Health institute bill ‘too narrow’
The draft National Public Health Institute of SA bill needs to monitor environmental and workplace safety as ‘thousands of workers are injured’ in SA every day
The head of the National Institutes of Occupational Health (NIOH) has urged legislators to widen the scope of the draft National Public Health Institute of SA (Naphisa) Bill to include provisions for monitoring environmental health and workplace safety.
"Every day, thousands of workers are injured, many unrecognised. Yet they contribute to the public health burden facing SA," NIOH executive director Sophia Kisting told Parliament’s portfolio committee on health.
Kisting said environmental pollution by industry could affect communities for years to come, and showed MPs photographs of a schoolyard littered with blue asbestos to drive home her point. Children who had played in the yard were at risk of developing the cancer mesothelioma later in life, she said.
The committee is holding public hearings on the draft bill, which was released for comment in December 2015. The legislation paves the way for the creation of Naphisa, which will co-ordinate disease and injury surveillance and research. It is modelled on the US Centres for Disease Control and Prevention, and is expected to improve the government’s ability respond to disease outbreaks.
The Medical Research Council (MRC) said it supported the bill, but warned against duplicating the research capacity it already had
The draft bill says that Naphisa have five divisions dealing with communicable diseases, non-communicable diseases, occupational health, cancer surveillance, and injury and violence prevention. It proposes phasing in the institution over four years. Kisting said environmental health and safety should be included with occupational health.
"Environmental health in this context refers to risks to the health of communities arising from industrial activities, or where the home and workplace intersect, such as spray painting in backyards causing asthma, or women burning coal for home industries developing silicosis," she said. "The inclusion of environmental health and safety as a consequence of work-related activities will enhance … prevention and decrease the burden of disease."
The Medical Research Council (MRC) said it supported the bill, but warned against duplicating the research capacity it already had. "It is imperative to ensure complementary structures and activities harness the limited resources and skills in SA," said MRC national manager Nkosinathi Bhuka. The draft Bill should be amended to allow the MRC representation on the Naphisa board, and set up funding mechanisms to support collaborative research, he said.
The Cancer Association of South Africa (Cansa) used the public hearings to raise its concerns about the state of SA’s cancer registry. Cansa health specialist Michael Herbst said the registry was out of date and of limited use because it only contained laboratory-confirmed cancer cases.
A better cancer surveillance system would be a valuable tool in understanding the disease and improving cancer therapy and patient survival, he said. The committee chairperson Lindelwa Dunjwa expressed sympathy for the issues Herbst raised, but as they were outside the scope of the public hearings on the draft legislation, she suggested he return for a separate discussion about the cancer registry at a later date.