Govt outlines plans to tackle Aids
24 March 2003
Cabinet last week said the country had a plan to fight the life-threatening HIV-Aids disease in terms of prevention, treatment, care and support, in the context of development and poverty eradication.
"There is a plan, a comprehensive national strategy, based on the premise that HIV causes Aids," the Cabinet statement said.
Cabinet announced that the HIV-Aids budget (excluding allocations from provincial equitable shares) is set to increase ten-fold from R342-million in the 2001/2002 financial year to R3.6-billion in 2005/2006.
The Cabinet said conditional grants for HIV-Aids programmes to the provinces, including expanding voluntary HIV counselling and testing and the programme to prevent HIV transmission from mother to child, has been increased from R210-million in 2002/2003 to R334-million in 2003/2004.
The statement pointed out that prevention of infections was critical in the fight against the disease as there was as yet no
known cure for Aids, adding that surveys confirmed a high level of awareness among South Africans and the young in particular.
"The Khomanani campaign, with R98-million of government funds, is reinforcing this," added the statement.
Free condoms
As part of the concerted efforts to prevent the spread of HIV-Aids, government distributed 350 million free condoms in 2002. This number will increase to 400 million in 2003/2004.
The supply will be increased through non-traditional outlets - such as nightclubs, shebeens and spaza shops - and the number of sites where female condoms are available will be doubled (the number of such sites has already increased from 27 in 2000 to just over 200 in 2002).
Voluntary HIV counselling and testing is now available in nearly 1 000 public health sites, and more funds had been allocated.
By the end of 2002, voluntary HIV counselling and testing was available in 982 sites throughout the
country, including the sites of the programme to prevent HIV transmission from mother to child, said the statement, adding that there are plans to have voluntary HIV counselling and testing services available in 80% of public health facilities by the end of the 2003/2004 financial year.
"Most provinces are now extending this comprehensive package to more facilities, and at last count about 658 hospitals and clinics were providing the service," said the statement.
Provinces were also implementing the Constitutional Court ruling for all doctors working in public sector maternity services to offer Nevirapine to HIV-positive pregnant women, provided that adequate HIV testing and counselling facilities existed.
Voluntary counselling
By the end of December 2002, said Cabinet, over 101 202 women had visited the facilities attached to the 18 sites of the programme to prevent HIV transmission from mother to child, with 63 217 accepting
voluntary counselling and testing, 17 274 of whom tested HIV-positive.
"Nevirapine was dispensed, along with the package of support, to 10 043 women who accepted it and to 6 947 babies born to women in the programme."
Regarding care to rape survivors, Cabinet said the decision it took last April to offer antiretrovirals to survivors of sexual assault as part of a comprehensive package of support was being implemented.
The post-exposure prophylaxis programme includes counselling on the effectiveness and risks of using antiretroviralss for this purpose.
On treating opportunistic infections, Cabinet said public health facilities had a responsibility to offer treatment for opportunistic infections. "There can be no discrimination against anyone because of their HIV-status, and nobody should be sent away untreated.
"Treatment for TB is free and available in the public health sector. In additio, antibiotics such as Bactrim are available at innovative
joint HIV-Aids, TB management sites to prevent the onset of infection common in people infected with HIV," said the statement.
However, it said there was a need to detect cases much earlier, as currently many TB patients report this when the illness was at an advanced stage.
Lower drugs cost
Government was also working with pharmaceutical companies to lower the cost of drugs to treat such infections.
Government entered into the Diflucan Partnership Programme with Pfizer in 2000, to provide Diflucan, an anti-fungal, in the public health sector free of charge.
The drug is used to treat two of the most common opportunistic infections associated with HIV-Aids - cryptococcal meningitis and oesophageal candidiasis, which affect the brain and the oesophagus respectively.
The partnership has since been extended indefinitely. In the first two years of the partnership, 1.5 million doses of Diflucan were dispensed and 11 000
health workers trained in managing relevant conditions.
On strengthening the immune system to avert opportunistic infections, Cabinet said measures to alleviate poverty and improve nutrition were critically important to improve the quality of life of those infected with HIV or living with Aids.
Food security crucial
For this reason, government views its food security and poverty alleviation interventions as an intrinsic part of its response to HIV, Aids and TB.
"These include measures to counter the impact of high food prices, announced in October 2002, both short term and medium to long term, as well as a Department of Health programme to enhance the cultivation and use of more nutritional food."
It said close inter-sectoral co-operation would be pursued to ensure that such measures benefited families affected by HIV and Aids or TB, with a significant emphasis placed on improving nutrition in 2003, for South Africans in
general, as well as for people living with HIV-Aids more specifically.
To provide antiretrovirals to people infected with HIV, Cabinet said the team tasked with investigating resource implications of providing anti-Aids drugs to people living with the disease in the country, was about to complete its work.
In April last year, government established a joint technical task team comprising the health department and Treasury, to look into these issues, including comprehensive costs and benefits of various Aids treatment options.
Cabinet said it would consider the findings of the task team and any policy option that could have major costs ought to be thoroughly examined.
Source: BuaNews
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