REPUBLIC OF SOUTH AFRICA COMBINED SECOND PERIODIC REPORT UNDER THE AFRICAN CHARTER ON HUMAN AND PEOPLE`S RIGHTS and INITIAL REPORT UNDER THE PROTOCOL TO THE AFRICAN CHARTER ON THE RIGHTS OF WOMEN IN AFRICA 282. The National Health Laboratory Service is the largest pathology service in South Africa. It has 265 laboratories, serving 80% of South Africans. The labs provide diagnostic services as well as health-related research. 283. The doctor-to-population ratio is estimated to be 0.77 per 1 000. But the vast majority of general practitioners – 73% – work in the private sector. In response, the Department of Health has introduced clinical health associates, midlevel health-care providers, to work in underserved rural areas. About 1 200 medical students graduate annually. In some communities, medical students provide health services at clinics under supervision. Newly graduating doctors and pharmacists complete a year of compulsory community service in understaffed hospitals and clinics. To ensure sufficient availability of adequately trained, appropriately skilled, suitably placed, highly motivated and properly remunerated health care providers, the Department of Health launched the Human Resource for Health Strategy in October 2011. One of the strategic objectives is to ensure that rural areas have equitable access to health care providers – which in turn means providing patients living in rural and remote areas with good quality HIV and AIDS treatment. The Department sends about 80 students annually to Cuba to train as medical practitioners, as part of implementing this strategy. Government has also made it easier for other foreign doctors to register in South Africa. Legislative measures to ensure better health care 284. The National Health Act, 2003169 provides a framework for a single health system for South Africa. The Act provides for a number of basic health care rights, including the right to emergency treatment and the right to participate in decisions regarding one's health. 285. Other legislation relating to health care, passed in the period under review, include laws which aim to ensure that all health establishments comply with minimum standards through an independent entity,170 make medicines and pharmaceuticals more affordable and provide for transparency in the pricing of medicines,171 to limit smoking in public places, create public awareness of the health risks of tobacco by requiring certain information on packaging, and prohibit the sale of tobacco products to anyone younger than 18.172 286. Other legislation provides for the introduction of mandatory community service for nurses,173 and introduces a process to develop and redesign mental health services so as to grant basic rights to people with mental illnesses.174 Other important developments in health care policy and legislation include the Traditional Health Practitioners Act, 2004175 169 Act No. 61 of 2003 National Health Amendment Bill, 2010 171 Medicines and Related Substances Amendment Act, 2002, (Act No. 59 of 2002) 172 Tobacco Products Control Amendment Act, 2007 (Act No. 23 of 2007). 173 Nursing Act, 2005 (Act No. 33 of 2005) 174 Mental Health Care Act, 2002 (Act No. 17 of 2002) 175 Act No. 35 of 2004 170 82