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THE SMART NEWS SOURCE | Feb 11 2012 02:20 | LAST UPDATED Feb 11 2012 02:20 |
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Free State health minister Sisi Mabe is adamant that there’s “no shortage” of antiretroviral drugs in the Free State and that “there is nothing out of stock anywhere here”. Here is a transcript of the interview with the M&G Online. M&G: The TAC says people are not getting their drugs in the Free State, that there are shortages all over the province. What do you say to this? Mabe: Actually, currently, there’s no shortage of drugs that has been reported to our office. Our division of revenue has reflected a number of 4 539 new initiations -- which means new patients [on state ARVs], which was between April and now.” There was nothing out of stock. So, we do have stock. M&G: We were in the Free State last week to visit clinics there, and the TAC there says the Free State government refuses to cooperate with them in the province’s response to HIV/Aids, and to get people on to treatment. And that your health department sees them as enemies. Is this so? Mabe: No, it’s not true. We had some problems before, we managed to meet with them ... . So such people, we normally have time for them. We sit and discuss with them, and see how best we can help one another, together. M&G: Do you think the TAC can help you in your mission to prevent HIV/Aids in the Free State? Mabe: I think in terms of the information that they are talking about, it can be helpful -- if they become more specific. So that at least we know what they are talking about, for us to be able to respond properly. M&G: The TAC has offered to help you with drug literacy, to provide HIV-infected people who need drugs with training on how to take the medicine properly. But the TAC says your department doesn’t want to accept their people. Is this so? Mabe: As I’m saying now, I haven’t had a specific meeting with the TAC, for me to be able to comment now to say we didn’t want to work with them, because I don’t have their proposal on the table. Whatever you are saying, they haven’t sent it to me. I haven’t heard about it. M&G: The TAC says it, as a member of the Free State Aids Coalition, wrote seven letters requesting a meeting with you, before you finally agreed to meet with them. And the TAC says that meeting took place recently. Mabe: Yes, we met with them, it’s true. And then they gave us a number of questions. We responded to those. M&G: What happens to HIV-infected people with CD4 counts of 50 and lower? Does your department initiate them onto treatment immediately? Mabe: You know, there are guidelines in that regard. But what remains the priority is that these people need to be given treatment. However, it has been proven that at this level, at a CD4 count of 50, they develop a certain reaction to the treatment. But then they are being taken for rehabilitation to improve their CD4 counts, so that at least they will be able to respond positively to medication. M&G: So how do their CD4 counts improve? By putting them on the ARVs? Mabe: They are being given nutritional therapy, or whatever. Because when you give them straight the ARVs, when you talk about CD4 counts of 50, you talk about people who are very low, people who are very much ill. So, you will want to give them the treatment when they are not going to react negatively to the medication. So then other methods are being used for them to be able to pick up so that they are able to get the treatment. But they remain the priority to receive the treatment.  CONTINUES BELOW M&G: And how long does it on average take for an HIV-infected patient with a CD4 count of below 200 to get onto antiretroviral therapy at the National [District] Hospital in Bloemfontein? Mabe: The waiting period ranges from six weeks to 12 weeks, but at National Hospital specifically, they also start at four weeks. M&G: The reason we’re asking, Ms Mabe, is that when we went to the Free State, we met the family of Johanna Mohojane. She was infected with HIV, and she died last Friday at National Hospital. Johanna [Nanaki -- her Sotho name] wasn’t given any [antiretroviral] drugs. The family is blaming your department for her death. How do you respond? Mabe: That has never come to our attention. But as you say, you were there. What we know is that they start the patients on the treatment, and the waiting period as I said is six to 12 weeks. I even told you that they are also able to start the treatment at four weeks, at the very same National Hospital. M&G: Maybe some patients don’t get the treatment. Nanaki Mohojane definitely did not. Mabe: We will investigate that case, and check. M&G: We’ve also spoken to other patients who are not getting the treatment after waiting a very long time, at your clinics across the Free State. Mabe: We will investigate these matters. M&G: Then at some clinics where we were, there were very few nurses, and many, many patients coming to collect their antiretroviral drugs. Do you think there are too few nurses in the Free State? Mabe: I think we have a number of posts that we have advertised. And all those posts that we have advertised as the department, we are hoping to fill in all the institutions that are running short of the staff. The HIV clinics are part of this plan. If there is an indication that such an institution needs an additional nurse or whatever, they will get. But there is a plan in terms of increasing our human resources -- especially the nurses. M&G: How soon will that happen? Mabe: As soon as the interviews are over with, because I think we have advertised already. M&G: Are you satisfied with the amount of money you have for ART in the Free State, and how that money gets spent? Mabe: We are satisfied, but we can be happy if we can receive more. Because as you know, the issue of the ARVs, is an issue that you cannot determine that by the next two months, you will be at this level. It’s an ongoing type of a thing. You cannot say that if you have 50-million now for medicines, you are covered, because you would never know how many entrants you will have in the immediate future, in the next three weeks to come. So we are satisfied, but we would be happy if it can be added on. M&G: The TAC says that you’ve spent millions of rands on hosting parties and gala dinners since April, and now there’s not enough money for drugs and you have to rely on foreign donors to supply the drugs. What’s your response? Mabe: “Since I was an MEC in this department, I have never seen any party organized by the department. We don’t have such things. We have even cut costs on catering, when we have meetings. We are under very serious cost cutting measures. We cannot even entertain the an idea like that. That’s just a statement -- I don’t know where from. But it is wrong.” M&G: What do you think that the people who need medicine think when they see the premier and ministers like yourself buying expensive cars, and then you have to tell them: ‘There is not enough money for drugs for everyone’?” Mabe: “The spokesperson for the Free State government has already spoken to yourself on that matter of the cars. In our view, [the purchase of a fleet of luxury Mercedes Benzes] is a saving, more than any other. It’s a saving because it was bought in bulk. And in everything if you buy in bulk, there’s always a discount and there’s always less money that you spend than buying things [singly]. So that’s our take on the matter. Whichever way you look at it, the purchase of those cars is a saving. M&G: Do you think the people of the Free State, especially the poor and those who urgently need medicine, see it that way as well? Mabe: I think they are fine with it -- except those who have been in the media. We don’t know who they are because they are faceless, nameless. We don’t know if they are part of the Free State health department, or they are people outside of the province. We don’t know. M&G: A recent government report, by the Integrated Task Team, says the administrative system (by which the department is meant to establish how many people need ARVs) by means of which you collect figures for antiretroviral treatment, is outdated and inaccurate, so that you really can’t establish at this point how many people in your province need ARV help. What’s your response? Mabe: I don’t want to talk about that report because we [government health officials] are still engaging [one another] on that report. What we have in the Free State in terms of data collecting -- we have the Meditech, which is the software. We have the DHIS which is the software also -- from the department’s side. That is in all our districts. Then we also collect data through the pharmacies, who count the number of patients that are being given treatment. And every three months, the data capturers need to make sure whether their numbers tally or not. They sit and then they give us what they come up with. It means that if we maybe had a discrepancy in terms of data collecting, one of the three systems we use would have picked up such a thing. So I don’t know ... . M&G: So is there a problem with the system [used to establish how many people are on ARVs in the province]? Mabe: No. We’ve got three systems that we use, that will talk to each other, on a three-month basis. And after that, the information that we take is being used nationally. M&G: Some of the Aids activists we spoke with in the Free State are referring to you as the ‘new Manto’. What do you think of this comparison? Mabe: The new Manto? (laughs) It’s news to me. I don’t have any comment; I don’t know where it comes from, and the basis of that; I don’t know. M&G: Why do you think they’re calling you this? Mabe: I don’t know. Sometimes people have their own interpretations. But I cannot be regarding myself as someone else. I am an individual, with an individual identity. I’ve got my own way of thinking, my own way of doing things; so it’s their own thinking. M&G: Do you like the comparison? Mabe: I like to be most compared with myself, because I am an individual -- as I indicated. M&G: Is there anything that we haven’t asked that you’d still like to say? Mabe: The Free State did have a crisis. The crisis was that they had a number of patients on the roll that were taking ARVs before, and then they added some other numbers on top of that. But as we are now, we are now having our numbers, and then the number of people like I said to you, the number has increased to about four…. It’s about ... What’s that number? (she calls her assistant) The number has increased to about ... to about four ... . You took the number; I gave you the number ... Four-thousand ... Four-thousand-one ... . Thirty-one-thousand-six-hundred-and-eight. And these people are the people who are now receiving treatment. These are the numbers that we have until the end of September ... Also, I must add that we have engaged with Treasury, for us to get more funds. They are positive (that we’ll get more money for ARVs). We are not going to run out of drugs. TOPICS IN THIS ARTICLE
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