Questions and Replies

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08 October 2021 - NW2256

Profile picture: Motsepe, Ms CCS

Motsepe, Ms CCS to ask the Minister of Health

What are the reasons that unemployed community nurses are not utilised for the vaccination programmes in areas where shortages of nurses exist?

Reply:

According to the Scope of practice of nurses, only professional nurses registered with the South African Nursing Council (SANC) are allowed to administer vaccinations. Enrolled nurses, also registered with SANC, may administer vaccinations under the supervision of a professional nurse, on condition that they receive the relevant training.

Currently, there are no nurses registered with SANC in the “community nurse” category. For this reason, the Department of Health (DoH) may not use nurses who are not registered with SANC.

END.

08 October 2021 - NW2268

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

(1)Whether, concerning the policy on the Pathway for Registration of South African Citizens who hold Foreign Qualifications not prescribed for registration as medical practitioners, the Government has considered less restrictive ways for the registration of South Africans who obtained medical qualifications in foreign countries to practice as medical practitioners; if not, why not; if so, what are the relevant details; (2) what total number of foreign trained South African citizens who hold medical qualifications and who applied to the Health Professions Council of South Africa have to date not been granted the opportunity to sit for examinations and to undergo supplementary clinical training?

Reply:

1. According to Section 4 (Application for registration) of the Health Professions Council of South Africa (HPCSA) Regulation R101, An application by any foreign qualified person for registration as a health practitioner in any of the professions registered under the Act shall be made on the prescribed application form obtainable from the professional board concerned, and shall be accompanied by - (e) in the case of an application for registration in a profession for which internship training is a requirement, a certificate of completed training as an intern or of similar training or experience obtained elsewhere and the Programme for such training; (g) an original certificate of good standing, which shall not be more than six months old, issued by the foreign registration authority where the applicant is or was registered”.

Most of the South Africans who study abroad in institutions not recognized by the HPCSA are unable to meet these requirements. The pathway was intended to assist such applicants by providing an opportunity for clinical exposure and registration as student interns so that they could then be able to undertake formal internship. Unfortunately the pathway, which was approved by the National Health Council (NHC), has not been fully implemented because of the outstanding issues between HPCSA and medical schools, in terms of providing this opportunity for these students interns training.

(2) All applicants who are eligible and/or have submitted compliant documents have been allowed to sit for examinations. It should however be noted that, because of the COVID19 pandemic and subsequent lockdowns, there were no exams held in 2020. This led to a backlog that has, since the beginning of 2021, been attended to. The HPCSA is currently processing new applications that are currently being received for future examinations.

END.

08 October 2021 - NW2267

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

(1)Whether, in light of vaccination hesitancy surrounding the uptake of COVID-19 vaccines, the Government intends to make COVID-19 vaccinations mandatory by law; if not, why not; if so; (2) whether such mandatory vaccinations will be required for all persons in the Republic by law; if not, why not; if so, what are the relevant details; (3) whether the mooted mandatory vaccination will be targeting some industries; if not, what is the position in this regard; if so, (a) which industries and (b) what are the reasons; (4) what informs the Government’s position on making vaccinations mandatory by law; (5) whether the Government will allow the private sector leeway to impose such mandatory requirements for COVID-19; if not, why not; if so, what are the relevant details?

Reply:

1. No, Government does not intend to make COVID-19 vaccinations mandatory by law. the government approach is to invest in persuading in people seeing the life-saving value of vaccination.

2. As stated above, government wants to emphasis on rather convincing people of the value of vaccination.

3. While the state has no intention to make vaccination mandatory, we also have no intention to interfere in internal policies of private and independent institutions, including on the public health policies.

4. Not applicable.

5. As stated in (3), government has no intention in interfering in internal policies of private and independent institutions in this regard.

END.

10 September 2021 - NW1988

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1). What (a) are the details of the progress of the (i) Sekhing, (ii) Jouberton and (iii) Mathibestad clinics that are under construction by his department in the North West, (b) is the name of the company to whom his department awarded the contract to build each clinic and (c) amount did each clinic cost his department; (2) whether the three clinics are currently in operation; if not, why not, if so, what are the relevant details; (3) what is the current breakdown of the vacancy rate of health care workers in each (a) hospital and (b) position in the North West?NW2222E

Reply:

(1)and (2)

(I) CONSTRUCTION OF A NEW JOUBERTON CHC

1.1 STATUS SUMMARY

The project status summary is highlighted in the matrix below.

Table 1.1: Project status summary: Construction of a new Jouberton CHC

No.

Item

Description

1

Contract Number

DoH/020/PS/11

2

Date of Site Handover

19 September 2016

3

Original Contractor

JV Group Five & ENM

4

Implementing Agent

NWDoH

5

Principal Agent

Tiki Architects

6

Contract Commencement Date

19 September 2016

7

Contract Duration ( Original )

410 Calendar days

8

Practical Completion (Original )

3 November 2017

9

Revised practical completion date (As per EoT 8)

21 May 2019

10

Cost of EoT

R 4 358 562,97 Excl VAT

11

Contract value before EOT 8 (with EOT 7)

R 205 320 122, 91 Excl VAT

12

Revised contract value with EOT 7 & 8 awaiting Approval by Provincial treasury

R 209 678 685,88 Excl VAT

13

Original Contract Amount

R 146 622 724,20 Excl VAT

14

Progress to Date

100 %

15

Expenditure to date

R 222 217 461.09

​1.2 PROJECT SCOPE STATEMENT

The project scope includes the following health units amongst others:

CTOP, Dental, Emergency, Maternity, Theatre, Outpatients, Crisis Control, Radiology, Sputum Booth, TB and appurtenant works.

The following service units are also included:

Guardhouse, Main Reception and Administration, Pharmacy, Service Building, Generator and Gas Control, Medical Waste and refuse Deposit, Pump Station, Carports. Staff accommodation comprising of six (6) two bedroom flats and four (4) one bedroom flats and appurtenant works also forms part of the scope of works.

​1.3 PROGRESS TO DATE

The project is at 100% completion, with final completion achieved. The clinic is currently operational.

(ii) CONSTRUCTION OF A SEKHING chc

​1.4 STATUS SUMMARY

The project status summary is highlighted in the matrix below.

Table 1.1: Project status summary: Construction of a new Sekhing CHC.

No.

Item

Description

 

Contract number

NWDOH/PS/019/11

 

Contract sum

R 84 026 731.26

 

Commencement date

4 October 2012

 

Original Contractor

ENM Trading Pty Ltd

 

Principal Agent

Phitlhelelo Properties Pty Ltd

 

Project Period

22 months

 

Practical completion date (original)

31 August 2014

 

Revised practical completion date

21 February 2019

 

Progress to date

89%

 

Revised contract amount (Incl approved V.O’s)

R 130 686 350.69

 

Expenditure to date

R 121 557 456.64

​1.5 PROJECT SCOPE STATEMENT

Community Health Centre with Administration Building, OPD, Male and Female Medical Wards, CTOP, EMRS, Crisis Control, Pharmacy, Dental Unit and Services Building. Residential Accommodation with parking Bays, Water storage tanks, Generator and Diesel Tank Rooms, Boundary Fence for both developments and parking for visitors.

​1.6 PROGRESS TO DATE

The contractor has currently abandoned the site citing financial difficulties, and further requested settlement on the project. The Department has appointed an external investigator on the project, of which the finding on the report shall provide a way forward on the project as the Department is considering termination.

iii) Information about the Mathibestad CHC is still being verified by the Province, it will be submitted as soon as it is completed.

(3) According to the North West Provincial Department of Health the current breakdown of the vacancy rate of health care workers in each hospital are as follows (a)-

HOSPITAL / HEALTH CARE WORKER CATEGORY

FILLED

VACANT

TOTAL

VACANCY RATE

Bophelong Psychiatric Hospital

220

34

254

13.4

Brits District Hospital

377

72

449

16.0

Ganyesa District Hospital

96

27

123

22.0

Gelukspan District Hospital

142

37

179

20.7

Gen De La Rey District Hospital

44

14

58

24.1

Job Shimankane Tabane Hospital

792

113

905

12.5

Joe Morelong Memorial Hospital

289

40

329

12.2

Klerksdorp Tertiary Hospital

1032

144

1176

12.2

Koster Hospital

91

11

102

10.8

Lehurutshe District Hospital

74

25

99

25.3

Mafikeng Provincial Hospital

593

56

649

8.6

Moses Kotane District Hospital

426

119

545

21.8

Nic Bodenstein District Hospital

94

23

117

19.7

Potchefstroom: Hospital Primary

457

98

555

17.7

Schweizer-Reneke Hospital

72

16

88

18.2

Taung District Hospital

330

39

369

10.6

Thusong District Hospital

136

32

168

19.0

Tshepong Primary Hospital

121

26

147

17.7

Witrand Regional Hospital

509

130

639

20.3

Zeerust District Hospital

67

17

84

20.2

Grand Total

5962

1068

7035

15.2

(b) Position in the North West

The North West Provincial Department of Health has an overall health care workers vacancy rate of 15.2%. The North West Provincial Department of Health’s budget baseline for the financial year 2020-2021 is reduced over R400 million and therefore the department is mainly filling critical replacement posts and some priority posts which were identified in the beginning of the financial year. The posts are being filled as and when the budget is available and confirmed by the Chief Financial Officer.

The Province ensure that health care service are continuously provided in the Province and not compromised through payment for overtime for additional hours worked by health care workers.

END.

08 September 2021 - NW1987

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1)What are the details of the progress that his department has achieved in addressing the arrears payments with regard to the medical depot accruals that have large outstanding amounts which have a negative impact on procuring medical equipment, medication and other medical supplies; (2) what was the actual total accrual amount at the beginning of the intervention compared to the current outstanding arrears to the medicine depot?

Reply:

EASTERN CAPE

1. The province had allocated sufficient budget at the beginning of the financial year for the settlement of outstanding accruals for medicines in the Depots. The interventions also included a process of ensuring that all invoices are received and processed on time from the suppliers to the payment stage.

2. The Eastern Cape depot had a total of R847 461 million on accruals at the end of the financial year. The high level of accruals was due in part to the cash flow challenges faced by the department as a result of the high medico legal claims.

The department prioritized the settlement of accruals in the first quarter of the current financial year. At the end of August 2021, the department had settled R689 042 million of the accruals. This is equivalent to 81% of the total accruals on medicines and medical supplies. The balance is expected to be settled in the month of September.

FREE STATE

1. The Free State department of health does not experience problems in paying the claims of medical depot. The strategy we use is that of prioritizing medical depot and making sure that they remain afloat to enable it to pay suppliers on time. The arrangement is that they submit their claims at the beginning of every week.

2. The total accruals amount to R542,443,773 and total paid amount to R443, 963,155 which translate to 82% of the total payment made to date. The outstanding amount R97,267,083 was settled by 31 August 2021 and R1,213,534 by 09 September 2021.

GAUTENG

1. The department and the depot had agreed to submit claims at least twice a month as opposed to once a month. This has helped to keep the depot afloat so that it is able to pay its suppliers on time while procuring more medicines as may be required by health facilities. The GDOH is now able to process payments for submitted claim within 30 days on receipt of a claim. The Medical Supplies Depot is able to fulfil its mandate of procuring Medicines that are mostly delivered direct to health facilities and to pay its creditors.

2. As at 31 March 2021 the balance owed to the Medical Supplies Depot was R925 million, the outstanding amount was settled in full in the first quarter of the current financial year (2021/2022). At the end of quarter one of 2021/2022 financial year amount owed to the depot was R664 million and was paid in full in the month of July and August. The new current balance owed is R412 million but is still within 30 days.

KWAZULU-NATAL

1. The Medical Depot is continuously engaging with the facilities to submit payment packs on time in order to be able to process them to pay suppliers. Monthly account reconciliations are done in order to identify old outstanding payments. Strict turnaround times to process the payments on time once all necessary supporting documents are received from the facilities.

2. The actual total accrual amount at the end of August 2020 (excluding less than 30 Days) was R1,053,308,923 and the current outstanding amount August 2021 (excluding less than 30 Days) is R455,859,740.

LIMPOPO

1. Limpopo pharmaceutical procurement is partially centralized with the exception of the Regional and Tertiary institutions that are on direct delivery system. Total budget allocation for the 2020/21 financial year was R1,6 billion whereas the accruals as at the end of the financial year was R96 million which translate to 6%.

2. Total Medical depot accruals amount to R96 million. Accruals are expected to be in line with the monthly expected percentage expenditure equal to 8,3%. The department in the year under review managed to contain the accruals to remain under the acceptable percentage of 8,3%. All the accruals have been paid in the 1st quarter of the current financial year.

MPUMALANGA

1. Mpumalanga Department of Health does not have any outstanding invoices not paid as all accruals have been paid during the first quarter.

2. Total accruals outstanding as at 31 March 2021 has been R195,813,681 and all the invoices have been processed during first quarter and currently invoices not paid are within 30 days of been received.

NORTHERN CAPE

1. The department is currently experiencing cash flow constraints, thus a number of invoices cannot be paid within the 30 days of receiving the invoice, as determined in terms of Treasury Regulation 8.2.3. There is continuous challenge to settle the accruals which mainly affects the Equitable share. The payments are prioritised in terms of the source of funding, contractual obligations, non-negotiables items and other payments.

2. Total Medical Depot accruals & payables as at 31 March 2021 amounts to R96.512 million, which results mainly from cash flow constraints affecting the provincial equitable share funding. Currently, there is no intervention from the oversight departments.

NORTH WEST

1. The North West Department of Health could not pay all of its invoices for goods and services for the 2019/2020 financial year, starting from the third quarter. In the main, the challenge has been inadequacy of goods and services budget allocation over the years as opposed to the ever increasing burden of diseases and price escalation on non-negotiable items such as medicine and medical supplies.

2. At the beginning of the intervention, the North West Department of Health had accruals amounting to R236,649,308 relating to the medical depot and at the end of 2020/2021 financial year an amount of R265,928,108 was disclosed as accruals. As at 31 August 2021 accruals totaling R215,568,490 which is 81% has already been settled and the intention is to pay in full all in the invoices which are not disputed by end of September 2021.

WESTERN CAPE

1. The Cape Medical Depot (CMD) procures Goods and Services on behalf of the whole Western Cape Health Department via its MEDSAS procurement system. Once the CMD issues stock to a particular health institution the relevant budget of that institution is expensed. Once invoices are received, payments are effected and paid within 30 days, so there is no need for Medical Depot accruals payment strategy.

2. CMD’s accruals are significantly below the accepted threshold and will not be prevented from continuing to procure the relevant goods and services on behalf of the department. In terms of payment days, the department is well within the 30-day payment threshold.

END.

08 September 2021 - NW1986

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1)On what date will the findings of the forensic investigation into two companies (names furnished) be made available; (2) whether he will furnish Ms H Ismail with a detailed report on the (a) services, (b) challenges and (c) shortfalls of the emergency medical services in the North West province; (3) what are the details of (a) the involvement of Aurum’s Rustenburg Clinical Research Institute and his department and/or the SA Medical Research Council and (b) their contractual agreements; if not, why not; if so, what are the relevant details; (4) whether he will provide Ms H Ismail with a full report regarding the senior officials in the SA Medical Research Council who were suspended; if not, why not; if so, what are the relevant details?

Reply:

(1) (i), (ii) The NWDOH has not conducted any forensic investigation related to any of the Buthelezi entities. However a case was opened with the SAPS (Hawks) and the case number is: Mmabatho Case Number: 89/02/2018.

(2) (a) Services

The service is currently managed provincially with services decentralized to the sub-district level within Districts. The NWDOH has developed a Policy Framework and Strategy which details a number of interventions that the department is implementing to ensure improvements in EMS delivery. Key to the strategy is the centralization of EMS Command to the EMS district and provincial offices, moving away from the current decentralized command where district health services were responsible for management of EMS. However before vertical reporting of EMS could be implemented, a need was identified to capacitate both the districts and provincial EMS offices particularly with administrative support staff to enable the office to function. Critical vacant positions have been identified after funds were secured for this financial year and the department in process of advertising, and recruitment currently. Plans are that the centralization of command would be effected within the next financial year as the department continues to prepare accordingly.

Two other main objectives in the policy framework entails centralizing the 4 existing district call centres which are working on manual systems into one highly digitalized central communication centre and the establishment of the Planned Patient Transport (PPT) sub-program. The Infrastructure Development and Technical Services unit of the department has been allocated funds and has recently appointed consultants to refurbish and furnish the building identified for the Emergency Communications Centre. With regards to Planned Patient Transport the sub-programme responsible for budget (financial planning) within EMS is utilized to procure red fleet and does not have any staff attached to it. The function of PPT is currently done with the same EMS resources and this negatively impacts EMS operations. The revised EMS staff structure includes PPT and the entire ideal departmental structure is awaiting approval.

The primary response times of EMS in both rural and urban areas continue improving in order to meet the national norms and standards. The revised national standard for EMS response time is that Priority 1 (P1) patients should be reached within 60 minutes in rural areas and within 30 minutes in urban areas for 75% of the cases. EMS in the province over the previous financial year (2020/2021) registered an improved 76 per cent of rural patients and 70.9% per cent of urban patients serviced within the national norms. The target set for P1 urban and P1 rural in the current Annual Performance plan is ≥60% and ≥70% respectively given the resources available. EMS currently attends to 67 per cent of urban P1 patients in 30 minutes and 73 per cent of rural P1 patients within 60 minutes.

Currently there are 37 operational Paramedics and Emergency Care Practitioners (ECP) appointed across the districts which has helped reduce the reliance on private services. A number of ambulances are also upgraded to be utilized as Advance Life Support ambulances for ICU related cases.

(b) Challenges

The NWDOH is experiencing a shortage of ambulances. In addressing the gap the department has been using outright purchasing by procuring red-fleet using National Treasury approved RT57 contract. In 2018/2019 final year, the Department of Community Safety and Transport Management’s (DCST) Head of Department issued a circular instructing all provincial departments to cease procuring any fleet directly from RT57 as it results in unwarranted audit findings. DCST further indicated that they will no longer assist any department that procure their own fleet with any support from their Transport section, which is responsible for registration on e-Natis, licensing, e-fuel installations and maintenance/repairs of vehicles.

Following the circular, the Department transferred funds to DCST for procurement of red-fleet. However in January 2020, DCST returned funds to the Department proposing that the Department apply for roll-over of the same funds from Treasury. This was because the delivery period as per contract was going to overlap into next financial year whilst vehicle manufacturers were experiencing production challenges. As a result, the Department could not procure red-fleet in 2020/21 financial year. The Department applied for roll-over of funds to this financial year but the provincial Treasury did not approve the roll-over of funds.

For the 2021/22 financial year the department has already transferred R33 million allocated for motor vehicles to DCST to procure 41 ambulances and the DCST have committed a purchase order and is currently awaiting conversion of panel vans to ambulances before delivery to the NWDOH. The department is internally identifying funds which needs to be re-prioritized towards implementing an alternative strategy of procurement of red fleet through full maintenance leasing (this alternative procurement model is currently undergoing consultation processes). A further R30 million is estimated as the required budget for this initiative as part of the first phase.

(c) EMS Shortfalls

The lack of efficiency in the current manual based district call centers is affecting service delivery as well as management of resources and information management. The introduction of a comprehensive emergency communication solution which is technology based will greatly assist and also improve public access to these services. As already indicated above, a building has been handed over by the Department of Public Works and IDTS has appointed consultants to establish the central Emergency Communications Centre.

The inability to inject new fleet in the previous financial year has contributed adversely on the prevailing shortages, most specifically of ambulances. Furthermore, the current turnaround time for repairs (1 – 365 days) as well as replacement and repairs of red fleet is not responsive to the needs of the department, hence the department is pursuing leasing of vehicles as an alternative.

(3) (a) The SAMRC has a collaborative research agreement with Aurum Rustenburg to be a clinical trial site for Sisonke, the phase 3b open-label study of the Ad26 SARS-CoV-2 vaccine administered to health care workers.

(b) SAMRC entered into a collaborative agreement with Aurum to provide for funding to Aurum sites to participate in the Sisonke clinical trial. In terms of the agreement, Aurum is required to implement the study at its sites in accordance with the approved protocol and good clinical practice.

(4) There are no senior officials at the SAMRC that have been suspended.

END.

08 September 2021 - NW1931

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

What (a) are the reasons that racially inclusive demographics are not included in the (i) collection and (ii) sharing of COVID-19 related information and (b) effect does the lack of racial demographics have in relation to the response of the State in vaccine distribution across the Republic, but more importantly in Black communities?

Reply:

(a) and (b) When samples are taken from individuals the laboratory must complete the biographic data name, surname, ID, date of birth, address etc. This information is then captured into an electronic data system which is then used to analyse and publish statistics. Unfortunately biographic data is often not fully completed by the patient and health care workers consequently we do not have a full data set of biographic data in all cases. In the case of race specifically this data is often not reported at source. Consequently we have not been reporting COVID infections and vaccinations by race, since there is also no evidence that race is a significant risk factor.

END.

08 September 2021 - NW1952

Profile picture: Shembeni, Mr HA

Shembeni, Mr HA to ask the Minister of Health

What (a)(i) studies has his department done to ascertain the extent of vaccine hesitancy in the Republic and (ii) are the causes of the hesitancy and (b) communication measures has his department put in place to allay the fears of persons who are hesitant to take the COVID-19 vaccines?

Reply:

a) Our goal must be to vaccinate at least 70% of adults in South Africa, and especially to ensure that all people over the age of 50 are vaccinated before Christmas 2021. If we do that, the number of people who are hospitalised or die from COVID-19 will be substantially reduced.

(i) In terms of vaccine hesitancy, the South African population falls into three main groups:

  • Those who are eager or willing – this is the biggest group, roughly two thirds.
  • Those who are uncertain and need to be supported to get them over the line by providing them with information and reassurance and making it easy for them to get vaccinated – a quarter of the population.
  • Those who are opposed to vaccination (roughly a sixth).

This is encouraging, because it means that the vast majority of South African adults may come forward for vaccination if their concerns are addressed and if it is easy for them to access the service. The challenge is likely to be due to lack of urgency to be vaccinated rather than being unsure of whether to vaccinate or not.

Extent of vaccine acceptance

The Department of Health has drawn on a number of national studies to understand the extent and reasons for vaccine hesitancy. They include:

  • The NIDS-CRAM series of panel surveys (which found that vaccine acceptance has increased from 71% in Feb/Mar to 76% in Apr/May 2021. Half of those who were vaccine hesitant in Feb/Mar 2021 had changed their minds were now willing to vaccinated.
  • HSRC/University of Johannesburg survey (Dec/Jan 2021: Two thirds of the SA adult population say they will definitely or probably get vaccinated.
  • Ask Afrika Survey: 62% of South Africans willing to get vaccinated.
  • African Response (May 2021): 74% of South Africans are willing to get vaccinated and are confident of government’s efforts to manage the vaccine rollout.
  • Afro Barometer (May 2021): 43% say they are willing to get vaccinated; 64% approve of government’s performance and 78% say government has done a good job of keeping public informed).
  • SAMRC VAX-scenes (April 2020): 62% willing to get vaccinated.

All surveys with the exception of the Afrobarometer survey find that the majority (about two-thirds) of South Africans are willing to get vaccinated. Another quarter are open to persuasion. Only about one in six say they definitely won’t get vaccinated.

Reasons for acceptance.

The main reasons for accepting the vaccine are to protect themselves or family from contracting the virus (~75% of those who are willing).

Reasons for hesitancy

The main reasons cited for hesitancy include:

  • Concern over side effects (about ¼ of those who are vaccine hesitant)
  • Distrust of the vaccine (about ¼ of those who are vaccine hesitant)
  • Unsure of its effectiveness

b) The Department’s response on communication measures put in place:

  • The NDoH and GCIS work together on a national communications strategy to tackle the reasons for vaccine hesitancy. This includes a social media strategy, radio PSAS in all 11 languages as well as printed material in all 11 languages distributed to all districts. Over the past months, over 20 million information leaflets have been printed and are being distributed.
  • The NDoH and GCIS also leverage the communications and social mobilisation capability of civil society organisations, labour and the business sector through the National Communications Partnership which has produced and disseminated contents through their networks.
  • The private sector has also come on board, with the PEPKOR group of companies distributing over 10 million of the NDoH leaflets through their stores. Posters have been placed in 30,000 spaza shops encouraging people to get registered.
  • A national Demand Acceleration Strategy has been developed and a National Task team established to direct its implementation. These activities will be accelerated over the next three months, even as efforts are expanded to make it easier for people to get vaccinated through mobile outreach and other access strategies.

END.

08 September 2021 - NW2060

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

What are the details of hospitals that have recorded the highest infant mortalities in the Republic in 2021?

Reply:

Infant deaths are defined as deaths occurring during the first year of life, and are divided into newborn deaths that occur during the newborn period (0 – 28 days) and post-neonatal deaths that occur between 29 days and one year of age. The majority of infant deaths occur during the newborn period.

The thirty public sector hospitals with the highest number of infant deaths recorded thus far in 2021 are shown in the table below[1]. The hospitals with the highest number of infant deaths are predominantly national central, tertiary and regional hospitals – this is primarily due to the fact that these are large, referral hospitals which provide care to many newborns and other infants who are at highest risk of death.

Hospital

Level of care

No. of newborn deaths

No. of post-neonatal infant deaths

Total infant deaths

gp Chris Hani Baragwanath Hospital

Tertiary hospital

299

62

361

ec Nelson Mandela Academic Hospital

National Central Hospital

139

67

206

gp Dr George Mukhari Hospital

National Central Hospital

168

29

197

lp Mankweng Hospital

Tertiary hospital

159

27

186

gp Tembisa Hospital

Tertiary hospital

166

18

184

gp Rahima Moosa Hospital

Tertiary hospital

156

23

179

ec Dora Nginza Hospital

Regional Hospital

126

40

166

gp Thelle Mogoerane Regional Hospital

Regional Hospital

149

17

166

kz Queen Nandi Regional Hospital

Regional Hospital

116

41

157

fs Bongani Hospital

Regional Hospital

135

22

157

kz Prince Mshiyeni Memorial Hospital

Regional Hospital

129

20

149

wc Tygerberg Hospital

National Central Hospital

118

31

149

nw Mahikeng Provincial Hospital

Regional Hospital

126

11

137

nw Job Shimankana Tabane Hospital

Tertiary Hospital

119

17

136

gp Sebokeng Hospital

Regional Hospital

101

18

119

gp Steve Biko Academic Hospital

National Central Hospital

68

49

117

kz Mahatma Gandhi Hospital

Regional Hospital

95

17

112

fs Pelonomi Hospital

Tertiary hospital

92

17

109

kz Port Shepstone Hospital

Regional Hospital

87

21

108

kz General Justice Gizenga Mpanza Hospital

Regional Hospital

91

16

107

kz RK Khan Hospital

Regional Hospital

84

13

97

mp Witbank Hospital

Tertiary hospital

72

21

93

gp Kalafong Hospital

Tertiary Hospital

71

18

89

mp Rob Ferreira Hospital

Tertiary Hospital

65

22

87

gp Mamelodi Hospital

Regional Hospital

76

11

87

gp Leratong Hospital

Regional Hospital

67

18

85

ec Mthatha General Hospital

Regional Hospital

79

2

81

kz Newcastle Hospital

Regional Hospital

62

18

80

fs Universitas Hospital

National Central Hospital

69

11

80

gp Jubilee Hospital

District Hospital

77

3

80

END.

District Health Information System. Extracted 2nd September 2021.

08 September 2021 - NW2059

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

In light of the recent crime statistics report, what (a) are the details of hospitals that have recorded the highest incidents of rape-related treatment and (b) total number of rape victims have died in hospitals in the period covered by the latest crime statistics report?

Reply:

This question is unfortunately beyond the scope of information that is available to the Department of Health. The determination of rape requires a conviction in a court rather than an allegation or complaint. The SAPS may be in a better position to provide information regarding this question. Rape is not recorded as a cause of death in any health statistics and deaths associated with sexual assault will usually be recorded as death due to unnatural causes, most frequently recorded as ‘blunt trauma’ or ‘sharp trauma’, etc.

END.

08 September 2021 - NW2058

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

Whether, given that the Cancer Association of South Africa partnered with the World Health Organisation to highlight the risks associated with tobacco use and in light of the fascination with hooker amongst party-going youth, his department recorded any number of deaths and/or severe illnesses directly connected to the use of hooker; if not, what is the position in this regard; if so, what are the further relevant details?

Reply:

No. The Department is not aware of any deaths or severe illness reported that are directly connected to the use of hookah in South Africa.

However, studies conducted in other countries on the chemistry of waterpipe smoke had shown hookah smoking contained seven carcinogens, 39 central nervous system depressants, and 31 respiratory irritants (Pratiti, R., & Mukherjee, D. (2019). Water-pipe smokers are found to have significantly higher carbon monoxide in blood which reduces tissue oxygenation, than cigarettes smoking (Theron, Ansa, Schultz, Cedric, Ker, James A, & Falzone, Nadia. (2010).

The main ingredient used in waterpipe is tobacco, and its use has both acute and long-term harmful effects on the respiratory and cardiovascular systems. Hookah users tend to also add other substances to it such as alcohol and drugs. (Theron A et al: Carboxyhaemoglobin levels in water-pipe and cigarette smokers Original Articles122 -124.)

Waterpipe use is associated with an increased risk of transmission of infectious agents, including respiratory viruses, hepatitis C virus, Epstein Barr virus, Herpes Simplex virus, tuberculosis, Helicobacter pylori, and Aspergillus. WHO had raised concerns about waterpipe use and its risk of transmission of diseases, also indicated that it could also encourage the transmission of COVID-19 in social gatherings.

All innovative tobacco products, the related products, including the waterpipe should be strictly controlled in the country. The demand and supply of such products need to be reduced to ensure that we do not get more young people addicted to the products. Young people need to be continually made aware of the harm that goes with using these products and the tobacco industry needs to be controlled by, for example, development of the Control of Tobacco Products and the Electronic Delivery Systems Bill of 2018, which seeks to address all loopholes pertaining to these harmful products flooding our country as most countries are strictly regulating them or not permitting them at all.

Hookah/waterpipe, they uses molasses or moist tobacco. There are two types of waterpipes (hubbly bubbly, hookah pipes), the electronic (non-combustible) and those that cause emissions. A major source of tobacco addiction is nicotine, whose levels in hookah are extremely variable as they depend on the type of tobacco used.

A study conducted in South Africa found that while the tobacco was the norm in smoking hookah, significant numbers also reported using marijuana and/or alcohol-based products in combination with tobacco even among children as young as 13-15 years (Combrink, A., Irwin, N., Laudin, G., Naidoo, K., Plagerson, S., & Mathee, A. (2010). Results indicate that the hookah pipe is a gateway drug, as participants appear to use the hookah pipe with other substances like marijuana and alcohol. (Jacobs, L., Roman, N. V., & Schenk, C. (2015).

END.

02 September 2021 - NW1839

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1)What (a) is the total amount incurred by his department from tender irregularities with regard to the procurement of personal protective equipment that are currently being investigated by the Special Investigating Unit (SIU), (b) is the breakdown of the irregularities investigated in each province and (c) is the total irregular expenditure investigated by the SIU that has been returned to his department; (2) whether any (a) officials, (b) companies and/or (c) businessmen have been charged with and/or held accountable for such tender irregularities, fraud and corruption; if not, why not; if so, (i) who has been charged and/or held accountable and (ii) what is the breakdown of the persons charged in each province in his department?

Reply:

NATIONAL DEPARTMENT OF HEALTH

1. (a) No tender irregularities with regard to the procurement of personal protective equipment was recorded in the National Department of Health.

(b) and (c) Not applicable.

2. (a), (b), (c) Not applicable.

EASTERN CAPE

1. (a) No tender irregularity findings have been reported to the department to date.

(b) and (c) Not applicable.

2. (a), (b), (c) Not applicable.

FREE STATE

1. (a) No tender irregularities with regard to the procurement of personal protective equipment were found and/or investigated by the Special Investigating Unit (SIU).

(b) and (c) Not applicable.

2. (a), (b), (c) Not applicable.

GAUTENG

1. (a) The Department incurred costs to the value of R2,394,514,261.70 (Two billion three hundred ninety-four million five hundred fourteen thousand two hundred sixty-one rand and seventy cents) for procurement of goods relating to PPE.

(b) The SIU is performing the said investigation by order of the President in terms of Presidential Proclamation R23 of 23 July 2020. As soon as the report are made readily available a determination will be made available.

(c) The SIU is performing the said investigation by order of the President in terms of Presidential Proclamation R23 of 23 July 2020. As soon as the report are made readily available a determination will be made available.

2. (a) , (b) and (c)

Officials and other persons have been charged pertaining to the SIU investigation. The SIU is performing the said investigation by order of the President in terms of Presidential Proclamation R23 of 23 July 2020, the SIU reports directly to the President and for that reason, any questions pertaining to the SIU investigation should be addressed to the Presidency.

3. The SIU is performing the said investigation by order of the President in terms of Presidential Proclamation R23 of 23 July 2020. As soon as the report are made readily available a determination will be made available;

4. The SIU is performing the said investigation by order of the President in terms of Presidential Proclamation R23 of 23 July 2020. As soon as the report are made readily available a determination will be made available.

KWAZULU-NATAL

1. (a) R86,064,628.50 (Eighty-six million and sixty-four thousand six hundred and twenty-eight rand and fifty cents).

(b) Not applicable.

(c) None.

2. (a), (b), (c) None. Special Investigating Unit (SIU) started investigations in June 2021. The investigation is currently still on-going.

LIMPOPO

1. (a) R240 000 (Two hundred and forty thousand rand) has been found to be irregular expenditure.

(b) Not applicable.

(c) None

1. (a) Four officials are undergoing disciplinary processes.

(b) and (c) None.

MPUMALANGA

1. (a) The total amount paid by the Department for tender irregularities is amounting to R18,863,628.50 (Eighteen million eight hundred sixty-three thousand six hundred twenty-eight rand and fifty cents), as investigated by Special Investigating Unit (SIU).

(b) The Department is still awaiting the Final Investigation Report from SIU for the period from August 2020 to 31 March 2021.

(c) There was no amount recovered from the above tender irregularities as there was no element of fraud identified however, there were non-compliance during the procurement processes.

2. (a) Department has suspended two senior officials relating to the same tender irregularities.

(b) and (c) None.

NORTHERN CAPE

1. (a) R77,558,766.53 (Seventy-seven million five hundred fifty-eight thousand seven hundred sixty-six rand and fifty-three cents) are still being investigated for any irregularities.

(b) The breakdown of transactions under investigation are as follows:

No.

Supplier name

Total amount

1.

DNS Supplies

528 195,00

2

C-Med Medicals

7 447 681,00

3

Revolt Headboy

2 947 200,00

4

Asijiki Sound Bytes

13 918 100,00

5

Macronym 37 (Pty) Ltd

26 960 025,00

6

MKV Investments

16 906 667,50

7

Logan Medical

8 850 898,03

Grand total

R77,558,766.53

(c) Investigation is still in progress.

2. (a) On 23rd August 2021, the former Acting Head of Department and the Chief Financial Officer were arrested by the HAWKS.

(b) and (c) None.

NORTH WEST

1.(a) None.

(b) and (c) Not applicable.

2. (a), (b), (c) Not applicable.

WESTERN CAPE

1. (a) None.

(b) and (c) Not applicable.

(2) (a), (b) , (c) Not applicable.

END.

02 September 2021 - NW1894

Profile picture: Gwarube, Ms S

Gwarube, Ms S to ask the Minister of Health

(1)What are the reasons that two certain health professionals (names furnished) are not yet disciplined by the SA Nursing Council and the Health Professionals Council of South Africa for the Life Esidimeni deaths; (2) whether investigations regarding the disciplinary cases of the two health officials are still ongoing; if not, what is the position in this regard; if so, (a) what are the reasons for the delays, (b) by what date will the outcomes of the disciplinary proceedings be announced and (c) who is responsible for the disciplinary proceedings?

Reply:

South African Nursing Council (SANC)

1. The SANC is looking into allegations made against Dr Manamela as nurse practitioner, registered in terms of the Nursing Act, 2005 (Act No. 33 of 2005).

The process to discipline nurse practitioners is prescribed in regulations, and the SANC follows the legislated processes to investigate any allegations of unprofessional conduct against nurse practitioners so that where there is evidence of unprofessional conduct, appropriate action is taken.

The time it takes to finalise cases is dependent on the complexity of the matter as well as the number of and co-operation from role players involved in the matter and the timeous submission of the required information to SANC

2. (a) The disciplinary cases of the health official is still ongoing.

There was no delay on the side of SANC. Several correspondences to Gauteng Province were issued as soon as the matter was brought to the attention of SANC to request for further information to enable the relevant committee of Council to conduct the investigation accordingly.

There was, however, a delay in the provision of such information despite several follow ups made by the office of the Registrar at SANC.

(b) This is not possible to predict as it is dependent on many external factors and procedural factors for instance but in no way limited to:

  1. Availability of evidence;
  2. Availability of witnesses;
  3. Any legal challenges against or during the process; and
  4. Volume of the evidence both written and oral to be considered and or canvased

(c) Two committees of Council are responsible for the majority of the process, the Preliminary Investigating Committee, which has finalised the preliminary investigation and the Professional Conduct Committee, to which the matter has been referred, to effect a formal hearing.

The Health Professions Council of South Africa (HPCSA)

1. The HPCSA has taken disciplinary steps against Dr TE Selebano following the report of the Health Ombudsman.

The investigation was conducted and on the 11&12 October 2018 the matter was placed before the Fourth Preliminary Committee of Inquiry of the Medical and Dental Professional Board (“the Committee”).

After deliberations based on the available evidence the committee determined that there are grounds for a professional conduct inquiry into the conduct of Dr TE Selebano and directed that an inquiry into matter be held.

2. (a) The disciplinary cases of the health official is still ongoing

The matter had been set down for hearing on several occasions and had been postponed for a variety of reason including the obtainment of the transcripts from Judge Moseneke’s arbitration, lockdown due to COVID 19 making it impossible to have a physical hearing (and respondent objecting to virtual hearing), the delays in the appointment of new professional boards in 2020, unavailability of respondent legal representative, and inquest proceedings.

(b) The parties have agreed to set the matter down for 13-15 October 2021.

(c) Fourth Preliminary Committee of Inquiry of the Medical and Dental Professional Board.

END.

02 September 2021 - NW1925

Profile picture: Luthuli, Mr BN

Luthuli, Mr BN to ask the Minister of Health

With reference to the recent remarks by Dr Susan Vosloo discouraging persons from getting vaccinated against COVID-19, which comes at a time when the Republic is facing increased vaccination hesitancy, what (a) are the relevant details of the COVID-19 vaccination education drives planned in the Republic in the coming months, (b) budgets have been set aside for this and (c) are the relevant time frames?

Reply:

a) The COVID-19 vaccination education drive is a multi-faceted programme that involves the public and private sectors across the entire government (all departments and all three spheres) and that has many contributing private companies.

  • High programme visibility: Specific Activities
  • Visible signage of the vaccine roll-out on large key billboards in high transit areas
  • Use of taxi rank TV, Digital Billboards and others to promote vaccination messages
  • Conspicuous telescopic and other large banners at malls, places of worship, taxi ranks, retail stores, schools
  • Conspicuous and recognizable branding and clear signage at vaccine sites
  • Champions: Identifying apolitical vaccine champions that are relevant to the target group and have wide reaching influence (key influential leaders; Traditional Leaders, Faith Based, Business sector, Civil society and Celebrities) e.g. Limpopo targeted ZCC church leader
  • Involvement of Political leaders as champions: Health MEC and other political leaders such as Premiers, Mayors, Ward Counsellors
  • Partnership with private sector to collaborate on media campaigns and vaccine roll-out branding e.g. Medical Aids like GEMS, Discovery etc. and other businesses
  • Information in people’s hands: Specific Activities
  • Guide the community on where they should go to, who they should listen to and which number they should call to get the correct information on anything to do with vaccines
  • Use the time that clients spend at vaccination sites to empower them to be vaccine ambassadors
  • Use the observation time to educate the clients and equip them to be able to answer common misinformation questions e.g. Is it true that people are dying after they vaccinate?
  • Provide comprehensive IEC material on vaccines and adverse events following immunization with the call center number clearly visible that they can refer to and share with others.
  • Share information on the nearest functional vaccination sites; operating hours; dates for outreach with all stakeholders: radio stations, newspapers, community leaders, religious leaders, schools, workplaces, and all social media platforms
  • Use of social media to get the correct information into young people’s hands so that they do not discourage the elderly from vaccinating through sharing of misinformation they consume on social media
  • Use of teachers to get the right information into young people’s hands so that they can correct misinformation from social media and other sources at home
  • Address the play-off between various vaccines and preferences
  • Use of local media: Specific Activities
  • Continuous engagement to reinforce positive messages about vaccinations and to counter misinformation and disinformation
  • Ongoing “human” stories by individuals representing the target group to show authentic stories of registration and vaccination on radio, local newspapers, and all social media platforms
  • Radio stories addressing identified concerns about vaccines in local languages
  • Radio slots to boost confidence in vaccination explaining all the key steps in the vaccination journey
  • Collaboration with local newspapers, Radio stations, leadership, NGOs, Civil society organizations, tertiary institutions, schools, Unions, businesses, private vaccination sites in spreading correct information about vaccines
  • Public health messaging to raise public awareness of the notable fatality rate and potential long-term sequela of COVID-19
  • Weekly local radio station slots for advocacy messaging, adverts in local print media.
  • Local mobilisation and canvassing: Specific Activities
  • Whole society area based (ward-based) approach improving reach and raising capacity through collaboration with other stakeholders i.e. Private sites, Sector engagements (Business, Civil Society, FBOs, Traditional Authorities, Men’s Forum, Older Person’s Forum and people with disabilities e.tc. to be engaged during the month of August)
  • Identify and appoint area-based leads, local civil society activators and communicators who will play the catalytic role of bringing all these people together
  • Out-reach service: share the schedule with the sites, times and dates; plan well with all relevant local stakeholders to ensure that there is sufficient demand creation and social mobilization in the community leading up to the out-reach date including use of loud hailers
  • Identify individuals who can be vaccination ambassadors or champions with vaccine branded clothing with messages like do have any questions about vaccines? ‘Ask me’, who can be easily identifiable as they walk around the community and use local media to inform the community about them and to ask them questions.
  • Use of community WhatsApp groups to communicate correct information and counter misinformation and disinformation.
  • Work with local comedians to create fun videos on platforms like TikTok that can be shared on social media
  • Coordinating all of the community development practitioners, health care workers and resources to intensify the together with Door-to-door, Site visits by Executive Council and Mayors to mobilise communities.
  • Access strategies: Specific Activities
  • Transport: provide transport where possible; ensure that clients know when, how, which number to call, where to go and who is eligible to access this service
  • Home based vaccinations
  • District based promotion of vaccination sites, available assistance at all sites, pop up sites taken to remote areas, ward-based vaccination sites, mass vaccination sites opened across the districts, more sites opened on weekends to provide access to those at work during the week.
  • Increase outreach/mobile sites and strategical place them in areas with low uptake as informed by data
  • Increase sites in underserved areas
  • Increase sites that operate on weekends and make sure they are advertised widely including operation hours
  • Adopt specific strategies like Churches on Sunday, Malls on Saturdays, especially on weekends
  • Build trust in the system by providing excellent client friendly service so that positive reviews spread by word of mouth
  • Use familiar sites as vaccination sites e.g. churches, synagogues, mosques, malls
  • Other Activities
  • Continue with regular feedback and monitoring of daily performance through feedback sessions between Province & districts Mon-Fri
  • Each district, through the district vaccination coordinating committees meets at least three times a week to monitor progress and identify pressure points and problem areas to reaching targets.
  • Retain focus on >60 years as the most vulnerable population group until targets are met
  • Encourage clinicians to counter patients’ anecdotal “bad reaction” stories with “good reaction” stories rather than statistics.
  • Use messaging like “your parents made sure you were vaccinated as a child now it’s your turn to return the favour”, to encourage younger people to bring older people.
  • Coming up with little songs about vaccinations that can be taught at ECDs and Schools and share it through ECD networks (Vaccine, Vaccine on your arm, Will keep you safe from COVID-19).

b) Budgets that have been set aside for this come from all partners. Some are directly budgeted items funded from government departments, including GCIS, but the majority are cash and cash-in-kind contributions from the private sector (through Solidarity Fund and by media houses). We do not have a Rand value for all of these contributions at this stage.

c) The relevant time frames are that several activities have already commenced and all are continuing for the remainder of this year and into 2022.

END.

02 September 2021 - NW1898

Profile picture: Macpherson, Mr DW

Macpherson, Mr DW to ask the Minister of Health

With regard to the COVID-19 transmissions statistics in each month since the beginning of the National State of Disaster, what is the total number of persons in each province who have contracted COVID-19 in (a) restaurants, (b) gyms, (c) cinemas, (d) parks, (e) bars & taverns, (f) nightclubs, (g) casinos, (h) conferencing, exhibition and entertainment facilities, (i) museums and (j) libraries, archives and galleries?

Reply:

When an individual is exposed and then infected with COVID–19 the signs and symptoms usually appear after 5 to 7 days. If these symptoms are significant the person would then probably seek medical attention. It is at that point usually that a COVID test is recommended and results become available about 2 days later so from the time of infection an individual will be confirmed as positive only 7 to 9 days later. Most infected persons have very limited recollection of all the activities they were involved in a week ago and of those activities it would be impossible for a person to know exactly where or when exactly he/she became infected or the circumstances that lead to them becoming infected. Provincial health departments also report that persons that test positive are either unable to recall or reluctant to share information about their contacts as well which has hampered contact tracing efforts.

We therefore do not have data on exactly where a particular person has been infected.

END.

02 September 2021 - NW1891

Profile picture: Gwarube, Ms S

Gwarube, Ms S to ask the Minister of Health

What are the national minimum standards for (a) air ambulances, (b) helicopters and (c) fixed-wing aircraft?

Reply:

The national minimum standards for provision of air ambulances, regardless of whether is a rotor-wing helicopter or a fixed-wing aircraft used, is prescribed in the EMS Regulations, 2017.

EMS Regulations in relation to aeromedical services indicate that:

  • the provider is required to be registered to provide such services within the category of Aeromedical Services with the respective provincial Department of Health where it is operating from.
  • This registration should also involve the inspection and accreditation of the station/hangar operated from.
  • The aircraft operator must hold the appropriate G7 licence and CATS Part 138 accreditation as specified by the Civil Aviation Authority of South Africa.

An extensive minimum list of equipment is detailed in the attached Annexure B of the EMS Regulations.

With regards to the medical crew:

  • The senior medical staff member on the air ambulance must be registered in the category of a Paramedic or Emergency Care Technician or Emergency Care Practitioner with the Health Professions Council of South Africa, who shall hold valid CAT 138, Aviation Health Care Provider, Advanced Cardiac Life Support, Intermediate Trauma Life Support or Advanced Trauma Life Support and Paediatric Advanced Life Support or equivalent certificates.
  • The minimum staffing requirement for the second staff member on an ambulance shall be a person registered in at least the category of Basic Ambulance Assistant with the Health Professions Council of South Africa.
  • All crew are required to practice within their respective scope of practice as approved by the Health Professions Council of South Africa: Professional Board for Emergency Care.

Annexure B

DOH_HiResLogo.jpg

Airway Equipment

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Oropharyngeal Airway Nos. 00,0,1,2,3,4

2 each

2 each

2 each

2 each

2 each

2 each

Hard Suction Catheter (Paediatric)

2

2

2

2

2

2

Neonatal Suction Catheters Size No. 5 FG

2

2

2

2

2

2

Neonatal Suction Catheters Size No. 6 FG

2

2

2

2

2

2

Neonatal Suction Catheters Size No 8 FG

2

2

2

2

2

2

Paediatric Suction Catheter Size No. 10 FG

1

1

1

1

1

1

Adult Suction Catheter Size No. 12 FG h

1

1

1

1

1

1

Adult Suction Catheter Size No. 14 FG

1

1

1

1

1

1

Neonatal Suction Catheters Size No. 5 FG

1

1

1

1

1

1

Neonatal Suction Catheters Size No. 6 FG

1

1

1

1

1

1

Neonatal Suction Catheters Size No 8 FG

1

1

1

1

1

1

Paediatric Suction Catheter Size No. 10 FG

1

OPTIONAL

1

1

OPTIONAL

OPTIONAL

Adult Suction Catheter Size No. 12 FG

0

1

0

0

1

1

Adult Suction Catheter Size No. 14 FG

2

2

2

2

2

2

Portable Suction Apparatus (Combination of Battery and Electrically Operated)

1

1

1

1

1

1

Manual Hand Operated Portable Suction Apparatus (As a backup device)

1

1

1

1

1

1

Stethoscope (Combination of diaphragm and bell type head)

1

1

1

1

1

1

Endotracheal Intubation Equipment

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Laryngoscope set for adult and paediatric including the following:

           

Handle with batteries in full working condition

0

1

0

0

1

1

Batteries - spare for laryngoscope

0

2

0

0

2

2

Size 0 blade

0

1

0

0

1

1

Size 1 blade

0

1

0

0

1

1

Size 2 blade

0

1

0

0

1

1

Size 3 blade

0

1

0

0

1

1

Size 4 blade

0

1

0

0

1

1

Size 5 blade

0

OPTIONAL

0

0

OPTIONAL

OPTIONAL

Disposable, sterile ET tubes including the following:

           

Size 2.5 mm ID ET tube

0

2

0

0

2

2

Size 3 mm ID ET tube

0

2

0

0

2

2

Size 3.5 mm ID ET tube

0

2

0

0

2

2

Size 4 mm ID ET tube

0

2

0

0

2

2

Size 4.5 mm ID ET tube

0

2

0

0

2

2

Size 5 mm ID ET tube

0

2

0

0

2

2

Size 5 mm ID ET tube (cuffed, high volume, low pressure)

0

2

0

0

2

2

Size 5.5 mm ID ET tube (cuffed, high volume, low pressure)

0

2

0

0

2

2

Size 6 mm ID ET tube (cuffed, high volume, low pressure)

0

2

0

0

2

2

Size 6.5 mm ID ET tube (cuffed, high volume, low pressure)

0

2

0

0

2

2

Size 7 mm ID ET tube (cuffed, high volume, low pressure)

0

2

0

0

2

2

Size 7.5 mm ID ET tube (cuffed, high volume, low pressure)

0

2

0

0

2

2

Size 8 mm ID ET tube (cuffed, high volume, low pressure)

0

2

0

0

2

2

Size 8.5 mm ID ET tube (cuffed, high volume, low pressure)

0

2

0

0

2

2

Sub-glottic Laryngeal Mask (LMA), size 1

0

2

0

0

2

2

Sub-glottic Laryngeal Mask (LMA), size 1.5

0

2

0

0

2

2

Sub-glottic Laryngeal Mask (LMA), size 2

0

2

0

0

2

2

Sub-glottic Laryngeal Mask (LMA), size 2.5

0

2

0

0

2

2

Sub-glottic Laryngeal Mask (LMA), size 3

0

2

0

0

2

2

Sub-glottic Laryngeal Mask (LMA), size 3.5

0

2

0

0

2

2

Sub-glottic Laryngeal Mask (LMA), size 4

0

2

0

0

2

2

Sub-glottic Laryngeal Mask (LMA), size 4.5

0

2

0

0

2

2

Sub-glottic Laryngeal Mask (LMA), size 5

0

2

0

0

2

2

Endotracheal Intubation Equipment Continued

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Small ET tube introducer

0

1

0

0

1

1

Large ET tube introducer

0

1

0

0

1

1

Gum Elastic Bougie

0

1

0

0

1

1

Magill forceps - Adult

1

1

1

1

1

1

Magill forceps - Paediatric

1

1

1

1

1

1

10ml syringes

0

1

0

0

1

1

20ml syringes

0

2

0

0

2

2

Pair sharp, clean scissors

0

1

0

0

1

1

1m Tape / ET tube securing device

0

2

0

0

2

2

Water soluble lubricant gel

0

2

0

0

2

2

Heimlich type Flutter valves

0

2

0

0

2

2

Heat moisture exchanger valve for ventilated patients

0

1

0

0

1

1

Breathing / Ventilation Equipment

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Adult oxygen masks providing 40% inhaled oxygen with tubing

4

4

4

4

4

4

Adult non-rebreather masks providing 100% inhaled oxygen with tubing

2

2

2

2

2

2

Adult oxygen nebuliser masks including tubing and fluid reservoir

2

2

2

2

2

2

Nasal cannula with tubing

2

2

2

2

2

2

Paediatric oxygen masks providing 40% inhaled oxygen with tubing

2

2

2

2

2

2

Paediatric non-rebreather masks providing 100% inhaled oxygen with tubing

2

2

2

2

2

2

Paediatric oxygen nebuliser masks including tubing and a fluid reservoir

2

2

2

2

2

2

Oxygen T-Piece with tubing

2

2

2

2

2

2

Adult Bag-Valve-Mask with Reservoir and adult mask (size 4)

1

1

1

1

1

1

Paediatric Bag-Valve-Mask with Reservoir and paediatric mask (size 1)

1

1

1

1

1

1

Neonatal Bag-Valve-Mask with Reservoir and neonatal mask (size 0)

1

1

1

1

1

1

Oxygen Humidification Device

1

1

0

0

1

1

Oxygen Supply

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Minimum of a portable oxygen cylinder. Size “D”

2

2

2

2

2

2

Portable oxygen cylinder gauge with flow meter

1

1

1

1

1

1

Fitted oxygen cylinder/s, size “F” capable of supplying a minimum of 30 minutes of oxygen at a flow rate of at least 15 litres per minute.

2

2

0

0

0

2

Fitted oxygen cylinder gauge with flow meter

1

1

0

0

0

1

Ventilator

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Mechanical volume cycled ventilator with PEEP valve & pressure relief valve, with appropriate fitting allowing connection to fitted oxygen supply within the ambulance, including the following features (requires annual calibration certification):

0

1

0

0

1

1

• Volume and pressure control:

           

• Volume

           

• Inspiratory Pressure

           

• PEEP

           

• Fi02

           

• Rate

           

• Alarms (Peak Inspiratory Pressure, Low Pressure)

           

Heat moisture exchanger valve for both manual as well as mechanical ventilation methods.

2

2

2

2

2

2

Diagnostic /Therapeutic Equipment

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Sphygmomanometer including adult, paediatric and neonatal cuffs

1

1

1

1

1

1

Pupil torch

1

1

1

1

1

1

Glucometer and blood glucose monitoring strips

1

1

1

1

1

1

Pulse Oximeter (if not included as a feature of an ECG monitor or electronic patient monitor)

1

1

1

1

1

1

Automated External Defibrillator (AED) (annual calibration not required due to self-testing and self-calibration of the unit)

0

0

0

0

0

0

Automated External Defibrillator (AED) that is approved by the manufacturer for use in a moving vehicle, To be used in combination with a Vital Signs Monitor that includes visual 3 lead ECG Monitoring and a ECG rhythm printer/recorder feature (Vital Signs Monitor requires annual calibration certification)

1

0

1

1

0

0

OR

 

 

 

 

 

 

ECG monitor and defibrillator featuring 3 lead ECG monitoring capability, 3 lead cable, AED capability, AED pads, manual defibrillation, recorder / printer with paper and hard defibrillation paddles (requires annual calibration certification)

1

0

1

1

0

0

ECG monitor and defibrillator featuring 3 lead ECG monitoring capability, external cardiac pacing, cardioversion, pacing/AED pads, manual defibrillation, recorder / printer with paper and hard defibrillation paddles (requires annual calibration certification)

0

1

0

0

1

1

Defibrillation gel

1

1

1

1

1

1

End Tidal CO2 Monitor – Capnograph (if not included as a feature of an ECG monitor or electronic patient monitor)

0

1

0

0

1

1

Miscellaneous Disposable Equipment

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Boxes of disposable examination gloves (S,M,L)

1

each

1

each

1

each

1

Each

1

Each

1

each

Wound dressings 100mm x 100mm

5

5

5

5

5

5

Wound dressings 100mm x 200mm

4

4

4

4

4

4

Hydrogel Burn Dressing 100mm x 100mm

2

2

2

2

2

2

Hydrogel Burn Dressing 200mm x 200mm

1

1

1

1

1

1

Hydrogel Burn Dressing 200mm x 450mm

2

2

2

2

2

2

Gauze swabs (100mm x 100mm)

20

20

20

20

20

20

Roll of 25 mm adhesive tape (zinc oxide)

1

1

1

1

1

1

Roll of 10 mm adhesive tape (hypo-allergenic)

1

1

1

1

1

1

75mm elasticised bandages

4

4

4

4

4

4

100mm elasticised bandages

4

4

4

4

4

4

Sealed maternity pack (including 2 x sealed & sterile surgical blades, 4 x sealed sanitary pads, 2 x sealed space blankets, 4 x sealed & sterile umbilical cord clamps, 1 x sealed & sterile mucous extractor)

1

1

1

1

1

1

Regurgitation bags

Or

Large kidney bowl / receiver (may not be a bedpan)

4

4

0

0

0

4

 

1

1

0

0

0

4

Sealed space blanket

4

4

4

4

4

4

Clear safety goggles

2

2

2

2

2

2

Range of nasogastric tubes, including:

0

1

0

0

1

1

Size 5 French

0

1

0

0

1

1

Size 8 French

0

1

0

0

1

1

Size 10 French

0

1

0

0

1

1

Size 12 French

0

1

0

0

1

1

Size 14 French

0

1

0

0

1

1

Size 18 French

0

1

0

0

1

1

Urine drainage bag

0

2

0

0

2

2

Foleys catheters FG5, 8, 10, 12, 14, 16, 18

0

1

0

0

1

1

Intravenous Therapy Equipment

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Alcohol Swab (30mm x 30mm)

30

30

30

30

30

30

14 gauge intra-venous catheters

2

2

2

2

2

2

16 gauge intra-venous catheters

2

2

2

2

2

2

18 gauge intra-venous catheters

2

2

2

2

2

2

20 gauge intra-venous catheters

2

2

2

2

2

2

22 gauge intra-venous catheters

2

2

2

2

2

2

24 gauge intra-venous catheters

2

2

2

2

2

2

60 micro drops / ml – Administration Sets

2

2

2

2

2

2

Intraosseous needle or device with needle

0

1

0

0

1

1

15 drops / ml or 20 drops / ml- Administration Sets

2

2

2

2

2

2

10 drops / ml – Blood Administration Set

2

2

2

2

2

2

High Capacity 10 drops / ml Administration Set

0

1

0

0

1

1

Volume Control Administration Set (eg. Buretrol, Dosifix)

0

1

0

0

1

1

200ml Normal Saline – IV Fluid

2

2

2

2

2

2

1000ml Ringers Lactate – IV Fluid

Or

1000ml Balsol – IV Fluid

2

2

2

2

2

2

 

2

2

2

2

2

2

500ml Synthetic Colloid e.g. Haemacell / Haes-sterile

1

1

1

1

1

1

Transparent, waterproof, IV securing dressing (e.g. Tegaderm or similar) minimum of 10cm x 12cm dimensions

8

8

8

8

8

8

Infusion flow regulators (eg Dial-a-Flow, Dosi Flow)

2

2

2

2

2

2

3 Way Stopcock

1

2

1

1

2

2

Spencer Wells Artery Forceps

2

2

2

2

2

2

Pressure Infusion Bags

0

2

0

0

2

2

Medicines Therapy Sundries

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

50 ml syringes

0

1

0

0

1

1

20 ml syringes

2

2

2

2

2

2

10 ml syringes

2

2

2

2

2

2

5 ml syringes

2

2

2

2

2

2

2 ml syringes

2

2

2

2

2

2

1 ml syringes

0

2

0

0

2

2

16 gauge needles

4

4

4

4

4

4

20 gauge needles

4

4

4

4

4

4

Medicines

ILS

ALS

 

Medicines to be carried by the on-duty registered practitioner as per HPCSA approved scope of practice for a registered Ambulance Emergency Assistant or a registered Emergency Care Assistant.

Medicines to be carried by the on-duty registered practitioner as per HPCSA approved scope of practice for a registered Paramedic or a registered Emergency Care Technician or registered Emergency Care Practitioner.

Transport and Immobilization Equipment

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Hard/Stiff Neck Cervical Collars – Small

2

2

2

2

2

2

Hard/Stiff Neck Cervical Collars – Medium

2

2

2

2

2

2

Hard/Stiff Neck Cervical Collars – Large

2

2

2

2

2

2

Full set of Soft Cervical Collars (Small, Medium, Large)

OPTIONAL

OPTIONAL

OPTIONAL

OPTIONAL

OPTIONAL

OPTIONAL

Patient Extrication Device – Adult (e.g. KED)

1

1

OPTIONAL

OPTIONAL

OPTIONAL

OPTIONAL

Patient Extrication Device – Paediatric (e.g. KED)

1

1

OPTIONAL

OPTIONAL

OPTIONAL

OPTIONAL

Long spine board

1

1

0

0

0

OPTIONAL

Scoop stretcher

1

1

0

1

0

1

Vacuum Mattress

OPTIONAL

OPTIONAL

0

0

0

1

Set Head Blocks

2

2

OPTIONAL

OPTIONAL

OPTIONAL

2

Spider harness

2

2

OPTIONAL

OPTIONAL

OPTIONAL

2

Lower extremity traction splint – Adult

1

1

OPTIONAL

OPTIONAL

OPTIONAL

OPTIONAL

Lower extremity traction splint – Paediatric

1

1

OPTIONAL

OPTIONAL

OPTIONAL

OPTIONAL

Long splints – Leg

6

6

6

6

6

6

Short splints – Arm

4

4

4

4

4

4

Other

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Pillow

2

2

0

0

0

2

Sheet

6

6

1

0

1

1

Blanket

2

2

0

0

0

1

Bedpan/urinal

1

1

0

0

0

OPTIONAL

Waste disposal facility (enclosed container)

1

1

0

0

0

1

Red, medical waste disposal plastic bags

6

6

6

6

6

2

Enclosed, commercially manufactured, disposable sharps container

1

1

1

1

1

1

Suitably manufactured Jump Bag for safe, clean and secure storage and transportation of medical equipment

1

1

1

1

1

1

Suitably manufactured Drug Pouch for safe, clean and secure storage and transportation of medication and administration accessories

0

1

0

0

1

1

Pair rescue scissors

1

1

1

1

1

1

High visibility, reflective vest and / or jacket

2

2

1

2

1

OPTIONAL

Safety helmet

2

2

1

2

1

OPTIONAL

Fire Extinguisher (minimum of 2KG dry powder)

1

1

1

1

1

OPTIONAL

Thermometer (standard)

1

1

1

1

1

1

Casebook or patient record sheet

1

1

1

1

1

1

Map book or fitted GPS device

1

1

1

1

1

1

Requirements for MICU transfers - the following requirements are per station, and not per vehicle (mandatory)

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Vital signs monitor (requires annual calibration certification) - or separate automated NIBP, SpO2, electronic capnograph

0

1

0

0

1

1

Infusion pump including appropriate administration sets (requires annual calibration certification)

0

1

0

0

1

1

Syringe driver including approved syringes (requires annual calibration certification)

0

1

0

0

1

1

Requirements for MICU neonatal transfers – the following requirements are per station, and not per vehicle (optional):

ILS Ambulance

ALS Ambulance

ILS Response Vehicle

Medical Rescue Vehicle

ALS Response Vehicle

ALS Air Ambulance

Automated neonatal ventilator (requires annual calibration certification) - or mechanical ventilator featuring neonatal, paediatric and adult ventilation modes

0

access

0

0

access

1

Transport incubator with backup power and on board alarms (requires annual confirmation of servicing)

0

access

0

0

access

1

Vital signs monitor with neonatal probes (requires annual calibration certification)

0

access

0

0

access

1

Oxygen inspired analyser

0

access

0

0

access

1

Incubator head box

0

access

0

0

access

1

Neonatal SPO2 probe and monitor (if not included as a feature of the vital signs monitor)

0

access

0

0

access

1

 

END.

02 September 2021 - NW1885

Profile picture: Masango, Ms B

Masango, Ms B to ask the Minister of Health

Whether social workers are (a) categorised as frontline workers and (b) prioritised for the vaccination roll-out; if not, why not, in each case; if so, what are the further relevant details in each case?

Reply:

a) Yes, Social Workers are front-line workers in the care of the public.

b) Yes Social Workers were prioritised in the vaccination roll-out. After the healthcare workers the vaccination programme embarked on vaccination of workers in the basic education sector, police, social development and several other priority essential services sectors. Social Workers (public and private), along with all Social Service Professions registered with the Council were offered vaccination. The table below provide the details.

NO

CATEGORY / ELIGIBILITY

RATIONALE

1

Group A: DSD National and Provincial Staff (all on PERSAL) (Incl. of SACSSP Staff as well as cleaning and security staff)

Rationale: All frontline staff who are in direct contact with members of the public through NPO registration, monitoring and evaluation, processing of child protection register applications, consultations for adoptions, engagements with CSOs, civil society and stakeholders, incl. distribution of food parcels to the public, customer related queries etc. amongst others.  

2

Group B: SASSA Staff Nationwide (all on PERSAL)

All front frontline staff dealing with grant applications incl. home visitations to assist i.e. the elderly, persons with disabilities, and child support grant beneficiaries amongst others,

3

Group C: National Development Agency: (all on NDA database)

Our staff are in direct contact with the public collecting applications on a daily basis for consideration of grant funding for projects, in addition, they do capacity building training and monitor projects on sites across the republic. Furthermore, they include a cohort of people who assist in manning SASSA queues.  

4

Group D: Social Service Professions; (incl. SW +ASW + CYCCs + ACYCCs +Student Social Workers + CDPs)

Social workers who provide psychosocial support to citizens affected and infected by covid-19 as well as other social ills, conduct site visits and work with DoH across the country. Incl. of CDPs.

Incl. Private sector/ NGO’s / Public Sector etc.

5

Group E: ECD Workforce: (Incl. of entire workforce)

A cohort of educators looking after children at ECD centers which remain open during the current lockdown alert level, and are thus at risk in the a similar manner in which school teachers are.

Data base from ECD PES + ISF (for unregistered ECDs) 

 

END.

02 September 2021 - NW1841

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1)What checks and balances will he put in place to ensure that there will be no looting and corruption during the implementation process of the National Health Insurance (NHI) and beyond; (2) whether the allocation of funds to medical schemes will be automated; if not, what is the position in this regard; if so, what are the relevant details; (3) how will (a) his department ensure detailed monitoring of the Government Employee Medical Schemes (GEMS) (i) payments and (ii) claims and (b) GEMS ensure timely pay-outs that are free of glitches?

Reply:

1. The NHI is designed to purchase healthcare benefits directly from public and private providers. All prices will be set nationally and will be published by the NHI Fund for everyone to see what the fund is paying for. The Fund will not purchase any goods (healthcare products) for service providers. The Bill provides for an Office of Health Products Procurement that will describe, set standards and set prices of all products that are required in a national Formulary that is needed to deliver the services according to standard clinical guidelines. The digital systems of the NHI are already under development to manage the benefits, record accreditation of health care providers (establishments and individuals) and to capture the individual data required to process and make payments to providers. The systems are designed to identify any aberrant use patterns by patients, providers or suppliers and to flag them for investigation. This will include outright rejection for abuse to managing utilisation and provision patterns. The NDOH has been working with the SIU to develop the Risk Management Framework for the NHI. The Auditor General (AGSA) is the auditor of all public entities and will be responsible for oversight of systems and governance integrity. All attempted abuse will be reported and where appropriate placed in the public domain. The Bill provides for an Investigation Unit to follow up on identified or reported fraud or abuse. There is also provision for public reporting of Fraud.

2. No funds will be allocated to medical schemes. The Bill provides that medical schemes will be allowed to cover only those benefits that are not covered by the NHI Fund. The NHI Fund will be the ‘single’ purchaser of all benefits that are covered by the NHI.

3. Under NHI the GEMS, will cover only those benefits that are not covered by the NHI Fund. In the interim the department does not monitor any medical schemes as there is an independent regulator, the Council for Medial Schemes, (CMS) responsible for that function. GEMS is an entity of the Department of Public Service and Administration (DPSA).

END.

02 September 2021 - NW1840

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1)Whether he will furnish Ms H Ismail with a list of the (a) companies appointed by the Government Employees Medical Scheme (GEMS) who were implicated and/or involved in the R300 million irregular payments, (b) GEMS executives who directly benefitted from such irregular payments; (2) what (a) are the processes, policies and procedures that are in place in GEMS to prevent corruption and fraud and (b) checks and balances are in place to prevent conflicts of interest?

Reply:

1. (a) Please be informed that the Government Employees Medical Scheme (GEMS) has taken steps against the parties implicated/involved, including civil litigation, as such the matter is sub-judice and we cannot disclose the names of the parties and companies involved in line with the Constitution of the Republic. The matter is now with the Law Enforcement Agencies.

  • The tender irregularities were uncovered in 2016 after whistle-blower complaints were received;
  • A comprehensive forensic investigation, overseen by the Board was launched and was completed early in 2018. At the commencement of the investigation, key stakeholders including the Council for Medical Schemes (CMS) and the Minister for the Public Service and Administration were briefed. Members of GEMS were informed at the Scheme’s Annual General Meeting held on 31 July 2017 and the updates that could subsequently be provided were included in the GEMS Annual Integrated Reports. A copy of the signed 2017 AGM minutes can be provided if required. Stakeholders were kept informed as the investigation unfolded and the finalised forensic reports were handed over to the Council for Medical Schemes;
  • Criminal charges were laid with the SAPS on conclusion of the investigation and the forensic investigation reports were submitted to the SAPS. The matter is with the HAWKS at present;
  • The Scheme bound by the Laws of the Republic is unable to provide the names of the individuals as well as companies until this matter has been heard in court.

(b) With regards to GEMS executives who directly benefitted from such irregular payments -

  • As a result of the investigation by GEMS, disciplinary cases were brought against 7 employees. Of the 7 employees, 5 resigned during the disciplinary hearings in 2017 and 2 employees were dismissed after the hearings, also in 2017. The Scheme terminated all implicated contracts; and
  • The Scheme has taken steps against the parties as indicated above, laying criminal charges (Case number: CAS 244/04/2018 was opened at Brooklyn Police Station). Civil litigation is also underway and as such the matter is sub-judice and GEMS cannot disclose the names of the parties involved in line with the Constitution of the Republic. The matter is now with the Law Enforcement Agencies.

(2) (a) Processes, policies and procedures that are in place in GEMS to prevent corruption and fraud

  • The Scheme strengthened existing controls, implemented new controls and enhanced policies and systems subsequent to the forensic investigation. This includes the implementation of a strengthened ethics management programme and enhanced/new policies regulating supply chain management, vetting of Scheme officers, recruitment of employees and whistleblowing;
  • There was also the introduction of an internal whistle-blowing hotline and the establishment of an internal forensic investigation unit in addition to the systems already in place for investigating member and healthcare provider claims fraud.

(b) Checks and balances are in place to prevent conflicts of interest

The Government Employees Medical Scheme (GEMS) is registered as a restricted membership medical scheme under the Medical Schemes Act 131 of 1998, as amended.

  • The Scheme is run by a Board of Trustees, where 50% of the Trustees are elected by members and 50% appointed by the Minister for the Public Service and Administration;
  • The Scheme finances and systems are subjected to internal and independent external audit reviews and these are reported to the Board via the Audit Committee and ultimately the Public through the Annual Integrated Report;
  • All GEMS officers, including the Independent Audit Committee members are subjected to vetting. Vetting reports are compared to the Declaration of Interest forms submitted by Scheme officers (and updated annually) and inconsistencies/red flags are followed-up;
  • During the Scheme’s procurement processes, all Board members, Scheme Management and employees involved in the procurement processes are required to complete additional declarations of interest. In this regard, Scheme Officers are provided with a list of bidders, the directors and shareholders of bidders as well the bidders’ employees who would be involved in rendering services should the bidders be contracted. Scheme officers are then required to declare any conflict of interest against this information. Should a potential conflict be declared, the matter is referred for an independent legal opinion;
  • Further to the declarations of interests submitted, checks are performed against a procurement database to rule out any conflict of interest;

The Scheme is also implementing lifestyle audits for executives and has already piloted the new process.

END.

02 September 2021 - NW1804

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

What is the current operational status of Ketlaphela Pharmaceuticals?

Reply:

Ketlaphela SOC Ltd was established as a subsidiary of Pelchem SOC, a subsidiary of South African Nuclear Energy Corporation. These SOCs are part of the Department of Energy and Mineral Resources.

The Department of Health is not the responsible Department for Ketlaphela, the Department can therefore not comment on the current operational status.

 

END.

02 September 2021 - NW1802

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

What (a) is the current status of vaccine availability in the Republic, (b)(i) total number of vaccines are being used and (ii) from which companies and (c) is the current status for approving the (i) Sinovac and (ii) Sputnik V vaccines?

Reply:

a) Covid-19 Vaccines are widely available across all provinces and there are vaccination sites, fixed or mobile in every local municipal area.

b) (i) Two vaccines are presently in daily use

(ii) Pfizer and Johnson & Johnson

c) (i) Sinovac has been conditionally approved by SAHPRA for use in adults. The conditions primarily relate to evidence of efficacy and safety for use in people with HIV & AIDS and evidence of efficacy against Delta variant in a real-life setting (not laboratory Based). The NDOH has conducted an economic assessment and is presently engaged in the preparatory procurement process to obtain a price and availability information from the applicant.

(ii) The regulator has received two applications for Sputnik V vaccine but neither has been approved for use yet..

END.

02 September 2021 - NW1794

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

Whether, with reference to reports that the Delta variant has affected a lot of children in the United States of America resulting in overcrowded paediatric wards, his department has made the relevant preparations to ensure that the Republic does not face a similar predicament; if not, why not; if so, what are the full, relevant details?

Reply:

According to the reports from the DATCOV, in South Africa, children make up a smaller proportion of those tested for SARS-CoV-2, confirmed cases, hospital admissions and in-hospital deaths, despite comprising 37% of the population. The picture here below shows the low rate of infections among children including the data for the third wave, which is why the department has adopted an attitude of alert and caution on the infection and admission rate of children.

Figure 1: Incidence risk of SARS-CoV-2 cases per 100,000 persons, by age group and epidemiologic week, South Africa, 5 March 2020-14 August 2021

Hospital admissions

The records from the DATCOV show that Covid-19 hospitalisation rate is low among children in all three waves, compared to adults. However there was a 44% increase in admissions in children <19 years, in 3rd wave compared to the 1st wave peak. Among individuals under 19 years, the highest rate of hospitalization is in children < 1 year. The reasons for this increased admission is likely testing for non-COVID indications, because clinicians were likely admitting them as a precaution in this younger population group.

cid:image001.png@01D7967D.9B418600

Figure 2: Incidence risk of COVID-19 admissions per 100,000 persons, by age group and epidemiologic week, South Africa, 5 March 2020-14 August 2021

Although there have been slightly more children admitted during the third wave compared to the first, the delta virus doesn't seem to be causing more severe infections in children. It is for this reason that it is unlikely that paediatric hospital bed capacity and critical care capacity will be overwhelmed as has been seen in adults.

Despite these low numbers, the health system has made adequate provision for the increased hospitalisations for all age groups during all various waves of Covid-19 pandemic. With the information having come to our attention, the health system will pay special attention to this possibility during the review of the implementation of the third wave resurgence plans, which will include planning for the fourth wave.

Of the 11 129 COVID-19-associated admissions among individuals aged ≤19 years, 688 (6.2%) were admitted into ICU and 252 (2.3%) were ventilated at some point during admission. Children are generally managed in line with the guidelines on Covid in Children contained in the National Essential Medicine List Standard Treatment Guidelines. A more detailed guideline (Managing Maternal, Neonatal and Child Health during the COVID-19 pandemic in South Africa: A clinical guide for health workers and clinical managers) provides additional detail. Children and adolescents with mild disease should be managed at home, whilst those with moderate or severe disease should be admitted in the health facilities. From the previous waves, it has been shown that children and adolescents rarely required admission to ICU.

The public sector has approximately 11,000 paediatric beds and 3,000 neonatal beds (DHIS data). To date there has been sufficient capacity to accommodate the additional workload resulting from the Covid-19 pandemic. Adolescent beds are generally only available in central hospitals, with the result that many adolescents are cared for in adult wards in most hospitals, which are in good supply. Whilst the number of adolescents requiring admission and ICU care in particular remains small, these numbers have been included when planning for surge capacity during all waves.

Afrox, as the service provider for oxygen supply and support, has made provision for all means of supply ranging from different kinds of cylinders to the reticulated bulk oxygen supply. This includes coverage of paediatrics wards.

END.

02 September 2021 - NW1793

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

(1)Whether, in light of a case opened for theft of items estimated at R200 000 at the Charlotte Maxeke Johannesburg Academic Hospital, he will furnish Ms M D Hlengwa with reasons on how some fire doors were left unguarded when an amount of more than R3 million is being spent on security detail each month at the specified hospital; if not, why not; if so, what are the relevant details; (2) whether the relevant security company is being held liable for the theft; if not, why not; if so, what are the relevant details; (3) whether there is camera surveillance that can aid with the investigation, given that R450 000 is spent on electronic surveillance each month; if not, why not; if so, what are the relevant details?

Reply:

(1) The Gauteng Health Department reported that immediately after the fire, the City of Johannesburg inspected the facility and found out that the hospital was not compliant in several aspects. The hospital has more than 1500 fire doors, which are at the back of the wards and lead to the fire escape routes. The hospital had to remove burglar doors next to the fire doors and this meant wards were left with no protection on access to the wards. This meant that the risk of criminals entering the wards was high in the wards using the back side of the wards without being detected. Plans are in place to review different options of securing the units without compromising fire regulations policies, including extending the CCTV installation to the fire escape routes.

(2) The hospital entered into a Service Level Agreement (SLA) with the security company. The SLA under schedule of penalties give guidance to parties on handling of violations to any terms contained in the agreement. It has been difficult to apportion the liability to the security company as all hospital staff had to vacate the building due to the uncertainty on the safety of the building, including security personnel.

During the temporary closure of the hospital, the Department of Infrastructure Development (DID) took advantage of the situation and invited contractors to do fire remedial work and some maintenance work in the wards. This meant that the hospital had several contractors on site.

(3) Most of the hospital walkways are covered by camera surveillance except for the fire escape routes as per a response to question number 1. The fire escape routes did not have CCTV coverage, they had bugler proofs. As a result, it was not possible to review that footage in the areas where equipment was stolen.

The monthly payment of R450 000 is for repairs and maintenance of CCTV equipment. The monitoring/surveillance of cameras is done by physical security.

CCTV’s have assisted before in identifying and investigation of criminal activities within the hospital. Where criminals are identified the hospital submitted footage to SAPS and had successful prosecutions before. It is for this reason, that the hospital is now exploring the latest technology to have surveillance in fire escape routes.

END.

02 September 2021 - NW1781

Profile picture: Van Staden, Mr PA

Van Staden, Mr PA to ask the Minister of Health

(1)What is the (a) state of readiness of the Government’s facilities regarding the cold chain of COVID-19 vaccines and (b) role and responsibilities of the specified facilities; (2) whether he will make a statement on the matter?

Reply:

1. (a) Government facilities providing services for childhood vaccination programmes already had cold chain capacity before COVID-19. As a result of the oral polio vaccine program in the country, most public health care establishments already have -20-degree storage capacity plus 2-8 degree storage. A cold chain audit has further assisted in informing procurement of equipment in the provinces. Provincial procurement processes have already taken place.

(b) Roles and responsibilities must be in line with the Rules relating to Good Pharmacy Practice published in terms of the Pharmacy Act 53 of 1974. All sites that store COVID-19 vaccines must have contingency plans to manage power failures, equipment breakdowns, or cold chain breaches.

  1. Store the vaccine in a purpose-built vaccine refrigerator.
  2. Ensure that sufficient cold chain capacity is available for all thermolabile medicines stocked, including Expanded Programme on Immunisation (EPI) vaccines and COVID-19 vaccines.
  3. Products must be stored in a temperature-regulated environment as per the manufacturer's product recommendations.
  4. Enough refrigerator capacity should be available to allow orderly arrangement and air circulation.
  5. WHO-approved/compliant continuous temperature recording devices must be installed.
  6. Regardless of the system used, the temperature should be monitored physically twice daily.
  7. The cold storage area or refrigerator must be connected to a standby generator.
  8. The devices must be connected to an alarm and/or warning system in the event of a power failure or other events that may lead to temperature excursions.

2. Yes.

END.

02 September 2021 - NW1779

Profile picture: Van Staden, Mr PA

Van Staden, Mr PA to ask the Minister of Health

(1)With regard to the vaccine online registration system, also known as the Electronic Vaccination Data System (EVDS), what has he found are the reasons that on 2 May 2021 it was reported that only 500 000 South Africans above the age of 60, out of a group of 5 million persons in this specific age group, have so far registered to be vaccinated; (2) how can persons who are not equipped to register online be assisted by Government to enable them to register on the EVDS system; (3) whether he will make a statement on the matter?

Reply:

1. The reference date of 2 May 2021 was before the start of the National Vaccination rollout programme on the 17 May 2021. As of 31 August 2021, at 14h50 a total of 3,567,652 individuals older than 60 had registered for vaccination on the EVDS;

2. The response is as follows:

  • There are three options to self-register at no cost to the individual namely:
      • Through the internet at vaccine.enroll.health.gov.za
      • Through WhatsApp by sending a Whatsapp Message – Register to 0600123456
      • Through USSD by dialling *134*832#

    Two options for assisted registration exist namely:

  • Registration points at vaccination sites
  • Dial the National Call Centre Toll free numbers 0800029999, the call centres agents will assist the individual to register while on the call.

3. Yes.

 

END.

02 September 2021 - NW1522

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

Whether his department made any payments to a certain company (name furnished) to co-ordinate its media appearances and interviews relating to the COVID-19 global pandemic and/or any other subject matter and/or function; if not, what is the position in this regard; if so, what (a) are the full, relevant details and (b) is the total breakdown of the payments made in each specified case?

Reply:

Yes, the Department did make payments to Digital Vibes.

a) Digital Vibes was appointed on the 15th of November 2019 through a deviation process, which was approved by National Treasury, to provide communication services in relation to the National Health Insurance (NHI) Bill as released by the Cabinet for Parliament consideration. On the 25th of March 2020, the Department extended the scope of work of Digital Vibes to include Covid-19. This was done in accordance with the Emergency Procurement rules issued by National Treasury for COVID-19 Procurement.

b) The following table reflects the details in this regard.

END.

30 July 2021 - NW1549

Profile picture: Langa, Mr TM

Langa, Mr TM to ask the Minister of Health

What steps have been taken by his department to resolve the poor management of the Prince Mshiyeni Memorial Hospital in the Umlazi Township in KwaZulu-Natal?

Reply:

I am assured by the KwaZulu Natal Provincial Department of Health that the management of the Prince Mshiyeni Memorial Hospital is in good order. All senior management positions at the Hospital have been filled. The current management is capable of handling challenges that emanate from managing this large and busy regional hospital.

END.

07 July 2021 - NW1413

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1)Whether he will furnish Ms H Ismail with the scientific evidence on which the decision was made, as contained in the circular distributed by his department on 29 January 2021 entitled Wrapping of coffins with plastic, wherein some cases of bodies that were wrapped with plastic, the need for funeral directors to wear full personal protective clothing as a precaution, falls away; (2) whether an individual who handles the deceased can contract COVID-19; if not, what is the position in this regard; if so, what are the relevant details; (3) whether an individual can contract COVID-19 in the event that there has been contact with bodily fluids from someone who has died of COVID-19; if not, what is the position in this regard; if so, what (a) are the relevant details and (b) evidence is there showing that it is possible or impossible?

Reply:

(1) The evidence is clear and has been documented in the World Health Organization (WHO) guidelines on Infection prevention and control (IPC) for safe management of a dead body in the context of COVID-19, interim guidance, 4 September 2020. The National Infection Prevention and Control Guidelines (South Africa), based on WHO recommendations, outlines the evidence and steps required for handling of COVID-19 bodies and safe burial. The Centers for Disease Control and Prevention, has clarified the difference between death from Ebola and COVID-19 and the burial requirement for each. There is no need for extra PPE- gloves and aprons will suffice since the route of transmission is not like Ebola where the virus survives post mortem in body fluids.

(2) No, to date, there is no reported case of SARS-CoV-2 transmission from a dead body to a human. There is very little risk of infection being transmitted from a dead body to those carefully handling the corpse.

(3) No, however;

a) When dealing with a dead body, all handlers must ensure that IPC precautions are in place such as wearing appropriate personal protective equipment (PPE) which protects the body, respiratory tract and mucous membranes from accidental splash contamination. Hand hygiene, good ventilation and a clean environment is essential. Good general hygiene is importanct to make sure that working surfaces are free from contamination and by so doing this will ensure safety of everyone using the premises.

b) There is no evidence that SARS-COV-2 can be transmitted via body secretions post mortem.

END.

07 July 2021 - NW1521

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

(1)Whether his department has conducted adequate research on the capacity for vaccination roll-out programmes across the Republic; if not, why not; if so, what are the relevant details; (2) with reference to the report provided by the Health Sciences Faculty at the University of Fort Hare, what is the capacity of his department to deliver the planned number of vaccinations in the second phase by the end of June 2021 in the Eastern Cape; (3) whether his department supports the findings made in the specified report on its lack of capacity for the vaccination roll-out; if not, why not; if so, what are the relevant details; (4) what plans and teaching programmes does his department have in place to encourage South Africans to register for vaccinations, especially for the current cohort receiving vaccines?

Reply:

I am not able to respond to this Question as I am still waiting for the Honourable Member to share the report that the Honourable Member is referring to. Once the Honourable member has furnished me with the report, that would enable me to reply fully to the information requested by the question.

END.

07 July 2021 - NW1328

Profile picture: Hicklin, Ms MB

Hicklin, Ms MB to ask the Minister of Health

(1)Whether, with reference to his reply to question 856 on 15 April 2021, healthcare workers were made aware of the fact that the K95 masks presented to them only had a very low filtration-efficacy range and could compromise their own health; if not, why not; if so, what are the relevant details; (2) what consequence management will be meted out to the (a) procurers and (b) suppliers of the specified masks?

Reply:

1. The respirators that did not meet the minimum standard as per the laboratory test were not distributed to health care workers. Where the respirators were distributed these were immediately removed from circulation on instruction to the head of the institution and replaced with respirators that complied with the minimum standard. Communication was sent out to hospitals that received a consignment of donated KN95 that had to be recalled. In this instance the donor replaced the respirators with a new consignment.

2. The National Department of Health: Policy for the Regulation of Quality Respiratory Protective Equipment (RPE) Supply in Healthcare, August 2020 makes the following provision, in accordance with SAHPRA requirements, for all licensed establishments to conduct post marketing surveillance:

Prior to use of respirators purchased, a minimum of 10 respirators per 1000 (or part thereof) and at least 100 units of 10000 should be randomly picked by the purchaser from the boxes in their possession and sent at a minimum for a Particulate Filter Penetration test at a published accredited South African test laboratory (to sodium chloride) which test must indicate that the respirator has passed the minimum specification. This cost is borne by the seller (incorporated into cost of sale) and selection of respirators for testing is conducted by the purchaser to maintain integrity of random selection, testing and reporting to the purchaser.

a) If respirators pass this test, all respirators in the same production batch may be used, in the same purchase and having been delivered, and in possession of the purchaser.

b) Failed tests require a second batch of randomly selected (or the same) respirators be sent for formal testing as per point 6

c) The final result of the testing must be reported to the supplier and a copy supplied to SAHPRA and the NRCS. The supplier is then required by the regulators to report (as per pharmaceutical batch recalls), on a publicly accessible portal for the particular batch affected (as per many other global regulatory agency standards for quality testing) at a minimum on SAHPRA and NRCS websites (or a link from one to the other).

d) Publication will only reference the manufacturer, batch failed and test results. The implication should not necessarily be that all respirators from the manufacturer are defective.”

END.

05 July 2021 - NW1663

Profile picture: Marais, Mr S

Marais, Mr S to ask the Minister of Health

(1)Given the vaccination roll-out programme and the announcement of vaccinations based on age, by what date does he envisage will vaccinations to multiple disabled persons be offered, as they often have comorbidities making them the most vulnerable members of society to contract the COVID-19 virus; 2) what are the reasons that they will not be vaccinated at the same time as their parents and caregivers, since they are often cared for by their parents who are older than 60 years; (3) what are the full, relevant details of the reasons that their exposure to COVID-19 infection and the risk of them dying is not treated as a high priority in terms of the policies on the roll-out of the vaccine by his department?

Reply:

1. People with disabilities who live in care homes of any description are vaccinated through the outreach programmes through the ‘congregate settings’ programme. People who are bedridden can, where it is possible, be visited and vaccinated at home. Insured patients should arrange this with their medical aids. For public patients this will depend on the capacity of the provincial health department.

2. The Electronic Vaccine Distribution System (EVDS) is programmed to schedule vaccinations in age bands as determined by the government from time to time (after advice from various Ministerial Advisory and other committees).

3. Vaccination of every person in South Africa is considered important and urgent. The reality is that the capacity of the combined public and private health services to vaccinate people is limited. There are many competing priorities for vaccination and these priorities are addressed within the capacity of the system and the availability of vaccine. There is no objective way to choose one person’s health needs above another, so the focus has started with the groups where the greatest concentration of risk has been identified and that is in the age group over 60 years. The rollout to others is as fast as the vaccine and the services can manage.

END.

04 June 2021 - NW1030

Profile picture: Thembekwayo, Dr S

Thembekwayo, Dr S to ask the Minister of Health

What (a) has he found caused the fire at the Charlotte Maxeke Johannesburg Academic Hospital, (b) were the reasons that the response to the fire was so slow, which led to so much damage to the specified hospital and (c) steps has his department taken since the fire, in order to ensure that services are still provided to persons who depended on the hospital?

Reply:

The National Department of Health is still awaiting information from the Gauteng Provincial Department of Health, to enable the Minister to respond to this question. The response will be provided to Parliament as soon as information has been received from the Provincial Department of Health.

END.

04 June 2021 - NW1248

Profile picture: Majozi, Ms Z

Majozi, Ms Z to ask the Minister of Health

Whether his department has a strategy in place to ensure self-reliance of the supply of the COVID-19 vaccine in future; if not, why not; if so, what are the relevant details?

Reply:

The COVID-19 pandemic has highlighted the need for increased vaccine security and therefore, self-reliance. However, the development of local vaccine manufacturing is a complex process that has high risk associated with it. To ensure the quality and consistency of vaccine manufacturing, hundreds of process steps need to be followed and there are thousands of check points for testing. The transfer of intellectual property rights as well knowledge transfer on vaccine manufacturing should be coupled with massive investment in manufacturing capacity. Currently there is an unprecedented level of support across African governments, African and Global Public Health (GPH) institutions, and the private sector, which is driven by the need for increased vaccine security and self-reliance highlighted by the COVID-19 pandemic. 

As part of the African Union we have embarked upon a project to understand the strengths to leverage and challenges that could be faced develop a framework on vaccine manufacturing on the continent including opportunities for collaboration with a range of public and private sector stakeholders. This work is ongoing and is aimed at future pandemic preparedness.

END.

04 June 2021 - NW1230

Profile picture: Motsepe, Ms CCS

Motsepe, Ms CCS to ask the Minister of Health

Whether, taking into account the slow pace of COVID-19 vaccination, he has revised his vaccination targets for the nation; if not, what is the position in this regard; if so, what are the new dates by which he intends to have vaccinated enough persons to protect the nation against the spread of the virus?

Reply:

The targets for the vaccine roll-out as follows:

Phase

Time period

Number of vaccinations

1

February – May 2021

1.2 million

2

May – October 2021

16.6 million

3

November 2021 – February 2022

22.6 million

The targets remain as previously announced. The targets are linked to the vaccine supply pipeline, and may need to be revised if vaccine manufacturers do not supply vaccines according to the agreed timelines.

END.

04 June 2021 - NW1213

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

Whether (a) the President, (b) the Deputy President, (c) any of the Cabinet Ministers, (d) any of the Deputy Ministers and/or their (e) spouses, (f) partners and (g) children have been vaccinated against COVID-19; if so, (i) on what dates in each case and (ii) where did the vaccinations take place in each case?

Reply:

Leaders including politicians who are eligible to be vaccinated based on the prevailing eligibility criteria have been encouraged to vaccinate in order to publicise the vaccine roll-out, and to build confidence in the programme amongst vaccine-hesitant citizens.

President Cyril Ramaphosa and Minister of Health, were vaccinated in public on 17th February 2021 at the Khayelitsha District Hospital in the Western Cape at the start of the Sisonke Early Access programme.

However, vaccination status of individuals remains confidential, and the National Department of Health is therefore not in a position to divulge the vaccination status of the other persons identified in the above question.

END.

04 June 2021 - NW1083

Profile picture: Wilson, Ms ER

Wilson, Ms ER to ask the Minister of Health

(1)What are the reasons that 72 interns with 20 years of laboratory experience were (a) put on a forensic toxicology training programme under a certain person (name furnished) in Pretoria with a certain person (name also furnished) for a year in 2012 and (b) accommodated in a hotel for a year despite many of them coming from Pretoria; (2) (a) what number of days in a week did the interns attend lectures at the hotel and (b) at what time did the lectures take place; (3) what (a) is the name of the hotel where the interns were accommodated and (b) was the total cost of the accommodation for the interns, including meals, refreshments, phones and other relevant details; (4) where were the interns placed after they completed the training presented by the specified person?

Reply:

The National Department of Health is still awaiting information from the University of Pretoria, to enable the Minister to respond to this question. The response will be provided to Parliament as soon as information has been received from the University of Pretoria.

END.

04 June 2021 - NW1026

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

(a) What total number of recently graduated medical doctors (i) have been placed as medical interns as at 1 April 2021 and (ii) are still sitting at home, waiting to be placed and (b) what (i) has he found caused the delays in placing the recently graduated medical doctors and (ii) steps are being taken by his department to resolve the situation?

Reply:

a) According to records on the Internship and Community Service Placement (ISCP) online System, 257 medical students were confirmed to have met the requirements to be allocated for medical internship as at end of April 2021 (i.e. 138 NMFC students who passed the Cuban National Exam; 26 passed the HPCSA Medical Board Exam; and 93 completed their blocks in local universities which made them eligible for medical internship posts, (i) 0 has been allocated on medical interns on 1 April 2021, as there are only two allocation cycle for medical internship, which are 1 January and 1 July of each year and (ii) 257 are still waiting for allocation and will be allocated during June to take up positions on 1 July 2021 and (b) (i) there was no delay as the applicants were not yet eligible for medical internship at the time (ii) the ICSP online System will opened applications from 14 May 2021. Only after the application process is closed, the actual application numbers will be confirmed as more students are becoming eligible (i.e. completing blocks).

b) Due to increased number of qualifying applicants for medical internship posts the Public health sector remains challenged by budget cuts to fund additional internship posts and to accredit excessive number of medical internship posts in health facilities as it requires additional resources (appointment of additional specialists and senior medical doctors).

END.

04 June 2021 - NW1204

Profile picture: van der Merwe, Ms LL

van der Merwe, Ms LL to ask the Minister of Health

What is the total number of babies who were born to undocumented foreign nationals and/or illegal migrants in government health facilities in each year in the past five years?

Reply:

The Department of Health strives to take reasonable legislative and other measures to achieve the progressive realisation of the right to have access to health care services including reproductive health care in terms of its Constitutional obligations. Section 27 (1) (a) of the Constitution of the Republic of South Africa states that everyone has the right to have access to health care services, including reproductive health care. Section 27 (3) further states that no one may be refused emergency medical treatment.

The statistics on the total number of babies who were born to undocumented foreign nationals and/or illegal migrants in government health facilities in each year in the past five years is not available as our health facilities do not keep statistics on foreign nationals.

END.

04 June 2021 - NW1152

Profile picture: Chetty, Mr M

Chetty, Mr M to ask the Minister of Health

Whether, with regard to the Republic’s COVID-19 vaccine procurement that has lagged behind compared to most other emerging countries, his department has made an effort to leverage the Republic’s bilateral cooperation agreements with vaccine producing countries to procure more vaccines; if not, why not; if so, what are the further relevant details?

Reply:

The two major vaccine manufacturing countries are China and Russia. Vaccines require regulatory approval from SAHPRA. Countries cannot be the applicant and have to work through commercial entities to obtain approval. We have been in discussion with a number of companies having obtained marketing approval from the Gamaleya Institute of Russia for the Sputnik vaccine and with Numolux for the Sinovac vaccine. When all regulatory mattera have been attended to, the negotiations will progress further.

END.

04 June 2021 - NW1131

Profile picture: Gwarube, Ms S

Gwarube, Ms S to ask the Minister of Health

What (a) has been the breakdown of the costs of corruption within his department in the past five financial years, (b) number of tenders have been cancelled as a result of irregularities and/or corruption in each province in the past five years, (c) is the total amount of irregular expenditure in each province in the past five years, (d) is the percentage of tenders that have been put on the e-Tender portal in each province in the past five years, (e) is the percentage of tenders that have been uploaded on e-portal sites in each province and (f) is the (i) national and (ii) provincial percentage of tender processes that are paper based?

Reply:

According to the information provided by the Provincial Health Departments the reply is as follows:

EASTERN CAPE

a) The following table reflects the details in this regard.

PERIOD

CATEGORY

TOTAL NUMBER OF CASES

CASES ABOVE R100,0000

 

FRAUD

CORRUPTION

   

2017/2018

7

11

18

2

2018/2019

7

13

20

2

2019/2020

2

8

10

-

2020/2021

2

3

5

-

TOTAL

18

35

53

4

b) No tenders have been cancelled as a result of irregularities or corruption.

c) The bulk of irregular expenditure as per the table below comprises of extension of contracts above the 15% NT threshold. The 2020/21 figure not yet final.

d) All bids above R500k are advertised on the e-Tender portal other than deviations due to sole source or emergency procurement.

e) All bids above R500k are advertised on the e-Tender portal other than deviations due to sole source or emergency procurement.

f) (ii) The Eastern Cape Department of Health is currently using manual systems which are paper based. The plans to digitise procurement processes have been included on the departmental strategic plan and processes are underway to engage SITA for assistance.

FREE STATE

a) Free State Psychiatric Complex – Fraudulent payment to various transactions to suppliers at FSPC. Double payment were made to various suppliers on same order numbers by means of LOGIS and Sundry Payments (BAS System). Cost involved R7,821,587.62.

b) None, tenders were not cancelled due to irregularities or allegations of corruptions.

c) The total amount registered for Free State Department of Health is: R1,605,678,521.22.

d) 100% all tenders were published on e-Tender portal.

e) 100% tenders were uploaded on e-Tender portal and published on the Provincial Tender Bulleting.

f) (ii) 80% processes are paper based.

GAUTENG

a) 

Year

No of Cases of Corruption

Costs

2020-21

None

R0

2019-20

6

R12 600 944.78

2018-19

1

R2 773 209.60

2017-18

7

R2 875 716.49

2016-17

1

R987 032.00

b) There are two tender that have been cancelled, are as follows;

  • GT/GDH/118/119/120/121/2016) Supply of Physical Security Services
  • (GT/GDH/123/2013)-ICT Infrastructure Refresh – the provision of V-Blocks to Head Office, Zola, New, Natalspruit, Steve Biko and Charlotte Maxeke Hospitals.

Year

Amount

2017

2 050 841 000

2018

1 703 205 000

2019

2 862 156 000

2020

2 318 994 000

2021

3 549 745 000

TOTAL

12 484 941 000

d) 100%- Tenders are advertised by E-Gove as well as Government Tender Bulletin.

e) 100% Tenders are advertised by E-Gove as well as Government Tender Bulletin.

f) (ii) All tenders are advertised through National Tender Bulletin and can be downloaded from respective provincial e-tender portal by prospective bidders.

KWAZULU-NATAL

FY 2016/2017 R 16 918 744,00

FY 2017/2018 R 8 505 932,68

FY 2018/2019 R 118 169 545,62

FY 2019/2020 R 474 767,75

FY 2020/2021 R 110 000,00

b) No tenders have been cancelled in the province in the past 5 years due to irregularities and/or corruption in KZN.

c) 

 

‘000

‘000

‘000

ROOO

ROOO

Period

2015/2016

2016/2017

2017/2018

2018/2019

2019/2020

Totals

R1,257,484

R1,325,084

R1,464,342

R1,541,732

R1,433,975

d) 100%. All tenders in the province have been advertised on the e-Tender portal.

e) 100%

f) (ii) 100%

LIMPOPO

a) None.

b) None.

c) No irregular expenditure as a result of corruption within the department.

f) 100% of tenders were put on the e-Tender portal in the past five years.

e) 100% of tenders were uploaded on e-Tender portal site of the department.

f) (ii) 100% of tender process are paper based in the department

MPUMALANGA

a) The Department does not have known cases of corruption reported

b) The Department has cancelled contracts for appointed service provider for supply of perishable and non-perishable food due to non-compliance with UIF

c) 

Financial year

2016/17

2017/18

2018/19

2019/2020

Amount

1 552 623 000

309 920 000

138 899 000

122 157 000

d) Not applicable – Provincial Treasury competency

e) Not applicable – Provincial Treasury competency

f) (ii) Not applicable

NORTHERN CAPE

a) No cost of corruption incurred in the past five financial years

b) No contract was cancelled as a result of irregularities and/or corruption in the past five years.

c) 

2016/17: R574,183,000

2018/19: R714,939,000

2019/20: R497,829,000

2020/21: R492,748,000 (Preliminary)

Total: R2,692,078,000

d) 

2016/17: No tenders issued

2017/18: 60% (3 out of 5)

2018/19: 0%

2019/20: 0%

2020/21: 0%

e) No tenders were ever uploaded on the e-Portal site.

f) (ii)

2016/17: No tenders issued

2017/18: 40% (2 out of 5)

2018/19: 100%

2019/20: 100%

2020/21: 100%

NORTH WEST

a) No cost of corruption incurred in the past five financial years

b) NWDOH 40/2021, Supply of Physical Security Services

c) 

Year

Amount

2016/2017

721 445 000

2017/2018

809 267 000

2019

1 333 654 000

2020

1 189 467 000

2021

682 000 000

TOTAL

4 735 833 000

d) Irregular expenditure for the past 5 years = R4 728 202 000.

e) 100%- Tenders are advertised by E-Gove as well as Government Tender Bulletin

f) 100%- Tenders are advertised by E-Gove as well as Government Tender Bulletin

g) (ii) All tenders are advertised through National Tender Bulletin and can be downloaded from respective provincial e-tender portal by prospective bidders

WESTERN CAPE

a) None.

b) None based.

c) 

(R’000)

2020/21:               2,452 (unaudited)

2019/20:               6,472

2018/19:             13,260

2017/18:             23,553

2016/17:             11,459

2015/16:               7,284

d) Indeterminable. E-portal is a NT app and has been off-line for a few months. NT unable to provide date as to when it will become available.

e) Indeterminable. E-portal is a NT app and has been off-line for a few months. NT unable to provide date as to when it will become available.

f) (ii) BSC, BEC, BAC processes were paper based up to March 2020. Since March 2020, documents had to be worked on electronically, meetings had to be held electronically and declarations of interest and confidentiality of meetings had to be declared at each virtual meeting.

END.

04 June 2021 - NW1281

Profile picture: Graham, Ms SJ

Graham, Ms SJ to ask the Minister of Health

(1)With respect to the commitment of Government to address the scourge of gender-based violence, what (a) number of Thuthuzela Centres are located in each province, (b) number of hospitals do not have rape kits in each province and (c) are the reasons that the specified hospitals do not have rape kits; (2) whether there is a prescribed number of rape kits required in each hospital; if not, what is the position in this regard; if so, what number is prescribed; (3) whether hospital staff in emergency wards are trained in processing a rape victim; if not, why not; if so, what are the relevant details; (4) whether hospitals are precluded from processing a rape victim if that person has not given a statement at a police station first; if not, what is the position in this regard; if so, what are the relevant details?

Reply:

First and foremost, on the matter of handling of alleged rape cases, it must be borne in mind that the process of investigating the alleged rape must follow a specific and prescribed chain of evidence to ensure that medico-legally there is no compromise to the quality of evidence collected, thus protecting the victim when the evidence is before a court of law. Bearing this in mind, the response to this question is as follows:

(a) The total number of Thuthuzela care centres (TCCs) in the country is 55.

Eastern Cape: 9

Free State: 4

Gauteng: 7

KwaZulu Natal: 8

Limpopo: 7

Mpumalanga: 5

Northern Cape: 4

North West: 5

Western Cape: 6

a) Hospitals are not obligated to have rape kits as the Department of Health is not involved in the procurement and delivery of rape kits as procurement and delivery is the responsibility of the South African Police Service (SAPS). The SAPS brings these kits along to the Thuthuzela Care Centres (TCCs) as and when there is a sexual assault reported. Therefore the issue of keeping rape kits at health facilities only emanates where there is a discussion between the health facility and the SAPS station responsible.

b) Not applicable based on the response in 1(b). 

2. There is no prescribed number of rape kits required in each hospital. The provision of rape kits is a competency of the SAPS. However as Department of Health we take Gender based violence very seriously and it is our duty to ensure that these rape kits are available at all times to execute evidence collection at our health facilities.

We are therefore working closely together with SAPS to ensure that rape kits are always available. These kits are then delivered to the health facilities by the SAPS, for collection of evidence by health professionals, during physical examination of the survivors of sexual violence. The evidence collected by health professional using these rape kits, is then taken by SAPS to the Police Forensic Laboratory for DNA analysis.

(3) Yes, hospital staff in emergency wards is trained in processing a rape victim.

The Department of health provides service at all hospitals to manage and process survivors of rape. This is done through:

  • qualified clinical forensic nurses and doctors
  • Ten (10) to more days training using the manual developed by the South African Medical Research Council, the content of which is highlighted below. if not, why not; if so, what are the relevant details; 

Health professionals provide the following services to survivors of rape:

  • physical examination,
  • Collection of forensic evidence using J88 form. Medico-legal evidence comprises both documentation on the examination done and DNA evidence collected during the examination.
  • in children, laboratory evidence of particular sexually transmitted infections can also be used as evidence.
  • reporting child abuse, neglect and exploitation to Department of Social Development and SAPS where necessary.
  • registration of women and children seen for sexual assaults at health facilities
  • providing HIV testing and counselling, which includes providing post exposure prophylaxis
  • provision of Prophylaxis (PEP) medication to survivors of rape; which should be available 24 hours a day and patients should be prioritised irrespective of the nature of physical injuries among others.
  • provision of ccomfort packs for rape victims;
  • referral of women and children to Department of Social Development in the instance their safety is at risk to ensure that they are provided a safe environment such as shelters.
  • referral to Psychiatrists and Psychologist to manage emotional and psychological trauma.

(4) No, hospitals are not precluded from processing a rape survivor if that person has not given a statement at a police station first. Survivors of rape have a choice of which authority they wish to access first. We however have noted that majority of rape survivors access the health facility first before they report the matter to a police station and are not dismissed at all.

END.

04 June 2021 - NW1303

Profile picture: Masango, Ms B

Masango, Ms B to ask the Minister of Health

(1)What total number of children were born in the Republic (a) in the period 1 January 2011 to 31 December 2020 (b) in each year in the specified period; (2) what total number of children were born in each province (a) in the period 1 January 2011 to 31 December 2020 (b) in each year in the specified period?

Reply:

1. (a) The total number of children born in the Republic in the period 1 January 2011 to 31 December 2020 was 9, 609, 814.

(b) The total number of children born in the Republic in each year in the period 1 January 2011 to 31 December 2020 was as follows:

2011

2012

2013

2014

2015

2016

2017

2018

2019

2020

947,912

962,705

957,798

961,036

926,723

891,482

924,898

970,698

1,010,853

1,055,709

Source: DHIS

2. (a) The total number of children born in each province in the period 1 January 2011 to 31 December 2020 was as follows:

Province

Year 2011 to 2020

Eastern Cape Province

1,124,581

Free State Province

471,875

Gauteng Province

2,178,280

KwaZulu-Natal Province

1,964,786

Limpopo Province

1,283,147

Mpumalanga Province

795,754

Northern Cape Province

220,051

North West Province

592,056

Western Cape Province

979,284

Total

9,609,814

Source: DHIS

b) The total number of children born in each province in the period 1 January 2011 to 31 December 2020 was as follows:

Province

2011

2012

2013

2014

2015

2016

2017

2018

2019

2020

EC

119,7

121,606

118,302

120,048

113,52

103,988

101,902

106,139

108,034

111,342

FS

48,55

49,439

47,377

46,432

44,992

41,625

45,769

48,394

49,598

49,699

GP

207,963

211,389

212,873

211,247

209,181

206,18

218,149

224,414

231,927

244,957

KZN

195,541

196,27

194,074

193,032

182,634

177,795

184,828

202,388

218,535

219,689

LIMP

129,695

129,807

129,952

130,059

122,813

119,09

121,728

125,612

131,004

143,387

MPU

75,891

78,53

78,146

79,472

75,654

72,928

77,239

81,482

83,698

92,714

NC

21,473

22,643

22,24

22,973

22,318

20,549

20,918

22,079

22,313

22,545

NW

59,004

59,695

58,999

58,304

57,55

56,309

57,362

59,8

61,591

63,442

WC

90,095

93,326

95,835

99,469

98,061

93,018

97,003

100,39

104,153

107,934

Total

947,912

962,705

957,798

961,036

926,723

891,482

924,898

970,698

1010,853

1055,709

Source: DHIS

END.

04 June 2021 - NW1277

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1)What are the relevant details of the Johnson and Johnson vaccine trials in the Republic with regard to the (i) number of Johnson and Johnson trials that have been conducted in the Republic, (ii) relevant details and results of such trials, (iii)(aa) number of participants in each ensemble and (bb) their relevant details, outcomes and results and (iv) breakdown of the results for each trial test; 2) (a) where were the specified trials conducted and (b) what are the details of the administering bodies, hospitals and/or clinics?

Reply:

1. (i) There were three Johnson&Johnson trials conducted in South Africa, the ENSEMBLE 1 trial which was a Phase 3 single dose study, ENSEMBLE 2 which is a phase 3 two dose study (which is still ongoing), and the SISONKE study which was an open label phase 3b trial. 

(ii) The SISONKE trial ended recently (on 17 May 2021) and the analysis is only just starting. 

The ENSEMBLE trial was published in the New England Journal of Medicine, main author GJ Sadoff: Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19. A summary of the results: “A single dose of vaccine protected against symptomatic Covid-19 and asymptomatic COVID-19 infection and was effective against severe-critical disease, including hospitalisation and death. Safety appeared to be similar to that in other phase 3 trials of Covid-19 vaccines. 

(iii)-(iv) (aa) SISONKE: the trial ended on 17 May and the analysis on the data is starting now. 

ENSEMBLE: a total of 44 325 participants underwent randomisation of which 43 783 received either placebo or vaccine. The per-protocol population included 39 321 participants, 19630 of which received vaccine and 19630 received placebo. 

(bb) SISONKE: the trial ended on 17 May and the analysis on the data is starting now. 

ENSEMBLE participants 

Median age: 52 years

Gender: female 45% male 54.9% other <0.1%

Ethnicity: American Indian/Alaskan native <1%; South American 9%; Asian 3%; Black 19%; Pacific Islander <1%; White 58%; Multiracial 6%; unknown 3%.

Country: Latin America 40.9%; South Africa 15%; USA 44.1%

> coexisting condition: 40.8%

Outcomes & Results: Vaccine efficacy after 28 days administration

Moderate to severe-critical COVID-19: 66.1% (95% confidence interval 55.0 – 74.8%)

Symptomatic COVID-19 of any severity: 66.5% (55.5-75.1)

No differences in vaccine efficacy were observed among subgroups (sex, race or ethnic group). Only a marginal decrease in vaccine efficacy noted in participants > 60 with comorbidities after 28 days after administration. Vaccine efficacy against hospitalisation was 100% 28 days after administration. Of the South Africa population, 95% of participants had the 501Y.V2 variant, but the vaccine efficacy remained high. 

 

(2) (a) ENSEMBLE was conducted in South Africa, Latin America (Argentina, Brazil, Chile, Colombia, Mexico, Peru) and the USA.

SISONKE was conducted in the following 17 institutions, from all 9 provinces:

EC: Frere, Livingstone, Nelson Mandela Academic, Netcare Greenacres hospitals

FS: Bongani, Fezi Ngumbentombi, Life Rosepark, Pelonomi, Universitas hospitals

GP: Ahmed Kathrada, Charlotte Maxeke, Chris Hani Baragwanath, Dr George Mukhari, Netcare Milpark, Steve Biko Academic hospitals

KZN: General Justice Gizenga Mpanza, Edendale, Madadeni, Netcare St Augustines, Prince Mshiyeni Memorial hospitals

LP: Tshilidzini, Donald Fraser, Malamulele, Mediclinic Polokwane, Netcare Pholoso, St Ritas hospitals

MP: Ermelo, Life Cosmos, Mediclinic Nelspruit, Mapulaneng, Rob Ferreira hospitals

NC: Mediclinic Upington, Robert Mangaliso Sobukwe hospitals

NW: Job Shimankana Tabane, Klerksdorp-Tshephong Tertiary, Life Peglarae, Mahikeng Provincial, Moses Kotane hospitals

WC: Groote Schuur, Tygerberg, Gatesville, George, Karl Bremer, Khayelitsha District, Paarl, Worcester hospitals.

(b) ENSEMBLE was a multi-national study funded by Janssen Research and Development and others. 

Vaccines for SISONKE were secured by the Department of Health and were administered by teams of researchers and vaccinators. Research staff from the South African Medical Research Council where responsible for ensuring the cold chain and drawing up the correct amount of vaccine. Vaccinators where responsible for complete assessment checks, administering the vaccine and monitoring the participants for a few minutes after administration. END.

04 June 2021 - NW1056

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

What are the relevant details of the specific impact of COVID-19 vaccines approved for vaccination in the Republic, on persons, including with regard to (a) the different age groups and (b) persons with comorbidities, with reference to how effective and/or for how long the vaccines will provide protection against re-infection?

Reply:

Only a marginal reduction in efficacy has been noted the elderly (>60-65 years) in the trials conducted to date. With regards to comorbidities, current trials have shown no difference in efficacy compared to persons without comorbidities. Theoretically they may be less effective in persons with decreased immune system, however the limited trials to date have not shown this.  

There is currently no data on how long the vaccines will provide protection against re-infection.

END.

04 June 2021 - NW1054

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

What are the relevant details of (a) how the Government’s procurement of COVID-19 vaccines is funded and (b) the detailed breakdown of the funding provided by (i) the Government, (ii) medical aids and (iii) any other person and/or entity?

Reply:

a) Government procurement of vaccines is supported by the allocation of funds from National Treasury to the National Department of Health as earmarked funds.

b) (i) As sole procurer of vaccines from manufacturers, all the vaccines are purchased by the National Department of Health

(ii)-(iii) The vaccines are supplied to vaccination sites in the private and public sector who administer vaccines. Private sector sites buy the vaccine from the NDOH and will claim from medical schemes for the vaccine and administration of vaccines to the insured patients. For uninsured patients, the vaccination sites will claim from the Department

END.

04 June 2021 - NW1055

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

Whether he will provide a full report on each vaccine with regard to ethnicity efficiencies studied; if not, why not; if so, what are the relevant details?

Reply:

END.

04 June 2021 - NW1027

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

What is the (a) race and (b) gender demographic of the persons who have been vaccinated as part of the Johnson & Johnson vaccine trial to date?

Reply:

a) Race is not a data element recorded nor collected as part of the vaccination record for vaccinees.

b) Total number of Vaccinations as at 9 May 2021 at 15h30 total 382 568.

  • Number of Male Vaccinees = 93 220 which represents 24.4 % of the total number of Vaccinees
  • Number of Female Vaccinees = 382568 which represents 75.4 % of the total number of Vaccinees

END.

04 June 2021 - NW1028

Profile picture: Thembekwayo, Dr S

Thembekwayo, Dr S to ask the Minister of Health

What role will (a) medical schemes and (b) private hospitals play in the roll-out of COVID-19 vaccinations in the Republic?

Reply:

a) South Africa’s national COVID-19 vaccination strategy is designed along the principles of equitable access, social solidarity and fair pricing. Our main priority as government is to ensure that we have the most rational approach to procuring, distributing and administering the vaccine to all members of the national population, irrespective of whether they have medical scheme cover or not.

Medical schemes, as per the provisions of the Medical Schemes Act and its enabling regulations, are mandated to fund for all their members’ costs associated with the diagnosis, treatment, management and vaccination for COVID-19. These costs are to be paid for in full as per the categorization of COVID-19 as a Prescribed Minimum Benefit. Government has also put into place a mechanism to support medical schemes, and their administrators, in establishing accredited COVID-19 vaccination sites across the country. This is intended to expand the number of sites that medical scheme members and non-members can access in order for them to receive their vaccination as per their registration and scheduling on the Electronic Vaccination Data System (EVDS).

b) Government position is that the effective, fair and sustainable achievement of the targets outlined in the vaccination plan requires a collaborative effort involving a number of partners. Private hospitals, including general practitioner as well as community and corporate pharmacies, are playing a role in the roll-out of the COVID-19 vaccination strategy. The National Department of Health, in liaison with the South African Pharmacy Council, has determined clear criteria that all facilities must comply with (such as having the appropriate cold change facilities and trained personnel to administer the vaccines) in order to receive accreditation as a vaccination site. Therefore, private hospitals would also need to comply with these requirements to be able to participate in the roll-out. Private hospitals and private pharmacies are already participating in the vaccines roll-out program.

END.

04 June 2021 - NW1249

Profile picture: Cebekhulu, Inkosi RN

Cebekhulu, Inkosi RN to ask the Minister of Health

(1)Given the reality brought to us by the COVID-19 pandemic about the importance of investing in scientific research capacity for pharmaceutical production, what strategies has the Government adopted to boost local research capacity in pharmaceuticals; (2) whether the Government intends to intervene in the pharmaceutical sector to ensure self-reliance in pharmaceuticals; if not, why not; if so, what (a) are the relevant details of the strategy and (b) is the projected timeline?

Reply:

1. The SAMRC has a variety of grant programs (both internal and through strategic partnerships) that are supporting drug discovery research and development in key health priority areas. These projects are leading to novel drug targets and candidate molecules and include plant-based medicines as well as biologicals such as vaccines and monoclonal antibodies.

The Technology Innovation Agency, with funding from the Department of Science and Innovation has established an API Cluster aimed at increasing the capacity of the country to develop the processes and manufacturing capability for the manufacture of active pharmaceutical ingredients. This cluster links innovators at the universities and science councils with industry, including development partners and pilot production facilities. This provides a mechanism to advance new drugs in development by local innovators towards testing and approval. One of the objectives is to synthesise molecules that may have efficacy against Covid to ensure continuity of supply. We are in discussions with international partners round this.

Government, through the Department of Science and Innovation, is a shareholder in The Biovac Institute, which has embarked on an ambitious journey to bring manufacture of vaccine APIs to the country. Biovac has been pursuing a backward integration strategy and has undertaken technology transfers with major pharmaceutical companies to establish the capacity for formulation, fill and finish of vaccines. It is raising funding to expand this capacity and to add a production suite for antigens/immunogens/biologicals. The same applies for Afrigen Biologics. Biovac and Afrigen are, further, developing its own vaccine candidates. Government has also been supporting the CSIR’s efforts to establish GMP manufacture of biologicals using plant production systems. The team are actively working on a concerted strategy to leverage off South Africa’s scientific investments to see if these can translate into products.

There are a number of pockets of excellence in drug discovery and vaccine development research in South Africa, situated predominantly at the universities and science councils. A key bottleneck, however, is the pilot scale manufacture of these under GMP conditions for clinical trials and later commercial manufacture at scale. This is where further investment is required to ensure that the full pharmaceutical and vaccine development value chain is in place in the country.

2. On 2 October 2020, India and South Africa proposed the TRIPS Waiver”, a proposal to suspend intellectual property protections for products and technologies needed for the fight against COVID-19, including vaccines, for the duration of the pandemic. This would involve a temporary suspension of certain rules set out in the Trips agreement, the intellectual property treaty of the World Trade Organization (WTO). The waiver proposal by India and South Africa presents an important opportunity for all governments to unite and stand up for public health, global solidarity, and equitable access through a concrete step at the international level that can provide an automatic and expedited solution to address IP and technology challenges collectively.   The TRIPS Waiver proposal is now gaining support from major drug manufacturing countries.

The Department of Science and Innovation, and Trade, Industry and Competition are developing strategies for the local production of pharmaceuticals, especially the production of the active pharmaceutical ingredients.

Inter-Ministerial Committee on Covid-19 vaccines has a DPME lead Technical Working Group tasked with mobilizing local capacity to deliver the dosages required and building a long-term capability step by step using current capacity from upstream to downstream to prepare for the next pandemic. They are starting by looking at the vaccines already developed and approved and those in the pipeline to determine what they can do locally in ensuring dosages by using a fill/finish strategy and then move to how to build capabilities to enable future pandemic response.

The following are key milestones that have been achieved to date:

  1. Several partnerships established with current and under development Covid-19 vaccines developers (Biological E partnership; ImmunityBio; Centre for Genetic Engineering and Biotechnology of Cuba; Greenlight BioScience for technology transfer of mRNA technology; Kentucky Bio-Products; and J&J – already manufacturing locally through Aspen)
  2. South Africa have the following competitive advantages which can be used to build permanent State Infrastructure to enable future pandemic response

      a) South Africa has experienced principal investigators who are employees of universities and Science Councils which is an advantage.

       b) Bioanalytical laboratories e.g. North-West University/DSI – Preclinical Drug Development Platform facility has been developed for this purpose

       c) Ethics related expertise including individuals for the data safety and management board

       d) Existing capabilities locally: CAPRISA, SAMRC, AURUM, DESMOND TUTU, WITS HEALTH, AHRI, and others on the clinical research side

END.

04 June 2021 - NW1275

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(a) Whether he will furnish Ms H Ismail with a full report on the Ivermectin controlled-access programme and (b) how long is it envisaged that the review programme for the applications of patients will take before Ivermectin will be allowed to be used?

Reply:

a) Ivermectin Authorisation Status 25/05/2021

 
           
 

Approved

Rejected

Pending

Duplicate

 

Tier 3: Section 22C(1)(b) - licence holder

8

3

0

0

 

Tier 2: Healthcare Facility Stock

134

40

0

4

 

Tier 1: Named-patient

112

15

0

2

 

TOTAL

254

58

0

6

318

b) The use of Ivermectin in the treatment and prevention of COVID-19 infections received avid interest recently due to the antiviral and anti-inflammatory properties in vitro. Available data to date, mostly from small under-powered studies, show a trend towards some benefit in the management of COVID-19. National and international bodies have reviewed the data; and have concluded that there is unclear evidence of both benefit and harm, in the treatment and prevention of COVID-19. After consideration of the impact of the second wave as well as the clinical equipoise that was presented through the various studies reviewed, SAHPRA implemented an Ivermectin Controlled Compassionate Use Programme for approved unregistered ivermectin products to be accessed via a three-tier programme for Section 22C(1)(b) permit holders, healthcare facilities, and named-patient applications. On 16 March 2021,SAHPRA registered Soolantra 10mg/g cream formulation, which contains ivermectin. Soolantra Cream is indicated for the topical treatment of moderate to severe inflammatory lesions of papulopustular rosacea in adult patients and is not for the prevention or treatment of COVID-19. The registration of this product enabled the compounding of ivermectin on a prescription basis for specific patients as well as off label use of ivermectin under the section 21 Controlled Compassionate Use Programme.

END.