The IFP congratulates the Ministers of finance and health, the DG and his team and the probing committee chair, for a health budget that is moving in the right direction. But in my 9 years of work with the health portfolio committee, I have seen some problems that persist and others that become steadily worse. Therefore, I make no apologies for focusing on the dangers that lie ahead and highlighting weaknesses in government policy that render much of the hard work done by the department futile.

When we speak of health and medicine it is necessary that we think increasingly about war. Had we confronted the AIDS war unflinchingly at the outset, we would not have have landed ourselves in the current quagmire.

We are only into the third year of the new millennium, but it is high time to pay attention to the defining feature of this century; biotechnology, which has the capacity to change the face of living, healing, war and dying.

Like all other technologies it can be used creatively or destructively. While gene therapy has the potential for halting anthrax AIDS and TB, it also has the capacity for designing biological agents that put warfare into the realm of nightmare and science fiction. Our own preoccupation with the TB AIDS MALARIA triad, should not blind us to the possibility of SA becoming a haven for maverick bio terrorism and even as we begin to make progress with the war against AIDS, we need to build watertight regulations around this field of research and experimentation to prevent the horrors of science fiction becoming the scourge of reality.

To give you some idea of the scope of bio terrorists, I will quote these examples:

1. Polioviruses have recently been made synthetically from segments of mail ordered DNA , using genetic information available on the web. In future any virus could be engineered in this way.
   
2. More lethal forms of anthrax or small pox can be engineered to become resistant to normal methods of destroying them.
   
3. Microbes living normally in the gut can be engineered to create disease producing toxins.

The list is as long as the human imagination. South Africa has as much potential to utilise the tools of biotech as most other countries in the world, as was recently evidenced by the creation of Fute the calf. But we have not clarified the ethical boundaries in which the research should be done, nor do we have adequate controls to ensure that is remains safe.

While we have clear records of having destroyed our nuclear arsenal we do not have such clear confirmation of the whereabouts of Apartheid's biological arsenal.

As to the current war in which we are engaged, that against AIDS and TB, the budget per se, is moving in the right direction. But as the Finance Minister told the Millennium Fund director last year, its not only money we need so much as capacity to use it.

The ethics that informs our Aids strategy also leaves much to be desired.

Other than preventive advocacy, most of the good that is done for people with HIV or AIDS has been squeezed out of government, either by TAC, opposition parties or the courts. Treatment of pregnant mothers and rape victims are examples hereof. Meantime the AIDS epidemic grows apace; TB is on the increase as is the resistant form of TB, tenfold more costly to treat, more dangerous and difficult to halt.

The way to beat both these diseases is to have sound ethical principles, use rights fairly, increase provincial autonomy and expand partnerships with civil society. A mere R43 million is budgeted for NGO's. Last year 34 projects were approved but many lacked capacity to access funds timeously. 

There must be accountability but government makes the process complex and does not adequately or effectively support communities, traditional leaders, traditional healers or international donors. Conditional grants are increased but remain difficult to spend because the mechanism is bureaucratic. Centrist controls still hamper progress on the Aids front. It is almost a year since the Global Fund offered to fund the KZN Enhancing Care Initiative, stalled by red tape and politics. WE still have anonymous testing, people who can refuse to know their HIV status and no laws that realistically assist people infected knowingly by a sex partner. The IFP has draft Bills that effectively criminalise the knowing and willful transmission of HIV which we are sharing with the Justice Committee and department and we support their efforts to test alleged sexual offenders.

The IFPs view on Aids therapy is to treat where there is capacity, beginning somewhere and expanding our care. Do away with anonymous testing, broaden pre test counselling; let every pregnant women know if she has HIV.

Knowledge protects both the affected and the uninfected. Why should we as MPs have access to a/r at public expense while they are denied it.

On the issue of health funding and the Medical schemes we have yet another bad dream. Engineer as the Medical schemes council will, schemes become more costly with fewer members.

The IFP proposal is for all who earn to be on an enforced scheme of their choice with a government low cost scheme offering basic care, as one of the options. Make greater use of private public partnerships to bridge the gap between public and private sector care and to bring down costs in the private sector. If we privatised the entire chain of medicine distribution to the state from producer to user, there would be less theft and lower prices.

As the cost of medicine and technology soar, we should focus more money and attention on homeopathy, ayurveda, Chinese medicine, herbalism, naturopathy and traditional medicines. We should strengthen our partnerships with traditional healers through collaborative workshop programmes and research. Hundreds of people are using sutherlandia and the African potato the basis of moducare, but no government funds or encouragement has been dedicated to researching these products. Instead we have government encouraging research into Russian electromagnetism.

We have created a jumbled Council for Alternative health Care, mixing well trained practitioners in established ancient health paradigms, with fly by night therapists who have done weekend courses. It is impossible for the public to differentiate between the categories. The accountability and interaction with conventional medicine that would be encouraged by well trained professionals is diluted, in fact neutralised, by the wishes of beauticians and holistic healers. These are valuable complementary therapists, but should not be confused with doctors trained for 6 years.

Yet, we must try, in spite of this, to make greater use alternative care to the public's advantage.

We are on a path of moral renewal and hear much about a health charter. But right money and right words are of no value without integrity, clarity, accountability, right understanding and right action. We are wasting our talents, our human goodwill and the lives of our people. Let us use the money budgeted for health, beyond politics to contribute to healing and happiness.