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
10 Not printed. Back
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