Issued by National Department of Health
16 September 2006
In an effort to enhance the provision of antiretroviral therapy component of the Comprehensive Plan for Management, Care and Treatment of HIV and AIDS, the Department of Health has reviewed the accessibility of this service to patients for the period between April and June 2006.
The review established that 178 635 people had been initiated on antiretroviral therapy in the 262 accredited facilities in the country by June this year.
At least 31 255 patients were on the waiting list to receive for this treatment during this period. This number of patients on the waiting list is significantly lower than the figure of between 500 000 and 800 000 that has been mentioned as the number of people who are unable to access this treatment.
The 500 000 to 800 000 figure is not the number of people who have presented at health facilities and were unable to receive treatment. The figure is arrived at by assuming that between 10-15% of people currently estimated to be living with HIV and AIDS (5,4 million according to the Antenatal Survey) have progressed to a stage of 200 CD4 or below and therefore may need ARVs. The model does not necessarily take into consideration the impact of healthy lifestyle interventions in delaying progression from HIV infection to development of AIDS defining conditions. Antiretroviral drugs can prolong life at the latter stage.
The people on the waiting list are those patients who have undergone voluntary counselling and testing (VCT) and have been assessed for CD4 count, Viral Load and Clinically at stage 3 or 4 of the disease. Based on these assessments (200 CD4 count or below), these patients qualify to receive antiretroviral drugs. The assessments can be done at an accredited facility or in an unaccredited facility that is part of a referral network of an accredited facility.
Limited capacity, particularly with regard to staffing and space in accredited facilities, require that some of the patients remain on the waiting list for a certain period before they can undergo clinical evaluation and treatment is initiated. The Department of Health appreciates the efforts being made by clinical teams to accommodate as many patients as possible.
The limited human resource capacity at a pharmacy level remains one of the major challenges that the Department is trying to address. Pharmacists need to have a one-on-one session with every patient to reinforce the messages on the importance of compliance and adherence to the specific times at which the medication has to be taken. Adherence is critical because if patients miss their specified time for taking medicine for more than an hour, they have a risk of developing resistance.
The Department of Health is determined to intensify the implementation of the Comprehensive Plan in its totality and ensure that everyone progressively realises the right of access to prevention, care and treatment services.
Dr Nomonde Nxundu
Chief Director: HIV, AIDS, TB and STIs
For more information call Sibani 082 772 0161 or Charity 083 679 7424