Hu­man tu­ber­cu­lo­sis found in ele­phant

The Sunday Independent - - FRONT PAGE - DR BANDILE MA­SUKU

THE Gaut­eng Depart­ment of Health has been al­lo­cated R50.8 bil­lion for the 2019/2020 fi­nan­cial year, this be­ing one of the largest al­lo­ca­tions in the pro­vin­cial govern­ment.

While this is a sig­nif­i­cant in­vest­ment to the im­prove­ment of the prov­ince’s pub­lic health care sys­tem, it is also im­por­tant to un­der­stand the so­cio-eco­nomic and po­lit­i­cal con­text of this prov­ince.

Although ge­o­graph­i­cally smaller than other prov­inces, the Gaut­eng pop­u­la­tion is the largest in the coun­try at ap­prox­i­mately 14.7 mil­lion.

The re­al­ity is that most of the peo­ple in the prov­ince de­pend on the govern­ment for most so­cial ser­vices, in­clud­ing pub­lic health care.

Gaut­eng is also sig­nif­i­cantly af­fected by in­creas­ing mi­gra­tion pat­terns from other prov­inces, and other coun­tries on the con­ti­nent.

Its highly con­gested na­ture im­pacts govern­ment ser­vices such as pub­lic health­care – as the needs tend to ex­ceed ca­pac­ity at a given time.

Tak­ing this into con­sid­er­a­tion, this fi­nan­cial year’s bud­get vote stream­lines the re­sources of the depart­ment in a way that the five pri­or­ity ar­eas that have been iden­ti­fied for this cur­rent ad­min­is­tra­tion are ad­e­quately re­sourced and that the trans­for­ma­tion of pub­lic health in Gaut­eng hap­pens suc­cess­fully.

The pos­ture of the health depart­ment in Gaut­eng is one that is premised on ush­er­ing in Na­tional Health In­sur­ance (NHI) through our ad­min­is­tra­tion of our pri­or­ity ar­eas. We are con­vinced the in­ter­ven­tions that we will be mak­ing in the next few months will align with the goal to see the im­ple­men­ta­tion of NHI. It is very im­por­tant to note that NHI is a fund­ing model that will ad­dress un­equal ac­cess to health care.

It is aimed at ad­dress­ing the in­ac­ces­si­bil­ity of health ser­vices due to peo­ple not hav­ing enough money or in­sur­ance to meet their health needs. Es­sen­tially, it is ex­pected the NHI will en­sure the coun­try’s pri­vate and pub­lic health care sys­tem op­er­ates as a peo­ple-cen­tred sys­tem tran­scend­ing so­cio-eco­nomic class bar­ri­ers.

The con­text of high un­em­ploy­ment cou­pled with in­creas­ing cli­mate change will heighten vul­ner­a­bil­ity and poverty lev­els, re­sult­ing in more peo­ple mov­ing to­wards ur­ban cen­tres.

The UN Depart­ment of Eco­nomic and So­cial Af­fairs pre­dicts that by 2050 68% of the world’s pop­u­la­tion will be liv­ing in ur­ban ar­eas – as one of the big­gest in Africa, Gaut­eng will be im­pacted and ex­pected to re­spond to this phe­nom­e­non which is likely to cause con­straints on the so­cial ser­vices of­fered by the state.

In ush­er­ing in the NHI, it is cru­cial that im­ple­men­ta­tion draws strate­gi­cally from the pri­vate sec­tor, to the ex­tent that a har­mo­nious re­la­tion­ship ex­ists be­tween the sec­tors.

Specif­i­cally speak­ing, the one ap­proach is to en­gage med­i­cal pro­fes­sion­als, par­tic­u­larly spe­cial­ists in the pri­vate sec­tor to avail them­selves for pro­vid­ing ser­vices in pub­lic hos­pi­tals to al­le­vi­ate the pres­sure on our staff.

Sec­ond, the depart­ment will en­gage some pri­vate hos­pi­tals to make the­atre space and equip­ment avail­able and shorten the wait­ing times for sur­gi­cal oper­a­tions. Both these in­ter­ven­tions ad­dress our pri­or­ity ar­eas – im­prov­ing staff morale and pa­tient ex­pe­ri­ence.

In our de­part­men­tal bud­get we have also al­lo­cated more than R6 bil­lion to­wards the im­prove­ment of our clin­i­cal ser­vices – which in­clude HIV/ Aids and tu­ber­cu­lo­sis pre­ven­tion and treat­ment, men­tal health, im­prov­ing pri­mary health­care and Emer­gency Med­i­cal Ser­vices.

Dr Ma­suku is Gaut­eng’s Health MEC.

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