More healthcare news snippets...

Billions to be pumped into hospitals

SOUTH Africa will spend billions to improve healthcare by renovating dilapidated hospitals, according to Health Minister Aaron Motsoaledi. He said there would be massive investment - more than the country spent during the soccer World Cup. Motsoaledi, as well as doctors, engineers and Development Bank of South Africa (DBSA) representatives were attending a workshop aimed at preparing for the revamp of Durban's King Edward VIII Hospital. The hospital was one of five that would receive a massive, billion-rand facelift, Motsoaledi said. The other hospitals were Nelson Mandela Academic Hospital in the Eastern Cape, Dr George Mukhari and Chris Hani Baragwanath Hospitals in Gauteng and the Limpopo Academic Hospital. He said the revitalisation was part of the 10 point programme which was needed in preparation of National Health Insurance (NHI). The Minister said government had decided to involve all health stakeholders in the revitalisation programme and task teams would be formed. He said the actual cost of revamping hospitals would be known after the teams had started their work. Dr Massoud Shaker, provincial health department head of infrastructure, said the project manager for King Edward would be appointed before the end of the year. DBSA divisional executive, Lucy Chenge, said her bank would be a partner and "possibly finance it". 

SAPA, 27 September 2010

Ageing population tests health system

SOUTH Africa's population is getting older and the health system is going to have to pull up its socks if it wants to keep up. This is according to a new study due to be published in the journal Global Health Action, co-edited by professors Stephen Tollman and Kathleen Kahn of Wits University's School of Public Health. Worldwide, even in HIV-ravaged sub-Saharan Africa, the percentage of people in the population who are over 50 is expected to jump from 21 percent next year to 34 percent by 2050. In South Africa, 19 percent of the population is expected to be older than 50 by 2030, compared with 15 percent last year. Kahn, who conducted the study in Agincourt in rural Mpumalanga, said globally it was to do with improved socio-economic status and advances in health and medical technology. What this means is a greater prevalence of chronic, long-term and non-communicable diseases more common in older people - conditions such as diabetes, high blood pressure and heart disease. But is the South African healthcare system ready for this? According to the study, no. It said the high HIV prevalence and recent access to highly active antiretroviral therapy together with an ageing population and the emerging epidemic of non-communicable diseases would put immense pressure on already weak health services as well as on society as a whole. Kahn said it would put a great responsibility on the government to ensure that primary healthcare services were targeted better towards the care of older people. She said these primary services had always been aimed at mothers and children, but the government needed to consider tailoring the programmes to the needs of older citizens. The services still suffered major inefficiencies, such as low quality of care, demoralised and unmotivated health workers, and lack of training and essential equipment. Kahn said chronic health conditions needed continuity of care to avoid complications - like monitoring a patient's blood pressure monthly rather than waiting for a stroke. She said there were advantages to keeping older people healthy as they played an increasingly important role in society. Older women in particular were nursing and caring for chronically ill children suffering from AIDS and AIDS-related illnesses. They looked after the orphans left behind or the children of young women who migrated to the city for work. In rural areas, many households were dependent on the monthly pensions of their older members. Kahn said the health and wellbeing of older adults in rural South Africa had become a crucial issue which might impact on the wellbeing of the entire population.

Kristen van Schie: The Star, 27 September 2010

Eye care experts say avoidable blindness linked to poverty

AVOIDABLE blindness had to be included in the broader development agenda to receive the necessary attention from policymakers as it was also linked to poverty, according to speakers on the first day of the World Congress on Refractive Error. The speakers said governments, business and civil society had to come together to address this disability because the solutions and the resources were available. At least 670 million people, 10 percent of whom are in Africa, are blind or vision impaired because they do not have access to basic eye examinations and spectacles. Of those, 153 million suffer from treatable blindness at distance and a further 517 million due to nearsightedness.

According to the Bulletin of the World Health Organisation, the global economy loses $269 billion (R1.9 trillion) in productivity every year because of avoidable distance vision impairment. These are people who cannot read, work effectively or get a job. Brien Holden, the chief executive of the International Centre for Eyecare Education (ICEE), said it was a disgrace that an industry that made $40 billion in optometry sales could not spend $5 billion to solve this problem. He said that to fix this problem, $5 billion would be needed in the first year and then $3 billion a year for the next five years. Holden said it should be the owners of the companies who pushed and supported these initiatives. Besides the eye tests and spectacles, the money would be used to train the necessary eye care personnel. Holden said the world was short of at least 200 000 optometrists.

Kovin Naidoo, the ICEE director of global programmes, said South Africa should strive to at least achieve a ratio of one optometrist per 100 000 of the population. Currently, this ratio is at one per 500 000. He said it was the responsibility of government to address this problem and that non-governmental organisations and business should be there to support the effort. He said a system rather than a service was needed so that there would be somebody at the first point of call in communities. The ICEE has collaborated with the KwaZulu-Natal departments of health an education and Standard Chartered Bank in a campaign called Seeing is Believing, which was launched two years ago and through which 750 000 patients have been helped.

Slindile Khanyile: Business Report, 21 September 2010

SA health workers getting deadly TB

University of Cape Town (UCT) researchers have shown that health workers in South Africa are contracting extensively drug-resistant tuberculosis (XDR-TB), the most serious form of the disease that is extremely difficult to treat. This was the first report of this type of TB in health workers, according to lead researcher Keertan Dheda, of UCT's department of medicine. XDR-TB is an emerging and serious problem in South Africa that Dheda called "one of the biggest health threats" facing the country. The new research shows that 10 out of 334 people diagnosed with XDR-TB in the Western and Eastern Cape between 1996 and 2008 were healthcare workers. Most were nursing staff. The results were published online in the journal Tropical Medicine and International Health yesterday. UCT researcher Shahieda Adams, a co-author of the paper, recently announced the results of separate research which showed that health workers in KwaZulu-Natal were six times more likely to have drug-resistant TB than the general population. This was worrying because "health workers were already in short supply". Adams urged the government to implement stringent infection control measures at all health facilities.

Udani Samarasekera: The Cape Times, 21 September 2010

Time to shape up

South Africans are getting fatter, according to a multinational pharmaceutical firm's health survey. We place third in obesity behind the United States and Britain - not a world ranking we want. What happened to slender South Africa? 61 percent of adults are overweight, as are 17 percent of children younger than nine, GlaxoSmithKline tells us. 78 percent of obese people are in denial about their bulk, and 52 percent of the morbidly obese are too. Fat is a killer and a major source of chronic disease. It should be a national concern. Its dire consequences were further illustrated by a study by a reputable think tank, the Brookings Institution, on its economic burden to America: at least $215 billion in direct and indirect costs, including medical expenses and loss of productivity.

Editorial Comment: The Star, 21 September 2010

AIDS takes its toll on industries

THE Mining, transport, heavy construction, agriculture and fishing industries are bearing the brunt of AIDS-related deaths, which triggered a total of R2.4 billion in insurance claims this year. The costs pass directly through to the employers in the premiums they pay for group life insurance benefits. According to the Department of Health, 5.7 million people are infected with HIV and about one million receive antiretroviral (ARV) drugs from the state. But companies have not left the fight against the spread of HIV/AIDS to the government. They have initiatives to assist employees and their families in dealing with the disease. Internal wellness programmes include voluntary counselling and testing (VCT), awareness campaigns and support structures. These include allowing workers to take time off from work in order to recuperate without forfeiting their salaries, even in cases where employees have exhausted their sick leave. The chairman of the Actuarial Society task force on retirement reform, Colin Dutkiewicz, said the amount could have reached R3 billion had it not been for the country's current ARV programme. He said this meant there were now fewer death claims from insurance companies and fewer people being absent from work.

The health industry's AIDS-related death costs have reached 1.1 percent of salary costs, while non-AIDS deaths are 0.8 percent, totalling 1.9 percent for the sector. Retail and the education sectors' AIDS-related death costs stand at 1.6 percent and non-AIDS deaths at one percent, reaching 2.6 percent in total. Transport's AIDS-related death costs were 2.4 percent and non-AIDS deaths were 1.3 percent, totalling 3.7 percent. Heavy construction's AIDS-related death costs were 3.4 percent, while non-AIDS deaths were 2.5 percent, totalling 5.9 percent. Mining's AIDS-related death costs were 3.4 percent, while non-AIDS deaths were 2.8 percent, totalling 6.2 percent. AIDS-related death costs in agriculture and fishing were 2.9 percent and non-AIDS deaths were 1.2 percent, totalling 4.1 percent.

Corporate efforts that have been effective include Standard Bank's wellness programme introduced in 2001. Peter Philip, the bank's head of corporate health, said the programme looked at a number of infectious diseases and trauma counselling, but it also had a strong focus on HIV/AIDS. He said it made business sense because anything that affected the staff would impact on productivity. Standard Bank estimates that for every year that a senior staff member remains productive, it saves about R300 000 and this rises to R750 000 for middle managers. Anglo American's HIV/AIDS response has focused on having everyone know their HIV/AIDS status. Pranill Ramchander, Anglo American's spokesman, said 80 percent of the company's southern African employees now participated in VCT, compared with less than 10 percent in 2002. Over 6 000 employees were enrolled in HIV disease management programmes, he added. Fergus Marupen, the chief of human resources at Absa, said the bank had spent R75 million on its wellness programme over the past three years. He said regular employee engagement sessions were held where industry and medical experts were invited to present to staff on HIV/AIDS management.

Mzwandile Jacks & Slindile Khanyile: Business Report, 14 October 2010

WHO announces new plan to fight TB

THE World Health Organisation (WHO) has unveiled a new five-year plan to help fight tuberculosis (TB). The plan hopes to close research gaps to bring fast TB tests and fast treatment. WHO has called for partnership between the public and private sectors across the world to put more money into helping find new drugs to combat the disease. WHO's Mario Raviglione said the Global Plan to stop TB aimed to increase the current 86 percent cure rate for TB to 90 percent by 2015. Also speaking at the Johannesburg launch, Gauteng health MEC Qedani Mahlangu emphasised the importance of community participation in the fight against the disease. She said the province had raised awareness about the disease and had an 83 percent cure rate. South Africa had the world's third highest number of TB cases after China and India. Rifat Atun, chair of the Stop TB Partnership coordinating board, said the plan was a timely answer to the call for a new framework to fight the scourge. He said for it to be successful, $32 million in funding would have to be found. The relationship between HIV/AIDS and TB has added to the spike in TB cases between the 1980s and 2004. Atun said the risk of TB is 20 to 37 times higher in people living with HIV than in the general population. He added that under the plan - in HIV treatment settings - all patients would be screened for TB and receive appropriate preventive medicine or treatment as needed. He said by 2015 four new vaccines would be at the final stage of testing before they came to market.

Theo Nkonki: SAPA, 13 October 2010