Coming soon NCDs+ national strategy

Coming soon NCDs+ national strategy

 

Celebration time. It’s happening on 31 May 2022 in Somerset East, Eastern Cape, as part of a World No Tobacco Day event. At last, the NCDs+ civil society can breathe a collective sigh of relief. IT is the long-awaited National Department of Health’s (NDOH) NCDs+ policy for 5 years until 2027. The about-to-launched plan is a compromise, but it is way better than the early drafts. As Churchill may have said, “we are at the end of the beginning”.

If the SANCDA+ had left the NDoH decision makers to their own devices, the 3rd NCDs+ National Strategic Plan (NSP) would have been done and dusted in 2019 without credible transparency and authored mainly by a WHO Country Office appointed contractor. And that version looked remarkably similar to the previous failed 2nd NCDs plan 2013-2017. That plan wasn’t funded, implemented and only externally reviewed/evaluated in 2021.

Yes, it is the SANCDA+ activism that put a spanner in the works. Our early enthusiastic cooperation soured as it became clear that the plan would never be implemented or funded. It moved the SANCDA+ from advocacy to activism using similar tactics as HIV activists in the early part of this century. Memories are short but what is good for the goose is good for the gander.

What is different about the 3rd NCDs+ NSP? (more…)

Planning Commission to analyse NDP implementation shortcomings

Planning Commission to analyse NDP implementation shortcomings

gungubele 11 April 2022
Minister in the Presidency, Mondli Gungubele, says a key issue commissioners appointed to the National Planning Commission (NPC) will be expected to address is the slow progress in the implementation of the National Development Plan (NDP) and to identify solutions to make sure that the country fast tracks its route to the NDP goals.

The Minister, who serves as chairperson of the NPC, was speaking during a first media briefing of the third NPC which was appointed in December last year. “One of the shortcomings that [the NPC] has identified…was the incapacity of the state to implement the proposals of the NDP. This often combined with poor leadership that pay lip-service to the NDP without understanding its goals has acted as an obstacle to implementation of developmental objectives.

“As government, we are clear that the greatest challenge has been around implementation and in the discussions held to date, this was my emphasis to guide the discussions,” Gungubele said.

The National Development Plan – which was adopted ten years ago – was created as an action plan for government to tackle several challenges facing the country including unemployment, poverty, inequality, safety and healthcare. “The NDP was designed to change the lives of all South Africans by taking a comprehensive approach where the reality of 2012 [would] become a different one by 2030. We must recognise that we have not met the goals as we intended 10 years ago, that is true.

“Recognising this is the first step to asking: how do we do things differently to change the trajectory that we are on. This is where [the commission] will assist us as we tackle this challenge where implementation of our plans has not met the targets,” he said.

NPC Deputy Chairperson, Professor Tinyiko Maluleke, said the third NPC begins its term at a precarious moment in our country’s history and the “tall order” it faces in bringing the country closer to what the NDP envisioned. “There is, of course, a reason why we are called the NPC…and not the National Implementation Commission. But if implementation is slow or non-existent, planning alone, is clearly insufficient. Given that ours is a tenure that is closest to the finish line of 2030, we cannot afford to be dismissive, smug or philosophical about implementation.

“We have to probe why it is, why it has been so hard to coordinate, to cohere, to cascade down, to streamline and pinpoint down the necessary catalytic interventions which will embed and institutionalise the NDP within the departmental, provincial and municipal plans,” he said.

Professor Maluleke said the NPC will also give attention to identifying catalytic areas for government to pursue. “Countries which have successfully achieved their national developmental goals and targets are those at the heart of whose plans are clear catalytic priorities around which the whole state machinery is mobilized.

“The third NPC will help to enhance the ability of the state to identify and pursue catalytic priorities which will expedite the attainment of NDP goals,” he said.  According to Maluleke, another focus area for the NPC will be mobilizing the country’s support for the NDP and its goals.

“Although the NDP is a plan for the whole country, it has not been sufficiently adopted by all sectors at all times. As we mark its tenth anniversary in September, the NPC is urging all South Africans to rally behind the NDP to ensure its implementation and to call government to account on the basis of the promise contained in the NDP. “To that end, the NPC is committed to building partnerships broadly across society and to pursing engagements that should ensure active citizenry and strong leadership for development,” he said. 

2023 NDoH Annual Performance Plan presentation

2023 NDoH Annual Performance Plan presentation

Today is the health budget speech at 14:00, and in the interests of transparency and inclusivity, it would be great if we, the people, had a look at it beforehand. The budget speech is a version of the Annual Performance Plan (APP) for the financial year to 31 March 2023.

So we are already into the financial year, and the APP23 s already in progress. Having asked for said APP23 PDF, and scouring government and parliamentary websites, we are still in the dark. The closest we came to is a presentation from the health portfolio committee.


The most positive aspect for NCDs+ is that NCDs+ are still in stream, branch or programme 3 along with communicable diseases. At least it hasn’t be shoved back in Programme 4 Primary Health Care where it languished without food or water.

Mind you it is unlikely to change much since the Medium Term Strategic Framework 2019-2024 (MTSEF24) does not prioritise NCDs+ or allocate funding. Except in the most peripheral way. I call this the legacy of 3M era: MDGs, Motsoaledi and Mkhize. Too bad that we are in SDG times and need different action to achieve universal health coverage (UHC target 3.8) and there is more than the target 3.4to achieve action on NCDs.

The MTSF 2019-2024 – a lasting legacy courtesy of the 3M era, MDGs, Motsoaledi and Mkhize.
The absence of national budgets for NCDs+ is not the only issue. At the last count maybe one province had a sort-of-NCDs plan. Clear budget line items are awaited as an evolutionary step like the missing link. It would would great to have progress at the implementation level and within National Health Insurance budgets.

Joy there is a change to the number of outcomes and outputs covering NCDs+ in the APP23. That means a lot without a programme budget and an implementation plan.


Right to access to care? Progress since 2007?

Right to access to care? Progress since 2007?

Early in the COVID-19 pandemic WHO’s @DrTedros  highlighted the problems of access to health services by millions of people living with NCDs+ in his tweet.  His tweet certainly mirrors what the SA NCDs Alliance and our allies have been saying since 2007 when the SA Human Rights Commission  (SAHRC) held its first public hearings into the right access to health services.
COVID-19 changed the parameters of vulnerability to include NCDs+, mental health, and reemphasised disability in all its shapes and forms.

SAHRC report 2007

15 years ago the primary focus was understandably on access to HIV/AIDS and TB services. It was the height of the communicable disease epidemic. And amidst our homegrown “AIDS-denialism”. It was also the midpoint of the Millenium Development Goals (MDGs) where vast amounts of funding were channelled into communicable diseases and maternal-child services. That pattern of expenditure and funding remains in place today.

Executive summary

The report’s executive summary is salutary: it fits today’s health service access issues in the COVID-19 pandemic. Just substitute NCDs+ for communicable diseases.  And, we have a similar complaint today.
The report’s opening quote is ironically, but not surprisingly, from The AIDS Law Project, the early version of Section 27:

“We don’t yet have a definition of essential health services. This means we don’t have a base line for the right to health and it is impossible to cost the health service and thereby determine objectively what can be
afforded.”

We still don’t have the definition. But HIV unlike NCDs+ is a  National Development Plan priority. As for the rest of the conclusions, they mostly are unmet PLWNCDs+  The main change to health services is that HIV/TB services dominate primary health care. We beg for evidence-based inclusion of NCDs + throughout the life-course. And, more not just a tack on to HIV, TB and STI services.

That is why we fight on.  Read the SAHRC 2007 report on access to health services SAHRC 2007Health Report

Advocating for Universal Health Coverage Workshop

Advocating for Universal Health Coverage Workshop

Advocating for Universal Health Coverage:

A workshop for civil society and community groups in Eastern & Southern Africa

EANNASO with the Civil Society Engagement Mechanism for UHC2030 (CSEM) and partners in the region invites all civil society and community representatives interested in achieving health for all to an advocacy workshop on universal health coverage (UHC) on 23 November 2021.

The online session will be an opportunity to explore the Health for All Advocacy Toolkit, a new resource for civil society and community advocates, and connect with others engaged in this space in the Asia Pacific.

This session will bring together advocates from across issue areas in the Eastern and Southern Africa region to learn more about the state of UHC, discuss the role of civil society and community engagement, and explore how they can meaningfully integrate their work in support of the global movement for UHC.

Register for this workshop