NHI set to cull small medical schemes

Sweeping changes to medical schemes on the road to National Health Insurance came a step closer this week when the medical scheme regulator announced the potential closure of small schemes, the rationalisation of scheme options and an accelerated alignment of scheme benefits with the government’s health policy.

At the Board of Healthcare Funders conference in Cape Town this week, a senior Department of Health official also announced that the Council for Medical Schemes would start consulting on how to make scheme membership mandatory for all who can afford it.

The conference heard that the council was considering dissolving 29 medical schemes that have fewer than 6,000 members to better cross-subsidise risk….more

Mall anchor tenants may be cast adrift

Retail mall owners may be scurrying around in the hunt for new anchor tenants as legacy businesses fall behind changing retail trends.

The 10- to 25-year leases that are usually given to anchor tenants when property developers establish a new mall form part of a model that is quickly becoming obsolete, and this may mean changing the face of the traditional anchor tenant.

Elaine Wilson, the divisional director for research at Broll Property Group, said although grocery and department stores were expected to remain anchor tenants, “certain tenants such as H&M will become more of a necessity for your larger centres”.

Wilson said anchor tenants would always draw feet to a centre due to their offering and size…..more

Gupta e-mails reveal suspected multibillion-rand tax avoidance scheme

Evidence in the leaked Gupta e-mails points to a complex multibillion-rand tax avoidance scheme with family patriarch Atul Gupta at its centre.

Various tax experts said on Thursday that the transactions in the leaked e-mails pointed to evidence of a complex practice known as staggering or revolving loans. The Guptas appear to have used personal and inter-company loans to and from their group companies, many of which are located offshore…..more

The Lancet: Eliminating acute rheumatic fever and rheumatic heart disease

A comment in today’s print issue of The Lancet starts:

‘Acute rheumatic fever and its major sequela rheumatic heart disease are conditions of poverty… Both conditions continue to be a major cause of death and suffering in low-income and middle-income countries with an estimated 33 million people living with rheumatic heart disease worldwide and more than 300,000 deaths each year, most among people younger than 30 years. Importantly, acute rheumatic fever and rheumatic heart disease can be prevented by improvements in socioeconomic conditions and public health measures, including penicillin for streptococcal sore throat in endemic areas.’

And concludes:

‘The World Heart Federation worked with WHO to create a draft resolution document in 2016. Member states accepted the memorandum in January, 2017, and debated and agreed the resolution text at the 141st WHO Executive Board meeting in June, 2017. The World Heart Federation will now marshal the rheumatic heart disease community to help ensure that member states are politically invested in passing the resolution text at the 71st World Health Assembly in May, 2018…’

CITATION: Eliminating acute rheumatic fever and rheumatic heart disease
Magdi Yacoub, Bongani Mayosi, Ahmed ElGuindy, Alain Carpentier, Salim Yusuf
The Lancet, Volume 390, No. 10091, p212–213, 15 July 2017
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31608-2/fulltext

An earlier paper (Carapetis and Zühlke 2011) notes ‘There have been three surges of activity in RF/RHD research and control over the past half-century.’… ‘the Global Programme on Rheumatic Fever and Rheumatic Heart Disease… was disbanded in 2001… The first decade of the 21st Century saw RF/RHD research and control steadily recede from the global public health agenda.’
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104531/

The periodicity of global interest, action and political and financial investment in RHD is a feature of other diseases too and presumably has causes (largely political?) and impacts, both positive and negative. Can anyone on HIFA say more about these phenomena?

For more information on RHD and current global advocacy see:
http://rhdaction.org

Best wishes, Neil

Behind the Jerusalem attack: How Trump & Netanyahu pushed Palestinians into a corner

On Friday July 14, three Palestinian men killed two Israeli officers stationed at the Haram al-Sharif compound, which includes – aside from the Al-Aqsa Mosque – the famed Dome of the Rock and other Palestinian Muslim sites, revered by Muslims. Mohammed Ahmed Jabareen, 29, Mohammed Hamed Abd Al-Latif Jabareen, 19, and Mohammed Ahmed Mafdal Jabareen, 19, were immediately killed by occupation soldiers.

On the day of the attack, several Palestinians were killed in various parts of the West Bank and a 3-year-old child from Gaza died while awaiting a permit to cross from the besieged region to the West Bank for treatment. None of this registered in international media. The armed Palestinian attack on Israeli soldiers, however, made headlines around the world…..more

Nod for proposal to fund health plan with medical aid rebates

The ANC supports the policy proposal put forward by Health Minister Aaron Motsoaledi to use money allocated for tax rebates to South Africans on medical aid to fund National Health Insurance (NHI), it confirmed on Monday.

Naledi Pandor, chairwoman of the subcommittee on education, health, science and technology of the ANC national executive committee, made the pronouncement following the governing party’s policy conference last week.

Pandor said that the medical aid tax rebates amounted to about R20bn…..more

Universal healthcare coverage costs under scrutiny

EDITORIAL: Dirty game for clean officials

In the past few weeks, two directors-general of government departments have been suspended and the CEO of the South African Social Security Agency (Sassa) fired.

The three cases have lots in common. The directors-general, water affairs head Dan Mashitisho and agriculture head Mike Mlengana, had been asked by their  political principals to sign contracts they believed were illegal or unprocedural.

Sassa CEO Thokozani Magwaza has had a long conflict with his principal, Bathabile Dlamini, over her interference in the agency’s work, in particular finalising a contract with a new service provider to conduct the payment of social grants….more

Private sector involvement vital for NHI – expert

South Africa should rely on the expertise and strengths of its private healthcare system for a successful rollout of its planned national health insurance (NHI) scheme, according to the former head of Ghana’s national health insurance system.

Nathaniel Otoo, former CEO of the Ghanaian National Health Insurance Authority (NHIA), addressed delegates at the Board of Healthcare Funders’ national conference in Cape Town, sharing some of Ghana’s challenges with implementation of universal healthcare…..more

Green Infrastructure in the Gauteng City-Region

As the population, economy and urban built environment in the Gauteng City-Region (GCR) expand, the government is increasingly under pressure to provide urban infrastructure to support growth. It is more and more important that this infrastructure is sustainable to minimise the negative environmental impacts often associated with traditional forms of urban development. Green Infrastructure (GI) can achieve this. GI is the interconnected set of natural and man-made ecological systems, green spaces and other landscape features that provide services and strategic functions in the same way as traditional infrastructure. In harnessing the benefits of ecosystem services, GI is a more efficient, cost effective and sustainable alternative – and sometimes accompanying approach – to conventional forms of infrastructure….more

Swarms of smart drones to revolutionise how we watch sports

6733112543_6c215bcb6f_o_cropDrone innovators are transforming the way we watch events, from football matches and boat races to music festivals.  Anyone who has watched coverage of a festival or sports event in the last few years will probably have witnessed commercial drone use — in the form of breathtaking aerial footage. But a collaboration of universities, research institutes and broadcasters is looking to take this to the next level by using a small swarm of intelligent drones.

The EU-funded MULTIDRONE project seeks to create teams of three to five semi-automated drones that can react to and capture unfolding action at large-scale sports events. Project coordinator Professor Ioannis Pitas, of the University of Bristol, UK, says the collaboration aims to have prototypes ready for testing by its media partners Deutsche Welle and Rai – Radiotelevisione Italiana within 18 months.

‘Deutsche Welle has two potential uses lined up – filming the Rund um Wannsee boat race in Berlin, Germany, and also filming football matches with drones instead of normal cameras – while Rai is interested in covering cycling races,’ said Prof. Pitas. ‘We think we have the potential to offer a much better film experience at a reduced cost compared to helicopters or single drones, producing a new genre in drone cinematography.’…more

Your phone to ID you by the way you swipe

Fingerprint scanners are all the rage, yet new research shows that this is just the beginning of biometric identification. With millions of people around the world now using fingerprint readers, facial recognition software and iris scanners on a daily basis to access their smartphones or to authorise mobile banking services, there is a need to ensure these remain secure.

Hackers have shown it is possible to fool smartphone fingerprint sensors, for example, into giving them access to devices, while others have developed ways of breaking into devices that require facial recognition or voice identification…..more

The Lancet: Eliminating acute rheumatic fever and rheumatic heart disease

A comment in today’s print issue of The Lancet starts:

‘Acute rheumatic fever and its major sequela rheumatic heart disease are conditions of poverty… Both conditions continue to be a major cause of death and suffering in low-income and middle-income countries with an estimated 33 million people living with rheumatic heart disease worldwide and more than 300,000 deaths each year, most among people younger than 30 years. Importantly, acute rheumatic fever and rheumatic heart disease can be prevented by improvements in socioeconomic conditions and public health measures, including penicillin for streptococcal sore throat in endemic areas.’

And concludes:

‘The World Heart Federation worked with WHO to create a draft resolution document in 2016. Member states accepted the memorandum in January, 2017, and debated and agreed the resolution text at the 141st WHO Executive Board meeting in June, 2017. The World Heart Federation will now marshal the rheumatic heart disease community to help ensure that member states are politically invested in passing the resolution text at the 71st World Health Assembly in May, 2018…’

CITATION: Eliminating acute rheumatic fever and rheumatic heart disease
Magdi Yacoub, Bongani Mayosi, Ahmed ElGuindy, Alain Carpentier, Salim Yusuf
The Lancet, Volume 390, No. 10091, p212–213, 15 July 2017
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31608-2/fulltext

An earlier paper (Carapetis and Zühlke 2011) notes ‘There have been three surges of activity in RF/RHD research and control over the past half-century.’… ‘the Global Programme on Rheumatic Fever and Rheumatic Heart Disease… was disbanded in 2001… The first decade of the 21st Century saw RF/RHD research and control steadily recede from the global public health agenda.’
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104531/

The periodicity of global interest, action and political and financial investment in RHD is a feature of other diseases too and presumably has causes (largely political?) and impacts, both positive and negative. Can anyone on HIFA say more about these phenomena?

For more information on RHD and current global advocacy see:
http://rhdaction.org

Best wishes, Neil

Publish in European Journal of Primary Care – low costs for Africans

Researchers based in less-economically developed countries are able to apply for waivers and discounts to support publishing in fully open access journals which have Article Publishing Charges (APCs):

– Corresponding authors based in low-income countries, as categorized by the World Bank, are eligible to apply for a full waiver of the APC.

– Corresponding authors based in lower-middle-income countries, as categorized by the World Bank, are eligible to apply for a 50% discount of the APC which applies to their article.

Eligibility is determined by the country of the corresponding author’s primary affiliation.

Our discretionary waiver policy, for researchers who are not automatically eligible under the above policy, will still be handled on a case-by-case basis. Authors should supply full details of institutional affiliations and grant funding when making their request.

Applications must be made upon submission.

All discussion and decision on APC waivers and discounts is entirely separate from the peer review process. This is key for our membership of the Open Access Scholarly Publishers Association (OASPA) and inclusion in the Directory of Open Access Journals (DOAJ). We therefore ask editors to defer all questions from authors regarding the policy and requests under the policy to Rebecca Evans, Open Access Coordinator (Rebecca.evans@tandf.co.uk)…. see details below and here

EJGP Waivers

‘Not even its supporters agree’ on what NHI means for private health

Even supporters of the National Health Insurance disagree on what the shift will mean, especially for private medical schemes, writes Amy Green in a Health-e News report. Meanwhile, the SA  Department of Health has again lashed the media and other critics, saying that Health Minister Dr Aaron Motsoaledi had predicted ‘a war’ by those ‘ideologically opposed’ to the NHI.

Even among those who support the implementation of universal health coverage in the form of a National Health Insurance (NHI) there is disagreement on what the shift will mean especially for private medical schemes, writes Amy Green in a Health-e Newsreport.

Green writes that according to the new NHI White Paper, the role of medical schemes inSouth Africa will change fundamentally with the implementation of a universal healthcare system. The first victims will be government schemes, including the Government Employee Medical Scheme (Gems), the Police Medical Scheme and the Parliamentary Medical Scheme (Parmed)…..more

New countrywide training initiative to combat lifestyle diseases

A new approach to patient care has been launched, developed at Stellenbosch University and spearheaded by Pharma Dynamics. The training initiative, aimed at reducing chronic lifestyle diseases, is being introduced in medical school curricula and to practising doctors as continuing professional education, writes Karen MacGregor for MedicalBrief.

The resource, Brief Behavioural Change Counselling or BBCC, offers training on how to quickly and effectively advise patients about lifestyle adjustments that can help to reduce the epidemic of chronic lifestyle diseases which cause close to 40% of deaths in South Africa…..more

The ANC is tired. It’s also tiring

Obviously, now that the ANC’s national policy conference has come and gone, your intellectual life has been enriched more generously than the troughs at the Saxonwold shebeen. In no time at all, the material conditions of your life will also start to improve, flowing from this festival of policy ideas debated (robustly, of course) over the past week, ready for imminent adoption at the ANC’s elective conference in December.

By the time we get to the 2019 general elections, you will experience orgasmic joy as you witness the early and demonstrable positive returns on the policy debates that took place in Johannesburg some two years before. Evidence of the ANC having started to “renew” itself will be everywhere, from the branches of the organisation, functioning as world-class debate chambers, right up to the quality men and women heading up critically important institutions such as the South African Police Service, the Hawks, the National Prosecuting Authority and the SABC…..more

Essential medicines shortage hit Gauteng

Gauteng hospitals and clinics are not receiving all the vital and essential medicines they need, with the problem being particularly bad on the East Rand.

According to a recent presentation by the Gauteng Health Department to the Health Committee of the Gauteng Legislature, there was 98.13% availability of essential medicines at health facilities from April 2016 to March this year. The report said while vital medicines stocks rated 98.56% availability for this period, this was below the target of 99% availability.

“The real target should be closer to 100%, as even a 1% drop means thousands of patients not receiving their correct medicine,” said Jack Bloom of the Democratic Alliance…..more

Plans to upgrade Joburg’s health facilities

drugs-slider-900x356Staff shortages at clinics in Alexandra, social workers brought in for extra help and drug rehabilitation centres at some clinics – these are amongst the plans and improvements for state health institutions in Johannesburg. These strategies were announced by Dr Mpho Phalatse, Member of the Mayoral Committee (MMC) for Health and Social Development in the City of Johannesburg, during a surprise visit to the four Region E clinics in Alexandra. Her unannounced visit was to the Sandown, 8th Avenue, Eastbank and the newly built Riverpark clinics. Riverpark, she said, would be expanded to include a drug rehabilitation centre…..more