With a R64.5bn budget allocated to the national department of health, minister Joe Phaahla says he is worried that the budget will be going down by 1.7% each year — before inflation is factored in. 

Phaahla on Tuesday said this would potentially compromise SA’s already overburdened health system. He was presenting his 2022/23 budget in parliament.

In this financial year, the department’s major focus will be on the recovery of comprehensive health services countrywide, he said.

He said 86% of the budget, around R55bn, would be transferred to provinces as conditional grants to support various activities such as the HIV and Aids, TB and STT programmes, support for human resources including medical interns and community services doctors, and a significant allocation for infrastructure support.

“We are, however, concerned that in the medium term, the health budget will be going down by 1.7% each year, before even factoring in inflation, which cannot be good for health services in the country,” he said. 

Universal health coverage for all was among priorities outlined by Phaahla as he told MPs that a foundation for a strong public health system was being laid.

“Within this budget, allocations made under NHI are essentially meant for strengthening the public health delivery platform such as targeted infrastructure upgrades across the country, contracting private PHC doctors, acquiring oncology services and adding more capacity for mental health services.

“We also have a ring-fenced amount to prepare for implementation of the NHI such as the benefits design and pricing, provider accreditation, management of health products procurement, further development of the digital information systems and developing risk management and anti-corruption systems,” he said.

Phaahla revealed the government had made significant strides in the fight against HIV and Aids and in the current financial year R24bn would go towards this cause. 

Despite the strides made, Phaahla raised concerns that millions of infected people, particularly the youth, were not taking their medication.

“As of June 2021 the number of people on ART was 5.4-million, meaning that there is a gap of more than 2-million who are projected to be HIV positive but are not.

“Our major concern is the continued spread among young people, especially young girls. Our policy is to provide treatment for everyone who tests positive to achieve viral suppression and reduce transmission,” he said.

To mitigate the continued spread of the virus, Phaahla said, the government would conduct widespread testing and encourage people to start and maintain the treatment at all points of care where the testing is done, including  mobile clinics.

“Our target is to scale up treatment by another 700,000 this year to above 6-million people. Our treatment coverage of those who know their status has slipped to only 76% since the Covid-19 pandemic.   

Phaahla admitted that the pandemic caused a setback to several programmes planned by his department. It had led to deterioration in the maternal and infant mortality ratios.

“Despite Covid-19 there are promising trends in terms of infant mortality which if it is maintained will lead to infant mortality of less than 20/1,000 live births and less than 25/1,000 live births by 2024.  

“While immunisations did not suffer in the Covid-19 lockdowns, they have recovered sufficiently late in 2021 to 83.6% with 82.2% receiving two doses of measles vaccine compared to 80.2% in 2019 and 77.3% in 2020.” 

 Phaahla used the budget to highlight strides made in the employment of health practitioners at overburdened facilities.  

The presidential stimulus package introduced in 2022 enabled provinces to employ more than 73,000 additional staff, many on short-term contracts.  

In addition, 2,429 medical interns, community service personnel, doctors, nurses and pharmacists were employed. Phaahla said he was grateful that an additional R2.1bn over the next two financial years was allocated for medical interns.

In his closing remarks, Phaahla warned that the risk of the fifth wave of the Covid-19 pandemic continued to loom large and pleaded with South Africans to get vaccinated.

“The past two years have been difficult as we battled the Covid-19 pandemic here in SA and together with the rest of the world. It has taught the world that no-one is safe until all of us are safe and that international and national solidarity is the answer to defeating the pandemic.

“While the pandemic is still with us we believe there is a light at the end of the tunnel. Let us not be tempted to lower our guard at the last mile. Let us continue to save lives, protect our health workforce by being responsible but above all encourage more South Africans to vaccinate so that we can open all facilities of life fully but safely,” he added.