[pronut-hiv] South Africa: Country's Comprehensive HIV And AIDS Programme

["ProNut-HIV" <pronut-hiv@healthnet.org>]

South Africa: Country's Comprehensive HIV And AIDS Programme - a Fact
Sheet, May 2006
" Nutritional supplements are provided  as part of the comprehensive
response to HIV and AIDS"
BuaNews (Tshwane)
May 19, 2006

The South African Government's programme to address the challenges
posed by HIV and AIDS is one of the most comprehensive and largest in
the world.

Commitment of resources

* Government expenditure on HIV and AIDS increased substantially over
the years - it grew from R30 million in 1994 to over R3 billion in
2005/06.

* In the report to the previous United Nations (UN) General Assembly
Special Session on AIDS (UNGASS), the UN Secretary General commended
South Africa for tripling its resource allocation for HlV and AIDS
programmes since the adoption of the UN Declaration in 2001.

* The World Health Organisation's <BLOCKED::http://www.who.int/en/>
(WHO) progress report on the expansion of AIDS treatment, released in
June 2005, noted that: 'South Africa has committed US$1 billion over the
next three years to scaling up antiretroviral (ARV) treatment, by far
the largest budget allocation of any low- or middle-income country.'

Implementation

* These resources are being used effectively to curb the spread of HIV-
infection and reduce the impact of AIDS:

o This is reflected in very high levels of awareness; stabilisation in
recent years of the level of prevalence which had been rising fast and
the creation of infrastructure to support and sustain counselling,
testing, care and treatment across the country. Behaviour change is
reflected in that secondary abstinence among females rose from 13,9% in
2002 to 20% in 2005 and the use of condoms among those with multiple
partners increased from 48,6% in 2002 to 79,1% in 2005. Government will
be scaling up the communication and social mobilisation campaign. The
budget for the campaign over a two-year period has been increased from
R160 million to R200 million. The department is currently finalising the
specifications for the new communication tender, which will be
advertised and awarded accordingly.

o The condom distribution programme cannot be compared with any in the
world. Public health sector male condom distribution has increased from
270 million in 2003 to 346 million in 2004 while female condom
distribution rose from 1,3 to 2,6 million during the same period. The
Human Sciences Research Council's HIV-Prevalence, Incidence, Behaviour
and Communication Survey of 2005 shows that there is nearly universal
access (97%) to condoms, with government hospitals and clinics being the
main sources of availability.

o There are now 231 accredited public health facilities providing HIV
and AIDS-related services, including ARV drugs. These facilities are
spread across the country's 53 districts and cover at least two thirds
of local municipalities. By the end of March 2006, at least 134 473
people had been initiated on ARV treatment in these facilities. Combined
with an estimated 80 000 people initiated for private-sector ARV
treatment, South Africa has the largest ARV treatment programme in the
world. More than R3,4 billion has been allocated for procurement of ARV
drugs for the period up to the end of 2007. Government is involved in
ongoing initiatives to reduce the prices of relevant medication.

o Health facilities providing voluntary counselling and testing (VCT)
have doubled from 1 500 in 2002/03 to 3 700 in 2004/05. The number of
people counselled for testing in the public sector rose from 413 000 in
2002/03 to 691 000 in 2003/04 and 1,3 million in 2004/05. The total
number of people tested during 2003/04 was 511 843 compared with 247 287
in the previous year.

o The prevention progamme includes prevention of mother-to-child
transmission (PMTCT), with 2 500 facilities in operation and
post-exposure prophylaxis (PEP) - almost all hospitals and trauma
centres provide PEP for sexual assault survivors.

o On 11 April 2006, the Minister of Health launched the Accelerated
Prevention of HIV and AIDS Initiative as part of an extensive initiative
regarding prevention by the member states of the Africa Region of the
WHO.

o More than 1 060 health professionals have been recruited to support
the programme. Some 7 600 health professionals have been trained in the
management, care and treatment of HIV and AIDS. Government is also
improving working conditions so that it can recruit and retain more
health professionals. This includes providing scarce skills allowance
for certain categories of health professionals (doctors, pharmacists and
specialist nurses) and a rural allowance for health professionals
working in less developed parts of the country. This is in addition to
the steadily improving salary packages.

o Nutritional supplements are provided to those who need them, as part
of the comprehensive response to HIV and AIDS, as a complement to the
appropriate forms of treatment. Some 90 000 people have accessed this
service since April 2004. An amount of R7 million was made available for
purchasing nutrition supplements in the 2003/04 financial year.

o Support and care for those affected by HIV and AIDS is expanding,
through growing programmes such as home- and community-based care.

Partnership

* Critical to successful implementation is an active partnership of all
of society with government. The partnership is embodied in the South
Africa National AIDS Council and expressed in action, which sees
government, communities and non-governmental organisations (NGOs)
working together to implement all aspects of the comprehensive plan.

* The Department of Health invited 14 members of civil-society groups
to be part of South Africa's delegation to the United Nations General
Assembly Special Session (UNGASS) on HIV and AIDS. Government programmes
are complemented by private sector, NGO and civil-society initiatives.

* In this partnership, there is appreciation that the role-players may
agree on all or some of the elements of the comprehensive programme.
What we seek to ensure is for the partners to work together on those
issues on which they are in agreement.