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HIV/AIDS
What is government's approach to HIV and AIDS?
Government is implementing a comprehensive plan to deal with HIV and AIDS, which combines prevention, to ensure that those who are not infected remain so, with treatment, care and support for those infected or affected.
It is based on a five-year strategic plan adopted in 2000 which has unfolded into what is probably the largest programme in the world, sustained by a budget which has expanded and is set to grow still further in order to sustain it. Essential to the programme is the strengthening of the national health system.
Government expenditure on HIV and AIDS increased substantially over years – it grew from R30 million in 1994 to over R3 billion in 2005/06. The World Health Organisation’s progress report on the expansion of AIDS treatment, released in June 2005, noted that: ‘South Africa has committed US$1 billion over the next three years to scaling up antiretroviral treatment, by far the largest budget allocation of any low- or middle-income country’.
The programme's impact is reflected in very high levels of awareness; changes in behaviour, especially among the young; 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.
Critical to successful implementation is an active partnership of all of society with government. The partnership is embodied in the South Africa National AIDS Council and expressed in action which sees government, communities and non-governmental organisations (NGOs) working together to implement all aspects of the comprehensive plan.
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What progress has been made in implementing the country's comprehensive plan?
Progress has been made in the various aspects of the plan:
- in accordance with the plan, each of the 53 health districts in the country now has at least one service point providing comprehensive HIV- and AIDS-related services, including antiretroviral treatment (ART), from prevention to terminal palliative care
- 250 laboratories have been certified to provide support to the programme
- three pharmacovigilance centres have been established to monitor and investigate adverse reaction to treatment.
By the end of June 2006, over 178 635 patients had been initiated for ART and there is no stock out in all facilities.
To date, 254 facilities are implementing the comprehensive plan covering 72,5% of the country’s subdistricts. Forty-three CD4 counts, 11 viral load and seven PCR machines are operational in laboratories across the country. [ Top ] What place does prevention have in South Africa 's HIV and AIDS programme?
South Africa’s approach emphasises the centrality of prevention, so that those not infected remain so; and the importance of strengthening the national health system to provide a complete continuum of care and other interventions that would mitigate the impact of HIV and AIDS and other diseases.
A significant reduction in sexually transmitted infections has been reported over the last few years due to communication and treatment programme
Government programmes are complemented by private-sector, NGO and civil-society initiatives. A new phase of the awareness campaign started in September 2002, joining government with partners like loveLife, and focusing on youth prevention, support for orphans and vulnerable children, and living positively.
Prevention activities have further been strengthened through the Khomanani (Caring Together) Campaign, a multimedia mass communication campaign supporting all aspects of the comprehensive programme and driving the ABC message for sexual behavioural change.
The Khomanani Campaign is being decentralised to provinces.
The distribution of condoms increased to 386 million male and 1,3 million female condoms in 2005/06.
The prevention progamme includes prevention of mother-to-child transmission, with 3 000 facilities in operation, covering 87% of health facilities, Post-exposure prophylaxis is provided in almost all hospitals and trauma centres for sexual assault survivors and health professionals exposed to HIV.
Health facilities providing voluntary counselling and testing increased from 3 369 in 2004/05 to 4 930 in 2005/06. [ Top ] How is the country approaching human resources in the public health system?
More than 1 060 health professionals have been recruited to support the programme and 9 107 health professionals have been trained in the management, care and treatment of HIV and AIDS.
Government is also improving working conditions so that it can recruit and retain more health professionals. This includes providing scarce skills allowances for certain categories of health professionals (doctors, pharmacists and specialist nurses) and rural allowances for health professionals working in less developed parts of the country. This is in addition to steadily improving salary packages. [ Top ] What treatment is offered in the public health sector?
Treatment at public health facilities is covered in the Operational Plan for Comprehensive Treatment and Care for HIV and AIDS in the country, which was approved by Cabinet in November 2003. This covers the areas of counselling, good nutrition and healthy lifestyles, treatment of opportunistic infections, traditional medicine and antiretroviral drugs.
Public health facilities have a duty to treat opportunistic infections, irrespective of the patient's HIV status. The Department of Health is continuing with the training of healthcare workers in the management of opportunistic infections. Currently, all health facilities are providing treatment for opportunistic infections.
Nutritional supplements are provided to those who need them, as part of the comprehensive response to HIV and AIDS, as a complement to the appropriate forms of treatment. About 480 000 qualifying TB and HIV-positive patients have accessed this service since April 2004.
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What is done to provide care and support and to fight discrimination?
Support and care for those affected by HIV and AIDS is expanding, through increased governmental social grant registration and increases in grants, as well as growing home- and community-based care programmes.
There are 45 step down care facilities, 732 support groups and 1 176 home-based care organisations providing services in the communities.
The public health system provides nutritional supplements to patients with HIV and AIDS and/or TB and this has therefore increased macro and micronutrient requirements.
The Khomanani Campaign is tapping public willingness to help alleviate the suffering caused by HIV and AIDS.
A tool kit on how to live positively with HIV and AIDS has been developed in collaboration with people living with the disease. It aims to put faces and share experiences to reduce the stigma, and is being distributed to support groups.
About 10 million Information Education and Communication (IEC) materials were distributed in 2005.
Government efforts are further complemented by initiatives of the private sector, and non-governmental, community-based and faith-based organisations aimed at addressing the impact of HIV and AIDS on individuals and the broader society.
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Where can I learn more about Khomanani?
Khomanani is a dynamic government-led communication campaign funded and driven by the Department of Health. Learn more about Khomanani.
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Where can I find speeches and statements on HIV/AIDS by government leaders?
You can find information and documents on HIV/AIDS on the Key Issues page.
You can also go directly to the Speeches and Statements index page.
Source: Department of Health
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Last modified: 07 December 2007 10:35:16.
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