South Africa ups tempo in HIV fight
A comprehensive report on how the country is going about the war against the killer disease has been made public. The government expenditure on Aids/HIV has increased substantially over the years, growing from R30 million in 1994 to over R3 billion in 2005/06. In the report to the previous United Nations (UN) General Assembly Special Session on Aids (UNGASS), the UN Secretary General Kofu Anon commended South Africa for tripling its resource allocation for hl and Aids programs since the adoption of the UN Declaration in 2001. The World Health Organization’s progress report on the progress on treatment of Aids released last year noted that: “South Africa has committed US$1 billion over the next three years to scaling up antiretroviral (ARV) treatment, by far the largest budget allocation of any low- or middle-income country.” The report noted that the resources are being used effectively to curb the spread of HIV infection and reduce the impact of Aids. This, said the report, is reflected in very high levels of awareness; stabilisation in recent years of the level of prevalence which had been rising fast and the creation of infrastructure to support and sustain counselling, testing, care and treatment across the country. Behaviour change is reflected in that secondary abstinence among females rose from 13,9 percent in 2002 to 20 percent in 2005 and the use of condoms among those with multiple partners increased from 48,6 percent in 2002 to 79,1 percent in 2005. The Government will be scaling up the communication and social mobilisation campaign. The budget for the campaign over a two-year period has been increased from R160 million to R200 million. The department is currently finalising the specifications for the new communication tender, which will be advertised and awarded accordingly. The condom distribution programme cannot be compared with any in the world. Public health sector male condom distribution has increased from 270 million in 2003 to 346 million in 2004 while female condom distribution rose from 1,3 to 2,6 million during the same period. The Human Sciences Research Council’s HIV-Prevalence, Incidence, Behaviour and Communication Survey of 2005 shows that there is nearly universal access (97 percent) to condoms, with government hospitals and clinics being the main sources of availability. There are now 231 accredited public health facilities providing HIV and Aids-related services, including ARV drugs. These facilities are spread across the country’s 53 districts and cover at least two thirds of local municipalities. By the end of March 2006, at least 134 473 people had been initiated on ARV treatment in these facilities. Combined with an estimated 80 000 people initiated for private-sector ARV treatment, South Africa has the largest ARV treatment programme in the world. More than R3,4 billion has been allocated for procurement of ARV drugs for the period up to the end of 2007. The Government is involved in ongoing initiatives to reduce the prices of relevant medication. Health facilities providing voluntary counselling and testing (VCT) have doubled from 1 500 in 2002/03 to 3 700 in 2004/05. The number of people counselled for testing in the public sector rose from 413 000 in 2002/03 to 691 000 in 2003/04 and 1,3 million in 2004/05. The total number of people tested during 2003/04 was 511 843 compared with 247 287 in the previous year. The prevention programme includes prevention of mother-to-child transmission (PMTCT), with 2 500 facilities in operation and post-exposure prophylaxis (PEP) – almost all hospitals and trauma centres provide PEP for sexual assault survivors. On 11 April this year, the Minister of Health launched the Accelerated Prevention of HIV and Aids Initiative as part of an extensive initiative regarding prevention by the member states of the Africa Region of the WHO. More than 1 060 health professionals have been recruited to support the programme. Some 7 600 health professionals have been trained in the management, care and treatment of HIV and Aids. The Government is also improving working conditions so that it can recruit and retain more health professionals.