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Health Promotion and Development Fund

Health Promotion and Development Fund. Presentation to Select Committee for Social Development 28 July 2015 Aadielah Diedericks Savera Kalideen. Every day, every week…. Disease leads to Poverty. SA government…. Income revenue

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Health Promotion and Development Fund

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  1. Health Promotion and Development Fund Presentation to Select Committee for Social Development 28 July 2015 Aadielah Diedericks Savera Kalideen

  2. Every day, every week…

  3. Disease leads to Poverty

  4. SA government… • Income revenue • from alcohol excise tax vs Expenditure on alcohol related harm R16billion R17billion (direct costs) • R38 billion (direct and indirect costs, MRC, 2012)

  5. South African statistics

  6. South African Statistics…

  7. Alcohol consumption statistics… • Youth • 2011 SA Youth Risk Behaviour Survey (MRC)  – representative survey of school going youth, grades 8-11 • 37% of male learners report past 30 day drinking, 28% for female learners • 30% of male learners report past month binge drinking (5 drinks or more), 20% for female learners • 16% of male learners drink before age 13, 9% for female learners

  8. Alcohol consumption Statistics… • Adults • 2009 National AIDS Survey (Shisana, et al) - 15 years and up (sample of15 845) • 41.5% of males report past 30 day drinking, 17.10% for females • 17.10% of males report past month binge drinking (5 drinks or more), 3.8% for females • 16.4% of males drink harmful/hazardous levels , 2.9% for females

  9. Challenge … Individual vs Population

  10. Population health status and national spending on health Conventional health care. (99% of health budget) Health Promotion/prevention (1% of health budget)

  11. What is health promotion? Health Promotion - “the process of enabling people to increase control over, and to improve, their health”. Health = Personal choices + environment Giving people skills and creating supportive environments to impact positively on health.

  12. Health promotion seeks to make: “the healthy choice the easy choice & the unhealthy choice the more difficult choice.” We do not want to take choice away from people only to tip the scale in favour of healthy choices.

  13. Individual vs Population • HP involves the population as a whole rather than just people at risk of disease. • Teach individuals to boil drinking water vs Providing clean water supply to community

  14. Causes of Major Disease Burden 1. Unsafe sex (AIDS) -Behavioral 2. Tobacco - Complex issue 3. Alcohol - -Many factors 4. High blood pressure -No vaccine 5. Road traffic accident -No curative 6. Nutrition drug

  15. Determinants of Drug use The level of drug use in society depends upon: Affordability Availability Social acceptability

  16. Interventions needed…

  17. What is a health promotion and development foundation? • independent, implementing agency • identify strategic national health and development priorities • coordinate interventions across sectors • commission and fund relevant research and translate knowledge into accessible information • build societal capacity to promote health and development • lobby for appropriate public policies • fund, implement and support evidence based interventions • Dedicate resources

  18. Other countries • Thailand • Australia • Malaysia • Singapore • Mongolia • Switzerland

  19. Thailand experience • ThaiHealth established in 2001 through Act of parliament • Funded by 2% surcharge on alcohol and tobacco • Governing board chaired by the Prime Minister • Boards appointed by cabinet • Report to parliament annually

  20. ‘Surcharge’ for ThaiHealth 2% (OfExcise Tax) Surcharge levy 100% Excise Tax Excise Dept. Tobacco Industry & Alcohol Industry ThaiHealth VicHealth 1987-1997 : Increase tax by 5% dedicated to VicHealth

  21. Thai Health Impact • 1.6 million ex-smokers in 2000 increasing to 6.3 m in 2009 • 12% drop in drinkers from 2004 to 2007 • 31% drop in traffic accidents between 2004 to 2009 • 10% drop in number of deaths through road accidents

  22. VicHealth Australia • Established through Act of parliament • First 10 years, funded through tobacco tax • Presently included in annual government budget • 30% of resources earmarked for sport development (removes challenge of sponsorship) • Focus beyond health – domestic violence, mental health, racism, social connectedness

  23. Why impose excise taxes? To provide the State with a constant stream of revenue To influence consumer behavior & discourage harmful consumption: • health (tobacco products, alcohol)   • the environment (plastic bags, carbon tax)

  24. The benefits of raising excise taxes • Higher excise taxes on tobacco and alcohol will ⬇︎Reduce consumption (volume used) ⬇︎Reduce the number of users (prevalence); and ⬆︎Increase government revenues.

  25. Regional experience… • Botswana • 40% Alcohol levy has generated funds utelised for youth and sport development, skills development, gender programming • Generated p1.441billion from 2008 to June 2014 • Zimbabwe • Tobabcco tax is used to fund HIV and AIDS programmes

  26. SA success thus far… Tobacco • Banning public smoking • Banning advertising • Increased tax on tobacco products

  27. South Africa 1993 -2009 *Values adjusted for inflation#Billion

  28. New Possibilities … • TAX HARM for GOOD. • It is WIN-WIN-WIN. • A win for health and development. A win for the Treasury, and A win for communities. • What could SA achieve if the taxes on alcohol and tobacco products were increased with 2% and earmarked for health promotion and development?

  29. New possibilities… • Generate +R500million annually, dedicated to alcohol and tobacco harm reduction and prevention • Sports sponsorship – reduce visibility of products • Create jobs - more trained personnel in communities to enforce and monitor • Create infrastructure – safe homes for women and children • Ultimately… • Reduce deaths • Reduce injuries • Reduce dependence • Provide alternative recreation and jobs

  30. Economic argument in favour of a HPDF • Alcohol and Tobacco manufacturing in SA is extremely profitable. • The profit margins on tobacco products are very high - about 68% compared to only 15-20% for other consumer goods. • In 2014, BAT’s adjusted profits in South Africa were about R9 bn. • SABMiller reported$3.557m global profit after tax for 2014/2015, with earnings from SA $4.352m • Smoking and alcohol imposes enormous costs on society (treatment, lost productivity, regulatory). • It is therefore fair to make the alcohol and tobacco industry pay these costs. • Research shows that the public support a levy on alcohol and tobacco to be used for health promotion. • As citizens, public health researchers and professionals, we ask you to support us in promoting better health for all South Africans.

  31. Not Every day, not every week…

  32. Colin chabane health promotion development fund??? • The choice is ours! • Thank you…

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