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IdentifierCreatedClassificationOrigin
06PRETORIA2065 2006-05-19 07:58:00 UNCLASSIFIED Embassy Pretoria
Cable title:  

SOUTH AFRICA PUBLIC HEALTH May 19 2006 ISSUE

Tags:   ECON KHIV SOCI TBIO EAID SF 
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VZCZCXRO0332
RR RUEHDU RUEHJO RUEHMR
DE RUEHSA #2065/01 1390758
ZNR UUUUU ZZH
R 190758Z MAY 06
FM AMEMBASSY PRETORIA
TO RUEHC/SECSTATE WASHDC 3508
INFO RUCNSAD/SOUTHERN AFRICAN DEVELOPMENT COMMUNITY
RUCPDC/DEPT OF COMMERCE WASHDC
RUEATRS/DEPT OF TREASURY WASHDC
RUEAUSA/DEPT OF HHS WASHDC
RUEHPH/CDC ATLANTA GA 1140
					  UNCLAS SECTION 01 OF 04 PRETORIA 002065 

SIPDIS

SIPDIS

DEPT FOR AF/S; AF/EPS; AF/EPS/SDRIANO
DEPT FOR S/OFFICE OF GLOBAL AIDS COORDINATOR
STATE PLEASE PASS TO USAID FOR GLOBAL BUREAU KHILL
USAID ALSO FOR GH/OHA/CCARRINO AND RROGERS, AFR/SD/DOTT
ALSO FOR AA/EGAT SIMMONS, AA/DCHA WINTER
HHS FOR THE OFFICE OF THE SECRETARY/WSTEIGER, NIH/HFRANCIS
CDC FOR SBLOUNT AND DBIRX

E.O. 12958: N/A
TAGS: ECON KHIV SOCI TBIO EAID SF
SUBJECT: SOUTH AFRICA PUBLIC HEALTH May 19 2006 ISSUE


Summary
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1. Summary. Every two weeks, Embassy Pretoria publishes a
public health newsletter highlighting South African health
issues based on press reports and studies of South African
researchers. Comments and analysis do not necessarily reflect
the opinion of the U.S. Government. Topics of this week's
newsletter cover: Fears that New Health Act Would Increase
Absenteeism; TB Leading Cause of Death in Eastern Cape
Metropolitan Area; Media Study Reports that 2% of South African
News Report about AIDS; South African Department Conducts
HIV/AIDS Survey; KwaZulu-Natal Increases Mobile Clinics; SA
Government Invests in Nanotechnology; Spending on Health
Conditional Grants Examined; Aspen to Manufacture Tamiflu;
South Africa has Largest ARV Program. End Summary.

Fears that New Health Act Would Increase Absenteeism


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2. According to a study by management company CAM Solutions,
the direct costs of absenteeism to employers in 2005 was R12
billion ($2 billion using 6 rands per dollar) and the indirect
costs through lost productivity and hiring and training of
additional staff totaled R 24 billion ($4 billion). Attorney
Ndumiso Voyi of Leppan Beach, suggested that the new
Traditional Health Practitioners Act could lead to increased
absenteeism. According to section 23 of the Basic Conditions
of Employment Act, companies are not obliged to pay workers if
they have been absent for more than two days without a medical
certificate. The medical certificate produced has to be signed
by a medical practitioner or a person authorized to treat
patients, and must be registered with a professional council
established in terms of legislation passed by parliament. The
new act now includes a wider range of health workers eligible
to sign certificates. Voyi believes the largest concern is
that it is practically impossible, even by another traditional
healer, to verify findings by a traditional health
practitioner. South Africans spend about R250 million ($42
million) on traditional healers each year and the Traditional
Health Practitioners Act recognizes more than 300,000
traditional healers. Sazi Mhlongo, the president of the SA
Traditional Healers' Association, said that the provinces were
already training sangomas so that the system would not be
abused. Source: Business Day, May 9.

TB Leading Cause of Death in Eastern Cape Metropolitan Area


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3. In the metropolitan area Nelson Mandela Bay (Port Elizabeth
environs), 17% of all deaths are attributed to tuberculosis,
the most common cause of fatalities. More than 13,000
residents were registered with the disease in 2004/2005. Two
Eastern Cape districts - Nelson Mandela Bay and Amatole
district - have been included in the national TB crisis
management plan, which focuses on four districts with a high
number of TB cases and low cure rates. The OR Thambo
metropolitan area is another problem TB area in the Eastern
Cape Province. Nelson Mandela Bay's cure rate for 2003/2004
was 38.9%, while the successful treatment completion rate was
60.3%. Both figures are significantly below the national
average cure rate and treatment completion rate of 50.1% and
62.9%, respectively. The high number of TB cases in the O R
Thambo district can be explained by the metropolitan area's
rural poverty and the inability of health department staff to
access many areas to treat and educate residents. Explanations
of the high TB rate are fewer for Nelson Mandela Bay, and
reports on tuberculosis in the area were being studied. Many
analysts link the metropolitan area's high HIV/AIDS infection
rates. According to a national study of pregnant women
receiving antenatal services, Nelson Mandela Bay has an HIV-
positive prevalence rate of 34.5%, compared to the provincial
average of 28%. The Eastern Cape has set aside R23 million
($3.8 million) to fund the TB crisis management plan and would
provide more treatment and education programs. Source: The
Herald, May 11.

Media Study Reports that 2% of South African News Report about
AIDS


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4. The HIV and AIDS and Gender Baseline Study, conducted by
Gender Links and the Media Monitoring Project reports that only
3% of media articles in 11 SADC countries reported on HIV/AIDS,
with only 2% of South African news items focusing on HIV/ADIS.
The study monitored 118 media organizations with 37,000 news
items over October-November 2005. The reporting on HIV/AIDS
varied across SADC countries from 19% in Lesotho, to only 1% in
Mauritius. People living with HIV/AIDS constituted 4% of all
sources, compared to 42% of government officials and officials
representing international organizations. People living with
HIV/AIDS were most often used as sources in Swaziland (10%),
Tanzania (7%) and South Africa (6%). In Malawi, no mention of
people living with HIV/AIDS was made as sources in the period
under review. Despite the disproportionate burden of the
HIV/AIDS borne by women, only 39% of the news items used women.
In the area of treatment, the media focus remains on
antiretroviral treatment (32%) and the medical aspects of AIDS
(27%), with positive living, the role of nutrition, and where
to go for help receiving only marginal mention. The study
found that there have been a number of improvements in media
reporting. These include fewer blatant stereotypes (10%) and
increased sensitivity to language. Feature stories on HIV and
AIDS are higher (10%) than in general coverage (5%) and that a
high number of stories are original stories produced by
newsroom journalists. In South Africa, the Mail & Guardian had
the most news items on HIV and AIDS and Rapport the lowest.
Source: Health e-News and www.journalism.co.za, May 3; The
Star, May 4.

South African Department Conducts HIV/AIDS Survey


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5. The Department of Correctional Services is conducting a
survey to determine the prevalence of HIV and AIDS in prisons.
Department of Correctional Services Chief Deputy Commissioner,
Teboho Motseki, told a committee in Parliament that the survey,
already underway in some prisons in Gauteng, would be extended
to other provinces. Two weeks ago, 119 HIV positive prisoners
at the Durban Westville prison started a hunger strike,
demanding access to antiretroviral treatment (ARV). The
Department of Correctional Services does not provide ARVs, but
provides transport to HIV positive prisoners to sites of the
Department of Health where they can receive the treatment.
However, the Department of Health could not provide the
prisoners with ARVs at treatment sites, as the prisoners did
not have identity documents. The prisoners are now receiving
treatment after intervention by the Department of Correctional
Services to obtain necessary documents for the affected
prisoners. Source: Bua News, May 10.

KwaZulu-Natal Increases Mobile Clinics


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6. The KwaZulu-Natal Health Department increased the number of
mobile clinics valued at R11.9 million ($2 million) so that
rural communities will have better access to primary health
care. A total of 74 vehicles mounted with equipped capsules
will be used to reach rural areas that have no fixed clinics.
The capsules are fitted with medical equipment and medication
used in primary health care. Each mobile unit is staffed by a
minimum of two nurses. Each vehicle, a Nissan truck, cost
R95,000 ($15,800) and constructing and fitting the capsules on
each vehicle cost R62,500 (10,400). An additional doublecab
4x4, valued at R161 000 ($26,800), has also been bought to
service areas with poor road infrastructure. Unlike previous
mobile clinics, which had removable capsules, the new vehicles
were not separable from the capsules so that they could be used
only as mobile clinics. Of the 74 vehicles, 12 will be sent to
the Ugu district, 11 to Uthungulu, eight to Sisonke, seven each
to Zululand and Umkhanyakude, six to eThekwini and Ilembe, five
to Umzinyathi and Umgungundlovu, and four each to Uthukela and
Amajuba. The mobile clinics will supplement the work of 375
fixed clinics that serve about 1.4 million rural patients in
the province every month. Patients will have access to basic
medication, and be examined and treated for minor ailments.
Source: The Mercury, May 11.

SA Government Invests in Nanotechnology


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7. The Department of Science and Technology recently launched

PRETORIA 00002065 003 OF 004


a national nanotechnology strategy for South Africa, which will
include a R450 million ($75 million) investment over the next
three years. The government views investment in nanotechnology
as an opportunity to improve information technology,
environmental sciences, health and industrial technology. The
government is looking at investing in technology that can
purify mine waste water, develop lower-cost solar cells for
energy, and develop drugs that work against biological diseases
- all areas where nanotechnology has shown promise. A new
national facility will be housed at Mintek, a Johannesburg
science council specializing in mineral and metallurgical
technology. Project AuTEK is a joint venture formed between
Mintek, local universities, and the three major South African
gold mining houses - AngloGold Ashanti, Gold FQlds and Harmony
Gold. Within this project, AuTEK Biomed, headed by Dr Judy
Caddy, focuses on creating gold-based chemo-therapeutics for
diseases where there is a need for improved medicine, such as
cancer, malaria and HIV and AIDS. Caddy said that since 2002
the team had been working on developing cancer drugs that are
gold-based. Currently, the two largest-selling anti-cancer
drugs are platinum-based. Caddy explained that gold-based
drugs have an advantage over platinum-based drugs because gold
drugs accumulate in the mitochondria. Caddy said the key is to
ensure that the drugs are structurally fine-tuned so that they
are selective, and destroy only unhealthy cancerous cells. In
2005, the team began HIV research to determine whether gold
compounds can act as inhibitors to HIV. South Africa has to
compete with countries such as Japan, India and the U.S., which
each invest nearly a billion dollars annually on nanotechnology
development. Source: The Star, May 6.

Spending on Health Conditional Grants Examined


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8. The Finance and Fiscal Commission found that the spending
of conditional grants (grants designed to be spent for a
specified purpose) at national and provincial levels was not
properly monitored. The Commission examined several health
conditional grants to illustrate conditional grant
shortcomings. According to the Commission's findings, new
conditional grants have been introduced without regard to their
relationship to existing grants, with several uncoordinated
grantQserving the same purposes. In addition, the
Commission's report pointed out that there were no pre-
implementation plans and assessments that identified potential
risks that might impede implementation, nor were there
guidelines to mitigate such risks. Challenges related to the
administrative requirements of the conditional grants are not
identified and resolved before implementation. Conditions for
spending were not specified in detail and provinces were not
required to meet minimum standards. The Commission asserted
that misdirected spending of two conditional health grants
worth R6.5 billion ($1.08 billion) undermined public health
goals and that these grants have not been independently
reviewed since they began in 1998. The Commission's report
claimed that public hospitals received only 52% of the funds
necessary to provide a reasonable service. There were also
10.4% fewer hospital beds for the sick than there should have
been. The Commission, set up under the constitution to advise
the Treasury on the division of revenue between national,
provincial and local governments, presented its recommendations
for 2007-08 allocations to the National Council of Provinces.
Source: Business Day and Business Report, May 16.

Aspen to Manufacture Tamiflu


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9. Roche Holding will allow Aspen Pharmacare Holdings,
Africa's biggest maker of generic drugs, to make copies of its
Tamiflu influenza medicine for use in the event of a bird flu
pandemic. Roche will provide technical and clinical data to
help Aspen produce and register the medicine and will supply
the active ingredient oseltamivir. The World Health
Organization and other governments are stockpiling Tamiflu for
use as a preventive treatment in case the virus mutates into a
form that is contagious among humans. The agreement is non-
exclusive, meaning that Roche and other companies that have
licensed the drug can fill orders in Africa. Source:
Bloomberg and Business Report, May 16.

South Africa has Largest ARV Program

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10. According to Health Department statistics, more than
210,000 South Africans were now receiving anti-retroviral
treatment (ART), making it the largest treatment program in the
world. By the end of March 2006, 134,473 people began ART
treatment and an estimated 80,000 people began treatment in the
private and non-governmental organization sectors. No data was
available on how many of those undergoing treatment remained on
it, for how long, or how many had died. Improvements in
programs devoted to promoting behavior change and condom use,
the expansion of health facilities accredited to provide AIDS-
related services, the recruitment and training of health
professionals, the provision of nutritional supplements and
home- and community-based care were also noted. Source: Cape
Times, SAPA, May 18.

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