Die ontwikkeling van wetgewing vir die progressiewe verwesenliking van die reg op toegang tot voldoende voedsel, word as ʼn nasionale en internasionale doelwit bestempel. Artikel 27(2) van die Grondwet van die Republiek van Suid-Afrika, 1996 plaas ʼn mandaat op die Suid-Afrikaanse regering om redelike wetgewende en ander maatreëls te tref ten einde, binne sy beskikbare middele, die reg op toegang tot voldoende voedsel toenemend te verwesenlik. Die Verenigde Nasies se Food and Agricultural Organization stel ʼn drievlakstrategie vir die implementering van die reg op voedsel op nasionale wetgewende vlak voor, naamlik deur: grondwetlike erkenning, die implementering van ʼn voedselraamwerkwet en die hersiening van relevante sektorale wetgewing. Hierdie studie fokus op die laaste vlak van wetgewende voorsiening, naamlik die hersiening van sektorale wetgewing wat ʼn invloed het, of moontlik kan hê, op die verwesenliking van die reg op toegang tot voldoende voedsel. Die reg op toegang tot voldoende voedsel beskik oor multidimensionele, interdissiplinêre en kruissektorale eienskappe wat gevolglik verskeie sektore by die verwesenliking van die reg op toegang tot voldoende voedsel betrek. Die Food and Agricultural Organization is van mening dat die beoogde doelwit is om alle sektorale wetgewing wat moontlik ʼn invloed op die beskikbaarheid, stabiliteit, toeganklikheid en toereikendheid van voedsel kan uitoefen het, te identifiseer en te hersien aan die hand van ʼn voorgestelde hersieningsproses. Hierdie voorgestelde hersiening is gevolglik omvangryk en uiteenlopend en daarom word daar vir die doel van hierdie studie slegs op die hersiening van relevante omgewingsverwante wetgewing gefokus. Die Food and Agricultural Organization maak egter nie aanbevelings ten opsigte van die spesifieke aspekte wat in omgewingsverwante wetgewing vervat moet wees ten einde by te dra tot die toenemende verwesenliking van die reg op toegang tot voldoende voedsel nie (met ander woorde die aspekte waaraan omgewingsverwante wetgewing geëvalueer kan word). Daarom bevat hierdie studie saamgestelde hersieningsriglyne wat gebruik kan word by die hersiening van omgewingsverwante wetgewing. Die geselekteerde Suid-Afrikaanse wetgewing wat aan die Food and Agricultural Organization se hersieningsproses, asook die saamgestelde hersieningsriglyne in hierdie studie, onderwerp word, is: die Wet op Nasionale Omgewingsbestuur 107 van 1998; die Wet op die Bewaring van Landbouhulpbronne 43 van 1983 en die National Climate Change Response White Paper van 2011. / LLM (Environmental Law and Governance), North-West University, Potchefstroom Campus, 2015

Die ontwikkeling van wetgewing vir die progressiewe verwesenliking van die reg op toegang tot voldoende voedsel, word as ʼn nasionale en internasionale doelwit bestempel. Artikel 27(2) van die Grondwet van die Republiek van Suid-Afrika, 1996 plaas ʼn mandaat op die Suid-Afrikaanse regering om redelike wetgewende en ander maatreëls te tref ten einde, binne sy beskikbare middele, die reg op toegang tot voldoende voedsel toenemend te verwesenlik. Die Verenigde Nasies se Food and Agricultural Organization stel ʼn drievlakstrategie vir die implementering van die reg op voedsel op nasionale wetgewende vlak voor, naamlik deur: grondwetlike erkenning, die implementering van ʼn voedselraamwerkwet en die hersiening van relevante sektorale wetgewing. Hierdie studie fokus op die laaste vlak van wetgewende voorsiening, naamlik die hersiening van sektorale wetgewing wat ʼn invloed het, of moontlik kan hê, op die verwesenliking van die reg op toegang tot voldoende voedsel. Die reg op toegang tot voldoende voedsel beskik oor multidimensionele, interdissiplinêre en kruissektorale eienskappe wat gevolglik verskeie sektore by die verwesenliking van die reg op toegang tot voldoende voedsel betrek. Die Food and Agricultural Organization is van mening dat die beoogde doelwit is om alle sektorale wetgewing wat moontlik ʼn invloed op die beskikbaarheid, stabiliteit, toeganklikheid en toereikendheid van voedsel kan uitoefen het, te identifiseer en te hersien aan die hand van ʼn voorgestelde hersieningsproses. Hierdie voorgestelde hersiening is gevolglik omvangryk en uiteenlopend en daarom word daar vir die doel van hierdie studie slegs op die hersiening van relevante omgewingsverwante wetgewing gefokus. Die Food and Agricultural Organization maak egter nie aanbevelings ten opsigte van die spesifieke aspekte wat in omgewingsverwante wetgewing vervat moet wees ten einde by te dra tot die toenemende verwesenliking van die reg op toegang tot voldoende voedsel nie (met ander woorde die aspekte waaraan omgewingsverwante wetgewing geëvalueer kan word). Daarom bevat hierdie studie saamgestelde hersieningsriglyne wat gebruik kan word by die hersiening van omgewingsverwante wetgewing. Die geselekteerde Suid-Afrikaanse wetgewing wat aan die Food and Agricultural Organization se hersieningsproses, asook die saamgestelde hersieningsriglyne in hierdie studie, onderwerp word, is: die Wet op Nasionale Omgewingsbestuur 107 van 1998; die Wet op die Bewaring van Landbouhulpbronne 43 van 1983 en die National Climate Change Response White Paper van 2011. / LLM (Environmental Law and Governance), North-West University, Potchefstroom Campus, 2015

Biodiversity considerations form an essential component of Environmental Impact Assessment (EIA), especially in areas with both a high biodiversity value and development pressure such as the Cape Floristic Region (CFR) in South Africa. Limited research has been conducted within the South African context on the quality of biodiversity inputs to EIA. The aim of this research was to evaluate the quality of biodiversity input to EIA in the CFR. To address this aim, a customised review package was generated to evaluate the quality of 26 Biodiversity Impact Assessment (BIA) reports in the CFR. The results were then compared with international trends of biodiversity input to EIA in order to show how prevalent such trends are within an area with high biodiversity value. This comparison showed that the quality of biodiversity input to EIA in the CFR generally concur with inadequacies identified in international EIA literature. Typically, significant weaknesses identified during the review were the lack of public participation and an insufficient evaluation of alternatives. Specialists also failed to develop adequate monitoring programmes. Furthermore, a very pertinent limitation was that, in general, assessments are conducted during inappropriate seasons and over insufficient time periods. However, some variations to the international trends are also present within the Region. For example, a particular strength was that a precautionary approach was adopted by most of the specialists to avoid negative impacts on biodiversity. In addition, specialists did not merely focus on lower levels (species and habitats) of biodiversity, but incorporated ecological processes in assessment techniques. The inadequacies identified in this dissertation pose particular challenges for biodiversity management and conservation practices. The development and implementation of mechanisms such as Best Practice Guidelines and improved biodiversity related legislation is proposed to improve biodiversity input to EIA. / M Environmental Management, North-West University, Potchefstroom Campus, 2014

Biodiversity considerations form an essential component of Environmental Impact Assessment (EIA), especially in areas with both a high biodiversity value and development pressure such as the Cape Floristic Region (CFR) in South Africa. Limited research has been conducted within the South African context on the quality of biodiversity inputs to EIA. The aim of this research was to evaluate the quality of biodiversity input to EIA in the CFR. To address this aim, a customised review package was generated to evaluate the quality of 26 Biodiversity Impact Assessment (BIA) reports in the CFR. The results were then compared with international trends of biodiversity input to EIA in order to show how prevalent such trends are within an area with high biodiversity value. This comparison showed that the quality of biodiversity input to EIA in the CFR generally concur with inadequacies identified in international EIA literature. Typically, significant weaknesses identified during the review were the lack of public participation and an insufficient evaluation of alternatives. Specialists also failed to develop adequate monitoring programmes. Furthermore, a very pertinent limitation was that, in general, assessments are conducted during inappropriate seasons and over insufficient time periods. However, some variations to the international trends are also present within the Region. For example, a particular strength was that a precautionary approach was adopted by most of the specialists to avoid negative impacts on biodiversity. In addition, specialists did not merely focus on lower levels (species and habitats) of biodiversity, but incorporated ecological processes in assessment techniques. The inadequacies identified in this dissertation pose particular challenges for biodiversity management and conservation practices. The development and implementation of mechanisms such as Best Practice Guidelines and improved biodiversity related legislation is proposed to improve biodiversity input to EIA. / M Environmental Management, North-West University, Potchefstroom Campus, 2014

Text in Afrikaans / The Convention on the Rights of the Child was adopted by the United Nations General Assembly on 29 November 1989. Included in the inherent rights set out in the Convention is the right to the highest attainable standard of health. In implementing the Convention states parties must refer to the requirements of article 2 of the Convention, which places them under a duty to respect and ensure the rights in the Convention to each child. The term “respect” implies a duty of good faith to refrain from actions which would breach the Convention. The “duty to ensure”, however, requires states parties to take whatever measures are necessary in order to enable children to enjoy their rights. A state party must also review its legislation in order to ensure that domestic law is consistent with the Convention. South Africa showed commitment to protecting and promoting children’s health when it ratified the United Nations Convention on the Rights of the Child in 1995 and subsequently adopted the Constitution of the Republic of South Africa, 1996, which includes provisions guaranteeing the health rights of children. South Africa also showed commitment to give legislative effect to the protection and promotion of children’s health by reviewing the Health Act 63 of 1977 (reviewed as the National Health Act 61 of 2003) and the Child Care Act 74 of 1983 (reviewed as the Children’s Act 38 of 2005). The review of the Child Care Act 74 of 1983 revealed that the act is virtually silent on the issue of child health. This led to the decision to identify and evaluate existing policy and legislation, as well as pending relevant law reform and policy affecting child health in order to assess how well South African legislation addresses the issue. The research showed that although much legislation exists, none provides comprehensively for child health rights. The legislation that does exist contains obvious gaps. Most importantly, there is no reference to the core minimum requirements for the state in providing for the health of children, particularly in the way of health services and nutrition. Further, there is a complete lack of legislation which protects the health needs of disabled children. A comparative study was also undertaken. Legislation of India and Canada were evaluated in order to make recommendations as to how the gaps in South African legislation can be rectified. However, the research showed that South Africa has made far more significant progress in promoting a rightsbased approach to children’s health in legislation. In order to ensure that the health rights of children are protected and promoted, I propose more comprehensive legislative protection. / Private Law / LL.D.

The most frequent intervention performed by physicians is the writing of a prescription. Modern medicine has been remarkably effective in managing diseases. Medicines play a fundamental role in the effectiveness, efficiency and responsiveness of health care systems. However, health care expenditure is a great cause for concern and many nations around the world struggle to contain rising health care costs. Pharmaceutical benefit management programmes such as pharmacoeconomics, drug utilisation review (DUR) and disease management have emerged as control tools to ensure cost effective selection and use of medicine. These managed care instruments are often used to determine whether new strategies or interventions, such as the implementation of a managed medicine reference price list, are appropriate and have "value". The general objective of this study was to investigate the influences of the implementation of a managed medicine reference price list on the usage and cost of antibiotic medicine in the private health care sector of South Africa. The research design used in this study was retrospective, non-experimental and quantitative. The data used for the analysis were obtained over a two-year study period (1 May 2001 to 31 April 2003) from the central medicine claims database of Medschem&. Data was analysed according to prevalence, cost and original (innovator) or generic medicine items. For the purpose of this study antibiotics referred to beta-lactams (penicillins, cephalosporins and "others"), erythromycin and other macrolides, tetracyclines, sulphonamides and combinations, quinolones, chloramphenicol and aminoglycosides. The results of the empirical investigation showed the total number of medicine items claimed during the study period amounted to 49098736 medicine items having a total expenditure of R7150344897.00. There was a decrease in the prevalence of original (innovator) products during the two-year period. The prevalence of generic products increased from 25.87% to 32.47%. A total of 4092495 antibiotic medicine items were claimed with a total cost of R526309279.43 representing 7.36% (n = R7150344897.00) of all pharmaceutical products purchased during the two-year period. Original antibiotics had a prevalence of 42.32%, while generic antibiotics constituted 57.68% of all antibiotic products claimed (n = 4092495). However, original (innovator) products contributed 62.32% and generic products 37.68% to the total cost of all antibiotics claimed. It was concluded that the beta-lactam antibiotics represented 56.99% of all antibiotics claimed (n = 4092495) and contributed 52.51% to the total antibiotic expenditure (n = R526309279.43) for the two-year period. The average cost of beta-lactam items ranged between R112.88 * 69.95 and R122.18 + 81.42. The Medschema Price List (MPL) was implemented in May 2001. The aim of this reference pricing system was to allocate a ceiling price to a group of drugs, which are similar in terms of composition, clinical efficacy, safety and quality, with the ultimate goal to reduce medicine expenditure. During the year of implementation of the MPL 62.24% of beta-lactam antibiotics claimed (n = 1303464) were MPL listed. These products contributed 43.25% to the total cost of all beta-lactam antibiotics (n = R157142778.38). Medical aid companies reimbursed R61649211.86 for penicillins claimed and MPL listed. If all penicillin products were claimed at the ceiling price set by the MPL, a cost saving of 2.79% could have been achieved. Cost analysis indicated that it is possible to reduce health care costs by implementing strategies with the aim to reduce medicine cost. Further research, however, is necessary and in this regard recommendations for further research were formulated. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2005.

The most frequent intervention performed by physicians is the writing of a prescription. Modern medicine has been remarkably effective in managing diseases. Medicines play a fundamental role in the effectiveness, efficiency and responsiveness of health care systems. However, health care expenditure is a great cause for concern and many nations around the world struggle to contain rising health care costs. Pharmaceutical benefit management programmes such as pharmacoeconomics, drug utilisation review (DUR) and disease management have emerged as control tools to ensure cost effective selection and use of medicine. These managed care instruments are often used to determine whether new strategies or interventions, such as the implementation of a managed medicine reference price list, are appropriate and have "value". The general objective of this study was to investigate the influences of the implementation of a managed medicine reference price list on the usage and cost of antibiotic medicine in the private health care sector of South Africa. The research design used in this study was retrospective, non-experimental and quantitative. The data used for the analysis were obtained over a two-year study period (1 May 2001 to 31 April 2003) from the central medicine claims database of Medschem&. Data was analysed according to prevalence, cost and original (innovator) or generic medicine items. For the purpose of this study antibiotics referred to beta-lactams (penicillins, cephalosporins and "others"), erythromycin and other macrolides, tetracyclines, sulphonamides and combinations, quinolones, chloramphenicol and aminoglycosides. The results of the empirical investigation showed the total number of medicine items claimed during the study period amounted to 49098736 medicine items having a total expenditure of R7150344897.00. There was a decrease in the prevalence of original (innovator) products during the two-year period. The prevalence of generic products increased from 25.87% to 32.47%. A total of 4092495 antibiotic medicine items were claimed with a total cost of R526309279.43 representing 7.36% (n = R7150344897.00) of all pharmaceutical products purchased during the two-year period. Original antibiotics had a prevalence of 42.32%, while generic antibiotics constituted 57.68% of all antibiotic products claimed (n = 4092495). However, original (innovator) products contributed 62.32% and generic products 37.68% to the total cost of all antibiotics claimed. It was concluded that the beta-lactam antibiotics represented 56.99% of all antibiotics claimed (n = 4092495) and contributed 52.51% to the total antibiotic expenditure (n = R526309279.43) for the two-year period. The average cost of beta-lactam items ranged between R112.88 * 69.95 and R122.18 + 81.42. The Medschema Price List (MPL) was implemented in May 2001. The aim of this reference pricing system was to allocate a ceiling price to a group of drugs, which are similar in terms of composition, clinical efficacy, safety and quality, with the ultimate goal to reduce medicine expenditure. During the year of implementation of the MPL 62.24% of beta-lactam antibiotics claimed (n = 1303464) were MPL listed. These products contributed 43.25% to the total cost of all beta-lactam antibiotics (n = R157142778.38). Medical aid companies reimbursed R61649211.86 for penicillins claimed and MPL listed. If all penicillin products were claimed at the ceiling price set by the MPL, a cost saving of 2.79% could have been achieved. Cost analysis indicated that it is possible to reduce health care costs by implementing strategies with the aim to reduce medicine cost. Further research, however, is necessary and in this regard recommendations for further research were formulated. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2005.

Text in Afrikaans / The Convention on the Rights of the Child was adopted by the United Nations General Assembly on 29 November 1989. Included in the inherent rights set out in the Convention is the right to the highest attainable standard of health. In implementing the Convention states parties must refer to the requirements of article 2 of the Convention, which places them under a duty to respect and ensure the rights in the Convention to each child. The term “respect” implies a duty of good faith to refrain from actions which would breach the Convention. The “duty to ensure”, however, requires states parties to take whatever measures are necessary in order to enable children to enjoy their rights. A state party must also review its legislation in order to ensure that domestic law is consistent with the Convention. South Africa showed commitment to protecting and promoting children’s health when it ratified the United Nations Convention on the Rights of the Child in 1995 and subsequently adopted the Constitution of the Republic of South Africa, 1996, which includes provisions guaranteeing the health rights of children. South Africa also showed commitment to give legislative effect to the protection and promotion of children’s health by reviewing the Health Act 63 of 1977 (reviewed as the National Health Act 61 of 2003) and the Child Care Act 74 of 1983 (reviewed as the Children’s Act 38 of 2005). The review of the Child Care Act 74 of 1983 revealed that the act is virtually silent on the issue of child health. This led to the decision to identify and evaluate existing policy and legislation, as well as pending relevant law reform and policy affecting child health in order to assess how well South African legislation addresses the issue. The research showed that although much legislation exists, none provides comprehensively for child health rights. The legislation that does exist contains obvious gaps. Most importantly, there is no reference to the core minimum requirements for the state in providing for the health of children, particularly in the way of health services and nutrition. Further, there is a complete lack of legislation which protects the health needs of disabled children. A comparative study was also undertaken. Legislation of India and Canada were evaluated in order to make recommendations as to how the gaps in South African legislation can be rectified. However, the research showed that South Africa has made far more significant progress in promoting a rightsbased approach to children’s health in legislation. In order to ensure that the health rights of children are protected and promoted, I propose more comprehensive legislative protection. / Private Law / LL.D.