MINUTES Summary of presentation (made by the Minister of Health)
The fight against poverty remains central to the work of the Social Sector Cluster. The Integrated Sustainable Rural Development Strategy and the Urban Renewal Programme provide a framework within which the cluster can confront the challenge of poverty.
Services such as water and sanitation, health care services, and welfare services have to be provided around various nodal points. Government’s efforts at alleviating poverty are however not confined to the nodal areas.
- In advancing systems of sanitation one of the areas where priority will be given are the areas most severely affected by the cholera epidemic. Sufficient resources will have to be made available to step up water and sanitation delivery. The Social Sector Cluster will make the necessary representation to raise these resources. Cabinet has also decided to provide free water up to a specified limit starting in July 2001.
- There is a high level of micronutrient deficiency and low energy intake amongst South African children. This is a manifestation of poverty. This cluster must develop a coherent strategy for household food security with a special focus on the impact on children.
- They will continue to strengthen the multi-sectoral response to HIV and AIDS. Special focus will include strengthening primary prevention efforts, implementing a strategy of home-based care, and improving access to counselling and voluntary testing services.
- The scope of the Urban Renewal Programme needs to be broadened. The cluster will develop an approach which will ensure that towns and cities offer a better quality of life. This includes better housing, health services, and water and sanitation. They are striving for a clean and safe urban environment and for towns and cities that attract investment.
- A Cabinet appointed Committee will submit a report to Cabinet containing proposals for a comprehensive social security system by July this year. Meanwhile, access to services under the existing system must be improved.
- Eight justice centres will be rolled out in the first half of this year. These centres will provide legal assistance and advice to those who cannot afford private legal representation. The target is to establish 60 centres over a period of 4 years.
Discussion Minister of Health: Minister Msimang (Q) It has been said that anti-retroviral drugs could be imported into South Africa cheaply if the government declares a national emergency. Has government considered this?
(A) HIV/AIDS is a high priority issue not only for SA but also for the SADC region. Government must develop and implement policies in respect of HIV/AIDS. Drugs must be available at affordable prices. However anti-retroviral drugs are not the only way to treat HIV/AIDS. There are many HIV related conditions which can be treated with other drugs. Just because there are no anti-retroviral drugs in SA it does not mean that AIDS is not being managed. For example meningitis is a an AIDS related illness and there is treatment available for this. It is incorrect to say that HIV is not being treated simply because there are no anti-retrovirals. An essential drug list was developed and the drugs on this list are available. The President has already stated on record that Government is facing a catastrophe with HIV/AIDS and they are gearing up to fight it. They do not need to call a national emergency.
Prevention and education is also very important. Prevention is a priority the world over. No matter what other steps are there to deal with HIV/AIDS there must always be preventative measures.
Government is looking at the concept of community based care. This operates at district level where a core group will ensure that villages and so forth have access to what they need. The concept includes transport for care-givers. They are looking at comprehensive care. It is not only anti-retrovirals which must be provided. The caregivers must have pocket money because when they arrive at some homes the person has not eaten for two days. Aside from providing the drugs the caregiver might also have to buy bread and so forth. The idea is to provide comprehensive care.
(Q) What percentage of the budget is going into HIV/AIDS?
(A) They would like to get additional funds. Firstly however they must identify the resources within the Department’s own budget and pool these resources together. Some NGOs receive funds from government. NGOs and so forth must show what they are pouring into the HIV/AIDS struggle. Government must know what SA is putting into HIV/AIDS. When the Minister of Finance deals with the budget then the amount allocated to HIV/AIDS will become clear. Each department of government is expected to allocate funds for HIV and STDs.
(Q) There is still a social problem that people who have AIDS face. People do not always accept them and they get thrown out of homes a. Has government considered making AIDS a notifiable disease to combat this problem?
(A) This is a human rights issue. Government has addressed the problem by funding an advertisement to promote tolerance for example. They have also engaged NGO services to monitor discrimination in the workplace.
Minister of Water Affairs: Minister Kasrils (Q) Will it be the provincial councils responsibility to provide free basic water by the first of July deadline?
(A) The Department of Water Affairs is working with the Department of Provincial and Local Government and the National Treasury on this. They are running workshops in all the provinces to prepare people. There is a great deal of capacity which must be developed. There will be cross-subsidisation through the tariff structure. They want to develop it as soon as possible. It will probably take place over a period of 2 – 3 years.
(Q) Does this mean that not all councils will be ready by the deadline? How many will be ready by July 2001? What percentage will be ready by the end of the year?
(A) It is difficult to say. Some councils such as the Durban Metro are already providing the service. Some have communal pumps - this is one form of free service. They are doing everything possible to get the councils on track. They are optimistic in seeing strong movement. Some teething problems with the rural councils are expected. In these areas there will not be strong cross-subsidisation from the affluent areas. At the end of the year they expect a strong percentage.
(Q) In light of the cholera outbreak, is there a budget to take clean water to hard to reach areas?
(A) There is approximately R 1billion per annum for the next 3 years. In light of the onslaught of cholera it is clear that one cannot solve the water problem through the pipewater system. There must be a sanitation approach. They had one in the past but they are now working on a new structural approach. They can educate people with the help of the Health Department. Also, the housing programme brought improved conditions. In the cholera infected area in KwaZulu-Natal they rearranged the budget to provide funds for developing latrine toilets. There is also a programme for block latrines in schools. This is a pilot programme and they need more like this. They must bring sanitation onstream to prevent cholera.
(Q) Comment on the water restrictions on Cape Town
(A) The water restrictions have been light. Augmentation via a new dam is on the cards. This is necessary. They have looked at the objections of environmentalists. Demand management must be done.
General questions to the panel (Q) How will one assess the progress of the social sector cluster programmes?
(A) Minister Msimang: All figures are to be made available as departments. There are no figures as clusters. In some areas there are concrete figures example 16 Justice Centres.
(Q) Why has there been silence on the implementation of the TRC recommendations?
(A) Minister Msimang: This is work in progress and it will be attended to. There will be individual reparation as well as collective reparation.
In conclusion the Minister of Sport (Minister Balfour) noted that the clusters are expected to report Cabinet monthly.