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 
------- 
 
¶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 
--------------------------------------------- ------- 
 
¶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 
--------------------------------------------- -------------- 
 
¶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 
--------------------------------------------- ----------------- 
 
 
PRETORIA 00002065  002 OF 004 
 
 
¶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 
--------------------------------------------- ---- 
 
¶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 
-------------------------------------- 
 
¶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 
--------------------------------------- 
 
¶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 
--------------------------------------------- - 
 
¶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 
---------------------------- 
 
¶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 
 
PRETORIA 00002065  004 OF 004 
 
 
------------------------------------ 
 
¶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. 
 
TEITELBAUM