speculated
16 October 2006
In an effort to enhance the provision of the antiretroviral (ARV) 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 between
April and June this year.
At least 31 255 patients were on the waiting list to receive 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
themselves at health facilities, and were unable to receive treatment. The
figure is arrived at by assuming that between 10-15 percent 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 a CD4 count of 200 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 are clinically at stage three or four 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.
Enquiries:
Sibani Mngadi
Cell: 082 772 0161
Charity Bhengu
Cell: 083 679 7424
Issued by: Department of Health
16 October 2006
