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Government's Plan to Deal With
March 23, 2003
Posted to the web March 24, 2003
The HIV/AIDS budget (excluding
allocations from provincial equitable shares) is set to
increase ten-fold from R342-million in 2001/02 to R3.6-billion
To this end the conditional grant for
HIV/AIDS to the provinces, including expanding VCT and the
programme to prevent HIV transmission from mother-to-child,
has been increased from R210-million in 2002/3 to R334-million
Updating the nation on the
implementation of the strategic plan against HIV/AIDS last
week, Cabinet said the country had a plan to fight the
life-threatening disease in terms of prevention, treatment,
care and support, in the context of development and poverty
'There is a plan, a comprehensive
national strategy, based on the premise that HIV causes AIDS,'
With prevention critical in this regard
because there was yet no known cure for AIDS, it said surveys
confirmed a high level of awareness amongst South Africans and
the young in particular.
'The Khomanani campaign, with
R98-million of government funds, is reinforcing this.'
As part of the concerted efforts to
prevent the spread of HIV/AIDS, government distributed 350
million condoms free of charge in 2002. This will increase to
400 million in 2003/04.
'We will increase the supply through
non-traditional outlets - like clubs, shebeens and spaza shops
- and double the number of sites where female condoms are
available (the number of such sites has already increased from
27 in 2000 to just over 200 in 2002).
Voluntary HIV counselling and testing (VCT)
was now available in nearly 1 000 public health sites and more
funds had been allocated.
'By the end of 2002, VCT was available
in 982 sites throughout the country, including the sites of
the PMTCT programme (programme to prevent HIV transmission
from mother-to-child). It is planned to have VCT services
available in 80 percent of public health facilities by the end
of the 2003/4 financial year.
By providing Nevirapine to mother and
baby in the PMTCT programme, Cabinet said this had expanded
and would continue to develop in 2003.
'Most provinces are now extending this
comprehensive package to more facilities and at last count
about 658 hospitals and clinics were providing the service.'
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.
By the end of December 2002, Cabinet
said over 101 202 women had visited the facilities attached to
the 18 PMTCT research sites, 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 (ARVs) to survivors of sexual assault as part
of a comprehensive package of support was being implemented.
The post-exposure prophylaxis programme
(PEP) includes counselling on the effectiveness and risks of
using ARVs 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 addition 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.
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.
Government was also working with
pharmaceutical companies to lower the cost of drugs to treat
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.
For this reason, government views its
food security and poverty alleviation interventions as an
intrinsic part of its response to HIV, AIDS and TB.
The importance of good nutrition for the
health of people living with HIV an AIDS was stressed by the
World Health Organisation (WHO).
For this reason, a number of measures
aimed at enhancing nutrition were announced towards the end of
'These included measures to counter the
impact of high food prices, announced in October 2002, both
short-term and medium term to long term, as well as a
Department of Health programme for enhancing 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 ARVs to people infected with
HIV, Cabinet said the team tasked with investigating resource
implications of providing anti-AIDS drug to people living with
HIV/AIDS in South Africa, 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
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.
Regarding other work that had been done,
it said there had been some other important developments to
support the safe and effective use of ARVs in the country
For instance, the Medicines Control
Council (MCC) in partnership with the Medical University of
South Africa (Medunsa) had created a system to monitor the
safety of antiretrovirals in use in the country.
The Medicines Control Amendment Act
would also come into force this year to facilitate the
purchase of medicines at cheaper prices.