Substance Abuse Roundtable Workshop

NCOP Health and Social Services

28 July 2015
Chairperson: Ms L Dlamini (ANC; Mpumalanga)
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Meeting Summary

The round table workshop was organised in an attempt to reflect on the implementation of the National Drug Master Plan 2013-2017, and to hear about its capacity, support and impact of interventions. Although some specific NGOs were making submissions, others were present and contributed to the discussion. There were common concerns about the issues, and attendees actively engaged and gave vigorous input.

The Western Cape South African National Council on Alcoholism and Drug Dependence (SANCA), Cape Town Drug Counselling Centre (CTDCC), Eldorado Park Local Drug Action Committee (LDAC) and National Health and Development Foundation Alliance (NHDFA) made submissions. They expressed disappointment that there were no representatives from the South African Local Government Authority at the workshop. They were agreed that integrated approaches, focusing on bottom up interventions involving communities actively, and coupled with sound research and partnerships, were the route to follow.


SANCA, in its brief, highlighted the inter-departmental and youth partnership and successful youth interventions that had been made. While there had been strides made, it was noted that there were still far too few treatment centres to address the need. SANCA said that its main challenges included legislation, changing trends, more complex substance abuse patterns, as well as capacity building and training. Whilst the National Drug Master Plan (NDMP) had proved to be extremely effective over the years, there were challenges with its implementation and lack of uniformity in implementation in provincial and local government.  The need for specialised and advanced qualifications and training was noted, as well as compensation for those currently volunteering. Success stories were outlined, including partnerships and Memoranda of Agreements. SANCU recommended the need to review the objectives and structures of the NDMP, increase funding by earmarking taxes and fines, place more emphasis on early intervention, ensure capacity building and community-based programmes, and conduct research. Legislation that was crafted for tobacco might not be readily transferrable to alcohol and drugs. Because cannabis use and dependency still remained a huge problem, it advised caution in crafting any legislation permitting medicinal use of cannabis

CTDCC read out some of the appreciative endorsements of service users, and success stories, as well a the services offered by this organisation to users and the family, and stressed that cooperation and understanding of families and communities was vital to the rehabilitation of former users. Dagga still remained the main drug of choice drug, followed by tik and heroin, and the profiles of addicts had changed over the years, and there were more female and adolescent users, with a 75:25 ratio of male to female users. CTDCC carried out drug and HIV testing, using a trust-building approach. the approach to testing was not a punitive tool but rather a trust-building tool for families and responsible persons. A major challenge was access to services was the main challenge, particularly for minors and in remoter communities, and even on the Cape Flats. Retention of staff was an internal challenge, and education to up-skill community based service providers was needed. It was suggested that more was needed by way of intervention at schools, since youngsters were using substances on school grounds. This organisation agreed that lack of integration of services and keeping service providers informed was a problem. LDACs needed to be running and active, to regulate service providers properly.

The Eldorado Park LDAC appreciated the intervention of the President in 2013, which had led to more focus on this community in order to address its severe drug problems. The LDAC had a number of successes, including a mobile service, the Kemojo mobile programme, Chris Hani Baragwanath Treatment Centre for Men. This initiative focused on harm reduction, supply reduction and demand reduction. Statistics causing concern included the age of users, with the youngest addict being only six years old, and 94 suicides in 2014 of under-21 year olds. This LDAC was concerned that many dealers continued to operate in communities without apparent hindrance, and rather than trying to criminalise every user, the LDAC was trying to target the dealers and engage in demand-reduction programmes. In the last two years rehabilitation had increased to meet the needs and there had been increased research, including this area.  This organisation agreed that integrated approaches with all relevant government bodies and stakeholders were needed, but many lacked understanding of their roles and responsibilities, and more faith-based organisations should become involved. 

The NHDFA set out the top causes of death in South Africa, with drunk driving causing the most deaths, at 6 000 per year, followed by gun violence, stabbings and serious assaults. It was concerned that despite increases in alcohol consumption, more money was still being put to treatment of conditions rather than to prevention which would cut down the need for treatment. It suggested that high excise taxes on alcohol and tobacco, and specific redirection of that money to programmes to address the effects had been used successfully in many other countries, including neighbouring states, and should be instituted in South Africa. Sales of alcohol contributed R16 billion to income revenue, but expenditure on alcohol related harm reflected a total of R17 billion in direct costs only, and probably drained nearly 2% of gross domestic product overall. Alcohol consumption statistics were given, that also highlighted that 16% of male learners and 9% of female learners would drink before age 13. The rate of drug use was dependent on affordability, availability, and social acceptability. Both upstream and downstream interventions could be made and the HPDF aimed to coordinate interventions across sectors, identify strategic national health and development priorities, lobby for appropriate public policies, dedicate resources, commission and fund relevant research and translate knowledge into accessible information.

In the discussion sessions, participants and MPs agreed that the underlying causes of drug abuse needed to be further researched, and that integration of services and acceptance by society of the need to address the multiple problems was needed. It was clarified by a government service that NGOs could get additional funds only if the current funds provided were being fully utilised. On the other hand, NGOs said that only early interventions were funded and many social workers were available, but unemployed. Many organisations mentioned their support for decriminalisation of users, noting the huge resources being spent on tacking this that would be better put to finding skilled professionals to treat the users. It was agreed that services were available, and affordable. However, the lack of coordination was hindering uptake, and communities, whilst apparently knowing who the druglords were, were not reporting them. Any attempts to lock down supplies had to be coupled with other opportunities offered to drug dealers for gainful employment in legal avenues. Marketing of alcohol was being done without corroborating education. The Central Drug Agency commented on the remarks, reiterating what strides had been made, what research was ongoing, and noting that R150 million had been acquired from the National Treasury to establish treatment centres and to assist existing ones to register properly. A partnership between the Departments of Social Services and Health was suggested. 

Meeting report

Chairperson's opening remarks
The Chairperson noted that substance abuse was something with grave potential to ruin the youth and the future of the nation if not properly studied and addressed. She narrated her experience during a recent oversight visit at the Limpopo Border in the Mpumalanga Province, tagging it as “an eyesore”. She said that the border post appeared to be merely a structure for the sake of formality, for there appeared to be no restrictions to illegal immigrants entering into South Africa from Mozambique. Although the rail transport across the border officially closed at 22:00, the service was being run for 24 hours. She added that there had been another report that there were over 200 private airports in the country and wondered what activities they were engaged in. She highlighted some of the duties of the Parliament, which included conducting oversight, enhancing public involvement and making laws and expressed her concern about the effectiveness of the laws and the effectiveness of the Government in supporting non profit organisations (NPOs). She encouraged concerned bodies and individuals to be vigilant as the inflow of drugs seems to be aimed at South African children.

South African National Council on Alcoholism and Drug Dependence (SANCA) submission
Dr David Fourie, Regional Director, SANCA Western Cape, led the submission. He stated that the "playing space" for substance abuse had drastically increased over the years,  buttressing this with reference to only two NPOs handling this in 1994, to the much larger number today. He described SANCA’s national footprint,  detailing facility locations inclusive of out-patient facilities, in patient facilities, satellite services as well as adolescent in-patient facilities. He confirmed that although the national footprint had improved over the years, the current facilities were still not nearly enough.

Dr Fourie highlighted the challenges to the organisation as including changing trends and more complex multi-substance abuse patterns, increased severity on users as a result of a simultaneous use of two or more drugs, rapidly changing profiles of users  - now seeing more females and adolescents even though they ignored available help - different abuse in cultures and different cultural attitudes, a general lack of life skills of and values of users, and increased life challenges.

There had been a progressive development of policies and legislation on substance abuse since 1994. The current National Drug Master Plan (NDMP) Policy met international standards and had proved to be extremely effective over the years. However, there had been some challenges as regards implementation of NDMP and legislation within the sector and existing structures. These included lack of national uniformity and implementation (with not all provinces meeting expectations), implementation challenges at provincial forums and local drug action committees (LDACs), fragmentation and limited coordination motivated by poor inter-departmental communication. There was also poor commitment and motivation of certain stakeholders, lack of sustainable funding, a need for capacity building and development initiatives, and a need for clarification of roles in terms of responsibilities and boundaries. There were specific challenges associated with capacity building and training of those of working in the sector and existing structures. He confirmed the need for divergent training of volunteers and professionals, adding that this required to deal with various levels of educational development. Other challenges in this regard were the need for specialised and advanced qualifications, challenges faced regarding accreditation of training courses, capacity building needs of emerging organisations, integration of training and supervision with in-service trainings, the need to look at some form of compensation or payment for volunteers and trained candidates, as they could not continue to be volunteers for their entire lives.

Dr Fourie mentioned the success stories of SANCA as standardisation of minimum treatment requirements and implementation of guidelines to register treatment centres and progress with monitoring and evaluation of services. SANCA had achieved some greater involvement of both local and national government departments in addressing substance abuse in their business plans, and there were some (although few) examples of well functioning provincial substance forums and LDACs (Northwest, Free State and Western Cape). It had worked to partnerships between the departments of Education and Department of Correctional Services and NGOs, to render integrated services and youth intervention programmes focused on penetrating all schools, and not just selected areas. There were Memoranda of Agreement in place between the Community Anti-Drug Coalitions of America (CADCA) and SANCA to render community development and capacity building in the North West. There were also agreements related to informative and correct research and data collection by Medical Research Council (MRC) in partnerships with service providers South African Community Epidemiology Network on Drug Use (SACENDU) and South African Addiction Treatment Service Assessment Unit (SAATSU) respectively.

SANCU recommended the need to:
-review the objectives and coordinating structures of the NDMP to ensure greater implementability and provision for capacity building and resources
- promote promotion of inter-departmental and stakeholder partnerships to render programmes such as prevention instead of laying emphasis on treatment
- increase adequate funding through ear marked taxes and fines
- lay greater emphasis on early intervention through treatment assessment and plans
- ensuring capacity building and mentoring for emerging organisations
- facilitate community-based treatment programmes
- facilitate the reinstatement of Alcohol Safety Schools for drinking and driving or other offences, as they proved effective before they were phased out
- offer community-based development opportunities in a healthy and balanced way
- expand accredited addiction and post-graduate training courses
- conduct research in an attempt to determine the population use of substances and identification of high-risk groups, researching to conduct an evaluation of the impacts of the current intervention and prevention services
- exercise caution about simply applying tobacco legislation to alcohol and drugs, as the legislation might not always be practically applicable.

Dr Fourie mentioned that cannabis use and dependency still remained a huge problem and as a result, there was a need to think very carefully about revisiting legislation permitting medicinal use of cannabis

Cape Town Drug Counselling Centre (CTDCC) submission
Mr Ashley Potts, Director, CTDCC, shared with the Committee some strong testimonies of clients who had benefited from the organisation’s services. The treatment process at the CTDCC is facilitated by all members of the organisation, and not just the counsellors. He described the services offered by the organisation. These ranged from a six-week outpatient programme aimed at group therapy, lectures, and a few other services, and ended with a four-week aftercare programme. He highlighted the adolescent and adult programmes, and said all were aimed at a holistic approach. The Family Programme aimed to offer professional assistance to affected service users in gaining a better understanding on how to deal with their problem in a broader context. Whilst the CTDCC carried out drug and HIV testing, the approach to testing was not a punitive tool but rather a trust-building tool for families and responsible persons. He then acknowledged the inputs of service providers, adding that there were currently twelve service providers in the network.

Mr Potts further stated that the favourite drug of choice still remained dagga, followed by methamphetamine (tik) and then heroin. He reiterated that adolescents were the main service users; the youngest user who came to the CTDCC for help was a nine year old. He confirmed that the population of service users was divided as 75% male and to 25% females, but the number of female service users had increased over the years. Treatment access of outpatients was over 70% and that of inpatients less than 30%. He reaffirmed that according to statistics, dagga remained the drug of choice and the rate of teenage users of this drug had increased over the years.

He then described the recurring challenges throughout the sector. Access to services was the main challenge, and here he focused on problems of transport and support for minors during treatment as the main contributing factors. Limited services to selected areas was also highlighted and he explained that not all facilities provided adolescent services even though adolescents accounted for 50% to 60% of all service users. On farms and in the Cape Flats there were limited services.

Mr Potts noted that for the CTDCC, retention of staff had posed a serious challenge as salaries were not regulated. He said that the organisation had battled with getting accredited training to up-skill community based service providers and to deal with education of community structures over the years. He added that more needed to be done through school based interventions, as young people using substances on school grounds was fast becoming the norm. De-criminalisation of service users was being considered. In regard to after-care and re-integration, and he claimed there had been challenges with the communities dealing with the user or recovering service provider, as well as family-related problems with those in recovery and treatment. He also voiced his concerns over the integration of services and Government’s position in relation to stakeholders, highlighting his concern over the fact that many service providers were not always informed about available tenders and how to access them. He finally mentioned that the LDACs needed to be active and running, as there was little or no regulation of new services as many service providers were not currently registered.
 

Discussion
The Chairperson expressed her concerns about the young age of children involved in drug abuse, including the nine-year old mentioned. She then narrated the story of the former Soccer Star, Jabu Mahlangu, and the damage done to his life by drugs. The Chairperson then wondered if the Committee was really fulfilling its mandate. She asked if there was any certainty on the underlying causes of the scourge of drug abuse.

Mr Albert Fritz, Western Cape MEC for Social Development, Western Cape, stated that acceptance of the problem by society was key to finding a long-lasting solution. He then suggested an integration of services with local facilities and existing health facilities. He claimed many service providers were very reluctant to visit rural areas requiring their services, adding that there seemed to be a constant tension between NGO administrators and social workers in relation to getting funding released. Mr Fritz made a clear statement that additional funds could only be requested if the current funds provided were being fully utilised. He closed by mentioning that the current substance abuse programme was fulfilling its mandate.

The Chairperson stated that further engagements would be needed to see how best the issues raised by the Minister could be addressed.

Ms A Plaatjie, Director, Equilibrium, Elsies River, raised her concern over insufficient funding of service providers. She explained that only early intervention was funded and there seemed to be a lot of unemployed social workers. she expressed her gratitude for the organised training at University of Western Cape, and also stated that engagements with the National Youth Development Agency (NYDA) were under way.

Mr Shaun Shelly, Advocacy and Psychosocial Co-ordinator, TB/HIV Care Association, said that emphasis should be placed on community based services. He suggested that instead of being carried away with the “Drug Demon” alone, it would be necessary to tackle community problems properly. Mr Shelly showed his support of decriminalisation of service users, adding that criminalisation of a largish percentage of the population was not the way to go.

Dr Robert McDonald, Head of Department, Social Services, Western Cape, mentioned that the South African Police Service (SAPS) was spending a great deal of time and resources on drugs arrests only and courts had a huge backlog of cases which made them dysfunctional. He also commented that the biggest gap in rendering services lay with finding skilled professionals for the treatment of children and adolescents, as it requires some special skills.

Ms L Zwane (ANC, Kwazulu-Natal) commented that the presentations were very informative. She added that other underlying factors could have led to the substance abuse menace but doubted if those underlying factors were necessarily also applicable to adults. She mentioned that the critical issue is education of children by parents and teachers. Ms Zwane then inquired if a research had been conducted into the magnitude of the problem, impacts achieved and the effectiveness of interventions made by service providers. She then asked what the problem with the accreditation of service providers really was and also inquired about the accessibility and affordability of provided services for all members of the community.

Mr Potts addressed Ms Zwane’s question and mentioned that the provided services are were accessible and affordable. He said although the services were not totally free, they were subsidised and at no cost to clients.

Dr Fourie endorsed all comments received.

Mr Kalaemodimo Mogotsi, Chairperson, Central Drug Authority, acknowledged the fact that drug abuse was on the rise. He further acknowledged the issues and concerns and promised to address these issues later during his presentation.

The Chairperson, reflecting on comments raised, said that lack of inter-departmental coordination and selective quality of services rendered appeared to be a big issue. She then enquired as to the ongoing activities, asking about the locations of ongoing interventions and responsible organisations.

Eldorado Park LDAC submission
Ms Cheryl Pillay, Representative, Eldorado Park LDAC, expressed her gratitude for the intervention of President Jacob Zuma in 2013 to help assist the plight of the Eldorado Park community who had felt they were losing the battle against substance abuse and illicit trafficking of drugs. She added that the community felt privileged to have everyone look into how it could be assisted. Ms Pillay mentioned that since the inception of the Eldorado Park LDAC in 2012, the LDAC had initiated programmes such as harm reduction, supply, prevention, and research. While highlighting different services rendered by service providers, she informed attendees that there were currently a handful of them that were all clustered into harm reduction. She also stated that Kemojo, Early childhood development (ECD), and counselling buses were all initiatives of the LDAC. She confirmed that it was known that at present many dealers were operating in the community without hindrance, and that whilst the LDAC was not planning to decriminalise every youth, it would be trying to engage actively with the dealers in discussions. In an attempt to cut down on suppliers, this LDAC had partnered with SAPS to conduct school raids, to petition  against low bail conditions set by courts to drug dealers, to mount road blocks, to set out campaigns, and many others. The LDAC had demand reduction programmes such as promoting a drug free community, active engagement in sports, creating a Men’s Forum, as there were very few good male role models, running holiday programmes aimed at keeping children off the streets and others. She added that the initiatives included research and media support, and gave examples such as Eldos FM which was a local media, door to door campaign, research into community based substance abuse and related ills, and others.

Ms Pillay outlined some of the achievements from 2013 to 2015. These included an increase in rehabilitation to meet increased client need, the ECD Mobile Bus, monthly regional LDAC meetings, an establishment of 94 LDACs in the Gauteng Province, provincial capacity building workshops, the establishment of Chris Hani Baragwanath Treatment Centre for men, safe housing in Eldorado Park. overall the LDAC was trying to promote self reliance as a community, ensure accountability, and more community involvement and activism in creating a drug free community. Adding to this, she said that the LDAC’s participation in Miss SA reflected the created and ongoing integrated community that commemorated and addressed successes and challenges. She clarified that the LDAC’s involvement in the Substance Abuse Summit was initiated by the provincial Department of Social Development (DSD) as a means of engagement with other departments. Research on services and intervention in substance abuse and other related social ills was conducted in Eldorado Park prior to the Summit, and there were pre and post summit reports available. She highlighted that some of the important lessons learned included the fact that an integrated approach with all relevant departments in the community was the key to a successful implementation of the NDMP in the local community. The LDAC had to follow a bottom-up approach, and day to day operation by the LDAC was the most effective approach, rather than a monthly or quarterly event. Challenges included a lack of understanding of departments, organisations, and stakeholders of their mandate in relation to the substance abuse legislation, NDMP and LDAC, and this was of major concern. She reiterated that impacts were not felt, and resources were wasted as a result of duplication, lack of integration and competitiveness. There were no intra and inter departmental collaborations. She informed attendees that LDACs still lacked basic resources, and it was the mandate of Local government to provide that. There was a lack of participation of  which is the mandate of the local Government and that there’s a lack of participation of faith-based organisations in Eldorado Park, although there were many buildings which could be used to make positive impacts in the community.

Discussion
Ms Zwane reaffirmed that the NDMP seemed to be misunderstood by many Departments. She added that with all the commitments and interventions being made, drug peddlers were still getting away with their crimes. She then wondered whether there should not be more stringent conditions or penalties for drug peddlers, such as applied in other countries.

National Health and Development Foundation Alliance (NHDFA) submission
Ms Savera Kalideen, Representative, Soul City, Johannesburg, started with a very graphic page detailing the top causes of death in South Africa. It pictured drunk driving as the highest cause of death, with 6 000 deaths per year, followed by use of firearms, causing 5 000 deaths per year, sharp instruments with 3 000 yearly, blunt Instruments   2 000 yearly, poison killings numbering 600 per year and killing with bare hands  at 400 deaths per year. She elaborated also on the spiral of ill health and poverty. She added that, contrary to public opinion and popular beliefs, alcohol was a major player when it came to revenue generation, as studies in 2010 revealed that alcohol contributed R16 billion to income revenue, but expenditure on alcohol related harm reflected a total of R17 billion in direct costs only. According to Medical Research Council studies in 2012, alcohol drained R38 billion , or almost 2% of the GDP (Gross Domestic Product) of South Africa. According to statistics around the top eight diseases caused by alcohol consumption, alcohol claimed130 deaths daily. She then set out some alcohol consumption statistics for South African school going youth in 2011 (Grades 8-11), which confirmed that 37% (male) and 28% (female) learners reported drinking in the past 30 days. 30% of male learners and 20% of females reported binge drinking in the past month. 16% of male learners and 9% of female learners would drink before age 13.

She then described some of the statistics on adults, reporting that statistics in 2009 reflected that 41.5% of males and 17.10% of Females reported drinking in the last month, 17.10% of males and 3.8% of females reported binge drinking in the last month, and 16.4% of males and 2.9% of females drank to harmful or hazardous levels.

Ms Savera said it was shocking to know that only 1% of resources were allocated for health promotion (HP) and prevention, whilst 99% of resources were allocated to conventional healthcare. She reiterated that if health promotion was given a higher priority, there would not be a need to spend 99% of the health budget on reactive approaches. While addressing the issues of individual and population health, she noted that through HP individuals could be taught better ways to living healthily. She added that over 80% of illnesses were caused by lack of access to drinking water. Many of the major diseases resulted in behavioural issues which were capable of creating negative issues in a community. She said the rate of drug use was dependent on affordability, availability, and social acceptability, and then recommended that upstream and downstream interventions could be made.

Ms Savera stated that the objectives of the Health Promotion and Development Foundation (HPDF) were to coordinate interventions across sectors, identify strategic national health and development priorities, lobby for appropriate public policies, dedicate resources, commission and fund relevant research and translate knowledge into accessible information. It aimed to build societal capacity to promote health and development, and to fund, implement, and support evidence-based interventions. She advised that lessons could be learnt from other countries and gave an example of Thailand which surcharged tobacco and alcohol taxes by 2% in 2001 in an attempt to channel the funds into Thai Health. Thai Health had made enormous strides and had seen the number of people stopping smoking rise from 1.6 million in 2000 to 6.3 million in 2009, and a 12% drop in drinkers from 2004-2007, a 31% drop in traffic accidents between 2004-2009, and a 10% drop in number of deaths though road accidents. Lessons could also be learnt from other countries in the region, such as Botswana and Zimbabwe. In Botswana, 40% of the alcohol-levy generated funding (P1.441 billion from 2008 - mid 2014) was utilised for youth and sport development, skills development and gender programming. Tobacco tax was used to fund HIV and AIDS programmes in Zimbabwe. Some successful actions taken to reduce tobacco consumption were banning advertising, banning public smoking, and increased tax on tobacco products. A “win-win” possibility would be gained by levying higher excise taxes on tobacco and alcohol as it would help reduce consumption, reduce the number of users, and increase government revenues. She added that spin-off benefits could include reduction of deaths, reduction of injuries, reduction of dependence and provision of alternative recreation and jobs.

Whilst reflecting on the economic argument in favour of a HPDF, she said the government spent about R249 million on campaigns against alcohol and drugs while R1 billion was spent on marketing by three prominent alcohol-producing companies (including Distell and SAB Miller). Alcohol and tobacco manufacturing in RSA was extremely profitable as profit margins were very high, so that increased taxes would not necessarily cause a negative impact on businesses.

The Chairperson handed over the chair at this point to Ms L Zwane.

Discussion
Ms Zwane commented that South Africa as a country should learn from neighbouring countries like Botswana and Zimbabwe  how to curb the harm induced by alcohol.

Dr McDonald said that the industry Association for Responsible Alcohol Use (ARA) invested only R11 million for several social development programmes in the country, while investing R1 billion advertising their products. He endorsed the recommendation to inflate the price of alcoholic products as mentioned by Ms Kalideen. He further said the Eldorado Park model was extremely promising but it was unfortunate that it was not recognised according to the legislation, which in turn made it difficult for local governments to actively engage.

Ms Catherine Williams, Representative, TB/HIV Care Association, said that she runs a mobile wellness clinic. She commented that it was extremely difficult for ex-criminals to integrate again into the system, especially in terms of gaining employment, once they had a criminal record. She added that appropriate measures needed to be in place to assist them.

Mr Shelly commented that there would always be outbreak of violent displays when trying to lock down supplies. He cited examples of such displays in Mexico and Russia. Any attempt to cut and lock-down supplies should be coupled with creation of other opportunities for drug dealers to gainfully find employment or access other business opportunities.

Mr Cecil John Fabricks, Sultan Bahu NPO, Johannesburg, claimed that the only people who could understand the heartbeat of the community were members of the community. He reiterated that there was an urgent need to find a mechanism to amend the Constitution to allow local drug authorities to operate effectively. He mentioned that the structure which seemed to be working in Mitchell’s Plain for over 12 years had been disbanded due to some legislative process, and said that the drug issue had worsened ever since.

Ms A Fredericks, Eldorado Park LDAC, also expressed her gratitude to the President for the assistance received so far. She claimed that the youngest addict she knew of was only six years old. She commented that when "motherly instinct kicks in, legislation is the last thing you think of”. She affirmed that in 2014, there were 69 suicides in Eldorado Park, and all the victims were less than 21 years of age.

Mr Claude Schroeder, Toevlug Rehabilitation Centre, expressed his disappointment over the absence of the South African Local Government Association (SALGA) from this workshop. He noted that the National Drug Policy had been effective in meeting its mandate. However, lack of coordination and alignment of processes seemed to be a major issue. He mentioned that an effective management of funds was the only criterion that disqualified NGOs for requesting additional funds. He commented that, with an estimated of 90 000 gang members in Western Cape alone it was vital for NGOs to actively engage in interactions with municipalities.

Ms T Mpambo Sibhukwana (DA, Western Cape) commented that political will was needed to win the fight against drugs. She said that marketing of alcoholic products should be channelled in the right direction. There were, in the townships, bill boards advertising alcoholic products publicly without restrictions, but this was not coupled with any form of education about the dangers of substances. Communities should be actively engaged in fights against drug and alcohol abuse and children should be engaged in extramural activities and have healthy youth hubs to keep them busy. More efforts should be concentrated, in terms of awareness campaigns, in all spheres of Government. She too was worried that a lot of resources were channelled into cure rather than prevention, and an active involvement of communities in this would also be essential.  


Ms Zwane mentioned that only a collective action would win the fight against drugs and substance abuse, rather than fragmented efforts.

Ms Pillay replied to Mr McDonald’s comment about the alignment of Eldorado Park LDAC with the legislation. She said that Eldorado Park LDAC was elected by the Mayor and as a result, all legislative procedures were duly followed.

Ms Savera mentioned that the government should not expect the same companies manufacturing endangering products to campaign against their own products and, as a result, government should not rely on campaigns or funds from the same companies.

Ms Zwane re-echoed the Chairperson’s comment that this workshop obviously would not be the last engagement as there were lots of issues that needed to be dealt with.

The Chairperson said that she appreciated the presentations from the Eldorado Park LDAC and NHDFA. She agreed that the focus should be shifted from casting blame to actively participating together to address and mitigate the menace of substance abuse. She asked if those present felt that there had been a thorough analysis of all collated researches to take a common line.

Mr Kalaemodimo, Central Drug Agency, noted that substance abuse was a global issue. He briefed attendees about the provisions of the NDMP, mentioned that the Central Drug Agency (CDA) was a board that implemented through departments, and there were only two secretariat members who ensured its implementation across departments. Mr Mogotsi added that there were currently 241 LDACs across the country, but some of them were not fully resourced. He reiterated that government had made some strikes in community based services currently being implemented countrywide, a social mobilisation strategy had been developed, a Bill had been submitted in respect of advertising alcoholic beverages to address concerns raised, and there was a policy in place that restricted liquor shops to a minimum distance of 500 metres away from schools. Furthermore, he said that five learners were selected from eight provinces and sent to Eldorado Park for experiential training that would make them useful in their respective provinces.

Mr Kalaemodimo said, in response to the research based questions and concerns, that research would be conducted into the impact of substance abuse on nature, as it would help to carve out evidence-based interventions. He added that research was under way to confirm the positive uses of cannabis and that University of Cape Town and University of Johannesburg would be considered in starting a Colombo plan.
He then affirmed that there were suspicions that some LDACs might have drug dealers as members and there were investigations under way in this regard. In regard to treatment centres, he said that about R150 million had been acquired from the National Treasury to establish treatment centres, that existing treatment centres would be assisted with registration instead of closing them down, and that the Department of Health was helping treatment centres to obtain the necessary accreditations. He mentioned that inter-departmental partnerships were on the way, giving examples of provinces such as Gauteng, Eastern Cape. He added that a different accreditation body other than South African Qualifications Authority would be used for therapeutic interventions. He confirmed that there were gaps in the current legislation and these would be closed soon. He rounded off by mentioning that there was a resource directory for people to locate services.

Ms Zwane interrupted Mr Kalaemodimo and enquired about the extent to which schools in the Western Cape were affected by drug and substance abuse.

Mr Fabricks suggested prioritisation of a partnership between the Social Services Department and the Department of Health.

Mr  Schroeder said that it would be wise for the government to tackle the issue of accreditation and registration of treatment centres effectively, as it could otherwise initiate divisions within communities.

Ms Zwane asked about the position of the Kwazulu Natal Province with regard to partnerships.

Mr M Khawula (IFP, Kwazulu Natal) asked about the difficulties of establishing a collaborative effort of the relevant stakeholders, agreeing that it appeared that currently, drug lords were operating freely in well known areas and there seemed to be no form of intervention. He reiterated that the Eldorado Park LDAC initiative was successful but wondered why it took a Presidential visit before an action plan was developed.
 
Ms T Mampuru (ANC, Limpopo) appreciated the suggestions for Limpopo.

The Chairperson thanked all NGOs and concerned parties for their attendance, engagement, and work being done. She said that interventions needed to be well-informed otherwise they would be a waste of resources, and that specific interventions in particular areas would need to be clarified. If the communities were admitting to having drug lords operating in those communities, people must be able to identify them and it was up to the community to report them to the police and police officials who might be colluding should be exposed if guilty of any corruption. She wanted to know to what extent academic institutions were involved in research, commenting that they were not usually driven by profit motives. She stressed the need for centres to be easily accessible to all service users. She lastly said that with the high level of concern about the issues being deliberated, there must also be a national dialogue.

The meeting was adjourned. 

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