SA won’t meet ARV roll-out target, says Motsoaledi

by PEROSHNI GOVENDER

South Africa will not meet a target of providing life-prolonging drugs to 80% of people living with HIV/Aids by 2011 due to logistical problems and a lack of personnel, Health Minister Aaron Motsoaledi said on Tuesday.

“We are now covering 700 000 people. Unfortunately it is only 50% of the number that has been targeted. By 2011, we are supposed to cover 80% of the people who need to be on ARVs [antiretroviral drugs],” Motsoaledi told Reuters.

South Africa, which has one of the world’s heaviest HIV caseloads, has been accused by activists of dragging its feet in dealing with the virus, which kills an estimated 1 000 people every day. At least 5,7-million people are infected.

Former president Thabo Mbeki drew sharp criticism after coming to power in 1999 when he questioned accepted Aids science and failed to make life-prolonging ARVs widely available.

The health minister in the Mbeki Cabinet, Manto Tshabalala-Msimang, has been lampooned by leading scientists and activists for recommending garlic and beetroot as treatments.

But President Jacob Zuma’s appointment of Motsoaledi — a respected medical doctor and a former provincial minister who served in various portfolios — has been welcomed.

He has fostered closer ties with leading Aids activists and NGOs and wants to change the way HIV/Aids is treated.

Funding shortfall

Motsoaledi says the government’s HIV programme has a shortfall of about R1-billion.

Already one province has had to reduce the provision of ARVs, and unless the budget is supplemented by additional funds, other provinces may run out of money by next month.

“We have discussed it with Treasury, calculated the costs and I have already met international funders. We are waiting and hoping that there is no chance of the actual shortfall happening.”

Despite his overstretched budget, Motsoaledi is exploring providing ARVs to patients as soon as they are diagnosed as HIV-positive.

Once transmitted, HIV attacks the T-cells and replicates the virus — making it impossible for the immune system to protect the body from infection and illness. Public hospitals dispense ARVs when HIV deteriorates to Aids and patients’ CD4, or T-cell, counts are below 200.

“The issue of ARV provisioning is to make them able to work and live. Waiting for people to go to a CD4 count of 200 is too low, too late. Maybe we should start them at 350,” Motsoaledi said.

South Africa’s hospitals are under-funded, lack resources and in some cases in a state of decline. Higher pay and better conditions have seen many doctors and nurses lured overseas.

Motsoaledi says the declining standards can be attributed to the flight of skilled staff.

“Medical and nursing training is of a very high quality in this country, but when you start experiencing problems now with shortages of staff, that standard … will start deteriorating.”

The country was also failing to produce enough doctors. It needed at least 9 000 a year but currently only 1 200 doctors graduate annually.

Apart from struggling to provide for its own citizens, the influx of political and economic refugees to South Africa is putting pressure on the country’s overstretched health, education and social services budgets.

Motsoaledi said: “On humanitarian grounds we have no option but to do it. But it does cause a serious strain.” — Reuters