Honorable Minister of Health, Dr Aaron Motsoaledi
Deputy Minister of Health, Dr Gwen Ramokgoba
Director General of Health, Ms Precious Matsoso
Senior Government Officials from National and Provincial levels
Your Excellencies, Ambassadors, High Commissioners, Heads of Diplomatic Missions and Representatives of Development Partners of the health sector
Colleagues from the UN in South Africa
Distinguished guests,
Ladies and gentlemen

On behalf of the United Nations in South Africa, I sincerely congratulate the Honorable Minister of Health and his team for the impressive achievements to advance health, welfare, and financial protection for communities across South Africa.

National Health Insurance

We appreciate the update provided today on the National Health Insurance implementation and pilots. The UN agencies, funds, and partnerships fully support your commitment to Universal Health Coverage – which ensures access to basic health services regardless of the ability to pay, and aims to promote an insurance system to protect individuals from falling into poverty from catastrophic health expenditures.

The UN agencies, funds and partnerships fully agree with you, Honorable Minister, that it is not whether NHI is implemented but how the global commitment to universal health coverage is achieved and through what means – given the existing institutional environment in South Africa.

We recognize that the NHI aims to address cost escalation in the private sector and improve the financing and quality of public services, primarily through the establishment of the National Health Insurance Fund (NHIF).  Substantial institutional requirements are needed to establish this Fund, and fundamental changes will be implemented on how health care is financed and delivered over the next decade.  We welcome and look forward to the issuance of the White Paper and NHI implementation plan, and WHO, in particular, continues to be fully committed to support this long-term process in collaboration with other partners.

We recognize that new sources of revenue are needed for the expansion of health services coverage, and urge you to consider mechanisms to generate new funds that do not exacerbate existing inequalities. In example, excises on tobacco, alcohol, and highly processed food with no nutritional value could be given greater consideration. We are encouraged by the cooperation established with the private sector, to mobilize their capacities in support of service delivery and advance public health goals.

The UN agencies, funds and partnerships are committed to continue providing support in the work ahead, which may include generating evidence for projecting resource requirements, improving value for health spending, testing service delivery innovations in the NHI pilot districts, strengthening health information systems, and addressing the social determinants of health.

Key interventions

We are greatly encouraged by the announcements made by the Honorable Minister during the 2013 Budget Vote Speech last month, and we congratulate you on the adoption of many cost-effective interventions.  This includes the introduction of HPV vaccine into the national immunization schedule in early 2014, to address cervical cancer – the leading cause of cancer among women, many of whom are in the most productive years of their lives.

The UN agencies wish to congratulate you on the new interventions and policies to address HIV and TB, including an aggressive expansion of care and treatment, scaling up GeneXpert, the introduction of fixed dose combinations, the expansion of male circumcision, and the policy of universal HIV counseling and testing, among other initiatives. We congratulate you on the development and submission of proposals to the Global Fund to address critical areas in HIV and TB – particularly drug resistance – and UN agencies are fully committed to support their successful implementation.

In particular, we commend you on your commitment to address TB among key populations, including among people working in the mining sector. South Africa maintains an important leadership role in advancing commitments to the harmonization of TB treatment guidelines to ensure that patients that initiate treatment in South Africa continue to receive good quality care as they cross borders. The UN agencies will continue to fully support this work.

In honor of World No Tobacco Day observed last Friday, we recognize the Government of South Africa’s strong commitment, under the leadership of the Minister and Deputy Minister, to implement the provisions of the WHO Framework Convention on Tobacco Control, including preventing cigarette smuggling and promoting graphic health warnings on cigarette packages. We fully support these efforts and anticipate that they will have a measurable impact on smoking prevalence and uptake, particularly among youth. We also recognize that policies are being advanced on the harmful use of alcohol, including full bans on advertising and promotion, and sales restrictions.

In terms of Maternal and Child Health, we commend the Government of South Africa and the NDOH on their commitments to improving maternal health at the regional and national levels. We acknowledge your leadership and efforts in advancing CARMMA and the revised Contraceptive and Fertility Planning Policy and Guidelines.  We also commend South Africa’s commitment to host the African Union Maternal Health Conference in August 2013.

We appreciate leadership from the NDOH to promote an inter-departmental response to teenage pregnancy, highlighting the importance of Adolescent and Youth Friendly Health Services (AYFHS), sex education, and addressing the unmet need for contraceptives among young adolescents.  We commend the statements by President Zuma to strengthen family planning services and offer comprehensive youth friendly services, as a means to reduce unplanned pregnancies, especially among teenagers, and to reduce maternal mortality.

The implementation of the revised contraception policy is an opportunity to scale up teenagers’ access to information on contraceptives and youth friendly services including, access to early antenatal and postnatal care. The policy also provides a platform for addressing the needs of teenagers at risk of HIV, teenagers living with HIV and the promotion of dual contraceptive methods.

Millennium Development Goals

Honorable Minister, we congratulate you on the progress made towards achieving the health MDGs.  We recognize that it is our collective responsibility as UN partners to provide our continued support to the Government to work together in identifying bottlenecks and achieve as much progress as possible in the last remaining 2 years.  We welcome the recent High-Level report on the post-2015 agenda, in which health goals and targets continue to form a central part of poverty reduction goals, and health is used as a measure of a country’s economic and social development progress. The UN group looks forward to working with the Department of Health on the new challenges that the post-2015 agenda will present.

Overall, South Africa’s early adoption of innovative tools, policies, and approaches has had a great influence on other countries’ health policy decisions, particularly in Southern Africa.

South Africa is being closely observed as a model for other countries – on the continent and elsewhere – and we hope that you can lead the way as an exemplar in how to achieve Universal Health Coverage and other health-related goals.

Closing

In closing, we commend the leadership and vision of the Honorable Minister, Deputy Minister, Director General, senior management at national and provincial levels for your outspoken commitments to address complex and sometimes controversial issues in health. The UN community recognizes that the stances you take are not always easy, and please be assured that we fully support your efforts to improve access to quality health care services, and advance public health policies and regulations to achieve better health for all people across South Africa.

The UN is committed to continue its support to the Government of South Africa. This may include normative work and guidance, hands-on support in technical areas and health system strengthening, and other areas as outlined in our individual agency cooperation agreements and the UN Strategic Cooperation Framework.

WHO, on behalf of the UN community in South Africa, takes this opportunity to reaffirm our collective support to the National Department of Health to ensure that the people of South Africa live long and healthy lives.

Thank you.