29 May 2018

Questions to Deputy President David Mabuza for oral reply at National Assembly

Mrs B L Abrahams (ANC) to ask the Deputy President:

With reference to the international community’s commemoration of World TB Day every 24th March, which is joined by South Africa as the day on which the bacteria causing TB was identified and his reflection in his address to the SA National Aids Council (Sanac) on former President, Mr Nelson Mandela’s revelation that he was a TB survivor in order to help defeat the stigma around the disease, what (a) are the plans of Sanac to mobilise leaders in line with this year’s World TB Day theme “Wanted: Leaders for a TB-free world. You can make history End TB” and (b) is the Presidency doing to ensure that Premiers and Mayors demonstrate leadership by ensuring that AIDS Councils are functioning to achieve the Government’s objectives of an effective response to the pandemics of HIV and TB?

Reply

Our success in responding to the fight against TB calls for a holistic intervention by all sectors of society and leaders across government and business. This includes the National Assembly which must also incorporate in its own programme and that of Honourable Members for their constituency work, the programmes developed by the Department of Health in the fight against TB.

We have made substantial progress in terms of collaborative work with the institution of traditional leadership. SANAC participated in the induction of the new leadership of the National House of Traditional Leaders in February this year. This followed on the National Pledge they had made in December 2017 in the Eastern Cape, to lead the fight against HIV and TB.

Subsequently, there were engagements with traditional leaders in KwaZulu-Natal to lead the fight against HIV/AIDS and TB. The commemoration of the World TB Day was implemented in partnership with the Royal Household and the Provincial House of Traditional Leaders. This was officiated under the leadership and support of His Majesty, King Goodwill Zwelithini. We are planning to make a series of follow-ups with other traditional leaders and broad civil society to intensify this fight.

This is an acknowledgement of the important role that Traditional Leaders can play in the fight against not only against HIV/AIDS and TB, but other social ills bedeviling our communities.

The vision of the Presidency is to ensure that all AIDS Councils at a Provincial and District levels are chaired by Premiers and Mayors, respectively, with no delegation to lower levels.

This is meant to strengthen leadership at other levels beyond the national sphere where this has been much more visible and coherent. We will be focusing on strengthening the capacity of Provincial and District Councils to roll out targeted programmes aimed at community mobilisation and activism towards the fight against these challenges.

As part of planning and implementation processes, the Premiers and Mayors will be expected to sign off the provincial and district plans, which will be guiding framework for the implementation of various initiatives. Our key interest as well will be assessing the functionality and effectiveness of these structures tasked with issues of HIV and AIDS as well as fighting TB and other social ills.

Thank you very much

Ms T M Mbabama (DA) to ask the Deputy President:

With reference to the findings of the High Level Panel on the Assessment of Key Legislation and the Acceleration of Fundamental Change in November 2017 that the Government has failed to protect the right to tenure security of many South Africans in contravention of section 25(6) of the Constitution of the Republic of South Africa, 1996, what steps will the Government take to provide direct ownership of land to persons, such as communal residents, who have insecure rights?

Reply

On land tenure, Section 25 (6) of the Constitution makes provision that: “A person or community whose tenure of land is legally insecure as a result of past racially discriminatory laws or practices is entitled, to the extent provided by an Act of Parliament, either to tenure which is legally secure or to comparable redress”.

This issue of security of tenure flows from a sometimes mistaken view that land under traditional leadership is owned by traditional leaders, which is a false view. In terms of custom, it is the people who own the land. Traditional leaders are only custodians of the people’s land.

Because of these perceptions and at times conflicting views on who has rights of ownership to such land between traditional leaders and ordinary people, government is then seeking to address this issue in a manner that gives certainty and removes any possibility of unwarranted conflict informed by distortion of customary law.

In this regard, the Department of Rural Development and Land Reform has published the Communal Land Tenure Bill for public comment and the Department is still considering comments. The Communal Land Tenure Bill provides for the transfer of ownership of communal land to communities that occupy such land.

The Bill further provides for the transfer of ownership of residential portions that are currently occupied by community members to such community members. In other words, communities will have title deeds for their communal land and members of communities will have title deeds for their residential and business portions.

Of course there are different views on this matter and we encourage that mature engagements continue in a manner that builds alignment of thought and approach in order to produce necessary cohesion. The bottom line is that that the land belongs to the people.

Through this Bill, we must see it as a process that is part of our intervention as a country in conclusively dealing with land question in a manner that leads to the development of all the people and not for exploitation of the customary rights of people to their land for unscrupulous ends.

Thank you very much

Ms M L Dunjwa (ANC) to ask the Deputy President:

With reference to the change of leadership in 2017 and the negative press coverage of the SA National AIDS Council (Sanac) since then followed by the appointment of the new Chief Executive Officer and board members, (a) what is the current state of the capacity of the institution to realise its mandate and (b) what is his vision as the leader of Sanac which spearheads the national effort to fight against HIV/AIDS?

Reply

Under the leadership of the new CEO, and with the support of the Board of Trustees, SANAC remains a national institution around which all South Africans have rallied to respond to HIV, Tuberculosis and Sexually Transmitted Infections.

The Council is in good standing, with a functional Board of Trustees which has ensured good governance as evidenced by 4 successive clean audits.

Since the appointment of new Trustees and the CEO, the Trustees and the management team have worked hard to ensure that all aspects of good governance are in place so that the funds entrusted to SANAC are properly managed and accounted for.

All relevant policies to manage people, funds and risks are in place and should give South Africans the assurance that SANAC has the capacity to fulfil its mandate. As the custodian of the National Strategic Plan 2017-2022, which guides the country’s response to HIV, TB and STIs, SANAC now has the responsibility to ensure that this ambitious Plan is implemented through the Provincial Implementation Plans as well as the Multi-Sector District Implementation Plans which have just been finalised and signed off.

As Chairperson of SANAC, my team is looking forward to working with all the key stakeholders and leaders at all levels to ensure that we reach our goal of a generation free of HIV by 2030.

SANAC is at the centre of all our national efforts to contain and reverse the spread of HIV and AIDS. The CEO’s role is to provide visionary leadership in driving the country’s Prevention Revolution. Against the backdrop of approximately 270 000 people who are newly infected with HIV every year, it is critical to prioritise, and upscale prevention measures in the same way we deal with HIV and TB treatment. Our renewed focus on prevention will assist in ensuring that almost 48 million South Africans who are HIV negative remain so, with more babies born HIV-free.

As CEO of SANAC, Dr Buthelezi’s major task is therefore to assist us to win the fight against HIV and AIDS and keep people negative from infections. We do appreciate that the pace of decline in new infections is not fast enough. The reality is that, over the years, we have not put adequate attention to prevention.

SANAC will have to take major strides to address this. That is why the National Strategic Plan for HIV, TB and STIs (2017-2022) has placed prevention as the first goal with the bold target of reducing new HIV infections by more than 60 percent and cutting TB incidence by at least 30 percent.

SANAC, however, cannot do this alone. Each and every South African has a role to play, and I urge you all to throw your support behind our National AIDS Council, the new CEO and his team as we push this new Prevention Revolution.

Thank you very much

Mr F Adams (ANC) to ask the Deputy President:

With reference to the Expanded Public Works Programme (EPWP) report that covers the six month period from April to September 2017 and which records 9 316 projects under the EPWP that created 591 614 job opportunities, of which almost 70% were held by women and 42% by the youth, what is the (a) level of skill and (b) kind of skill transfers that were achieved through these projects? NO1638E

Reply

As Members will recall, the Expanded Public Works Programme (EPWP) focuses on four main areas, namely the creation of employment, creation of assets, the delivery of services and lastly skills development.

Perhaps we must also reflect on the recruitment process. It is worth noting that participants in EPWP, are recruited by the employing government department through processes determined by provinces and municipalities.

For those participants who are trained through funds that are sourced by the Department of Public Works, the skill level requirements are determined by the Sector Education and Training Authorities as per the National Qualifications Framework.

However, for government departments, they select the required skills levels that the EPWP intervention provides training on. The type of skills training in a particular project, would largely depend on the skills required for that specific project.

During the period in question, training was provided through skills programmes and artisan development programmes. The skills programmes provided were in plant production, public awareness promotion on dreaded diseases, child and youth care work, environmental practice, general forestry, community home building, public area cleaning, psychosocial support and silviculture.

In the Infrastructure sector, skills programmes training were carried out in different areas that included: painting, carpentry, plastering, brick laying and house electrical works. The skills transfers under the artisan development programmes include: auto electricians, boilermakers, diesel mechanics, electricians, fitter and turners and motor mechanics.

Thus, a total number of 18 573 men were trained; 30 840 women; 6 545 young people; and 788 people with disabilities. Training covered more than 300 focus areas.

In terms of skills of development, these figures look positive. However, one of the critical issues beyond these processes is the proper placement of those that have undergone training in gainful employment or entrepreneurship development.

Despite these recorded numbers that are contributing in reducing unemployment and poverty, there is a need to review, streamline and enhance the performance impact of all public employment interventions.

As part of deepening the impact of anti-poverty initiatives, we are looking at how we can expand participation of key stakeholders including the private sector to ensure that these interventions are not only limited to EPWP.

Through this process of review, we want to look deeper into how those youth Not in Employment, Education and Training can meaningfully access skills development opportunities through private sector involvement.

Thank you very much

Mr J H Steenhuisen (DA) to ask the Deputy President:

With reference to the Cabinet’s decision to place the entire North West Provincial Government under administration in accordance with section 100 of the Constitution of the Republic of South Africa, 1996, (a) what reasons were put forth by the Inter-Ministerial Task Team to place the entire Province under administration and (b) who or which national department will be tasked with leading the administration of the Province in the pursuit of social cohesion initiatives?

Reply

Honourable Member,

The issues of North West Province have been sharply raised through various voices in that province resulting in protests that were accompanied by the destruction of property.

The national government had to intervene to bring an end to this untenable situation.

In cases where incidents of instability manifest themselves, any responsible state must quickly make interventions that respond to the plight of affected communities and restore stability in a manner that promotes democratic governance.

In this regard, the President sent an Inter-Ministerial Task Team (IMTT) whose work led to the invocation of Section 100 (1) on the entire North West Province. In terms of this intervention, the national government resolved that the intervention must execute the following obligations:

(i) Enhancing the effectiveness of internal governance structures
(ii) Strengthening of financial controls, governance and accountability
(iii) Implementation of sound financial management systems and stemming the tide of irregular expenditure, unauthorised expenditure, and accruals
(iv) Enhancement of Supply Chain Management (SCM) systems
(v) Improvement of contract management systems
(vi) Restoration of sound labour relations between government as an employer and trade unions in the health sector

The IMTT is implementing the necessary interventions intended to resolve issues and restore normalcy in the North West Province. Reports on progress will be made to Cabinet on a fortnightly basis in line with the IMTT mandate. The recent report was tabled to Cabinet on the 23rd May 2018 and Cabinet was satisfied with the progress in stabilising the province.

Cabinet then increased the members of IMC with addition of the Ministers of Basic Education; Public Service and Administration, Human Settlements, Social Development, Tourism; Environmental Affairs and Transport.

The IMC was asked to do further work in the Province and advise cabinet on which of the provincial departments should be placed under Section (1) (a) or section 100(1) (b) of the constitution. As a result of this work, Cabinet has approved that five of the Provincial departments should be placed under Section 100 (1) (b) and these are:

(1) Office of the Premier;
(2) Department of Community Safety and Transport Management
(3) Department of Basic Education and Sports Development;
(4) Department of Health; and
(5) Department of Public Works and Roads

Five departments are to be placed under section 100(1) (a) namely:

(1) Department of Finance, Economy and Enterprise Development;
(2) Department of Local Government and Human Settlement;
(3) Department of Rural, Environment and Agricultural Development;
(4) Department of Social Department; and
(5) Department of Tourism

Furthermore, the JCPS Cluster has to conduct further investigations where cases of maladministration and corruption are suspected. Consultation with the provincial government is an ongoing process.

Once the final report by IMTT has been presented to Cabinet, remedial action will be taken and implemented.

The bottom line is that services must be delivered to the people of North West in a prompt, effective and efficient manner as expected by citizens from their government.

Thank you very much

Ms N V Mente (EFF) to ask the Deputy President:

With reference to his role as the Chairperson of the South African National Aids Council (a) what are the causes of the continued delays around HIV testing, such as getting the blood to testing centres and the results back to patients on time, which has ostensibly led to further delays in HIV patients getting antiretroviral medication on time and led to deaths that could have been easily avoided, particularly in the rural areas of the Eastern Cape, North West, Limpopo, Free State, KwaZulu-Natal and Mpumalanga and (b) how is the Government planning to address the issue?

Reply

The diagnosis of HIV is made using a rapid diagnostic test which comprises two point of care diagnostic tests. The first test is following by a second test, using a test kit produced by a different manufacturer as a confirmatory test. The use of two rapid tests obviate the need to send bloods to a laboratory far away for testing.

This means that within 15 minutes a patient can be informed if they are HIV positive and offered treatment. This process applies to patients in all provinces, both in rural as well as urban areas.

In cases where ELISA (Enzyme – Linked Immunosorbent Assay) results are needed for diagnosis, the turnaround time is 48-72 hours so clients are usually requested to return to the clinic within 3-5 days maximum.

ELISA is a test that detects and measures antibodies in your blood. This test can be used to determine if you have antibodies related to certain infectious conditions.

Delays in treating patients living in rural areas may only occur in instances where patients are diagnosed for other conditions other than HIV. In this case, blood would need to be sent from a clinic to an off-site laboratory. Even in rural areas, most district hospitals have onsite laboratories. Very advanced tests, such as drug sensitivity tests, are only performed at reference laboratories. This is because they require very specialised machines and personnel. To optimise the use of limited resources, it was not making economic sense to have them in every district as the number of samples usually tested at district level are small.

When it is necessary for bloods to be sent to laboratories far away from the health facility which is usually a clinic, blood specimen are collected daily from the facility, transported by vehicles to laboratories and the result is sent back to the referring health facility. This process does take time and does require the patient to come back to the facility a few days after the blood specimen is taken. However, this is not the case for the diagnosis of HIV as is described above.

Of course much more needs to be done to improve efficiencies in the provision of treatment. Where there are challenges with the provision of drugs, we would welcome that the Honourable Member highlight such specific areas so that, as a Chairperson of SANAC, I can attend to such issues urgently so that lives of the affected people are saved as speedily as possible.

Having said that, I must point out that our struggle should be more on prevention so that we deal with incidences of new infections. In actual fact, in the last SANAC Inter-Ministerial Committee meeting, there was agreement that increased focus should be on interventions to reduce new infections. All of us have a role to play in this regard. We are confident that we will effectively deal with any prevalent challenges.

Thank you very much.