Great health policies, poor outcomes

Durban - South Africa has achieved much in health since the era of Manto Tshabalala-Msimang, but South Africans are still getting a raw deal, a health conference in Durban heard on Friday.

"We have poor health outcomes despite good policies," Salim Abdool-Karim, director for the Centre for the Aids Programme of Research in South Africa, told an SA Medical Association conference in Durban.

"Health outcomes are disproportionately poor."

He said since Tshabalala-Msimang stepped down as health minister in 2008, the government's decision to implement the world's biggest antiretroviral programmes had a major impact on South Africa's mortality rate.

A quarter of all people in the world receiving antiretroviral treatment were in South Africa.

The rate of mother-to-child HIV transmission had fallen almost 10-fold, from 27% to 2.7% of newborn babies being infected.

There had been other improvements in health, such as a slight decline in tobacco consumption.

The country was unique in that it carried an exceptionally high health burden, he said.

Some 17% of all HIV infections globally occurred in South Africa while it had less than 1% of the world's population.

The country had 5% of the world's tuberculosis cases.

Injuries caused by violence were higher than the global average, with South Africa accounting for 1.3% of such injuries.

South Africa had 1% of the world's non-communicable diseases, such as hypertension and cardiovascular disease.

Abdool-Karim said there was a steady increase in these diseases.

South Africa was unique in that it was affected disproportionately by several health problems at the same time.

Bangladesh, which had a population of about 150 million, spent less money per person on health and yet all its health indicators, such as infant mortality, matched those of South Africa, with a population of about 53 million.