Lack of state HIV/AIDS treatment plan could lead to welfare deluge

The government's failure to implement an HIV/AIDS treatment plan could result in an explosion of applications for disability grants by AIDS patients, the Financial and Fiscal Commission has warned.

In its annual report to parliament yesterday, the FFC said the Treasury's estimate that 1,2-million people are eligible for the grant does not take HIV/AIDS in account. Those with advanced AIDS symptoms can access the grant of R410 a month.

While about half of the 1,2-million currently received the grant, increased uptake by Aids patients could be much more expensive than the Treasury has expected, particularly if the existing medical assessment requirements remain unchanged.

"There is some indication from the 2001 uptake that this may be happening," the report states.

It also warns that the Treasury's estimate of about 316 000 eligible beneficiaries for the foster-care grant may be far below the number of projected orphans of HIV/AIDS orphans who might need foster care.

The FFC said the new assessments - that the impact of the disease could be lower than initially thought - meant that "many services could be supplied that were previously thought to be too expensive".

This assessment is based on last year's study by the Human Sciences Research Council, which put the prevalence of the disease a bit lower than previous studies at antenatal clinics.

The Treasury has provisionally budgeted an extra R1,1-billion this year for treatment, pending a decision by the cabinet, expected later this month.

The FFC report further warns that, due to the "significant impact over the next 10 years" of HIV/AIDS, there is a chance that limited budgeting for this could result in the crowding-out of non-AIDS-related health services.

Alternatively, a high degree of "implicit rationing" by medical staff could come about.

It agrees with the government's accelerated funding for HIV/AIDS through the equitable share to provinces, but warns that a "clear policy framework" should be established at national level.

The report recommends an evaluation of expenditure by provinces to ensure the increased HIV/AIDS funding is spent where it is needed.