Holes revealed in Aids treatment programme

The government’s comprehensive HIV/Aids treatment programme was launched 18 months ago and a proper system for monitoring and evaluating the roll-out is still not in place.

Delays in installing the system account for a large chunk of the R39-million underspend by the Department of Health’s HIV/Aids cluster this year, revealed by the mini-budget.

Analysts pointed out that this was a serious deficiency in one of the world’s largest Aids treatment programmes. Currently about 70 000 people take anti-retrovirals through public-sector health facilities, while another 60 000 are being treated in the private sector or through workplace programmes. Brazil has the second-largest treatment programme, with an estimated 120 000 patients.

Failure to get proper feedback from a developing programme of this size means that successes are not replicated, while failures are not corrected. Drug supplies need to be monitored to prevent the stock-outs that have already threatened to take or have taken place, reduce “leakage” into the black market and stem corruption.

François Venter of Wits University’s reproductive health and HIV research unit pointed to the safety issues. Without a pharmaceutical “vigilance” system, the government and doctors could not gather enough information about the side effects of powerful anti-retrovirals — even though the government has repeatedly stressed their toxicity.


A senior official said there were concerns about the speed at which assessment tools were being developed and used. “How does the country know if the programme is working? There is not enough information in this programme, we don’t know what is being evaluated, or the indicators of success or failure.”

The Department of Health has also failed to brief Parliament’s health committee on the treatment plan. Presentations to the committee have repeatedly been cancelled, while it is rumoured that a presentation to Cabinet on the plan was rejected.

Nhlanhla Ndlovu, head of the Institute for Democracy in South Africa’s (Idasa) Aids budget unit, said reporting back has not been adequately prioritised. “Some provinces have failed to provide information. It doesn’t surprise us to see that some monitoring and evaluation funds were not spent.”

The Joint Civil Society Monitoring Forum, a group of about 20 NGOs, is trying to monitor the rollout. Although health officials had asked to attend its last meeting, no-one turned up — despite invitations and telephonic confirmation.

At the last meeting, the forum summarised the last known treatment numbers: these suggest that, by mid-August, KwaZulu-Natal had 19 000 patients on anti-retrovirals, with figures for Gauteng and Limpopo standing at 20 000 and 5 000 respectively at the end of July. In mid-September, the North West had 7 578 patients, the Free State had 2 500 and the Western Cape had more than 11 147.

Recent figures for Mpumalanga — historically the worst-performing province — were not available. In January it had 936 patients on anti-retrovirals.

Subscribe to the M&G

These are unprecedented times, and the role of media to tell and record the story of South Africa as it develops is more important than ever.

The Mail & Guardian is a proud news publisher with roots stretching back 35 years, and we’ve survived right from day one thanks to the support of readers who value fiercely independent journalism that is beholden to no-one. To help us continue for another 35 future years with the same proud values, please consider taking out a subscription.

Rapule Tabane
Guest Author
Vicki Robinson
Guest Author

Related stories

North West ANC names its top six

The ANC leadership in the North West has, as expected, nominated President Thabo Mbeki to continue for another term as party president. Although the formal nomination process starts only in October, the provincial executive committee has released a list of its top six preferences to its regions and branches for discussion.

Lessons of health and history

Told in the first person, Elias Masilela's<b> Number 43 Trelawney Park KwaMagoga</b> (David Philip) puts a tragic, and in some ways nostalgic, human face to life in exile during the apartheid years. The book tells the story of 25 PAC and ANC members who passed through Number 43, Trelawney Park, writes Vicki Robinson.

A bump on the road to Polokwane

Last week's ANC policy conference brought to mind a traditional proclamation: The king is dead. Long live the king! However one interprets the minutiae of ANC pronouncements on the next leadership selection, three things can be said. First, Thabo Mbeki will not be South Africa's president come 2009; second, the internecine war for the presidency of the ANC will continue right up to the last moment.

ANC policy meet: Amandla ngawethu

Delegates at the African National Congress's (ANC) policy conference this week seemed on course to ensure that President Thabo Mbeki's legacy of centralising power in the Union Buildings would be eradicated through a series of policy changes set to return power to the ruling party's mass base.

ANC: To the left, to the left?

Zwelinzima Vavi does not seem to run out of hyperbole to illustrate what is wrong with the government’s economic policies. "It is like a doctor saying an operation has been successful when the patient is dead," he said to great laughter when addressing a youth rally in Mangaung in the Free State last Saturday.

Zuma’s plans for top job

ANC deputy president Jacob Zuma would not alter the broad parameters of South Africa's economic policy, but believes the national treasury has usurped the people "as the driver of economic change" and that "participatory democracy" has foundered under President Thabo Mbeki.
Advertising

Subscribers only

Toxic power struggle hits public works

With infighting and allegations of corruption and poor planning, the department’s top management looks like a scene from ‘Survivor’

Free State branches gun for Ace

Parts of the provincial ANC will target their former premier, Magashule, and the Free State PEC in a rolling mass action campaign

More top stories

Wheeling and dealing for a Covid-19 vaccine

A Covid-19 jab could cost hundreds of rands. Or not. It’s anyone’s guess. Could another pandemic almost a century ago hold clues for handling the coronavirus today?

The European companies that armed the Ivorian civil war

AN OCCRP investigation reveals that Gunvor and Semlex brokered weapons-for-oil deals in early 2011 when Côte d’Ivoire was in crisis, despite a UN arms embargo

Johannesburg cannot police its future

South Africa’s biggest city is ground zero for debates about the long-term effectiveness and constitutionality of militarised urban policing and how we imagine the post-Covid city

Fearless Burundi MP suffers in jail

Fabien Banciryanino, who challenged state on political murders, detained in notorious prison
Advertising

press releases

Loading latest Press Releases…

The best local and international journalism

handpicked and in your inbox every weekday