Cardiac Rehabilitation

Member Login

National Monitoring in Public Health Nutrition
All newborns who have delayed passage of meconium associated with a suspicious contrast enema should have a suction biopsy of the rectal mucosa and submucosa. So as we can see, combating aging is not so complex. These infants require a colostomy before final corrective surgery. Having a life-long interest and passion for healing, and after dedicating my life to the study and practice of the healing arts, I have written this book on the single most significant discovery relating to health; the understanding of the function and effect of specific nutritional components in relation to cellular support and communication, disease prevention, disease recovery, and effective anti-aging. Management of excessive gingival display by esthetic crown lengthening Wound healing analysis in diabetics patients.

Navigation menu


Intense competition among alternative claims on the public revenues means that if we are to be able to continue to make a strong claim for spending on agriculture, we must be able to show that we seek and obtain value for money. We need to ensure not only that funds are used only for high priority purposes, but also that the most efficient ways are found to achieve our aims. Where we decide that the Government should fund a particular service, our approach will be to encourage the most cost-effective suppliers of that service, and we will be prepared to outsource service provision in a transparent manner to achieve this.

There can be no assumption that a public-sector organisation has a permanent monopoly of the role of service provider: The past few years have seen rapid change in the farming sector. It is very encouraging to see the dynamism and adaptability shown by so many in the sector; by new farmers who are taking up the challenge; by established commercial farmers who have responded rapidly to radical changes in the established order; by the private sector, large and small, which is undertaking new functions for new types of clients; and by staff of national and provincial agriculture departments who are closely involved in this process of change.

Much remains to be done to achieve this vision for agriculture. All participants in the sector have a shared task, and success will be to the great benefit of all citizens. This policy document provides a framework of credible and consistent policies, which allows us to move together towards the future with confidence.

The development of agriculture in South Africa is often viewed solely as the technical advance, in this century particularly, of large-scale commercial farming specialising in crop and animal production according to the prevailing natural resources and climatic conditions, and taking advantage of both abundant low-cost labour and opportunities for mechanisation. The proponents of this view believe that agriculture can only contribute to the economy through a concentrated production structure such as the one currently existing.

Accordingly, they believe that smaller and medium-scale agriculture, based upon diversified production, family labour and lower technologies, has little to offer in terms of aggregate production and incomes from farming. Yet the current dominance of the modern large-scale and technically successful farming model must be seen in the context of a century of policy measures which seriously distorted agricultural development in South Africa.

This dominant model has some undeniable advantages, but in a country with high unemployment and food insecurity, it has serious limitations. In future, both efficiency and equity will call for a much greater diversity of farm sizes and technology in the sector, with large-scale commercial farming coexisting with small and medium-scale production.

In the latter part of the nineteenth century, African family farming successfully responded to the increased demand for agricultural products from the new mining towns and the major towns of the English colony of Natal. African owner-operated or tenant farming proved to be at least as efficient as large-scale settler farming based on hired labour. African farmers adopted new agricultural technologies, entered new industries and competed successfully.

In fact, white farmers argued that because of labour shortages, they could not compete with their African counterparts who had lower costs. Competition from black transporters of agricultural produce was also deemed unfair by white transporters. Critical to this African success was the unwillingness of the Government to intervene in markets, and the implicit support for African farming from land companies and big landowners who earned rents from African tenant farmers.

The aim was to create surplus labour for the mines and the white agricultural sector. At a stroke, it also eliminated competition from black farmers. At about this time, white farmers also started receiving substantial support in the form of subsidies, grants and other aid for fencing, dams, houses, veterinary and horticultural advice, as well as subsidised rail rates, special credit facilities and tax relief.

The Masters and Servants Acts of and , designed to increase the supply of cheap labour, further worsened the plight of farm workers who were prohibited from breaking contracts or changing employers.

Over the following half a century, the support system for white farmers was steadily strengthened. Over 80 Acts of Parliament were passed rendering assistance to the commercial farming sector, particularly in marketing.

In the s the Agricultural Credit Board ACB was established to give loans to farmers who were no longer found adequately creditworthy by commercial institutions. Infrastructure was built, strong support services were established and assistance was provided through the Land Bank for the acquisition of land for farming by whites.

The white commercial agricultural sector responded positively, with substantial output increases. Farmers were protected from foreign competition, subsidies continued, and producer prices, which were largely controlled, were frequently above world-market levels.

Although these policies encouraged technical advance and increased production, they also had high social, economic and environmental costs. Foremost among these was high capital-intensive production in the presence of widespread unemployment.

Favourable tax treatment of capital equipment, combined with negative real interest rates, encouraged overmechanisation and the shedding of labour. Further, it led to expansion into environmentally fragile areas. Guaranteed maize prices led to large stretches of marginal land in South Africa being planted to the crop, leading to costly programmes in the s to induce farmers to switch from maize to other products.

Until about , the total number of farm employees in South Africa steadily increased, but the impact of favourable credit and tax policies encouraged the substitution of labour by capital. Meanwhile, in the homelands, pressure on arable and grazing land continued to increase. The system of supports and subsidies of the period became increasingly burdensome to a Government already constrained by international financial sanctions and disinvestment.

From the s, there was an erosion in direct Government support to agriculture, which accelerated in the s with the removal of the barriers between black and white farmers and the creation of a less dependent and more market-driven agricultural sector. A great deal has already been accomplished over the past few years in eliminating the inefficiencies that have characterised large parts of the sector, in particular the inequality and insecurity in landownership and the distortions in price and other signals to the sector.

As a result of decades of dispossession and racist land laws, land distribution in South Africa is among the most highly skewed in the world, with large capital-intensive farms dominating much of the rural areas. In the face of this, the Government has introduced a market-based land redistribution programme, which provides grants and technical assistance to the landless poor. Several mechanisms have been used to date to enable prospective purchasers to acquire land - from direct purchase to a variety of equity schemes.

The Government has also introduced a programme of tenure reform which aims to bring all people occupying land under a validated system of landholding. The Government has also initiated a programme of restitution of land, which involves returning or otherwise compensating victims of land lost since June because of racially discriminatory laws.

Legislation was also recently approved to protect vulnerable occupiers of land which the occupiers do not not own , including farm workers. The Extension of Security of Tenure Act addresses the relationship between occupiers and owners, as well as the circumstances under which evictions are permissible, and the procedures to be followed.

Formerly controlled markets have been radically deregulated. It also provides for the collection of levies in very exceptional cases where proposals for their utilisation need to be fully justified in terms of improved market access, the promotion of marketing efficiencies, the optimisation of export earnings, and the enhancement of the viability of the agricultural sector.

By early , all control boards had ceased operation, and their assets were transferred to industry trusts which will provide services such as market information, export advice, and product development. Price controls were removed and single-channel markets disappeared with the abolition of control boards.

As a result, many new small, medium and large-scale enterprises have entered the domestic and export markets which offer good prospects for future job creation and marketing services to new farmers. A futures and options market in agricultural commodities has been established since and is playing a central role in price stabilisation. A shift in relative prices has led to a marked increase in the production of crops for export, especially fruit and vegetables and, to a lesser extent, animal production.

Finally, South Africa now ranks with countries such as New Zealand and Australia which have the lowest levels of market distortions. This enables the country to face future reforms to world markets with confidence, and places it in a good position to apply pressure for further reforms through such fora as the Cairns Group which South Africa recently joined.

The Government has taken a number of measures to restructure rural financial markets with the objective of building, from the bottom up, a system of financial services that provides much broader access for all. Simultaneously, as part of wider macro-economic reforms, subsidies on interest rates have been removed. The Strauss Commission, who examined all aspects of rural finance, made recommendations for further improvements to rural financial markets including a new role for the Land Bank, which is now being implemented.

The ACB, which provided cheap credit to large farmers and support through rollovers of loans to highly indebted farmers, has now ceased its operations. The tax treatment for agriculture has been amended so that, for example, capital purchases can now only be written off over three years rather than in one year as in the past. This reduces the implicit subsidy for capital equipment and is intended to favour job creation. The National Department of Agriculture NDA has taken steps to eliminate funding of many activities such as subsidies for fencing, the installation of irrigation facilities and the establishment of on-farm infrastructure.

The Government has also altered its policies on drought relief. In the past, policies tended to weaken farmers' inclination to adopt risk-coping strategies, with a consequent reliance on high-value, high-risk monocultures. In future, drought will be recognised as a normal phenomenon and farmers will be encouraged to adopt low-risk technologies, rather than plant drought-susceptible crops and maintain inappropriately high numbers of livestock in areas prone to drought. Against this background, the challenge is to establish policies which will ensure that agriculture contributes to the national economic policy objectives articulated in the RDP, and now encapsulated in the Growth, Employment and Redistribution GEAR strategy.

The purpose of agricultural policy reforms, articulated in the Foreword and in 1. Two points need to be made. Firstly, agriculture's contribution to the overall economy is much greater than is suggested by the quoted figures of its share in the GDP.

A closer examination of agriculture's role, especially during droughts or periods of exceptionally favourable rainfall, suggests that its contribution is more complex. This is a very high figure for a sector which is apparently playing a relatively small role in the economy. Agriculture's strong indirect role in the economy is a function of backward and forward linkages to other sectors.

Its purchase of goods such as fertilisers, chemicals and implements forms backward linkages with the manufacturing sector while forward linkages are formed through the supply of raw materials to industry. These linkages augment the sector's contribution to the GDP. Secondly, international comparisons suggest that the decline in agriculture's apparent share in the GDP has been more dramatic than is warranted by South Africa's level of development.

This has been due to inappropriate policies that have inhibited small scale black agriculture from contributing to total output. There is thus the possibility that agricultural output could be increased if this resource could be fully harnessed.

In terms of export earnings, agriculture contributes about R10 billion annually. Agriculture is therefore a crucial sector and an important engine of growth for the rest of the economy. Moreover, its potential for further growth is substantial because the results of past policy distortions are being addressed.

In particular, the recent growth in the production of poultry which has overtaken red meat , eggs, fruit and vegetables is an indication of the success of policy reforms, and in all of these products the labour requirements suggest advantages to small scale producers if capital and market access constraints can be overcome.

Thus the promotion of productive small and medium-scale producers, coexisting with large-scale producers, would help realise potential, while contributing to the Government's objectives of black empowerment, poverty elimination and a reduction in inequalities. While past policy has contributed to rural impoverishment, new policies will create the opportunity for reforms which will enable agriculture to make a much larger contribution to poverty alleviation and enhanced national and household food security in future.

An estimated 16 million South Africans are living in poverty, with its incidence highest in rural areas and among female-headed households. The rural concentration of poverty should not detract attention from urban poverty.

The point is, however, that poverty in rural areas is associated with agricultural policies which persistently marginalised small scale black farmers as their access to resources such as land, credit and technical know-how was curtailed. Food insecurity, defined as a lack of access to adequate, safe and nutritious food, is closely associated with poverty.

It can ultimately only be addressed as part of a broader attack on poverty, which will include direct employment, income and welfare measures. Emphasis will therefore be placed on food security at household level. Programmes will be examined in terms of their direct as well as indirect contribution to household food security through their impact on rural incomes and the distribution of those incomes. Increasing the production of small scale farmers will improve the availability and nutritional content of food, and hence food security generally among the poor.

A large proportion of the rural black population consists of women, and those of a working age, in particular, outnumber men. With the incidence of poverty highest in female-headed households, all programmes will be examined to ensure that women at least have equal access and that programmes are targeted at them. However, to determine policy priorities to address poverty and food insecurity, and to assess the role that agriculture can play in the national effort, it is necessary to understand how people in rural areas create livelihoods.

Poor rural households combine their resources in a variety of ways to enable them to maintain a minimum living standard. These livelihood strategies include agricultural production, off-farm wage labour, small and micro-enterprise activities, claims against the state e.

Poor people have few opportunities for economic activity. The central challenge for agriculture in poverty alleviation and food security for the rural population is therefore to contribute to improved livelihoods and employment. One of the encouraging developments in recent years has been the growth in support for home gardens, especially in peri-urban and urban areas, where small plots, of vegetables in particular, can contribute significantly to both livelihoods and nutritional standards.

The involvement of NGOs and sponsorship of the private sector are welcomed by the Government. However, much more needs to be done, especially among the poor in rural areas, to stimulate home gardening. Extension services have a major role to play in promoting production and, at the same time, encouraging suppliers of seed, tools and production requirements to devote more attention to this currently neglected section of the economy.

The contribution that own production can make to alleviating rural poverty is restricted, however, by factors such as the availabilty of land, the difficulties of obtaining water, or a lack of family labour. Employment opportunities therefore remain the most critical issue for many rural households. Formal agriculture provides employment including seasonal and contract employment for about 1 million farm workers, albeit often at very low incomes.

In addition, the smallholder sector provides full or part-time employment for at least a further 1 million households. Thus some 2 million households derive some or all of their income from agriculture. Furthermore, while farming is an important direct source of employment in the economy, these figures underestimate its significance, as they ignore the employment effects of agriculture's linkages with the rest of the economy.

For example, agro-processing and the food industry generally are major sources of employment. Generally, the number of jobs created per unit of investment is higher in agriculture compared to other sectors. This implies that growth in agricultural output overall has a greater impact on employment creation.

Yet in recent years, South Africa has witnessed a decline in full-time agricultural employment. Current legislation to improve security in employment has not yet created the desired improvement in labour relations and employers' investment in labour skills which, in due course, are expected to raise employment levels in agriculture.

The concept of small scale agriculture in South Africa is laden with subjectivity and has been associated with non-productive and non-commercially viable agriculture.

In recent years, some effort has been made to find a socio-economically accurate definition of a small scale farmer that was relevant to South Africa. An appropriate definition would then enable the Government to make black farmers the target of various support measures that would improve their access to resources, thus redressing the inequities created by past apartheid policies.

The question is whether a precise definition of small scale farmers is required. The reality faced by small scale black farmers is recognised. In general, most black farmers, whether small scale or not, have limited access to land and capital, and have received inadequate or inappropriate research and extension support.

This has resulted in chronically low standards of living and reliance to a greater or lesser extent on subsistence production. To achieve the Government's objectives of black empowerment and poverty alleviation, policy must address problems faced by black farmers in general and resource-poor farmers in particular.

Furthermore, increasing productivity in small scale agriculture will have significant broader economic benefits. Sustained and significant growth in employment and livelihoods in agriculture is unlikely to be achieved from formal wage employment alone.

The rate and extent of development in a more diversified farm sector, but especially in small scale agriculture, will determine such growth. There is considerable international evidence of the efficiency and labour intensity of small-farm agriculture in a wide variety of agro-ecological circumstances.

While this may not necessarily apply in all parts of South Africa, small scale farming generally means that labour is substituted for machines. Therefore production outlays that would have been allocated to paying interest, loan repayment and depreciation costs on machinery, are instead paid as wages to labour, or earned as self-employment incomes by family farmers.

In addition, small-farmers tend to make crop choices different from those made by large farmers. In particular, they tend to allocate more of their land to staple foods, vegetables, and drought-resistant crops that are less risky and also more labour intensive than the monocrop agriculture favoured on large farms.

Small-farmers, on international evidence, also tend to use their land productively for larger parts of the year than large-scale farmers. In particular, small-farmers' access to family labour often encourages them to make year-round use of available irrigation water.

Finally, small-farm production is indirectly labour creating as well, because it results in income flows to low-income rural dwellers who tend to purchase services, building materials and consumer goods from local small scale rural services and industries. South Africa has been meeting its food consumption requirements with domestic production for most items in most years. Projections show that the growing population, increases in income levels, and changes in preferences will lead to an increased demand for food, particularly for wheat, dairy products and meat, with a slower growth in demand for maize.

In aggregate, together with regional and international markets, this gives a buoyant picture of demand for the sector, with major opportunities for producers. The Government's approach is to promote comparative advantage and the efficient use of productive resources, encouraging the development of regional and international trading links, for exports as well as imports, as required.

Regarding food imports, South Africa's port facilities for the bulk handling of grains are adequate for the country's presently envisaged import requirements. However, the capacity is not without limitations especially when the SADC's requirements have to be met. These will, however, be partly met through developments to other ports in the region.

The economies of the region are mostly dominated by agriculture. Growth in agriculture, fostered by the move toward a free trade area and by internal market reforms in South Africa and in some of our neighbours, will serve to broaden and support trade and economic development in the region. The role of the Government in agriculture is to create an enabling environment for the development of the sector in such a way that the overall economic, social and environmental objectives described above can be achieved.

There are three aspects to this approach:. The role of the Government in regulating the market and determining agricultural product prices has been greatly reduced, which clearly enhances the competitiveness and efficiency of the sector.

However, failures still occur in the ways in which some markets operate, which affect small scale farmers in particular, and their access to production requirements and credit as well as to markets for their produce. The direct subsidisation of the costs of farm inputs and of loans will not be Government policy.

Such subsidies have distorting effects and cannot provide a basis for sustainable incomes from farming. Only in exceptional cases will the Government consider providing financial support to farmers. In such cases assistance will be provided to fulfil clearly defined objectives, will be carefully targeted and will have time limits.

For example, selective support to encourage new investments in agriculture among land reform beneficiaries and other small scale producers could be considered. In short, the Government will intervene where a public good can be achieved by its actions, which would not be achieved by decisions taken by the private sector and individual farmers. The Government itself will undertake only those activities for which it has the expertise and resources, to provide a better quality service than could be provided by contracting out.

Even in areas of strategic importance, consideration will always be given to outsourcing if it is most cost effective to do so, and if the quality and reliability of the function is not compromised by purchasing it from sources outside the Government.

In supporting agriculture, the Government is keenly aware of the contribution that the sector as a whole can make to enhance the effectiveness of its support. Partnerships will be sought with input suppliers, cooperatives and other farmer organisations, commodity organisations, financial institutions and others in seeking mechanisms to support policy objectives. The trusts established after the closure of the control boards are a particularly important form of partnership to promote market access and encourage new entrants to particular commodity production.

The Government will also encourage the development of different forms of farmer organisations and, where appropriate, the development of private suppliers, and assist these in providing the services which their members require from the Government. This can result, for instance, from: The effects of market failures may include, among others: In such cases of market failure, Government may intervene in several ways including: The Government will also seek to strengthen the efficiency of service provision by targeting those most in need of support, principally the resource-poor and emerging farmers.

Where Government-funded services are to be delivered, the Government will look for the most efficient service provider, whether public, private, NGOs or farmers' own organisations. Where a good case can be made out for outsourcing services, this will be done. In addition, it is the Government's intention to apply the principle of user payment to those who can afford to pay for publicly provided services and where the costs of collection can be justified by the likely revenues.

In future, the Government will only provide free services if there is a convincing argument for doing so. It will seek to recover at least part of the costs of activities such as meat inspection or soil testing that benefit individual producers.

The Government's intention is to ensure that agriculture is able to contribute to achieving national economic and social objectives, as described above. The strategy is therefore to reform policy to achieve three strategic aims. This will be achieved by continuing the process of market deregulation while assisting farmers to address some of the challenges of a deregulated environment section 2.

It also involves negotiating reductions in protectionist measures in trade policies as well as taking steps to encourage export competitiveness section 2.

Efficiency objectives also require new approaches, on the part of the Government, in assisting farmers to cope with risks, such as drought, inherent in agriculture section 2. This will be achieved by initiatives in six areas.

Steps will be taken to strengthen the agricultural research system to make it more responsive to a wider range of farmers section 3. Agricultural conservation policy will mainly focus on water, land use and biodiversity. Regarding water, new approaches to irrigation development and management, designed to ensure more efficient use of water in agriculture and its more equitable distribution, will be adopted section 4.

With regard to land, the policy is to design measures which will contribute to the sustainable use of agricultural natural resources, while recognising that the responsibility for such use lies with farmers and their communities.

Specific steps will be taken to initiate a national land care programme section 4. In respect of the conservation of plant and animal species and the protection of endangered ecosystems, the principal emphasis will be upon meeting internationally agreed standards and commitments and translating these into national programmes section 4.

Since , the Government has put considerable effort into the revision of agricultural marketing policy. The reason for this is that efficient, flexible and accessible agricultural markets are central to achieving its objectives of creating jobs and generating incomes, contributing to foreign exchange earnings, providing a spatial balance between rural and urban areas, providing food for all at affordable prices, and strengthening linkages with the industry.

Furthermore, at that time the marketing system was characterised by high levels of state control, concentrated ownership by a small number of vested economic and political interests, and the exclusion of black people and those farming on a smaller scale.

Aside from this, the system was widely criticised for giving only weak incentives for economic efficiency. Overall, it was not compatible with the principles of the RDP and GEAR, nor was it compatible with the agricultural sector the Government envisages in this paper. The reforms are now nearly complete in that the Government has created a new framework for the activities of all players in the market. What is now needed is a sustained effort by private-sector individuals, companies and farmer organisations, backed by the Government, to take advantage of the new opportunities for market development.

The changes have been based on the recognition that a market-orientated agricultural sector will be more dynamic and efficient, as it will give space for increased participation by new types of farmer, and will become internationally competitive. Agriculture's contribution to the GDP and employment growth will be maximised, the marketing margins between producers and consumers will be minimised, and the scope for cross-subsidisation of producers by consumers will be limited to explicit and visible policy instruments such as tariffs.

The Government is confident that the private sector, including cooperatives and other farmer organisations will, with encouragement from the Government, be better able to undertake the functions that the control boards previously carried out.

This will open up many opportunities for new entrants in trading, processing and transport in rural areas. The Act, which came into effect in January , is based on the view that state intervention in agricultural markets should be the exception rather than the rule.

The Act does provide for a certain number of limited interventions, which include the collection of levies, the conducting of pools, the keeping of records and returns, export controls and compulsory registration. However, when any intervention is proposed, it must be demonstrated that one or more of the aims of the Act will be promoted without food security or employment being affected negatively.

By early , the control boards dealing with maize, sorghum, oilseeds, wool, meat, wheat, cotton, mohair, lucerne, citrus, deciduous fruit, dried fruit, milk and canned fruit had all been closed except for residual legal and technical functions. The response to these changes has been very encouraging. After a period of uncertainty which many in the sector understandably found unsettling, there is clear all-round determination to make the new arrangements work and to take advantage of the opportunities they create.

The following are some of the recent developments: As a result of deregulation, a futures market in agricultural commodities was established by the private sector to provide producers, processors and traders with a means to manage their price risk. The evidence of its success has been the very rapid growth during the same year of the volume of trade in maize futures, the introduction of maize options and wheat futures, and proposals to extend the facility to other commodities.

This, together with other innovations to provide depth and stability to the new marketing dispensations, is fully in line with the Government's strategy for the sector.

Commodity-specific trusts have been established with the assets vested in former control boards. The aims of these trusts vary in detail, but there is a firm expectation on the Government's part that they will provide effective support for research, information services, improved market access for new entrants into the sector, export advice and product development.

The trusts, which consist of Government appointees and different stakeholders and hold funds on behalf of industries, will largely obviate the need for additional levies. However, in exceptional circumstances, trusts may apply to the Minister for the right to raise levies to supplement their income.

Approval for any levies will depend in part on the trusts' record of effectiveness in fulfilling their mandate. As the control boards have closed, so their former agents, the cooperatives, have experienced increasing competition.

While many cooperatives have responded successfully and are increasing their turnover, others have not, as farmers have bypassed their pools and dealt directly with processors and traders, the number of which has grown. Farmers are increasingly erecting on-farm storage facilities to take advantage of seasonal price differences, although the actual capacity of these facilities is still modest.

Growing competition is also evident in fruit exports, where until very recently new exporters had been allowed only a limited share of overseas markets. Now, however, many trading operations are gearing up to provide farmers with alternatives to the established exporters. Overall, the present arrangements provide a clear and consistent framework within which producers, processors and consumers can act and invest with confidence. However, there are still concerns that call for close monitoring and possible actions by the Government.

The South African economy in general can be described as highly concentrated, both horizontally and vertically, particularly at those points of agricultural commodity chains that interfaced with control boards and their marketing arrangements. As the marketing arrangements for various commodities become less regulated, there is a danger that the potential benefits of deregulation may be counteracted by market concentrations that were nurtured by the control-board system.

The Government will, therefore, monitor the impact of market concentration on the efficient performance of deregulated agricultural markets. Where problems are identified, the Government will have the option of utilising competition legislation under the DTI, or taking sector-specific initiatives. One area of concern could be the bulk storage and handling of grains and oilseeds.

Between the mids and the mids, a bulk storage infrastructure with highly concentrated ownership, particularly at local level, was built up as an integral part of the statutory marketing systems for grains and oilseeds. At present, as the markets for grains and oilseeds adjust to deregulation, the market for bulk storage and handling appears to be working reasonably well. This is particularly true of the market in silo receipts, which allows access to the storage capacity to a wide range of producers and processors.

However, it is important for the efficient and equitable working of the market that bulk silo facilities owned and operated by cooperatives and former cooperatives be made available to all potential customers farmer members, farmer shareholders, other farmers, traders and processors on the same terms.

Concentrated ownership of bulk silos should not become a means for controlling or manipulating one or more of the physical grain markets by, for example, pricing access to silo infrastructure in general, and tradable silo receipts in particular, in a discriminatory or oligopolistic manner.

Input and output prices are now, and will continue to be, determined by market forces, and the Government will not intervene directly to influence them. Producers, processors and consumers are expected to take their own measures to manage price risk. The exception would be where the Government may use tariffs to provide a reasonable level of protection to domestic producers. This issue is discussed in section 2. The Government may also take action when this is necessary to ensure price competition in a situation where one or more market players are abusing a monopoly position.

One of the main reasons for promoting greater flexibility and diversity in the marketing system is that it will become better able to provide the types of market services needed by new entrants into agriculture. The Government is confident that over time this will prove to be the case, especially to the extent that rural areas will be well served by transport infrastructure that will permit the low-cost and reliable movement of freight.

In some parts of the country, such infrastructure will be one of the main determinants of the adequacy of market facilities. Nevertheless, there will still be real and perceived cases where new entrants to agriculture will be faced with problems of market access. It is important to understand the real nature of the problem in order to determine whether a response by the Government is appropriate and, if so, what form it should take.

Problems of market access arise when producers, or groups of producers, face high transaction costs as a result of missing or incomplete markets. Thus, given the established market prices for commodities that they produce, or would like to produce, the resultant net farm-gate price makes production of that commodity an unviable proposition.

When the problem is broken down to its constituent parts, it becomes clear that market access problems arise from one or more of a very long list of difficulties faced by the farmer. Transaction costs impact on three factors that can contribute to viability: A low net farm-gate price may be the result of, inter alia , excessive per unit costs in getting the product to the market.

These costs may result from low volumes, long distances, poor infrastructure, poor quality, marketing at the wrong time perhaps because of a lack of information or credit , distance to the closest processor, or poor contacts. Input costs may be high because of difficulties in accessing credit, the distance from the source of farm inputs, poor infrastructure physical and trading , or the use of production systems which are unduly reliant on off-farm inputs.

In their turn, input costs affect the rate at which farmers adopt new technologies, and hence the yields they achieve. It follows that different root causes of market access and profitability problems may justify different responses by the Government. The Government may facilitate the development of alternative institutions that will break down barriers to participation. It may also reduce transaction costs through the provision of infrastructure, information, training and research.

The danger is that because the symptom is often quoted as the problem, efforts may be concentrated on the treatment of that symptom, rather than on confronting the root causes. If the underlying causes are ignored, it will be difficult to distinguish between situations where Government assistance is justified, and where not. The implication is that market access is a problem where generalisation is unhelpful. Market information is crucial to the proper functioning of any market. It promotes efficient arbitrage between markets, which is to the benefit of both consumers and producers, and the efficient allocation of productive resources.

It improves the bargaining power of producers when dealing with traders and processors, and it reduces transaction costs by reducing risks. In a deregulated market, certain types of market information will be adequately and reliably provided by the private sector. However, where there is no obvious reliable source of price information, the Government will take steps to give assistance.

For example, information concerning utilisation, imports and exports of agricultural commodities used to be readily available from control boards. Where the closure of boards has left an information gap, new initiatives have been launched, such as the South African Grain Information Service SAGIS which collects figures on the consumption, importation and exportation of maize, winter grains, sorghum and oilseeds.

Applications are being made in terms of the appropriate sections of the Marketing of Agricultural Products Act to oblige those who store, trade and process such commodities to submit the appropriate information on a monthly basis. Funding of SAGIS, and similar initiatives for other commodities, is likely to be reliant primarily on allocations from the various grain and oilseeds trusts, and secondarily on levies. The Government recognises the importance of these initiatives for the efficient and transparent functioning of the market.

Other information that is of particular importance with regard to the operation of the market relates to domestic production, and consumption, imports and exports by month. The National Crop Estimates Committee, coordinated by the Department of Agriculture, is responsible for estimates of area, by province, planted to a particular crop and for regularly updated estimates of the expected crop size by province.

It is very important that information on crop estimates should not only be objective and unbiased, but should also be perceived to be such. The Government will ensure that the composition and operations of the National Crop Estimates Committee enhance its reputation for accurate and objective estimates.

The Government will also put in place additional mechanisms to report on the commodities where existing arrangements for the collection and reporting of market information are inadequate. The Government recognises that one of the legacies of apartheid policies is missing or incomplete markets in areas where black farmers are located. This results from, among other things, unequal access to marketing information. Furthermore, international experience, obtained particularly from structural adjustment lessons, shows that adherence to the market, without paying attention to the constraints smaller farmers face, can lead to these farmers being further marginalised and income disparities being accentuated.

Government policies are addressing the marketing information problem for small and medium-scale farmers in a number of ways. The Government believes that deregulation of agricultural markets will go a long way to improve small and medium-scale farmers' access to marketing information. As the policy environment becomes conducive to small scale production, and when these farmers are less excluded from existing marketing arrangements, it is likely that traders will provide more information to farmers to stimulate the volume of their trade.

Institutional innovation involving producer and trader organisations, such as cooperatives, will also contribute to providing information. The Government's role will be to help build capacity in these organisations to enable them to meet the needs of their members see section 3.

More specifically, the Government will ensure that appropriate institutional arrangements are in place for collecting, analysing and disseminating information to small and medium-scale farmers. The focus will be on information enabling farmers to make better decisions regarding what to produce, when to harvest and sell and where to sell. This will include information on:. In order to ensure that the Government's role and responsibilities in relation to market access and market information are most effectively organised and properly resourced, new initiatives and procedures and their organisational and resource implications are being investigated.

The extension services will also be expected to play a significant role in disseminating such information. The envisaged reorientation of extension workers will include training in advising farmers on marketing their commodities, and helping farmers to understand marketing costs and margins. Agriculture in South Africa is emerging from a history of protection and subsidisation described in section 1 which affected the structure, efficiency and competitiveness of the sector.

Our strategy for achieving our set objectives of making agriculture more efficient, creating jobs and opportunities and using resources sustainably, is based on an outward-looking approach. In this approach the global village is seen not only as a market for output, but as a tool for effecting efficiency by exposing our producers to international competition.

The objectives of the agricultural trade policy are to enhance and maintain market access for agricultural products and ensure that the sector contributes to its full potential to the export growth target aspired to in GEAR. Agricultural exports are critical to the achievement of this target since their contribution to total export earnings is substantial. The potential for export growth in this sector exceeds the targets set in GEAR.

The agricultural trade policy vision applies to the whole of South African agriculture, which includes diverse producers and agro-industries. For the purpose of this policy, agriculture includes primary agricultural products and agro-industrial products. The Government's vision is to increase market access for the country's agricultural products, and to see an increase in the supply of highly competitive South African agricultural goods in international and domestic markets.

This will ensure that agriculture makes an optimal contribution to economic growth, food security and job creation, and contributes substantially to the reduction of income disparities. To achieve this vision, policy must create an environment in which the sector can exploit comparative and competitive advantages and be highly competitive at regional and international level. This will require effective use of the World Trade Organization WTO framework to eliminate market access barriers set up against South African agricultural exports, and to protect local agricultural industries against unfair trade practices.

In the context of this policy paper, static comparative advantage is defined by broad national resource endowment, including soil, climate and water. Dynamic comparative advantage is based on infrastructure, skills and technological innovations built through a policy regime. On the other hand, competitive advantage is based on individual entrepreneurial ability to capitalise on the existing static and dynamic comparative advantage.

Within the agricultural sector, the main objective of trade policy reform is to sustain the integration of the sector in the global economy in order to encourage internal and external competition and allow greater access to markets, technology and capital for South African agriculture. Effective participation in the WTO to press for global reforms of agricultural trade is critical to the achievement of agricultural trade policy objectives.

To achieve this, the Government will pursue the following strategic objectives: The Government will continue to work to ensure that market access barriers are minimised and, where possible, removed effectively and timeously. South African producers must be protected against unfair trade practices on the part of their competitors. Hence tariffs will be the main instrument for protecting the agricultural sector against unfair competition.

The Government will address these issues by means of three policy instruments, namely trade diplomacy, tariff policy and export promotion. The global trend now is to engage in trade diplomacy to secure improved and equitable market access.

Trade negotiations have increasingly become an important tool for opening up markets for South African agricultural products. Thus trade diplomacy is an integral part of agricultural policy designed to promote competition and efficiency. In the period since April , South Africa has been granted a number of nonreciprocal trade concessions by developed countries and regions. These concessions, though welcome, are of minor significance.

Market access impediments can only be resolved through continuing substantive negotiations. Future negotiations will take place within the following framework: This will influence the SACU agreement currently being renegotiated and any bilateral agreements with countries in the region.

The Government will seek other agreements on agriculture, where benefits are expected to be high. This includes agreements with regional organisations such as Mercosur or the Indian Ocean Rim. Trade diplomacy involves reciprocal obligations.

While seeking improved access to foreign markets for its producers, South Africa will also be required to offer concessions in terms of improved access to its market. Firstly, agriculture will have to play a significant role in prioritising sought-after partners where negotiated agreements will be necessary. Secondly, complex trade negotiations demand a clear understanding of the interests of the agricultural sector so that appropriate tradeoffs are agreed to.

There is a need for a detailed analysis of the threats facing South African producers from international competition and of the impediments to their participation in the global market place. South Africa's membership of the WTO offers both opportunities and constraints.

The Agreement on Agriculture defines commitments for the sector, to be implemented in equal annual instalments over a six-year period starting in These commitments relate to export subsidies, domestic support, and market access. Each member's specific commitments are contained in country schedules appended to the Marrakech Agreement.

South Africa's commitments are summarised in Box 2. South Africa's total export subsidy outlay commitment in was R million which must be reduced to R million by the year With the termination of the General Export Incentive Scheme in July , export subsidies are now zero. In value terms, domestic support commitment was R2. The commitments for and were met.

Anterior teeth were less affected by enamel fluorosis than were posterior teeth. This finding also was reported in the NIDR survey 71 and has been attributed to cohort effects, attrition, or a combination of the smaller anatomical surface and longer formation time of posterior teeth compared with anterior teeth 18, Further research also is needed to improve public health surveillance of fluoride exposure.

The difficulties observed in comparing data from the NIDR and NHANES surveys and the time lapse between exposure and clinical presentation suggest the need for new and more timely methods to measure total fluoride exposure. Methods such as fingernail analysis and urinary fluoride excretion have shown promise, but only with limited samples.

Research in these areas could result in the development of valid and reliable techniques to monitor total fluoride exposure in children, allowing adjustment in public health practice and recommendations to reduce the cosmetic consequences of fluoride exposure while preventing and controlling dental caries.

Epidemiologic data from Australia indicate that targeting reduction in discretionary intake of supplements and toothpaste can reduce the prevalence of enamel fluorosis Information is not available to evaluate the effects of these changes in the United States after they were implemented in the early s. Increased efforts are needed to disseminate published recommendations about appropriate use of fluoride to health professionals and the public.

This report documents improvements in the oral health of the civilian, U. The report documented important differences in disease prevalence and severity by sociodemographic characteristics that public health officers, the dental profession, and the community should consider in implementing interventions to prevent and control disease and to reduce the disparities observed.

The following is a list of seven important findings in this report:. The authors thank former members of the U. Dushanka Kleinman and Dr. We would also like to thank Dr. Finally, our thanks to Dr.

Mean number of decayed and filled surfaces in primary teeth Sum of individual dfs values divided by the population. MT Number of missing permanent teeth due to caries or periodontal disease does not count teeth extracted for reasons other than caries or periodontal disease. FT Number of filled permanent teeth teeth with carious lesions decayed teeth that have been restored.

Missing teeth are excluded because in adults, some missing teeth may have been lost due to reasons other than caries, including periodontal diseases and extracted for prosthetic reasons. DS Number of decayed surfaces in permanent teeth.

MS Number of missing tooth surfaces due to caries or periodontal disease does not count surfaces of teeth extracted for reasons other than caries or periodontal disease. FS Number of filled surfaces in permanent teeth carious surfacesdecayedthat have been restored. Missing surfaces are excluded because in adults, some missing teeth might have been lost because of reasons other than caries, including periodontal diseases and extracted for prosthetic reasons.

Mean number of decayed, missing due to disease , and filled surfaces in permanent teeth Sum of individual DMFS values divided by the population.

Mean number of decayed, missing due to disease , and filled teeth Sum of individual DMFT values divided by the population. Dental fluorosis See enamel fluorosis. Dental sealants Also called pit-and-fissure sealants, these are thin plastic coatings that are applied to pits and fissures in teeth to prevent decay. Dentate Having one or more natural permanent tooth present in the mouth excluding third molars.

Edentulous Having no natural permanent teeth in the mouth excluding third molars. Also called complete tooth loss or edentulism.

Enamel fluorosis A hypomineralization of enamel, characterized by greater surface and subsurface porosity than normal enamel caused by fluoride ingestion during periods of tooth development first 6 years of life for most permanent teeth. FPL Federal poverty level. Federal poverty thresholds are defined by the U. Census Bureau based on family income and size of family. A series of surveys fielded by the National Center for Health Statistics.

Root caries Tooth decay in the tooth root that it is exposed to the oral environment because of gum recession this part of the tooth that is normally below the gums in a healthy mouth. Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.

Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. This conversion may have resulted in character translation or format errors in the HTML version.

An original paper copy of this issue can be obtained from the Superintendent of Documents, U. Contact GPO for current prices. Reliability of Examinations Dental examiners were calibrated periodically by the survey's reference dental examiner. Diagnostic Criteria A list of terms and abbreviations is included to facilitate the reading and interpretation of the diagnostic criteria and results. Discussion Dental Caries Dental caries and tooth loss were among the most common causes for rejection of young men from military service during the Civil War and the two World Wars Dental Sealants Dental sealants are highly effective in preventing dental caries that occur on the surfaces of teeth that have pits and fissures.

Tooth Retention and Edentulism The findings in this report indicate that the prevalence of tooth loss continues to decline in the United States and provides further evidence that edentulism is not inevitable with advanced age. Enamel Fluorosis Enamel fluorosis is a hypomineralization of enamel, characterized by greater surface and subsurface porosity than normal enamel, and is related to fluoride ingestion during periods of tooth development by young children 55 first 6 years of life for most permanent teeth.

Conclusions This report documents improvements in the oral health of the civilian, U. The following is a list of seven important findings in this report: The decline in the prevalence and severity of dental caries in permanent teeth, reported in previous national surveys, continued during and It has benefited children, adolescents, and adults. A notable proportion of untreated tooth decay was observed across all age groups and sociodemographic characteristics.

No reductions were observed in the prevalence and severity of dental caries in primary teeth. The use of dental sealants among children and adolescents increased substantially.

This increase was probably the result of both public and private efforts and denotes a continuing interest in using dental sealants for the prevention of tooth decay. Older adults are retaining more of their teeth and fewer are losing all their teeth. Prevalence of enamel fluorosis has increased in cohorts born since This increase should be evaluated in the context of total fluoride exposure.

Recommendations for Public Health Action Appropriate public health interventions to prevent dental caries should extend to all age groups and sociodemographic categories. Factors related to the lack of reduction of dental caries in primary teeth need to be studied. Programs designed to promote oral health e.

Timely surveillance tools are needed to monitor fluoride exposure from multiple sources. Acknowledgments The authors thank former members of the U. A coefficient of agreement for nominal scales. Educ Psychol Meas ; Percent agreement, Pearson's correlation and kappa as measures of inter-examiner reliability. J Dent Res ;5: J Dent Res in press. Criteria for diagnosis of dental caries.

American Dental Association; Studies on dental caries: Dental status and dental needs of elementary school children. Public Health Rep ; A measurement of dental caries prevalence and treatment service for deciduous teeth.

J Dent Res ; Coronal caries in the primary and permanent dentition of children and adolescents years of age: Coronal and root caries in the dentition of adults in the United States, The prevalence of dental sealants in the US population: Tooth retention and tooth loss in the permanent dentition of adults: The investigation of physiological effects by the epidemiological method. Fluoride and dental health. American Association for the Advancement of Science; The differential diagnosis of fluoride and non-fluoride enamel opacities.

Oral health of United States children. The national survey of dental caries in U. National and regional findings. US Public Health Service; National Health and Nutrition Examination Survey, Age adjustment using the projected U.

National Center for Health Statistics; Healthy People Statistics Notes. Schenker N, Gentleman JF. On judging the significance of differences by examining the overlap between confidence intervals. Prevalence and trends in enamel fluorosis in the United States from the s and s. J Am Dent Assoc ; Oral health status in the United States: J Dent Edu ; Decayed, missing, and filled teeth in adults, United States, Decayed, missing, and filled teeth among children, United States.

HSM , Series 11, No. Decayed, missing, and filled teeth among youths years, United States. HRA , Series 11, No. The prevalence of dental caries in United States children, Oral health of United States adults. The national survey of oral health in U.

The future of the caries decline. J Public Health Dent ; Trends in caries prevalence in North American children. Int Dent J ;44 4 Suppl 1: Caries prevalence in the United Kingdom. Trends in dental care among insured Americans: Estimating rates of new root caries in older adults. Oral health in America: Relationship between smoking and dental status in , , , and year-old individuals. J Clin Periodontol ; Tobacco use and oral disease. J Dent Educ ; Ten-year cross-sectional and incidence study of coronal and root caries and some related factors in elderly Swedish individuals.

National Institutes of Health. Consensus development conference statement on dental sealants in the prevention of tooth decay. Factors influencing the effectiveness of sealantsa meta analysis. Community Dent Oral Epidemiol ; Task Force on Community Preventive Services. Recommendations on selected interventions to prevent dental caries, oral and pharyngeal cancers, and sport-related craniofacial injuries.

Am J Prev Med ;23 1 Suppl: Comparing the costs of three sealant delivery strategies. Impact of targeted, school-based dental sealant programs in reducing racial and economic disparities in sealant prevalence among schoolchildrenOhio, Measuring oral health and quality of life. Risk factors for total tooth loss in the United States; longitudinal analysis of national data. Surveillance for use of preventive health-care services by older adults, Public health and aging: The impact of edentulousness on food and nutrient intake.

The impact of oral health on stated ability of eat certain food; findings from the National Diet and Nutrition Survey of Older People in Great Britain. Intake of non-starch polysaccharide dietary intake in edentulous and dentate persons: Br Dent J ; How dentition status and masticatory function affect nutrient intake. The impact of dental status on diet, nutrition and nutritional status in U. University of London; The relationship among dental status, nutrient intake, and nutritional status in older people.

Association of edentulism and diet and nutrition in US adults. The relationship between oral health status and body mass index among older people: Shortened dental arches and oral function. J Oral Rehab ;8: Agerberg G, Carlsson GE. Chewing ability in relation to dental and general health: Acta Odont Scand ; An oral health strategy for England. Department of Health; The nature and mechanisms of dental fluorosis in man.

Risk of enamel fluorosis associated with fluoride supplementation, infant formula, and fluoride dentifrice use. Am J Epidemiol ; Use of fluoride supplementation by children living in fluoridated communities. Risk factors for enamel fluorosis in a fluoridated population. Risk factors for enamel fluorosis in a nonfluoridated population.

Risk factors for enamel fluorosis in optimally fluoridated children born after the US manufacturers' decision to reduce the fluoride concentration of infant formula. Fluorosis risk from early exposure to fluoride toothpaste. Trends in childhood use of dental care products containing fluoride: Advance data from vital and health statistics. Factors associated with the use of fluoride supplements and fluoride dentifrice by infants and toddlers. Fluorides and dental caries. Findings from the dental care supplement of the National Health Interview Survey, J Am Dental Assoc ; Recommendations for using fluoride to prevent and control dental caries in the United States.

Dental fluorosis in Grand Rapids during the seventeenth year of fluoridation. Community water fluoride levels, preschool dietary patterns, and the occurrence of fluoride enamel opacities. Describing the severity of mottling in a community: Fluoride exposure and dental fluorosis in Newsburgh and Kingston, New York: Esthetically objectionable fluorosis attributed to water fluoridation.

Nail and bone surface as biomarkers for acute fluoride exposure in rats. J Analytical Toxicol ; Fingernails and toenails as biomarkers of subchronic exposure to fluoride from dentifrice in 2- and 3-year-old children. Monitoring of renal fluoride excretion in community preventive programmes on oral health.

World Health Organization; Urinary fluoride excretion by children years old in a south Texas community. Pan Am J Public Health ;7: Urinary fluoride excretion in Jamaica in relation to fluoridated salt. Dental fluorosis decline after changes to supplement and toothpaste regimes.

Terms and Abbreviations Used in the Report Caries experience. Having decayed, missing, or filled teeth or tooth surfaces because of caries. A dental caries lesion that has passed the stage of remineralization and progressed to loss of tissue integrity, forming a cavity. Decayed, missing, or filled surfaces located in the part of the tooth that is normally above the gum line.

A disease manifested by loss of the mineral content of the tooth hard tissues demineralization. Dental caries is the disease that causes tooth decay. Prevalence of caries experience in permanent teeth. Proportion of population with one or more decayed, missing, or filled permanent tooth surfaces DMFS. Prevalence of caries experience in primary teeth. Proportion of the population with one or more decayed or filled primary tooth surfaces dfs.

By definition and calculation, this is equal to the proportion with one or more decayed or filled primary teeth dft. Prevalence of untreated tooth decay in permanent tooth. Proportion of the population with one or more permanent tooth surfaces with untreated decay DS.

By definition and calculation, this is equal to the proportion with one teeth or more decayed permanent teeth DT. Prevalence of untreated tooth decay in primary teeth. Proportion of the population with one or more decayed surfaces in primary teeth ds. By definition and calculation, this is equal to the proportion with one or more decayed primary teeth dt.

Measures for primary teeth are denoted with lower case letters; measures for permanent teeth are denoted with upper case letters.