1. Introduction

The UDM commits itself to protecting and promoting the constitutional right of all South Africans to basic health care, and providing proper and immediate responses to the major health risks facing the country.

2. Major health priorities

The UDM proposes that Primary Health Care and HIV/AIDS should be elevated as the two major priorities, recognising that in these two areas the current government is failing to protect the constitutional rights of all South Africans.

2.1. Primary health care
Currently the poor are still disadvantaged with regard to their access to, and the quality of, Primary health care they receive.

Infrastructure and services need to get closer to the poor. It remains a sad fact of daily life for many South Africans that they have to travel huge distances to the nearest clinic or hospital.

The UDM commits itself to health care that is linked to other social cluster portfolios, recognising the role of social welfare, water and sanitation, basic life skills and awareness to improve the basic health of the nation. In this greater context the UDM believes that housing is pivotal, recognising that all the fundamental human needs culminate in an adequate place of shelter. The UDM has proposed in its Public Works, Housing and Economic policies, a major initiative to create productive and safe environments, through Planned Sustainable Development programmes. The aim is to assist the people and communities of South Africa to improve their quality of life.

2.1.1. Health Infrastructure and services must improve.
• The quality of the buildings and their maintenance are often below standard. Hygiene at many clinics is at unacceptable levels, and must be addressed immediately. The UDM proposes in its Public Works policy that job creation can be achieved through infrastructure maintenance and development. This will be achieved with Planned Sustainable Development programmes. The provision of quality health facilities will be a priority of these programmes.
• The provision and stocking of medicine at many clinics and hospitals fall far short of the basic requirements. The current spread of infrastructure and services prevent medicine from reaching people in rural areas. The UDM proposes that a five year moratorium be placed on current regulations preventing doctors in rural areas from stocking medicine and that other measures be actively pursued to ensure that medicine reaches those who require it.
• The current number of clinics and hospitals must be expanded and facilities upgraded to deal with the massive increase in demand due to HIV/AIDS.
• Staff for Primary Health care facilities must be qualified and trained to give quality service to all South Africans.
2.1.2. Proper and functioning referral mechanisms have to be put in place.
It is vital that patients in need of specialised care be identified early and referred quickly to institutions capable to deal with their needs. This measure must aim to prevent long queues and inadequate treatment, or the practice of referring patients to institutions incapable of assisting them.

2.2. Dealing with HIV/AIDS

2.2.1. Develop a National Plan of Action to deal with HIV/AIDS.
The absence of a clear and coordinated national plan to deal with HIV/AIDS is a dangerous situation. A National Plan of Action must be developed as a matter of urgency to bind together and commit all sectors of society – individually and collectively – to deal with HIV/AIDS in a responsible and caring manner.
2.2.2. Everyone must play a part.
The role of each and every South African must be highlighted in all the activities falling under the auspices of the National Plan of Action. It is vital that every South African understands that the disease exists and that its transmission can be prevented.
2.2.3. HIV causes AIDS
It is vital that all South Africans acknowledge that HIV causes AIDS, until science disproves this. We cannot dither, delay and have policy debates, hoping that science will disprove it while millions die. It is equally important that each South African understands that HIV/AIDS is transmitted primarily through sex.
2.2.4. Education and Awareness
The above make it absolutely imperative that Education and Awareness regarding HIV/AIDS is enhanced and kept at high levels until the pandemic has been beaten. Education and Awareness must specifically be aimed at addressing the fact that young girls and women are particularly vulnerable, due to biological reasons and sexual relations (often coerced) with older men. The Awareness of HIV/AIDS must permeate South African society, acknowledging that stigmas, intolerance and discrimination are democratically unacceptable and morally wrong.
2.2.5. Funding must be made available for credible research
The National Plan of Action to deal with HIV/AIDS must set aside adequate funding for credible research into treatments and vaccines for HIV/AIDS.
2.2.6. Surveillance system
Government and all sectors of society must combine their efforts to create a Surveillance system to gather relevant statistics on HIV/AIDS and to monitor the effectiveness of responses implemented under the National Plan of Action

2.2.7. Make HIV/AIDS a notifiable disease
Making HIV/AIDS a notifiable disease is the only way to design and accurately and timeously implement a National Plan of Action to deal with HIV/AIDS. The decision to make HIV/AIDS notifiable must be guided by the firm and entrenched principle that confidentiality will be protected. This is not an impossible task since South Africans already trust both government and business to keep their private information confidential. Making HIV/AIDS notifiable will in the end help to break the mindset behind stigmatisation. This will mean that all Education and Awareness campaigns under the auspices of the National Plan of Action will emphasise tolerance towards people living with HIV/AIDS.
2.2.8. Preparing for the economic and social impact of HIV/AIDS
Government, business and labour must collectively prepare for the massive impact on economic growth and productivity, as well as the social impact of HIV/AIDS such as orphans, child-led households and declining life expectancy. The different and inter-related effects of HIV/AIDS on the various sectors of society must be analysed and integrated solutions implemented under the National Plan of Action.
2.2.9. Providing support
The Primary Health care system must be developed to ensure that it can provide the necessary medical and counselling support to all people living with HIV/AIDS. The equitable and widespread provision of drug treatments that prevent transmission, extend the lives or enhance the quality of life of people living with HIV/AIDS, must become a high priority. The building and staffing of HIV/AIDS hospices may become necessary. The cost of these measures outweighs the future economic and social cost of HIV/AIDS.

3. Additional health priorities

3.1. Better control over the budget. The UDM believes that the budget, excluding a response to HIV/AIDS, is sufficient, but that not enough value for the money is being achieved. Allocated money must be spent on the services it was intended for. No “savings” on budgets, or rollovers will be tolerated. The principle that will be applied to accounting officers will be that under-spending is worse than over-spending.
3.2. Diseases such as TB, Cholera and Malaria are preventable and can be treated. The Primary Health care system must be adapted to be responsive to the major diseases threatening the South African population.
3.3. Nutritional issues and family planning must form a basic part of primary health care, recognising that basic counselling and skills development in these areas, will have a major impact on the general health and well being of communities.
3.4. The department of health must be part of an integrated response to Alcohol and Drug Abuse recognising that substance abuse plays a major role in violence, death and social disruption in South Africa.
3.5. Private health care must be encouraged, since it provides to those who can afford it quality service. In this regard traditional healing remains popular, but needs to regulated. The UDM proposes that mechanisms be investigated to regulate and monitor this sector of health care provision and to ensure that exploitation does not occur.
3.6. Government must continue to be co-responsible for the training of medical professionals to ensure that high standards are kept. Within this context the length of time required to qualify, as a health professional, must be reassessed, taking into due consideration the cost to the state and the student, as well as the additional time spent on community service. Community service remains a necessary measure to address the health needs of South Africa. It plays a vital role in preparing students for the health realities that they will face after receiving their qualifications.