By Thabo Mbeki

ANC Today 2-8 March 2001

In the seven years since our liberation, perhaps the most contentious issues to which our country has been exposed have related to health. These have arisen out of the legislation enabling us to acquire affordable drugs and medicine and the questions we posed on HlV/AIDS.

The fact that health assumes such prominence in the public discourse confirms the objective importance of the issue of health in our continuing struggle for a better life for all.

In terms of the programme of action of our government, we are all called upon to join in united action to mount an all-round response to the problems of health that face especially the millions of poor people in our country.

That response requires that we attend to a number of things. Central to these is the fight against poverty.

It includes such matters as ensuring that our people have access to nutritious food, clean water, modern sanitation and a clean and healthy environment.

These are important elements of primary health care. However, that primary health care also includes access to basic medical services, including affordable drugs and medicines.

The government must work to address all these needs in an integrated manner. Among other things, this will require that we increase the numbers of people with appropriate types and levels of training deployed to work among the people at the grassroots level, such as community health workers. One of the tasks of these workers would be to conduct an educational campaign among the people dealing with a whole variety of questions, such as the importance of using clean water to avoid various illnesses as well as the need to use condoms, to deal with the serious problem of sexually transmitted diseases.

Once again, popular organisations, including the ANC and the Leagues, will have to mobilise their members to act in support of these community workers in the interest of the masses of the people. These organisations will also have to join in the campaign to eradicate the theft of drugs, medicines and equipment from our public health institutions. In addition to everything we have said, the issue of affordable drugs and medicines also remains central to our efforts to achieve the objective of health for all.

In this context, we must express our sincere appreciation to the US pharmaceutical company, Pfizer, which has decided to make one of its drugs available to our people for two years, free of charge. In addition to this, the company will also provide funds both to train medical workers to dispense this drug and to purchase the equipment enabling these workers to carry out the necessary medical tests on patients.

The acquisition of the drug alone, at no cost, will enable the public health service to save R350 million a year.

All this constitutes a practical example of what can be done jointly by the public and private sectors to address the life and death question of improving the health of those who are poor.

We recognise the fact that there is an inherent contradiction between the pursuit of the goal of health for the poor, to which our government is firmly committed, and the pursuit of profit, which is the goal of every commercial venture.

Among others, the truth of this proposition is illustrated by the fact that grossly inadequate resources are committed to the development of drugs and medicines to fight diseases of poverty and underdevelopment.

Accordingly, a permanent struggle between the masses of the people and the pharmaceutical companies cannot be avoided unless everybody concerned, including the developed countries, accepts that it is possible to address both the needs of the poor and the imperatives of normal commercial activity.

Given the now universal recognition of the challenge of the global eradication of poverty, the need to bridge the divides between the rich and the poor, between the North and the South, and the importance of health to the urgent challenge of economic development, it should be possible to come to a common position that health for the poor is a fundamental human right.

The effort must continue for the attainment of this position and, consequently, the development of sustained health campaigns radically to improve the health of the majority of the people in our country and the rest of the world.

It is unfortunate that this matter of human rights, human dignity and life itself, should have ended up in our courts, as though it would ever constitute an act of justice if we were to adopt laws that make it difficult for us to achieve the objective of health for all.

Nevertheless, as before, we will respect whatever decision is ultimately handed down by our judiciary.

Thabo Mbeki