Objectives to Improve Components of the Health Care Delivery System

I attended the Portfolio Committee Meeting on 29 February 2012 and the CSIR reported back to the members of Parliament on specific objectives to improve components of the health care delivery system.

Here is a summary on this meeting.

Introduction to the CSIR

The Council for Scientific and Industrial Research (CSIR) was established under the Scientific Research Council Act (No. 46 of 1988). The CSIR’s objectives are to contribute to improving the quality of life of the people of South Africa by fostering industrial and scientific development, through multi-disciplinary research and technological innovation. The CSIR’s strategy is focused on six newly formed Research Impact Areas (RIAs):

  1. Energy;
  2. Industry;
  3. Built Environment;
  4. The Natural Environment;
  5. Defence and National Security; and
  6. Health.

As identified in the 2012/13 Budget, one of the initial flagship programme areas to implement the newly formed RIAs will be health and nutrition.(See 3 major Flagship focus below)  The focus of the CSIR feedback cover items specific to the Health RIA.

CSIR Flagship 2012 focus areas are

  1. Water Sustainability
  2. Safety and Security
  3. Health and Nutrition

Health Research Impact Area (RIA)

The vision of the CSIR is to be a leading provider of innovative technologies and solutions to support reducing the burden of disease, and the transformation of South Africa’s health care delivery system, in partnership with key stakeholders. Its mission is to apply multi-disciplinary innovation to the design of effective and efficient health care systems, and to develop preventive, diagnostic and treatment solutions to address the priority diseases in South Africa.

The CSIR interacted with key stakeholders and reviewed strategy documents from the Department of Health, Department of Science and Technology, the National Health Laboratory Service (NHLS) and the Medical Research Council (MRC) Burden of Disease Report. Reducing the Burden of Disease and Improving the Health Care System were identified as key intervention areas.

The top 12 Government overall outcomes required are:-

  1. Improved quality of basic education
  2. Effective public service & inclusive citizenship
  3. Create a better South Africa, Africa & World
  4. Protected environmental assets & natural resources
  5. Safety for South Africans
  6. Long & Healthy life for South Africans
  7. Effective Local Government System
  8. Sustainable human settlements
  9. Decent employment through inclusive economic growth
  10. A skilled and capable workforce
  11. Comprehensive & responsive economic infrastructure network
  12. Rural development and food security

The National Development Plan objectives are:-

  1.       Fighting corruption
  2.       Improving infrastructure
  3.       Transition to a low carbon economy
  4.       An inclusive and integrated rural community
  5.       Reversing the spatial effects of apartheid
  6.       Improving education, training and innovation
  7.       Quality Healthcare for all
  8.       Building safer communities
  9.       Reforming the public service
  10.       An economy that will create more jobs
  11.       Transforming society and uniting the country

Strategic Goals

Emerging from the interactions described above, the CSIR defined two strategic goals namely:

  1. Improvement of the health care system; and
  2. Reduction of the impact of the burden of disease of HIV and tuberculosis (TB) in South Africa and Malaria in the region.

Improvement of the health care system

To improve service delivery, the CSIR will apply supply chain management (SCM) analyses, whole systems engineering, logistics, information and communication technology (ICT), and infrastructure design.

Reduce the burden of disease

To reduce the burden of disease, the CSIR will be focusing on developing technologies and solutions for prevention, diagnostics and treatment of HIV, TB and Malaria as these contribute greatly to the burden of disease in the country. These are also focused on because these are viewed to be an area of competitive advantage for South Africa; as opposed to focusing on developing technology for addressing cancer, diabetes and cardiovascular conditions, which are heavily invested in, globally. However, it must be borne in mind that technologies developed would also be able to be used for cancer, diabetes and cardiovascular conditions.

In addition, the CSIR will also be involved in developing nutrition solutions for general wellness, building on indigenous knowledge and existing high throughput imaging, and drug discovery platforms amongst others.

To achieve its strategic goals the CSIR has identified potential flagship initiatives that will focus on the following

  • ICT for enterprise architecture;
  • ICT for electronic patient records;
  • Laboratory service delivery in support of the NHLS (incorporating ICT, logistics around management of medicines and medical supplies distribution, and point of care diagnostics);
  • Diagnostics (short/medium term);
  • Novel and affordable cures (medium to long term); and
  • Nutrition (short term).

Enabling technologies, facilities identified and areas of focus are:-

  • Materials
  • Sensors
  • Photonics
  • Robotics
  • ICT
  • Modeling
  • Research facilities

Information and communications technology (ICT)

  • Provides access to computers to improve ICT literacy and access to information; learn through experimentation by rural communities
  • Digital Doorway evolved into Digital Drum, cited by Time Magazine, as one of the top 50 inventions in the world for 2011

Highlights of CSIR Health Research

The CSIR has many highlights in the Health research sector. Some of these will be listed for information purposes:

  • Tuberculosis (TB)
    Use of nanotechnology to deliver drugs allows for the number and frequency of tablets to be reduced, making it easier for TB patients to complete the course of treatment. This is important, as current TB treatments require up to four tablets to be taken several times a week for up to nine months. This high pill burden has been identified as a reason for patients defaulting on their medication, making them susceptible to Multi-Drug Resistant (MDR) and Extreme Drug Resistant (XDR) TB, which are more difficult and more expensive to treat.
  • HIV and AIDS
    Use of genetically engineered bacteria to produce the peptide needed in making the antiretroviral (ARV) Enfuviritide. This treatment normally costs R19 300 per treatment cost per patient per month but if successfully completed this research will bring the cost of the ARV down significantly.
  • HIV and AIDS
    Use of miniature technology to develop affordable small devices to detect and monitor viral load. If this research is successfully completed it would reduce the burden of testing from already highly burdened laboratory services, also have the effect of giving doctors and patients immediate information and significantly reduce the costs associated with regularly testing viral loads, including electricity and transport costs.
  • Malaria
    Using synthetic chemistry for Malaria drug development for a drug resistant strain of Malaria. This is seen as a cost effective method for producing the Malaria drugs once completed.
  • Cancer
    Use of lasers via Photodynamic therapy (PDT) to treat skin cancer. This is where a drug is applied in the form of a cream to a skin tumour and thereafter a laser is applied. This is an innovation that has been approved in the United States of America (USA) and European countries, but not yet in South Africa.
  • Tuberculosis
    Use of innovative building design for the long-term accommodation of people with MDR and XDR TB to reduce cross-infection. This innovation has earned awards and recognition.
in addition to the above the following matters was reported on by the CSIR executive team at the Portfolio meeting on Health.
  • Umbiflow: Foetal Assessment System for Clinics
    1. Enables sick-small foetus diagnosis at the primary health care level: Save >3,000 babies p.a. Enables ten-fold reduction in referrals to secondary level
    2. Low cost, easy to use, PC/Tablet computer, previously only possible by specialists at secondary level
    3. System entering regulatory process for CE Mark during 2012
    4. “Mother & Child suite“ proposed: to include Foetal Heart Rate & Maternal BP
    5. Spin off application into a low cost, clinic based diagnostic system to screen population for cardio-vascular disease
  • Emerging health technologies: diagnostics
    1. Point of care diagnostic technologies
    2. Mobile diagnostic technologies e.g. tablet-based technology to measure full blood count
    3. Advantages include:
      • Lower capital investment and operational costs
      • Lower skilled personnel at point of care
      • Faster turn-around time on diagnostics(near real time)

it is clear that CSIR have a very focussed approach in regards to Research in the health sector. The sectoral focus is in the Public sector area and with a strong rural focus which is where the greatest need in South Africa is.

I trust you found this information useful and feedback is always appreciated. 

If there are any topics that interest you please let me know.

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