that a national effort be undertaken to re-train and create
an appropriate police service in line with the values in the Constitution, more
specifically, respect for human rights, appropriate restraints in the use of force and
violence, development of the institutional culture of public service, non-racialism,
gender sensitivity, and to ensure that policing resources are allocated on a fair and
more equitable basis.
The police must enforce their code of conduct, to give practical expression to the
primacy of non-racialism, non-sexism, democracy, justice and peace.
>> Nathi Mthwethwa is an ANC NEC member and Minister of Police

                                                                                             LATEST SPEECHES
We are on course towards
improving the health profile of all                                                          Opening remarks by the Deputy
                                                                                             President, Kgalema Motlanthe, on
South Africans                                                                               the occasion of a working visit to
                                                                                             14 April 2010
                          I wish to start by paying tribute to a gallant son of the soil -
                          Dr Molefi Sefularo, former Deputy Minister of Health, who
                          passed away on 5 April 2010.
                          I have personally known Comrade Sefularo for over 30
                          years, as a comrade in the struggle for the emancipation of
                          the people of South Africa, as well as a colleague, friend         Address by President Jacob Zuma
                          and a fellow student and subsequently fellow medical               on the occasion of the Jacob
                          practitioner. He was a highly talented, gifted and astute          Zuma Education Trust Gala
                          person, who was always humble and easy to work with.               Dinner marking his 68th Birthday
                                                                                             hosted by the Leon H Sullivan
                          The late Dr Sefularo was a stalwart in the mammoth task of         Foundation Mandarin Hotel
                          liberating this country from the bondage of oppression and         13 April 2010
                          inequality, as well as in the transformation of the health
                          sector to an accessible, equitable system, providing quality       =ancdocs/speeches/2010/sp0413a.h
                          services to all South Africans. He was passionate about            tml
                          communities and their welfare and was particularly
                          interested in ensuring that we strengthen primary health
care in our country.
Amongst many other projects, the late Deputy Minister of Health worked tirelessly to         Statement by His Excellency
ensure the health sector’s readiness for the 2010 FIFA World Cup. Our health                 Jacob Zuma, President of the
services are ready to provide comprehensive health services to hundreds of                   Republic of South Africa, on the
thousands of football fans from the 31 nations that will visit our shores in June 2010,      role of the International Atomic
as well as fans from our own country. Dr Sefularo dedicated his time and energy to           Energy Agency (IAEA) in Nuclear
visiting all our health facilities in the cities where World Cup games will be held to       Security
ensure that we were indeed ready.                                                            13 April 2010
He has fought a good fight; he has finished the race and he has kept his faith. What         =ancdocs/speeches/2010/
is left is for us to honour him by dedicating ourselves to completing the work. Our          ml
deepest condolences to Mrs Kgomotso Sefularo, the children and the extended
This year marks the second year of implementation of our 10-point programme for
transforming the health sector into a well functioning health system capable of              ANC Treasurer-General, Dr
producing improved health outcomes.                                                          Mathews Phosa, speech at the
                                                                                             Chris Hani Memorial Service
The 10-point programme consists of the following priorities:                                 10 April 2010
         Provision of Strategic leadership and creation of a social compact for better
         health outcomes                                                                     =ancdocs/speeches/2010/sp0410b.h
         Implementation of National Health Insurance (NHI)
         Improving quality of health services
         Overhauling the health care system and improving its management                     Oration of the Deputy President,
                                                                                             Kgalema Motlanthe, at the Funeral
         Improved human resources planning, development and management                       Service of Dr Molefi Sefularo
         Revitalisation of infrastructure                                                    10 April 2010
         Accelerated implementation of the HIV and AIDS and Sexually Transmitted             =ancdocs/speeches/2010/sp0410a.h
         Infections (STI) national strategic plan 2007 to 2011 and increased focus           tml
         on TB and other communicable diseases
         Mass mobilisation for better health for the population
         Review of the drug policy                                                           Opening Remarks by the Deputy
         Strengthen research and development                                                 President, Kgalema Motlanthe, at
                                                                                             the 6TH South Africa-Germany
                                                                                             09 April 2010

A solid foundation has been laid for the attainment of the goals we have set
ourselves in the 10-point programme. It has been endorsed by a wide range of key
stakeholders in the health sector, including trade unions; medical associations;
nursing organisations; most of the private health sector, and indeed non-
governmental organisation (NGOs) and civil society. It also received support at the
Public Service Summit held from 10 to 12 March 2010.
In his State of the Nation Address, President Jacob Zuma emphasised the need to
fundamentally transform the health system and listed health as one of five key
priorities of government.

The health situation in the country that requires our collective and sustained
         Life expectancy in South Africa has declined. For the period 1985-1994,
         Statistics South Africa estimated life expectancy at birth at about 54,12
         years for males and 64,38 years for females. In 2009, Statistics South
         Africa estimated life expectancy at 53.5 years for males and 57.2 years for
         Maternal mortality and child mortality rates are unacceptably high.
         South Africa carries a significant burden of disease from HIV and AIDS and
         South Africa has a predominantly curative health system that places less
         emphasis on disease prevention and health promotion. Over the last 10
         years, there was an inadvertent shift of emphasis from primary health care,
         which was adopted by the first democratic government as the foundation of
         our health service delivery system, towards a predominantly curative health
         Ineffectiveness of the health system and provision of poor quality of health
         services. This has led to many people wrongly but increasingly believing
         that private health care is the only way possible towards meeting the health
         care needs of our country.
Clearly decisive, systematic and quantifiable interventions must be implemented to
address these adverse trends. In response to this a set of concrete outcomes that
must emerge from our interventions to transform the health sector over the next four
These can be classified into four broad categories namely:
         Increasing life expectancy
         Combating HIV and AIDS
         Decreasing the burden of diseases from (TB) Tuberculosis
         Improving health systems effectiveness, by strengthening Primary Health
         Care and reducing the costs of health care.
Based on these four broad categories mentioned above, the health sector needs to,
during the period 2010 to 2014, produce the following 20 outcomes:
         Increased life expectancy at birth
         Reduced child mortality
         Decreased maternal mortality
         Managing HIV prevalence and improving the quality of life of people living
         with HIV and AIDS
         Reduction of new HIV infections
         Expanding access to the Prevention of Mother to Child Transmission
         Improved TB case finding
         Improved TB treatment outcomes
         Improved access to antiretroviral treatment for HIV-TB co-infected patients
         Decreased prevalence of drug resistant TB
         Revitalisation of primary health care
         Improved physical infrastructure for healthcare delivery

         Improved patient care and satisfaction
         Accreditation of health facilities for quality
         Enhanced operational management of health facilities
         Improved access to human resources for health
         Improved health care financing
         Strengthened health information systems (HIS), including strengthening
         information, communication and technology (ICT)
         Improved health services for the Youth
         Expanded access to home based care and community health workers.
The key policy priorities for the health sector for 2010/11 to 2012/13 will strengthen
our ability to meet the health related Millennium Development Goals (MDGs). Our
Maternal Mortality Ratio (MMR) must decrease from the estimated 400-625 per
100,000 to 100 or less per 100,000 live births over the next four years. We will
implement a number of interventions to achieve this, including:
         Increasing access to health care facilities, including possibly the provision
         of waiting mothers homes
         Increasing the percentage of pregnant women who book for antenatal care
         before 20 weeks gestation
         Increasing the percentage of maternity care facilities which review maternal
         and perinatal deaths and address identified deficiencies
         Enhancing the clinical skills of health workers and improving the use of
         clinical guidelines and protocols.
We have also developed strategies to enhance our Prevention of Mother to Child
Transmission (PMTCT) programme, to ensure that by 2014/15, less than five
percent of babies born to HIV positive mothers are HIV positive. These include the
integration of antenatal care and HIV and AIDS services, so that our people do not
have to travel from one health facility to another to access each of these services. In
fact, the Executive Director of United Nations Programme on HIV and AIDS
(UNAIDS), Michel Sidibe has asked all countries to implement plans to "virtually
eliminate mother to child transmission of HIV". We are determined to achieve that no
child should be born HIV positive.
Our child mortality must decrease from the current 69 deaths per 1,000 live births to
not more than 30 to 45 deaths per 1,000 live births. The health sector will continue to
ensure that children less than one year of age are fully vaccinated against
pneumococcal infection and rotavirus. International evidence has shown this to be
an effective intervention in ensuring child survival, together with other key strategies.
Other key interventions to improve child health will include:
         Increasing the percentage of eligible infants receiving treatment for HIV and
         Increasing the percentage of mothers and babies who receive post-natal
         care within six days of delivery
         Increasing the proportion of nurse training institutions who teach the
         Integrated Management of Childhood Illnesses (IMCI) so that we have
         more nurses able to implement IMCI in our primary health care facilities;
         Increasing the proportion of schools which are visited by a School Health
         Conducting health screening of learners in Grade 1 in poor schools.

We need to prepare to deal with H1N1 influenza as we are entering the winter
season. Unlike last year when we did not have a vaccine, the good news is that we
have been able to secure vaccines this year but regrettably not sufficient for           UPCOMING EVENTS
everybody within our country. Following advice from the World Health Organisation
and our own experts, between 05 and 30 April 2010 we will prioritise for vaccination
against H1N1 the following:
                                                                                         Reburial of comrade Leslie
         80,000 children under 15 years of age who are living with HIV and AIDS          Massina on Saturday, 17 April
         10,000 officials at our ports of entry
                                                                                         The funeral will take place as
         700,000 pregnant women                                                          follows:
         1 million adults with HIV and AIDS who receive treatment at our ART clinics
         900,000 people with chronic heart and lung diseases.                            Rhema Ministries, Cnr Rabie and
                                                                                         Hans Schoeman Streets, Randpark
During this month we will also have a national Measles and Polio Vaccination             Ridge, Randburg
Campaign. I officially launched this campaign at the Benoni West Primary school on
13 April 2010, it will end on 28 May 2010. Our target is to vaccinate 15 million
children between the ages of six months and 15 years against measles and to              Graveside: Westpark Cemetery
vaccinate 5 million children under five against polio.
You are requested to assist the Department of Health by educating our people about       Time: 11h00
the importance of immunization against these diseases. We have the means to
eliminate measles and polio this means having a fully immunised community now
and in the future.
We must increase our TB cure rate from the current 64 percent to 85 percent by
2014/15. Based on a review of TB control programme led by the World Health
Organisation, we have developed concrete and clear strategies, in each province, to
strengthen this programme.
We will train 3,000 health workers in the management of TB. We will also expand
our TB DOTS programme and train 2,500 community health workers as DOTS
supporters. This will assist in reducing the defaulter rate of TB patients from the
current 8,5 percent to less than 5,5 percent by 2012/13.
A key strategy to strengthen TB control is social mobilisation. Working together with
the Desmond Tutu TB Centre and other development partners, we have developed
a social mobilisation campaign called ‘Kick TB 2010’. This campaign builds on the
excitement generated by the 2010 FIFA World Cup and aims to help to combat TB
and the stigma associated with it, by linking it with soccer.
The campaign will target approximately 250,000 learners who will be drawn from
diverse schools and backgrounds, across all nine provinces, to be ‘agents’ for TB
control and management. Each participating learner will receive a specially designed
soccer ball with TB appropriate messages that will educate and inform the
community about TB, its symptoms and treatment.
As announced by President Zuma on World AIDS Day in December 2009, we
started on 1 April 2010 to provide Antiretroviral Treatment to pregnant women at
CD4 count of 350 or less, to enhance maternal survival. ART is also being provided
to people co-infected with TB and HIV at a CD4 count of 350 or less. This will
contribute significantly to reducing morbidity, disease progression and mortality
associated with TB and HIV and AIDS.
In addition, HIV positive pregnant women are now receiving dual therapy from 14
weeks of pregnancy (not 28 weeks as was previously the case) until post delivery.
Most importantly, HIV and AIDS and TB are being integrated, and will be treated
under one roof. This means that all public health facilities that provide TB treatment
must over this financial year be strengthened to also provide treatment for HIV and
By the end of March 2010, only 496 public health facilities accredited were providing
antiretroviral therapy. We have decided that all 4,333 public health facilities should
over time provide ARVs. I am happy to report that we have prepared an additional
519 public health facilities and they have started to provide ARVs since 1 April 2010.
This means that as we speak more than 1000 public health facilities are initiating
eligible patients on treatment.
Some people were sceptical about our resolve to implement the new treatment
guidelines and increase access to treatment. I wish to assure you that we are very

This does not mean that we are not experiencing a few teething problems in the
implementation of these new policies and strategies, such as our human resource
capacity and supply and logistical problems in some facilities. However, these are
not insurmountable and are being addressed.
The prices that South Africa pays for ARVs are significantly higher than in all other
countries. This has been confirmed by our international development partners and
was publicly announced by the executive director of UNAIDS during the World AIDS
Day event last year when he shared a platform with the President. This is despite
the fact that South Africa has the largest ARV programme in the world.
This just does not make sense. Let me put it once and for all. There is no choice. We
must purchase ARVs at the lowest possible cost from whatever source that can
guarantee us the lowest prices, whether inside or outside the country! This position
has already generated some opposition from some of our local pharmaceutical
manufacturers. They have claimed that this approach will result in some job losses. I
believe this to be some sort of blackmail but I will never bow down to it!
We need to understand that unless we take decisive action we will not overcome the
challenge that HIV presents. This is why the new ARV tender specifications will be
prepared in a way that opens the way for us to purchase ARVs at the lowest
possible price. I will not comprise on this. Let me say however, that this policy
position applies to Antiretroviral only and not to all other pharmaceuticals products.
Many people, especially the media focused on one aspect of President Zuma’s
speech on 1 December last year. In his speech he focused on both treatment and
the importance of prevention. We have commenced implementation of the new
treatment guidelines. However the mainstay of our approach must remain
prevention! South Africa will initiate the largest HIV counselling and testing campaign
ever undertaken. The Cabinet took a decision on 10 March 2010 that the campaign
must be launched on 15 April with the President and Deputy President leading the
campaign and being the first to test.
They have subsequently requested that the date be reviewed, as they were both out
of the country on the 15th April. We have accordingly postponed the launch, both
national and provincial, to a later date to be announced as soon as The Presidency
is available.
This ambitious campaign seeks to mobilise the majority of South Africans to get
tested for HIV and AIDS. We aim to provide HIV counselling and testing to 15 million
South Africans by the end of June 2011. I have been crisscrossing the country in
recent weeks speaking to various constituencies to get them onboard. All the 17
sectors represented in South African National AIDS Council (SANAC) have thrown
their weight behind this campaign. Several private sector service providers have also
come on board to support us. These include: Pharmacy groups; medical aid
schemes; hospital associations; groups of medical practitioners.
In embarking on this massive HIV Counselling and Testing Campaign, we reflected
on the findings of the special series of the prestigious medical journal, the Lancet of
August 2009, which indicated that South Africa is facing a quadruple burden of
disease consisting of:
         HIV and AIDS and TB
         High maternal and child mortality
         Non-communicable diseases
         Violence and injuries.

We decided to also include in the campaign a focus on non-communicable diseases
and diseases of lifestyles. Apart from HIV Counselling and Testing, we will also
screen for:
         Blood pressure
         Blood sugar

This means that by June next year we will know the status on all of these measures
of 15 million South Africans. This will enable them to take better care of themselves,
and enable the health system to better respond to their health care needs.
Leaders in all sectors are strongly urged to provide leadership during the HIV
Counselling and Testing Campaign. Province-specific launches of the campaigns
will take place following the national launch. Premiers have been urged and have
agreed to take the lead in testing. Principals of universities have been requested to
take the lead in testing in their respective institutions and they have agreed. All
heads of department will provide leadership to their departments. Chief Executive
Officers of hospitals have been requested to do the same in their hospitals. In
churches, ministers of religion have been asked to lead their congregations in taking
the tests. Traditional leaders and traditional healers have been requested to do the
same in their respective constituencies. We also expect business people and                  The latest edition of Umrabulo is
captains of industry to take the lead in their respective businesses. Similarly, mine        now available, to subscribe complete
bosses and union leaders should lead this campaign.                                          and return the subscription form
In Parliament, we believe that the Honourable Speaker and the leaders and Whips              bulo/.
of the different political parties will be the first to test and to lead this campaign and
Honourable members are requested to do the same in their constituencies. I am                Subscribers receive Umrabulo
sure that during this debate we will get all political parties pledging their support for    quarterly by ordinary post.
the campaign.
Primary prevention will remain the mainstay of all efforts to combat HIV and AIDS.           This service is available to both
There are a number of interventions that we have to strengthen to ensure the                 South African and international
success of our prevention programme. These include:                                          subscribers.

         The PMTCT programme                                                                 Contact Information
         Syndromic treatment of sexually transmitted diseases                                Address: Umrabulo, PO Box 61884,
                                                                                             Marshalltown, 2107, South Africa
         Massively increasing the number of male and female condoms that are                 Telephone: 011 376 1000
         distributed which must be used during each sexual encounter                         Fax: 086 633 1437
         Medical male circumcision which was launched by his Majesty the King in
         Decreasing alcohol abuse which increases risky sexual behaviour
         Behaviour change, including decreasing multiple and concurrent sexual
To massively expand condom distribution has major costs implications, which
extend beyond our resources. We appeal to the Private Sector to assist in this
regard. One of the huge outcomes that must be achieved by the health sector is to
improve the effectiveness of the health system. Our interventions in this regard will
         Revitalisation of infrastructure
         Improving quality of care
         Overhauling the health system
         Reducing the ever-escalating costs of providing health care, both in the
         public and private health sectors.
With regard to the issue of Health Infrastructure, the department will implement a
three-pronged strategy to accelerate infrastructure delivery. The first entails
accelerating the delivery of health infrastructure through Public Private Partnerships
(PPPs) especially for the construction of the Tertiary Hospitals. Construction or
refurbishment of five tertiary hospitals will commence in 2010/11 and be completed
in 2014/15. These are: Nelson Mandela Academic Hospital in the Eastern Cape; Dr
George Mukhari and Chris Hani Baragwanath Hospitals in Gauteng; King George
VIII Hospital in KwaZulu-Natal and the Limpopo Academic Hospital.

The second element of the strategy entails improving our primary health facilities.
This process will be informed by the outcomes of the audit of primary health care          TO SUBMIT ARTICLES OR
infrastructure and services that will be carried out during 2010/11. The third consists    COMMENT FOR
of enhancing health technology and information communication technology
infrastructure. The department will conduct an audit of essential equipment in all
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nine provinces, which will inform the finalisation of the national health technology
strategy. Health technology maintenance, as a means to ensure safety will be
prioritised. An information communication technology strategy will also be finalised
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and implemented.
In terms of quality of care, we will build on the milestones achieved in 2009, and
implement various measures to enhance our people’s experience of our health
services. We will support all health facilities to produce quality improvement plans,                   OR
which will focus on turning around six key areas namely:
         Patient safety
                                                                                               By Fax to 086 508 2440
         Infection prevention and control
         Availability of medicines
         Waiting times
         Positive and caring attitudes.
The national core standards for assessing the performance of health facilities have
been revised extensively, and will be used to assess another cohort of facilities. We
will also audit 25 percent of health establishments annually to assess if they comply
with core standards for quality. This will be done with a view to accrediting those that
meet the standards. Our health facilities will also conduct standardised surveys to
measure the level of satisfaction of users of our services.
We will continue overhauling the health system. Our twin strategies for achieving this
include refocusing the health system on primary health care; and improving the
functionality and management of the health system. The primary health care
approach remains the mainstay of our health system. We will re-invigorate this
approach throughout the health system, based on the principles of equity; quality;
efficiency; integrated and comprehensive care; community involvement and inter-
sectoral collaboration.
To enhance the governance of the health system based on the primary health care
approach we will work with all spheres to ensure that we have a single unified
national health system as envisaged in the National Health Act of 2003.
Later in 2010, we will table the National Health Amendment Bill to parliament, which
will provide for a review of the powers and functions of both the national and
provincial Departments of Health; facilitate the establishment of an independent
office of standards compliance; and enable the review of the current position on the
licensing of blood transfusion services. We hope to table the bill in September 2010.
We will also table the Health Laws Amendment Bill, which will cover all important
amendments to all Acts administered by the national Department of Health, to
ensure that existing legislation enable us to implement government’s priorities,
where it is found to be inconsistent with these policies.
Our other key interventions to revitalise Primary Health Care will include:
         Producing a Primary Health Care (PHC)-oriented service delivery model for
         South Africa
         Establishing PHC teams in each district to improve access to health care
         Completing the audit of primary level services and infrastructure
         Establishing Governance structures for all health facilities
         Improving the resource allocation for primary level health services
In February 2010, the National Health Council, which consists of the Minister and
Deputy Minister of Health and the nine provincial MECs for Health, accepted the
Project Plan of the Development Bank of Southern Africa (DBSA) for assessing the
functionality, efficiency and appropriateness of the organisational structure of our
hospitals. This work has commenced. Based on the outcome of the assessment we
will implement interventions to create, sustain and enhance an enabling environment
for improving hospital management

Most countries globally are searching for strategies to reduce the costs of health
care delivery whilst improving access and quality. The establishment of a National
Health Insurance (NHI) system will go a long way to ensure this. Through NHI, we
will ensure universal access to good quality and affordable health services for all
South Africans. Our major objective of pursuing an NHI is to put into place the
necessary funding and health service delivery mechanisms that will enable the
creation of an efficient, equitable and sustainable health system for all South Africa
with the ever widening gap between the rich and the poor, a gap regarded to be one
of the biggest in the world, we have no option morally, economically, socially or
otherwise but to move in this direction. South African needs it more than any other
country that you can think of.
>> Dr Aaron Motsoaledi is an ANC NEC member and Minister of Health. This is an
edited extract of the Department of Health Budget speech


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