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Manto's final budget
Health-e 2008-06-13
Health minister Dr Manto Tshabalala-Msimang this week presented what may be her final budget as head of the health portfolio. She used the opportunity to mainly present successes by her department. The minister also used the occasion to claim victory in the battle against AIDS declaring that the 2007 HIV antenatal survey has shown a 1,2% drop in HIV prevalence among pregnant women.
The full survey was not released, but Tshabalala-Msimang said the figures suggested that we have a trend of decreasing prevalence overall and in the younger age cohort. Tshabalala-Msimang highlighted the slightly decreasing HIV prevalence in the 15 to 19 and 25 to 29 year age groups. She did not mention the 30 to 39 year age group where there have been significant increases in HIV infection over the last six years. Access to primary health care services doubled over the past decade with more than 101-million patients using these services in 2007/8 compared to 67-million in 1998, she reported.
In a veiled reference to her axed deputy and earlier newspaper reports on high numbers of infant deaths at Frere Hospital in East London, the minister said: Disturbing incidents in a few facilities have created a false impression that we are not doing enough to address issues of maternal and child health. I wish to state categorically that the Department of Health is fully committed to improving the health status of women, mothers and children of our country and to achieving the Millennium Development Goals (MDGs). However, experts say that South Africa will not reach the infant and maternal MDGs and that South Africas under-five mortality rate is increasing. The country is currently one of only 12 countries globally that has increasing rates of child deaths. Yet it is estimated that over 40 200 child deaths as well as many maternal deaths and stillbirths could be avoided with simple, internationally recognised interventions. At least 260 mothers, babies and children die each day in South Africa. The minister acknowledged that multi-drug resistant TB and extensively drug resistant (XDR) TB posed a particular challenge. She said the TB strategic plan would focus on community mobilization, decreasing the TB defaulter rate and the training of health personnel.
She said the department was on track to reach the 7% defaulter rate as set by our President in the State of the Nation address. Tshabalala-Msimang reported that Umsinga district in KwaZulu-Natal, which includes Tugela Ferry where XDR-TB was first reported, had reported a zero percent defaulter rate. However, critics have pointed out that a lot of resources had been sent to Umsinga, while other districts failed to control TB. According to the latest District Health Barometer districts such as Nkangala (Mpumalanga), Amathole (Eastern Cape) and Ugu (KwaZulu-Natal) continued to record TB cure rates well below 40%. Democratic Alliance (DA) spokesperson on Health Mike Waters responded to the budget speech by saying that all we have seen from this minister is business as usual, no accountability, no sense of urgency, no idea what the challenges are and no grasp on reality. If the President and the ANC really had the health interests of the public at heart, the minister would have been fired a long, long time ago. Fortunately for the 47 million South Africans, this is certainly the Ministers last budget speech, Waters told Parliament. DA MP and member of the portfolio committee on Health Sandy Kalyan said Tshabalala-Msimang had been a spectacular failure as Minister of Health and I humbly appeal to the incoming leadership after the next elections to ensure that the voice of reason prevails, and to never ever again entrust you with the health of South Africa. 
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