NHI is morally correct but handle with care, says Discovery’s Adrian Gore 

Discovery CEO Adrian Gore says the proposed National Health Insurance (NHI) fund is a moral imperative for the country that he supports fully, though he warned it would require careful implementation to ensure its long-term fiscal sustainability. “A well-functioning NHI is necessary and morally correct as we need to address unacceptable levels of inequality and ensure access to quality care,” Gore told Business Day. “Discovery is supportive of the NHI and will use its capabilities and resources to assist.”

While the ANC-led government has been a vociferous supporter of the NHI, which it says is needed to create more equitable access to quality healthcare, critics argue SA cannot afford it given current fiscal debt and economic growth constraints. The Institute of Race Relations estimated in 2020 that NHI could cost the country as much as R700bn a year when it becomes operational in 2026 as the government has envisaged. That compares with SA’s total health expenditure in 2021/ 2022, which Discovery says reached R523bn, or about 9% of GDP. Of that, Discovery says about 51% was covered by private medical scheme contributions or out-of-pocket expenditure by consumers. However, given that there are only about 9-million private medical aid members in SA out of a population of 60.14-million, the vast majority of citizens are reliant on state health care.

Workable model:

Gore says Discovery presented what it believes is a workable model for a sustainable NHI to the parliamentary portfolio committee on health on January 25, which proposes an incremental blended funding model that could achieve universal health coverage in a pragmatic and sustainable way. Through this blended model, the NHI fund would be supported by tax-derived funding and also receive a mandatory contribution from citizens who are able to afford it. “A one-size-fits-all NHI would only be palatable if it provided current levels of medical scheme benefits for all — this would be extremely desirable, but unfortunately unaffordable.” The model proposed by Discovery would not permit private medical scheme members to opt out of funding the NHI, but would allow them to purchase additional cover should they wish. Gore says this would leave consumers with some degree of choice, while improving overall healthcare access for all South Africans. “There is significant risk in limiting medical schemes to offering cover only for services not reimbursable by the NHI [as set out in section 33 of the proposed NHI Bill],” said Gore. “The reality is that employed people currently utilising the private sector via medical aid schemes would only be satisfied if the NHI could deliver care that they would expect relative to what they currently receive.” Gore said it would be best to follow an incremental approach to NHI that initially sought to provide primary health care for all citizens and then gradually bulk up cover as the economy grows to provide the fiscal leeway to fund the expanded cover. He emphasised that it would be important for the public and private sector to co-operate to ensure that public health care is better resourced. “The country does have the capabilities and resources to work towards universal coverage, but this will require time and excellent leadership,” Gore said. “Our view is that private medical cover can be accommodated alongside the NHI fund as part of a social solidarity framework.

We are committed to engaging constructively with policymakers and social partners on implementable and sustainable models to achieve broad and equitable care.”

PFIZER COVID-19 VACCINE BOOSTERS FOR OVER 60S SET TO START FROM JANUARY

The South African Health Products Regulatory Authority (Sahpra) has authorized boosters for people 18 years and older, to be administered six months after their second jab.

CAPE TOWN - Pfizer COVID-19 vaccine boosters for people 60 years and older are set to start from January.

The South African Health Products Regulatory Authority (Sahpra) has authorised boosters for people 18 years and older, to be administered six months after their second jab.

A second dose of the Pfizer COVID-19 vaccine has also been approved for those aged between 12 and 17.

Health department officials said six months after the second Pfizer shot, people start losing immunity and so a third jab is necessary.

The department's Dr Nicholas Crisp has reiterated that Sahpra found these booster shots to be safe.

"From January, once the Vaccine Ministerial Advisory Committee (V-Mac) has aligned with this approval, we will get the recommendation and plan the appropriate roll-out of boosters at that time."

Crisp added the regulator was also assessing data on Johnson & Johnson coronavirus vaccine boosters.

"Once we have that information, the V-Mac is on standby to make recommendations and we anticipate that we'll be ready for vaccination of boosters for J&J. If not next week, then probably the week after."

Saphra could give an update on its studies in this regard next week.

Health officials expect to cross the 27 million mark for COVID-19 vaccine doses administered in the country on Friday.

WATCH: Pfizer vaccine boosters to be rolled out in January 2022

Covid-19: Omicron storm is here, with increase of 400% of cases in Gauteng

By Siyabonga Mkhwanazi  Dec 10, 2021

Cape Town - Health Minister Dr Joe Phaahla says cases of Omicron continue to rise across the country, with Gauteng recording an increase of 400% in the cases and hospital admissions now sitting at 200%.

On Friday, Phaahla said scientists were conducting more studies on the variant after it emerged that the majority of those who were admitted to hospital had not been vaccinated.

He also called on the people not to panic as the government tried to contain the spread of the variant.

Competition Commission announces decrease in Covid-19 PCR test

By Tarryn-Leigh Solomons   22h ago

Breakthrough malaria vaccine offers to reinvigorate the fight against the disease

The World Health Organization has announced a historic move: it has recommended the widespread use of the first ever malaria vaccine. The recommendation is based on the results of an ongoing pilot programme in Malawi, Ghana and Kenya. Malaria is a huge global health challenge, around 409,000 people died of malaria in 2019 alone. The WHO African region carries a significant proportion of the malaria burden – 94% of all malaria cases and deaths occurred in the region. Children younger than five are the most vulnerable. Ina Skosana asked Eunice Anyango Owino to explain the development and its significance.

It has taken 30 years. Why so long?

The most significant reason is that the malaria parasite is very complex. It has different stages; some in the mosquito and some in the human. Thus, scientists had to pursue a diversity of approaches.

For example, in the human there are two stages. These are the:

• Pre-erythrocytic stages (sporozoite, or spore-like, stage). This is the period when the parasite’s sporozoite from a mosquito bite enters the bloodstream and heads for the liver to mature and multiply after which they are then released.

• The blood-stage (Merozoite stage). This is when the parasite’s merozoites are released from the liver, and multiply in the red blood cells.

So an effective vaccine against the first stage (pre-erythrocytic stage) would be one that elicits an immune response that would either prevent infection of the liver cells or lead to the destruction of the infected liver cells.

An effective vaccine for the second stage (blood-stage) would be the one that does one of three things: elicits immune responses that prevent infection of red blood cells; decreases the number of parasites in the blood; reduces the severity of the disease by allowing the body to develop a natural immunity with little risk of getting ill.

Another option was to develop transmission-blocking vaccines. An effective transmission-blocking vaccine would induce antibodies that would block the maturation of malaria parasites in mosquitoes that feed on vaccinated individuals.

Another factor that contributed to the delay is that scientists working on malaria vaccines in the early stages lacked an understanding of the specific immune responses associated with protection against the parasite.

Also, malaria parasites – such as Plasmodium falciparum – display a variety of antigens on their surfaces that help them escape the immune system and also render vaccines based on specific antigens less effective.

Can you tell us more about the vaccine?

The vaccine RTS,S, trade name Mosquirx, is given in four doses to children between the ages of 5 months and 17 months; the first 3 doses are given monthly with the first at 5 months and the third at 9 months. The fourth, which is a booster dose, is given at between 15 and 18 months.

The efficacy is about 40% against malaria cases and 30% against severe malaria.

No two vaccines or diseases are comparable. The WHO has set an efficacy level of 50% and above for most vaccines and most highly efficacious vaccines offer 75 % and above level of protection. For example, the COVID-19 vaccines based on messenger (m)RNA technology by Pfizer and Moderna offer well above 90% protection level.

The RTS,S vaccine targets the parasites before they infect liver cells; it targets the circumsporozoite protein on P.falciparum sporozoites surface and is thus considered a pre-erythrocytic vaccine.

What are the next steps?

First, the WHO and the manufacturers of the vaccine GlaxoSmithKline will be rallying countries, particularly those with high malaria burdens, to adopt the vaccine as part of their National Malaria Control Strategies.

They will also be asking these countries to set aside funds.

They will also be involved in fundraising from the global health community or work with partners, for a broader rollout of the vaccine.

There should be equitable and long-term access to the vaccine. The vaccine should also be cost-effective.

The hope is that the WHO announcement will re-energise the race to find even more efficient vaccines against malaria. Current reports by the Jenner Institute of Oxford University suggest that a malaria vaccine that might meet the WHO goal of 75% is under trial in Burkina Faso.

What does this mean for malaria control in Africa?

The vaccine is an additional tool to the malaria control tool kit.

The vaccine does not provide complete protection. And will be introduced as part of a tool kit geared to reducing malaria infections and reducing fatalities. Other measures include bed nets and indoor residual spraying.

Nevertheless, the vaccine has a great potential to reduce death and illness in high burden areas in sub-Saharan Africa especially if used in combination with pre-existing malaria prevention methods. For example, a study by the London School of Tropical Medicine reported a 70% reduction in hospitalisations and death in children given the Mosquirx vaccine plus antimalarial drugs.

Malaria control had been stagnating in some African countries, with countries like Sudan and Eritrea seeing a significant resurgence in the recent past.

The vaccine will reinvigorate the fight against malaria. And it offers the promise of bringing it back on track.

Following the two hard years we all experienced in 2020 and 2021, Fedhealth wants to give back to our members in a sustainable and responsible way in 2022.

Thanks to Fedhealth’s prudent financial view for 2021, the Scheme is in a strong financial position for 2022 and beyond, from which our members will duly benefit. Here is a brief summary of the most significant changes for the 2022 benefit year:

1. No contribution increases until April 2022

In 2022, Fedhealth will use R105 million of excess Scheme reserves to give members an increase holiday for three months.

The Scheme will fund the increase for the first three months, which means all members will continue paying 2021 rates until 31 March 2022.

Despite this increase holiday, the 2022 benefit enhancements will already kick in on 1 January – so even though members are still paying 2021 rates, they will enjoy these improved benefits.

Please note: Once the contribution increase holiday ends on 1 April, members won’t be able to downgrade to a lower option. Only upgrades to a higher option within 30 days of a life-changing event are allowed, in line with our unique benefit.

2. ONLY CPI increases for flexiFED 1 and child rates across the board

To make medical aid more accessible for young people just starting out in life, the flexiFED 1 option will only see a CPI increase. And since Fedhealth has a strong family focus, the same applies to child rates across the board. No double-digit increases have been applied in 2022, as you can see below:

3. New benefit enhancements for 2022

• Preferred providers for cancer. From 2022, all Fedhealth members on all options have the choice of an oncologist with ICON or SAOC (the South African Oncology Consortium). Both ICON and SAOC are preferred providers rather than DSPs, which means access to most oncologists in the country and therefore no co-payment for voluntary non-use.
• We now cover the HPV vaccine for girl beneficiaries between the ages of 9 to 14 from Risk as part of the screening benefit for children.
• Mammogram frequency on the screening benefit used to be once every three years – going forward, it will be once every two years.
• A stress and anxiety benefit – We’ve realised the effects of COVID-19 on mental health and especially on the younger population. We’ve therefore introduced a Stress and Anxiety benefit on flexiFED 1 which will deal with stress and anxiety only by means of virtual consults with a psychologist that is paid from Risk and not day-to-day benefits.

4. MediVault allowances still substantially higher than on comparative options

MediVault allowances across the board received inflationary increases and are still substantially higher than most Savings allocations on comparative competitor options:

These benefits enhancements, together with the contribution increase holiday, should provide Fedhealth members with real-world, practical value, as well as a financial breather to help with those overstretched budgets over the December holidays and January school expenses

DISCLAIMER: The information on this website is for educational purposes only, and is not intended as medical advice, diagnosis or treatment. If you are experiencing symptoms or need health advice, please consult a healthcare professional.