Minister of Health Budget Speech, responses by ANC, EFF, IFP & DA

Minister of Health, Dr Zweli Mkhize, gave his Budget Vote speech on 13 May 2021 

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Speaker of the National Assembly
Honourable Chair of the Portfolio Committee on Health and members of parliament My Colleague Deputy Minister of Health
MECS of Health
Heads of our Public Health Entities and Statutory Councils Deans of Faculties of Medical Sciences
Health professionals who have joined us today; Distinguished guests
Fellow Compatriots Ladies and gentlemen

Opening Statement

Thank you for this opportunity to table the Health budget vote and policy statement for 2021/ 2022.

Our country is emerging from a tumultuous year of 2020, which has seen huge global devastation from COVID 19. In our country, this resulted in 1,6 million positive cases, 10,9 million tests done, 54 968 associated lives lost, though 95% of those affected have recovered. The COVID-19 positive cases have started to rise significantly and we may find ourselves in the third wave. Of concern has been the emergence of B.1.351 in our country and the importation of B1.617.2  variant from India and B.1.1.7 from the UK. We all have a responsibility to use the non-pharmaceutical interventions to protect ourselves and reduce the risk of infection.

 

Our country is set to begin phase 2 of the vaccination program on 17th May 2021 targeting 130 sites in the public sector to be active next week, focusing on the population aged 60 and above and vulnerable groups, using Johnson and Johnson and Pfizer vaccine; as vaccination of the remainder of health care workers is being concluded. Private sector sites will open later next week.

Over the medium term, the department’s most urgent focus is combatting the Coronavirus through our comprehensive local intervention programmes, for which R9 billion has been allocated. We continue to play our strategic roles as co-chair of the ACT-Accelerator and COVID-19 champion of the African Union, following HE President Cyril Ramaphosa’s outstanding leadership in his capacity as chair of the AU in 2020.

Globally, the lesson from the impact of COVID-19 has emphasized the necessity of investing in long term resilience and sustainability of health systems to enable us to better respond to future health emergencies and crises.

The COVID-19 pandemic caused significant health seeking deterrence and a various results have pointed to this challenge. The mandates set out in the Performance Agreement that I signed with the President for the Period of June 2019 to April 2024, indicate the need for innovation to close these service delivery gaps. Chief amongst these include the establishment of the NHI Fund, implementing the recommendations of the Health Market Inquiry Report, building human resource capacity, quality improvement, expansion of health infrastructure, risk management, uprooting corruption and ensuring clean governance as well as building partnerships through social compact.

Today I rise to table a budget of R62,5 billion for the Department of Health for 2021/22.

Allocations per Programme are as follows (000):

 

 

 

	2021/22	2022/23	2023/24
Programme 1:  Administration	816 333	818 380	858 317
Programme 2:  National Health Insurance	1 340 471	1 436 961	1 448 660
Programme 3:  Communicable and Non-Communicable Diseases	32 605 402	30 674 180	27 756 632
Programme 4:  Primary Health Care	222 283	223 504	226 112
Programme 5:  Hospital Systems	21 372 304	22 439 906	23 064 751
Programme 6:  Health Systems Governance and Human Resources	6 186 478	6 062 498	6 031 983
TOTAL	62 543 271	61 655 429	59 386 455

Health expenditure is expected to increase by 0,8% per year, from R58,1 billion in 2020/21 to R59,4 billion in 2023/24. An estimated 85,9 per cent (R157,7 billion) of the department’s budget over the MTEF period will be transferred to provinces through conditional grants, increasing by 0,3 per cent, from R52,1 billion in 2020/21 to R52,6 billion in 2023/24. To remain within the national aggregate expenditure ceiling, Cabinet has approved reductions on the department’s baseline amounting to R15 billion over the period ahead (R4,1 billion in 2021/22, R4,9 billion in 2022/23 and R5,1 billion in 2023/24).

Needless to state that the backlog, current and future needs for health services far exceed the current allocation of resources; and all indications point to chronic underfunding of this sector. Despite the challenging reductions to the budget, I believe we have stretched our resources through strengthened relations with multilateral organizations such as the UNAIDS and UNICEF and key investment partners, such as Global Fund, PEPFAR, the Clinton Health Access Initiative and the Solidarity Fund to ensure that health services in this country continue to advance. We appreciate this support.

 

National Health Insurance (NHI)

The implementation of the National Health Insurance remains one of governments main objectives. Following the introduction of the NHI Bill to Parliament in July 2019, the Portfolio Committee on Health convened public hearings in all provinces during the latter part of 2019. These public hearings provided a platform for ordinary South Africans to be heard and contribute toward the shaping of the NHI Bill. The Department of Health attended all the public hearings to process the feedback from community members on the details of the NHI Bill and took the opportunity to attend to service delivery issues that were raised by communities. The hearings were due to progress to Parliamentary submissions in 2020, however this was disrupted by the COVID-19 pandemic and are due to resume in the near future. In the MTEF period R7.5 billion has been allocated to the NHI unit, to strengthen the system and contract service providers. Dr Nicholas Crisp has been appointed as the Deputy Director General of NHI, bringing a wealth of experience and passion into the portfolio. Tremendous progress has been made in Health Patient Registration System (HPRS) with 57 million individuals registered in 3111 public health facilities. The NHI fund will be set up, as soon as the NHI Bill is passed.

Infrastructure

We commit R20.6 billion in the MTEF, for health facility revitalization, to establish parity in the quality of public and private infrastructure through the Infrastructure Refurbishment Programme. From 2014 to Q3 of 2020/21, 10 hospitals have been completed or replaced and an additional 23 have been revitalized. A total of 151 CHC’s and clinics have been constructed and replaced and a total of 1232 facilities have been refurbished, renovated and rehabilitated. Of these, 116 facilities were maintained, repaired and/or refurbished during the 2020/21 financial year. The Health Facilities Revitalization Grant-Direct grant” (HFRG) and the National Health Insurance Indirect Grant: Health Facility Revitalization Component (also known as “In Kind”) grants have been the main financial contributors to these achievements, however we encourage public private partnerships to facilitate alternative infrastructure investment models.

 

Through the implementation of the Ideal Clinic Initiative, the MTSF 2024 target is to have 100% of Primary Health Care facilities maintaining their Ideal Clinic status. As at the end of December 2020, a total of 1 286 PHC facilities obtained ideal status, after conducting both peer reviews and updates. A revised Ideal Clinic Framework version is now being used which is aligned with Office of Health Standard Compliance measures developed for the Regulated Norms and Standards.

In June we will be piloting 16 Quality Learning Centres, defined as a cluster of health facilities at different levels of care servicing the same population. The pilot cluster will comprise 80 hospitals and 64 Primary Health Care facilities. After incorporating the learnings from the pilot phase, the programme will gradually expand until all facilities belong to a quality learning centre. R13,7 billion has been allocated for supporting tertiary health care services which are offered at tertiary and central hospitals to service patients from different provinces. The grant compensates the provinces that suffer inequality that results from this arrangement.

Human Resources for Health

During the 2020/ 21 financial year, a record 50 614 new posts were created, both health related and support personnel, to strengthen services in the public health sector. This significant recruitment was enabled by combining the COVID-19 earmarked budget for HR, funding from the Presidential Stimulus Package and from the Cuban Medical Brigade. This highlights the need to adopt a diversified approach for HRH going forward into NHI.

 

Despite disruptions to the academic year, 2 469 Medical Interns and 10 589 Community Service Personnel (including, amongst others, Medical Doctors, Nurses and Pharmacists) were placed last year. This was thanks to close collaboration between National and Provincial Department of Health officials and the Professional Councils to swiftly conclude the registration of the Medical Interns and Community Service Personnel and ensure timely remittance.

In response to COVID-19, the Department developed surge capacity guidelines for Human Resources and a Strategy to protect the health and safety of health workers in the occupational space. We salute all our health care workers for their dedication and hard work. You are the heroes that saved our nation!

A key development over the COVID-19 period was the deployment of community health workers for the community screening and testing campaign. This programme is now a seminal case study for all countries seeking to strengthen their primary health care systems. At the end of March 2021, a total of 47 630 CHWs received remuneration against the MTSF 2024 target of integrating 50 000 CHWs into the public health system. A Committee was established by the National Health Health Council to attend to the various issues around the conditions of service for CHWs. This work is still ongoing and the NHC is expected to finalize their recommendations and table these at the bargaining council.

Programmes for prevention and treatment of communicable and non-communicable disease

R82.6 billion has been allocated in the medium term to fund disease-specific programmes to prevent and treat communicable and non-communicable diseases.

HIV, TB, other communicable diseases of interest and non-communicable diseases remain great threats to overall public health in South Africa. Honourable members, I table the status of these pathologies in South Africa and our efforts to reclaim gains towards the control of these pandemics.

 

South Africa’s performance against the UNAIDS 90-90-90 strategy for control of the HIV pandemic is 93-70-88, meaning that as at the end of February 2021,

• 93 % of people living with HIV knew their status
• 70% of people living with HIV are on anti-retroviral treatment (ART)

• The estimated proportion of patients on ART that are virally suppressed at 12 months was 88% as of March 2021.

The public health management of HIV, as with all communicable diseases, focuses on early detection, early initiation of treatment and prevention of onward spread.

Despite a difficult year, a cumulative total of 14 685 210 HIV tests were performed during April 2020 to March 2021. The Department intensified community testing modalities to reach the untested and under-tested, including index testing in communities and facilities as well as HIV self-screening and self-testing.

As of February 2021, 5 069 398 people were on ART and in the last financial year 93.7% of antenatal HIV positive clients were initiated on ART against the 2024 MTSF target of 98%. To improve this indicator towards the 90:90:90 goal, the Department is scaling up and promoting same day initiations at every point of care including mobile clinics; intensifying the use of standard operating procedures for ART in communities (including initiation of PrEP and PEP where indicated); supporting data management in provinces; and strengthening the “Welcome Back” campaign to improve compliance and client retention.

We still promote the consistent use of condoms to prevent HIV, other STIs and unplanned pregnancies. The total number of male condoms distributed to date is 537 330 419 against a target of 850 000 000. The Department continues to explore all non-traditional platforms for condom distribution to ensure that anyone can access a condom.

 

Tuberculosis (TB)

The Department of Health commits to finding all persons living with active TB in our communities and to meeting the 90-90-90 targets for TB as outlined in the National Strategic Plan for HIV, TB and STIs 2017 – 2022.

Achieving this goal is ever more urgent as we noted a 50% reduction in the number of TB tests conducted during the COVID-19 period and a suboptimal TB success rate of 78,3%, against a target of 90%.

TB catch up plans have been developed in line with the recommendations of the National TB Prevalence Survey Reports and are implemented at district level, buttressed by the adoption of eHealth technologies, such as the TB self-screening mobile application that has been launched and will be available in all official languages.

The advantage we have is that we deployed Gene-Xpert tests with the mobile COVID-19 testing units. This allows us to integrate TB and COVID-19 community testing services and indeed this is being implemented.

To address the barriers to accessing health care, NDoH is developing a Social and Behavioral Change Communication strategy which aims to mitigate stigmatization and promote proactive health seeking behaviour. This will necessarily involve mobilising technical partners, civil society organizations and funding agencies.

To facilitate enhanced adherence to treatment, we intend to introduce new generation, shorter acting options such as Rifapentine and Isoniazid (3HP) and Rifampicin and Isoniazid (3RH), which are three-month treatments, as oppose to six months.

 

Malaria

The number of malaria cases in South Africa has decreased by 32% (from 16 690 cases in 2019/2020 to 11 323 cases in 2020/21 financial years). Similarly, malaria deaths have decreased by 48.5% (from 103 deaths in 2019/2020 to 53 deaths in 2020/21 financial years.

We believe that our target of eliminating malaria in South Africa by 2023 is still attainable, but can only be achieved through a concerted cross-border effort by harmonising malaria polices, investing in thorough intervention coverage and by synchronising operations.

Non-Communicable Diseases (NCDs)

The MTSF 2024 target is to have 25 million people screened annually for high blood pressure and elevated blood glucose respectively. A total of 22 793 617 screenings for high blood pressure and 21 780 846 for blood glucose were conducted from April 2020 to February 2021.

In partnership with Astra Zeneca, the NDOH will be piloting a community level screening project- the National NCD Campaign (NNCDC). At an operational level the Ward Based Primary Health Care Outreach Teams (WBPHCOTs) will be deployed to find, screen and refer identified clients for further chronic care. The strategy is aligned with the principles of Operation Sukuma Sakhe and the District Development Model and is planned to commence in four (4) pilot districts in Kwa-Zulu Natal- that is Amajuba; uMzinyathi; uMgungundlovu, and uGu). This will subsequently be scaled up throughout the country based on the evaluation of outcomes. To date, we have received a donation of 10 000 BP monitors from Astra-Zeneca to kickstart this initiative and we have conveyed our appreciation of this donation in a public hand-over ceremony last year.

The Chronic Medicines Dispensing and Distribution (CCMDD) programme facilitates treatment adherence and saves clients valuable time. We are thrilled that this programme continues to gain strength, having registered 4 321 755 users this past financial year. This exceeds the annual target of 3 500 000.

 

Sexual & Reproductive Health Services

SRH services were not spared the impact of the COVID-19 pandemic and there was an overall decrease in clients accessing reproductive health services reflected by the Couple Year Protection Rate decreasing from 55% to 47.7% in the 2020/ 2021 financial year. We also recorded a drop of antenatal visits with 67,9% of pregnant women attending against the MTSF 2024 target of 75%.

In addition our ability to acquire contraceptives was severely impacted due to disruption in the global supply chain. A number of initiatives to address stock issues are currently underway including joint forecasting with suppliers, diversifying the products on tender, and training to support the increased usage of Long Acting Reversible Contraception methods.

We have disseminated the new Sexual Reproductive Health and Rights (SRHR) policy and supported capacity building through a new set of training frameworks and packages. In addition, the BWise website has been revamped to become an essential resource of information.

The protection of parents and unborn babies is a key investment into future prosperity- the Department remains committed to providing safe and compassionate sexual and reproductive services to our people.

Child Health

South African peadiatrics continues to gain strength as seen in improved key health indicators as we indicated earlier. However, this specialty was also not spared the impact of COVID-19, as evidenced by decrease overall use of key child health services.

 

There was an overall decline in childhood vaccinations in 2020: immunisation coverage for infants (defined as children aged less than one year) was 78.5% in the months of April 2020 to March 2021, against the MTSF target of 90% by 2024.

The Department of Health is working in partnership with United Nations agencies, private health sector, non-government organisations and vaccine manufacturers to implement a catch-up drive for children who missed their vaccination schedule, even in years preceding lockdown. Demand generation strategies are also in place and implemented at all levels of health care.

The MTSF targets for under-5 indicators 2020 fell marginally short, threatening the major gains we have made in democratic South Africa. To address this the Department is implementing various strategies to improve health of children under 5 years including:

• Side-by-Side radio shows and social media campaigns to intensify communication of child health promotion and encourage demand for immunisation
• Early detection and referral of children with common childhood illnesses through improved use of the standard treatment guidelines and protocols;
• Strengthening of the implementation of standard inpatient paediatric register to improve data quality for data based response
• Collaborating with other departments and non-state players to address the socio- economics determinants that lead to poor health outcomes for children

Medico-Legal Claims

We have appointed service providers to analyze the purported 100 million rand liability. Their analysis has reduced the contingency liabilities by 32 million rand and we believe that it could still be reduced further by conducting forensic audits into the claims; leveraging off the precedent set by the Gauteng High Court granting provision for treatment in public health facilities instead of monetary compensation; and concluding the ratification of the The State Liability Amendment Bill of 2018 towards ascension.

 

Collaboration with Cuba

As I approach the conclusion of this address, I wish to pay tribute to the Cuban Medical Brigade worldwide and reiterate the call to consider their brave contribution worthy of recognition through the awarding of the Nobel Peace Prize. When other countries were seeking to retain their resources, Cuba went all out to share their human resources for the good of all mankind- this is no small gesture of love and solidarity, advancing an agenda of peace and health security. We also commend the continued collaboration between Cuba and South African medicine, which has seen us graduate 1 841 doctors through the Nelson Mandela Fidel Castro Medical Training Programme to date, of which 669 graduated in the past financial year alone. Our collaboration also extends to knowledge sharing, tech transfer and health systems strengthening, particularly in the primary health care space.

I wish to close this address by inspiring confidence in our ability to build local manufacturing capability. The government has undertaken some key collaborative initiatives and investments to ensure that South Africa can independently meet its own biotech needs: these include attracting the BRICS Vaccine Research and Development Centre for location in South Africa, fully capacitating our regulatory bodies and investing into academic and innovation institutions such as Biovac.

We believe that we have the expertise, including the precision guidance of genomic surveillance, as well as the desired global partnerships to grow our biotech capabilities.

Africa must become an independent, capable and leading continent, able to protect its people through quintessential African innovation and resilience.

I wish to thank the Director General of Health, MEC’s of Health, Statutory Entities and all health officials across the spheres of government as well as the Portfolio Committee on health and social partners for your support.

Honourable Speaker, I submit and thank you.

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Deputy Minister Joe Phaahla: Health Dept Budget Vote 2021/22

 

Honourable Chairperson
The Chair of Portfolio Committee for Health Hon . Dr. Sibongiseni Dhlomo
Hon Minister of Health, Dr Zwelini L. Mkhize Hon. Ministers and Deputy Ministers present Honourable Members of The National Assembly MECS of Health present
Heads of Public Entities and Statutory Councils Distinguished guests

Good Afternoon

I am very honoured to take part in the budget vote for the Department of Health which is taking place just a day after International Nurses Day when we celebrated the gallant contribution of our nurses in ensuring Long and Healthy Life for all South Africans,

I wish to take this opportunity to say again that as the Ministry and the Department of Health we have no hesitation in acknowledging that our nurses are the backbone of our Health Services at all levels from the basic primary health services at community level to the most advanced tertiary services. Without the nurses none of these services will be viable.

Honourable Chairperson our country and the world remain in the grip of the COVID-19 pandemic which has been with us just for over a year now. In this last challenging 15 months we have been blessed with outstanding leadership by our President, President Matamela Ramaphosa , cabinet collective, the Coronavirus Council and Team Health led by my colleague Minister Mkhize.

We extend our thanks to the cooperation we enjoyed from colleagues MECs and HODs of all provinces. We appreciate the support and cooperation we enjoyed from the leaders of civil society and community leaders. Without cooperation from traditional leaders , religious leaders , political leaders ,labour and business we would not be where we are, with the relative stability we have where our health services have not been overwhelmed. You can imagine if leaders of some of the big churches such as ZCC, st Engenas and Shembe had decided not to cooperate with government.

We all owe a lot to our health workers, not only the nurses but everyone from security at the gate to heads of clinical departments. Our health work force has been resilient, and we want to say to them that the fact that our fiscus has not enabled us to show the gratitude in monetary form is only because the pandemic has also battered already weak economy. You are the heroes of all South Africans and many of your colleagues have paid the highest price, life itself, we mourn with their families, may they get solace in the knowledge that their deaths were not in vain.

Honourable Chairperson and members it is common knowledge that the Annual Performance Plans of the NDOH for 2020/2021 were vastly disrupted and lot of adjustments had to be made as was the case with the life’s of South Africans in many respects

We now have more than 12 months experience in dealing with the pandemic but the reality remains that what will happen in the next weeks and months remain unpredictable .Minister Mkhize has already spoken about disruptions to our planned services such as HIV and AIDS testing treatment , TB services , maternal and child services etc and the fact that we are clawing back lost ground in these areas. We are of course concerned about the signs of rising numbers and that the 3rd wave may be on us sooner than expected.

Honourable Chairperson as we battle this pandemic, we must not lose sight of some of the quadrable burden of diseases where we still had lot of ground to cover and one such is the non- communicable diseases.

Diseases of Lifestyle remain serious challenge in our society which include diabetes mellitus, hypertension and cardiovascular diseases, kidney diseases, various cancers and mental illness. As we know most of these diseases are associated with unhealthy diet and lack of physical activity. I am aware that government came under criticism during hard lockdown when exercise opportunities were limited but this was just temporary. On the other hand, we made some gains in weaning people off tobacco and alcohol addition during the periods when these products were not available.

What adds more pressure on all of us not to take our eyes off the ball is that it has been proven all over the world that persons who don’t have these NCDs such as diabetes and hypertension and who are not obese have a higher chance of not getting severe COVID-19 complications .What these implies is that investing in healthy diet, regular exercise, avoidance of tobacco and alcohol puts you in a better position to avoid various NCDs or control them if already there and limit the risk of severe COVID-19 .

The closure of alcohol sales also contributed to the reduction of a second member of the quadruple burden which is trauma and accidents. I am aware that there was a glamour from some well meaning South Africans that we should prolong the closure or limit of alcohol and tobacco under the National Disaster provisions but this was legally unsustainable. What we need to do urgently is to speed up the tabling of the Tobacco Amendment Bill and to finalise a Bill on control of Alcohol advertising sale. As we know South Africans rank amongst the highest consumers of alcohol in the world.

Another area in which we need to refocus is the provision of Mental Health Services. As we know the Life Esidimeni debacle exposed our weaknesses. The COVID-19 pandemic has added more mental stress not only amongst the general public but also for health workers. There are many families who lost both parents and many more lost livelihoods adding more mental stress and in the current financial year we need to pay attention to these challenges.

We are conscious of the fact that the key answer is to improve on integrated health services wherever we do COVID-19 screening, testing and management, we should include HIV and AIDS, TB, mother and child and NCDs. As both our financial and human resources get stretched out, we are going to depend on integration from community outreach up to tertiary services. Even as we roll out vaccination, we are including basic screening for COVID-19 and other health risks. We urge honourable members to also promote healthy lifestyles at your constituencies such as the Thuma Mina walks initiated by President Ramaphosa

Honourable Chairperson and members, provision of adequate and suitable human resources is fundamental in managing the pandemic and sustaining a health service platform. One of the major contributors to the supply of well equipped medical personnel is the Nelson Mandela -Fidel Castro medical training program. Since its inception in 1997, this program started modestly with maximum of 80 students sent to Cuba per year. In 2012 they provided an option for additional students on an expanded program paid for by the sending government. Thanks to the visionary leadership of amongst other the chair of our Portfolio Committee Dr. Dhlomo for seizing this opportunity and sending hundreds of young students from rural and township disadvantaged families. The total number of graduates who have been contributed by the program stands at 1979 and out of this 1374 are those who were funded largely by the RSA government through provincial budgets since 2012 and they started coming back in batches of up to 700 students to complete in local universities since July 2018.In the last 3 years graduates from the NMFC program constituted 1/3 of all medical graduates in RSA. Currently we are having another 643 final year students in the local medical schools who will finish their clinical integration in December 2021.Another 463 final year students are expected in July this year to start their 18 months integration. By the end of 2022 we expect this program to have contributed more than 3000 doctors who are well trained in primary health care more than just Curative Medicine largely serving rural communities. What we need to address is to make sure that they are utilised in line with their strength which is our S. African weakness viz. Primary Health Care. I know that some members of the opposition only look at the cost and not the benefit while they claim to believe in business principles.

The HPCSA is continuing to look at better ways to enable South African medical graduates who qualified in universities not from the recognised list to be given a chance to go through requirements for registration so that they can practice. There are currently existing systems including a non-exam route for those from recognised universities and an exam and clinical training route for those from non -recognised universities. We will continue to work with the HPCSA to look at ways to streamline these processes. In the meantime we urge parents and students to check with HPCSA before they incur huge costs of going abroad to study medicine only to be frustrated on return.

Honourable Chairperson on the transformation of Nursing Education, 8 of the 9 provincial nursing colleges as well as the South African Military Health Services have been fully accredited to offer three year Diploma in Nursing leading to registration as a general nurse and started offering the new programme from January 2020.

The Eastern Cape is at an advanced stage of accreditation for the 3 year diploma. In addition, all colleges have been designated to offer certificates, degrees and postgraduate diplomas which are being offered in a phased approach from 2021.

Honourable Chairperson, the NHLS remains the cornerstone of provision of diagnostic pathology services in South Africans with a network of approximately 233 laboratories across the country, catering for 80% of such services for the population. It runs the largest HIV and TB program in Africa and can test for priority diseases. After some difficult administrative and financial challenges, it has now turned the corner and is stable both financially and in governance. It has also been able to tackle corruption where it has reared its ugly head. We thank our provincial counterparts for cooperating with the NHLS. NHLS also provides vital training for pathologists and medical scientists not only for RSA but the continent wide.

The NHLS rose to the occasion of COVID-19 growing capacity rapidly from two testing labs at the beginning to 130 across the country as we speak. Together with NICD they provide daily epidemiological information to us as to where the pandemic is. We acknowledge and thank the private labs for cooperating with NHLS.As of 11 May 2021, the NHLS conducted 4,800 342 COVID-19 tests of which 4 106 886 were PCR and 693456 were rapid antigen.

The other entity which is playing a major role in the fight against COVID-19 is the South African Health Products Regulatory Authority (SAHPRA)which has upped its game in making sure that we get speedy access to diagnostics, treatment, and vaccines. This young entity has risen to the occasion under tremendous pressure. Over the medium term it will focus on accelerating the clearing of its backlog of medicine products licensing.

The South African Medical Research Council is providing and supporting cutting edge research including in various aspects of COVID-19 in support of government.

The research support together with DSI includes areas such as the development of diagnostic products, treatment and prevention and vaccine studies. The two are also supporting network for Genomics Surveillance in South Africa which led to the discovery of SARS-COV-2 501y.V2 variant which has set an international precedent in Genomic Surveillance and is extending its services to support the Africa CDC.

As we know the SAMRC is a key player in the rolling out of Sisonke vaccination which will complete the vaccination of at least 5000 000 health workers by the 17 May 2021.

The Council of Medical Schemes has played a major role in mobilising medical schemes to come on board  to fund vaccination of COVID-19 as a Prescribed Minimum Benefit and to participate overall in the vaccination program.

Honourable Chairperson the way ahead in 2021/22 is going to be long and tortuours but I believe we have learnt a lot over the last 15 months. We can only defeat the invisible enemy by continuing to work together. The next few months are going to be critical as we roll out vaccines while we remain vigilant with the Non Pharmaceutical prevention methods.

Let’s continue to be guided by science behind our leader President Ramaphosa working together we can prevail.

I Thank You.