ATC151022: Report of the Select Committee on Social Services Substance Abuse Round Table held at the Townhouse Hotel, on 28 July 2015, dated 20 October 2015
REPORT OF THE SELECT COMMITTEE ON SOCIAL SERVICES SUBSTANCE ABUSE ROUND TABLE HELD AT THE TOWNHOUSE HOTEL, ON 28 JULY 2015, DATED 20 OCTOBER 2015.
TABLE OF CONTENTS
ARA Association for Responsible Alcohol Use
CBO Community-Based Organisation
CDA Central Drug Authority
CTDCC Cape Town Drug Counselling Centre
FBO Faith-Based Organisation
LDAC Local Drug Action Committee
MTEF Medium Term Expenditure Framework
NDMP National Drug Master Plan
NDP National Development Plan
NHDFA National Health and Development Foundation Alliance
NPO Non-Profit Organisation
PATSA Prevention of and Treatment for Substance Abuse
PSAF Provincial Substance Abuse Forum
SANCA South African National Council against Alcohol and Drug Abuse
- Ms LC Dlamini – Chairperson: Select Committee on Social Services
- Ms LL Zwane
- Mr M Khawula
- Ms TK Mampuru – Committee Whip
- Ms PC Samka Mququ
- Ms TG Mpambo-Sibhukwana
- Mr DM Stock
- Ms L Mathys – Apology
- Ms B Abrahams – Portfolio Committee on Social Development
Mr A Fritz – MEC, Western Cape Social Development
Dr D Fourie – Regional Director, SANCA
Mr A Potts – Director, CTDCC
Ms C Pillay – Eldorado Park LDAC
Ms S Kalideen – NHDFA
Mr K Mogotsi – Chairperson, CDA
- Ms Marcelle Williams – Committee Secretary
- Ms Thabile Ketye – Content Advisor
- Mr Gunther Mankay – Committee Assistant
- Mr Mkhululi Molo – Committee Researcher
- Mr Sean Whiting – Committee Researcher
The list of stakeholders that attended the Round Table is attached as Annexure.
The Select Committee on Social Services hosted a Round Table on Substance Abuse at the Townhouse Hotel on 28 July 2015. The theme of the Round Table was: “implementation of the National Drug Master Plan 2013-2017, reflections on capacity and support”. This was in line with the Committee’s Strategic Plan and Annual Performance Plan.
The objectives of the Round Table were as follows:
- To provide Members of the Select Committee on Social Services with a better understanding on substance abuse policy-making and policy implementation.
- To provide a platform for public participation to stakeholders from civil society and government to discuss challenges/issues of concern and possible solutions around implementing substance abuse policies and programmes in South Africa.
- To provide understanding to Members of Parliament of the challenges within the substance abuse sector – through the lens of non-profit organisations (NPOs) and Local Drug Action Committees (LDACs).
Substance abuse, which includes the misuse of alcohol and other drugs (cannabis, cocaine, heroin, nyaope, over the counter drugs, glue, etc.) is of national and global concern. President Jacob Zuma engaged with the community of Eldorado Park, in Gauteng, in 2014 to address the compelling issues of drug trafficking and adolescent drug use in that community. This scourge is nation-wide and it seems that everyone is affected directly or indirectly. Moreover, the problem of substance abuse continues unabated.
The Department of Social Development leads the issue of substance abuse in collaboration with other government departments, non-government organisations, research institutions, private sector and international bodies (United Nations Office on Drugs and Crime (UNODC) and World Bank (WB), etc.. Furthermore, there are structures to support government to implement strategies and legislation, like the Central Drug Authority (CDA), Provincial Substance Abuse Forums (PSAFs) and Local Drug Action Committees (LDACs).
The National Drug Master Plan (NDMP) 2013-2017 forms the (five-year) strategic framework of how substance abuse is managed and coordinated in South Africa, while the Prevention of and Treatment for Substance Abuse (PATSA) Act (2008) forms the general legislative framework for the sector.
The CDA and the Department of Social Development (in collaboration with other government departments and international bodies) are planning the 3rd Anti-Substance Abuse Summit in the 2015/16 MTEF (possibly February of March 2016). This will entail a platform for all stakeholders to converge and discuss issues of concern and challenges with regard to implementing the NDMP 2013-2017 and the PATSA Act.
Thus the Committee’s Round Table served as a platform for public participation to stakeholders involved in substance abuse in South Africa, particularly NPOs. This resonates with the broader parliament community to inter alia ensure: Public involvement in policy and legislative matters - as per the National Development Plan (NDP) – Vision 2030, Constitutional ‘good governance’ prescripts as well as international best practice guidelines.
The Constitutional prescripts include: “to ensure effective and efficient use of government resources. Government’s outcomes of: “a long and healthy life for all South Africans” and “an efficient, effective and development-orientated public service” forms the framework of deliberations.
The presentations made at the Round Table explored and led to engagements on the following key questions:
• What challenges are faced by NPOs and LDACs in the substance abuse sector?
• What are the capacity constraints and possible solutions (alternatives) for the substance abuse sector?
• What are best practice models (as solutions or alternatives) that South Africa can learn from to improve the sector?
All the presentations are available from the Committee Secretary.
4.1 Presentation by the Western Cape South African National Council against Alcohol and Drug Abuse (SANCA)
The presentation highlighted that substance abuse in South Africa across various age categories has increased over the years. Further, it acknowledged that Government had spearheaded in this field through a significant legislative framework – the Act on Prevention of and Treatment for Substance Abuse (No. 70 of 2008); progressive policies and plans including the National Drug Master Plan (NDMP), as well as inclusive rights in the Constitution; but implementation was hindered by a number of challenges.
The following challenges were highlighted:
- Changing trends and more complex multi-substance abuse patterns.
- Severe and complex psycho / social / health impact due to a simultaneous use of various drugs.
- Diversification of the profile of users in terms of age, gender, geographic location etc.
- A diverse substance abuse culture and attitudes.
- Lack of life skills and values by users of drugs.
- Increased life challenges.
Focusing specifically on the implementation of the NDMP and related legislation, SANCA submitted the following recommendations in relation to working in the sector and within existing structures:
- There should be better coordination to address lack of national uniformity and fragmentation in implementation.
- Between government departments, the private sector, CBOs, local community initiatives etc.
- Capacity building and development initiatives should be accessible to all role-players in the sector.
- There should be more commitment and motivation on the part of some stakeholders.
- There should be more resources especially sustainable funding.
- Need for capacity building and development initiatives (all role-players).
- Clarification regarding roles, responsibilities and boundaries should be done.
- Community needs should be prioritized.
4.2 Presentation by the Cape Town Drug Counselling Centre (CTDCC)
The presentation provided extracts of testimonies from CTDCC clients to provide a context of the services and types of programmes provided as well as experiences of clients. Further, the presentation highlighted that dagga (or cannabis or marijuana) followed by tik (or methamphetamine) and heroine were the most popular (or used) substances.
The following challenges were highlighted:
- In- and Out-patient access to services. Though treatment services are growing, service users are still finding it difficult to access these services.
- There are too few age and gender appropriate services.
- There are limited services, and these are limited to selected areas. There is a concentration of services in selected suburbs.
- Lack of, or poor available support for minors during treatment
- Retention of staff in the sector.
- There is no funding for selected services - the total basket of services is not accounted for and salaries are not regulated.
- Developing capacity is stifled due to the core focus or demands.
- There is insufficient training for lay community that is already providing treatment.
The following recommendations were made:
- There should be transport available organisations that provide treatment services so that they can reach service users who cannot go to them.
- Retention of staff.
- There should be accredited training for service providers and community based service providers should be up-skilled.
- LDACs should play an active role in registering service providers.
- Community structures should be educated and be made aware of available preventative services.
- School based interventions should be strengthened.
- Decriminalising of service users should be considered.
- Aftercare and Reintegration into communities should also be noted.
Mr Fritz highlighted the importance of programme integration in addressing substance abuse. He added that there needs to be a way of utilising existing facilities instead of building or establishing new ones – citing an example of local health care facilities/clinics that also serve as Treatment Centres.
He concurred with previous Speakers and participants formal training programmes such as those offered by the University of Cape Town (UCT) and the University of Western Cape (UWC) are good examples. He said that in addition to these there is a need to provide substance abuse programmes that are specifically targeted towards child and youth centres; and treatment centres in remote areas even if incentives are offered to attract trained providers to work there.
The presentation by the Eldorado LDAC started off by acknowledging the support provided by government, and expressed gratitude for the intervention made by the President in 2013.
The following challenges were highlighted:
- Many Departments, Organizations and Key stakeholders still lack in understanding their mandate in relation to the Substance Abuse Act, NDMP and LDAC.
- Duplication, lack of integration and competitiveness leads to wasteful resources and lack of positive impact.
- There is no Collaboration by departments in the Community (Intra – Inter).
- There is not enough awareness in the community pertaining to the mandate, functioning, representative and services pertaining to the LDAC.
- Resources are not available to the LDAC such as office, travelling, telephone costs and stationery. Funding for programs is a challenge - remuneration for services serves as the best practice for the LDAC.
- There is lack of participation by FBOs.
The presentation provided an overview of the main causes of death in South Africa. Statistics from various research studies were shared in this regard. Further, it provided an overview of how poverty contributes to illness, with a specific focus on substance abuse.
The presentation highlighted what encompasses the South African NHDFA and shared models of similar Alliances in other countries like Australia and Thailand. Some of the key research outputs shared are highlighted below.
- Alcohol and tobacco manufacturing in South Africa is extremely profitable.
- The profit margins on tobacco products are very high - about 68% compared to only 15-20% for other consumer goods.
- In 2014, British American Tobacco adjusted profits in South Africa were about R9 billion.
- SABMiller reported $3.557 million global profit after tax for 2014/2015, with earnings from South Africa standing at $4.352 million.
Briefly, the following recommendations were made:
- It was mentioned that smoking and alcohol imposes enormous costs on society (through treatment, lost productivity, regulatory and it is therefore fair to make the alcohol and tobacco industry pay these costs.
- Research shows that the public support a levy on alcohol and tobacco and that levy should thus be used for health promotion.
The CDA and the Department of Social Development were afforded an opportunity to provide a response to the submissions made (in the form of the preceding presentations and deliberations made during the course of the Round Table. The following are remarks from the Department and CDA.
- The NDMP is a national plan to address substance abuse at all levels and is currently in effect.
- All provinces have been trained on NDMP.
- The CDA has developed service models throughout the Republic and workshops have been conducted in communities.
- Community based services must register in order to be assisted.
- Provincial Substance Forums are not functioning at the same levels.
- There approximately 200 LDACs in the country.
- A treatment model has been developed.
- Prevention models for children (or minors) and adults have been developed.
- Treatment centres will be established in provinces where they are lacking.
- Currently R15 million is being received from the National Treasury per annum.
- Legislation is being drafted to close gaps where they exist.
- A resource directory has been established listing all the existing service providers.
- All participants agreed that a collaborative effort is needed to address the scourge of substance abuse in the country.
- Treatment centres should be established in all provinces such as Mpumalanga.
- NGOs must work together and mentor each other where the need exists.
- Local government should assists NGOs in all provinces
- Public policy regarding the criminalisation of the addict should be relooked.
- Different treatment centres are necessary to facilitate treatment for kids and adolescents.
- National awareness campaigns are necessary.
- Most services are subsidised.
- Increase taxation on alcoholic drinks, and use these funds to fund treatment centres.
- Establishment of extra mural activities in communities to encourage the youth in various activities, keeping them off the streets.
- The MEC, Mr Fritz added that at the University of the Western Cape an activist programme is being offered and assistance is lacking in the rural areas.
- Review objectives and coordinating structures of the NDMP to ensure greater implement ability and provision for capacity and resources
- Promote inter-departmental and stakeholder partnerships to render specific programmes for example, prevention, detoxification and multi-disciplinary teams.
- Increase adequate funding to render services: access to funding (ARA, taxes and fines).
- There should be greater emphasis on early intervention and community-based treatment programmes versus in-patient treatment. Capacity building, training and mentoring for emerging originations should be prioritized.
This Round Table was a good initiative in that it provided a platform for deliberations and discussions on the issue of substance abuse between the Select Committee on Social Services, and other stakeholders in Parliament, Government, and most especially civil society.
However, more needs to be done to address the high levels of substance abuse in the country, and to realise the implementation of the NDMP. The recommendations made in response to the acknowledged capacity and support challenges that hinder the realisation of the NDMP during the discussions are a step in the right direction.
The Select Committee on Social Services will hold a similar dialogue to track progress in this regard as a mechanism of oversight and strengthening the services that are offered by the various organisations and Government centres.
The Round Table ended with a resolution that there is a great need to assist the youth in developing healthy choices and living long and healthy lives.
List of attendees
Central Drug Authority
City of Cape Town
Department of Social Development
Department of Transport
Lighthouse Rehab Centre
Local Drug Action Committee
South African Revenue Service
Step up Project
Sultan Buhu Centre
University of Cape Town
Western Cape Provincial Department of Social Development
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