Select Committee on International Development Written Evidence


APPENDIX 9

Memorandum submitted by Mr Martin Hensher, Department of Health, Republic of South Africa

  On behalf of Minister Tshabalala Msimang, I have pleasure in attaching two reports[10] which form the basis of the Department of Health's submission to the International Development Committee's inquiry into the impact of HIV/AIDS. I must emphasise that both reports were produced independently of government, and hence do not necessarily reflect the policy of the Government of South Africa. The Department of Finance is currently in the early stages of developing a long-term model of the macro-economic impacts of HIV/AIDS, while a number of Departments (including the Department of Health) have recently launched sector-specific impact assessments—hence there is not yet a quantified impact model in use by the public sector, but this will clearly soon be remedied. In the meantime, I am sure that your Members will find that the two independent reports submitted herewith are of a very high quality, and address directly most of the matters to be considered by the forthcoming inquiry.

  From the viewpoint of the Department of Health, I would like especially to highlight the cost consequences to the public health system of caring for HIV/AIDS, which even without adopting anti-retroviral therapies may require public health expenditure in South Africa to increase by nearly 50 per cent in real terms over the next 10 years. This increase may just be feasible in South Africa, but could only be sustained by running a noticeably larger budget deficit, with negative consequences for savings, investment and long-term economic growth. But in many of our neighbouring countries, it is clear that, within the resources currently available to them, most cannot offer even basic AIDS care to more than a fraction of their affected populations. The Minister would therefore implore the Committee to spend some time in considering the role it can play both in the unfolding debate as to how best to achieve affordable and fairly-priced pharmaceuticals for use in HIV/AIDS care and management, and in influencing the mobilisation and augmentation of resources for HIV/AIDS prevention and care in those countries least able to cope with the crisis facing them. The latter question involves not only direct assistance, but is fundamentally linked with debt reduction and forgiveness, and avoiding the imposition of macro-economic policies and conditionalities which undermine public health and social protection systems.

  Should the Committee wish to receive oral evidence or an informal briefing from the Department of Health, please contact the Minister's office, who would co-ordinate an appropriate response. I very much hope that this submission will prove to be of assistance to the Committee, and may I pass on the Minister's best wishes in this important inquiry.

Martin Hensher

European Union Consultant in Health Economics

Directorate: Health Financing & Economics

May 2000




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