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Progress in the implementation of the Comprehensive Plan for Management, Care and Treatment of HIV/AIDS
Dr Manto Tshabalala-Msimang. 03 March 2004. Department of Health Press Release.
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When we started working on the implementation of the Comprehensive Plan for Management, Care and Treatment of HIV/AIDS as approved by Cabinet, we made an undertaking to report to South Africans on all the milestones we are taking in implementing the Plan.
There have been a number of statements and briefing of various stakeholders on the Plan. Today we would like to use this opportunity to have broader discussion on the Plan to ensure a better understanding of all its elements and what it seeks to achieve.
You will notice that we do not talk about an ARV roll out plan because this programme is not limited to that. It is a Comprehensive Plan that emphasises the centrality of prevention in response to HIV/AIDS. It emphasises the strengthening of the national health system that is able to provide continuum of care and sustain a series of interventions aimed at mitigating the impact of the disease.
We have visited a total of 110 facilities in all districts to assess their capacity and develop urgent action plans to close gaps where they exist. There will be another round of visits towards the end of this month to determine progress in strengthening the capacity of these facilities.
Recruitment of the necessary extra personnel is underway both at national level and in various provinces. For medical posts in particular, we have decided to target doctors who did community service last year and those currently in this programme to ensure that they are retained within the public service. Training guidelines have been developed and some provinces have started training.
We have increased Voluntary Counselling and Testing sites to ensure that people get tested. Those who test positive can be assessed through CD4 count and viral load tests to determine the stage of the progression from HIV to AIDS. Testing protocols have been developed and are in line with treatment protocols. The National Health Laboratory Service (NHLS) provides the bulk of the laboratory services. Initially, 18 laboratories have been identified to service the first 53 service points in all districts of the country. This capacity should be increased in line with demand and workload.
There are a number of interventions available for people with a CD4 count of above 200. These include counselling and psycho-social support, encouraging healthy lifestyles and provision of nutritional support. Tender for procurement of supplement meals for those who are food insecure is in place and an extra R4 million has been allocated to increase volumes. Micronutrient supplementation is also going to be provided. These services are important as they cover the vast majority of people living with HIV. As you know the majority of people living with HIV have not progressed to a CD4 count of 200 and below where antiretroviral therapy may be needed.
The plan also encourages the use of traditional medicines as one of the options available to patients. We have invested more that R6 million to the Medical Research Council to assist in the research and development to ensure quality and safety of these medicines. The MRC will also be a key partner in the development of a research programme for the Plan as a whole.
Those people with a CD4 count of 200 and below or have symptoms will have an option of antiretroviral therapy. Yesterday we adopted ARV treatment guidelines which have been developed through a wide consultation with both local and international experts on this field. They cover the use of ARVs in a wide range of circumstances including treatment for infants, for pregnant women, TB co-infection and for adults who have previously been exposed to ARVs.
To make these drugs available, we have over the past two weeks called on suppliers to express interest in supplying the drugs. The suppliers are also invited to a briefing session that is scheduled for the 9th of March where detailed documentation on the Request for Proposals will be made available. Proposals submitted will be shortlisted and qualifying suppliers will provide quotations that should form the basis for negotiating best possible contract. We hope that the qualifying suppliers will support this biggest HIV/AIDS programme in the world by offering the most competitive prices.
The guidelines ensure a robust, efficient and reliable drug distribution system has been developed. This includes the inventory management, patient prescription information and financial management. The standard operating procedures for labelling and dispensing are being finalised. Specifications for a tracker system that will electronically track the movement of stock are being drawn. These are measures we have to put in place to prevent theft of these drugs with a very high market value.
An integrated patient information system with electronic patient records and paper-based backup system has been developed and will use a unique patient identifier. We are in the process of purchasing computer and IT equipment and training staff on the patient information system, which should be up and running in April. This should enable us to track patients throughout the health system and ensure that appropriate services and correct treatment is provided.
To ensure safe and effective use of ARV and other HIV/AIDS related treatment, we are setting up a pharma-covigilance programme with support units in Medunsa and Free State University. These units will also assess the burden of drug-related morbidity and mortality in patients with HIV/AIDS in order to develop measures to minimize their impact.
Critical to the success of this programme is a strong communication and social mobilisation campaign that educate and inform the general public and potential service users. From this month, Khomanani service providers will begin to deliver information leaflet and posters on additional services being added to various interventions that have been underway over the past years. We are going to advertise in the print media and about R5 million has been set aside for vibrant radio and TV advertising campaign to support the programme.
This is a major initiative ever taken against HIV/AIDS. We are implementing it amid a major transformation and strengthening of the health system as a developing country. We are convinced that we presented a good Plan to Cabinet and with the support of various stakeholders including the media, we are determined to ensure that it is successfully implemented. |
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