HIV/AIDS and TB Newsletter

Note from the Editor

The Department of Health at national and provincial level has been very active in the last few months to ensure the implementation of the Comprehensive Plan on HIV and AIDS Care, Management and Treatment.  In the last few months, since Cabinet approved the Plan on 19 November.  Completed activities include:

• Purchasing additional nutritional supplements
• Treatment guidelines (being printed currently)
• Finalising an interim system for the Patient Information System
• Finalising the Communication Strategy, as well as the development of materials
• A patient information booklet (developed by Soul City)
• Briefing key stakeholders (including the AIDS Help Line staff)
• Training of health workers
• Advertising vacant posts
• Identified and completed the first round of assessments of the facilities identified for implementation in year one (the second round started last week)

The dedication and hard work of staff at national and provincial level is to commended.

HIV and AIDS Red Ribbon Resource Centre

Please remember that HIV and AIDS, STI and TB materials can be obtained free of charge from the Red Ribbon Resource Centre.  Contact the Centre at (011) 880-0405 to ask for order forms.

Health MinMEC Approves Interim Supply of Antiretroviral Drugs

Media statement released by the Department of Health on 23 March 2004

The Health MinMEC, comprising the Minister of Health and provincial MECs for Health, met in Johannesburg on 23 March 2004 to review progress in the implementation of the Comprehensive Plan for Management, Care and Treatment of HIV and AIDS.

MinMEC provided further guidance on future actions to be taken to speed up the implementation plan, including urgent accreditation of facilities that meet the accreditation requirements and interim measures to procure antiretroviral drugs.

MinMEC reiterated the approach that the Comprehensive Plan should reinforce prevention efforts and strengthen the health system to enable it to provide continuum of care.

MinMEC noted that a total of 110 facilities in all 53 districts have been assessed.  Urgent action plans to address challenges and strengthen the capacity of facilities were developed.

Teams from the Department of Health have commenced a second round of visits to provinces with a view to formally accredit facilities that are ready.  The accredited facilities will be announced shortly.

These facilities will begin to enrol patients.  This process includes:

• Doing CD4 counts and viral load tests to establish progression of the disease.
• Providing interventions that prolong progression of the disease including nutritional and micronutrient supplementations, providing complementary and traditional medicines and improving step down care.  An intensive training programme will be implemented to assist health workers to effective provide these services.
• Ensuring that patients who qualify for antiretroviral therapy (CD4 count of 200 or below) begin to undergo a treatment literacy programme to ensure that they adhere to treatment.

In relation to measures to procure supplies of ARVs, MinMEC took the view that interim measures should be explored and used in situations where sites were fully accredited but the national drug tender was still in process.

MinMEC acknowledged that flexibility in procurement methods was acceptable, provided that quality standards of the programme were not jeopardized.

It was agreed that the National Department of Health would coordinate this process through a national quotation system.  This will ensure in future that provinces will not be buying at different prices.

This temporary measure will not replace the tender process, which is far better suited to sustainable drug supplies, most competitive prices and longer term demand for ARVs that the South African programme may create.

Funding for all elements of the Comprehensive Plan becomes available through the conditional grants to provincial health departments from April 2004.

With regards to the national tender, more than 40 companies have expressed interest to supply the drugs and have until April 02 to submit their proposals.

A process of short-listing will follow and negotiations will take place with the short-listed companies during the month of May to secure the most competitive prices.

Successful implementation of the Plan also demands:

• Promoting public awareness and education. National and provincial awareness campaigns – using television, radio and newspapers as well as pamphlets – will be launched towards the end of March and continue for several months.
• Adequate staffing levels in all service points.  Collectively provinces have moved to fill a large number of vacancies in order to ensure there are sufficient skilled health workers to implement the Plan, without drawing staff away from other vital services.
• Special training based on standard protocols.  Training guidelines have been developed based on the national treatment protocol, which ensures a single standard of treatment nationwide.  These guidelines were approved by the MinMEC and distributed to provinces at the beginning of March.  Training has commenced in several provinces and will be strengthened with the award of a national training tender.
• Good access to Voluntary Counselling and Testing (VCT) services to determine HIV status.  Such services are the entry point to the continuum of care and are being increased from an existing network of 1 900 testing sites.
• Better laboratory services for general diagnostic laboratory tests, including CD4 and viral load testing.  These laboratory tests are necessary to monitor the progression of the disease and to determine the appropriate care that should be provided at different stages.  The National Health Laboratory Service (NHLS) has been allocated R25-million from Government to strengthen its services, effectively covering the entire country.
• Providing nutritional support and alleviating hunger.  People living with HIV and AIDS will be provided with micronutrients to supplement their diets.  An order valued at R4 million has been made to provide nutritional supplementation to those who are food insecure.
• Recognition of the widespread use of traditional medicine.  The Comprehensive Plan recognises that many people with HIV utilise traditional medicines.  This Plan seeks to incorporate this practice safely into comprehensive HIV and AIDS care through, among others, the funding of groundbreaking research to establish the safety and efficacy of traditional medicines and other remedies.  The Department of Health will be hosting a national conference on traditional medicines later this month.
• Use of a standard Patient Information System across all service points.  Every service point will collect the same information on their patients and the system will enable health services to keep smooth track of patients even if they move to other treatment points
• Development of pharmacovigilance systems for early detection of adverse drug reactions.  Three Universities – Cape Town, Free State and Medunsa - have been designated to assess the burden of drug-related morbidity and mortality in patients with HIV and AIDS in order to develop measures to monitor patient safety and to mitigate the negative impact of the drugs.

MinMEC acknowledged that much progress has been made in implementing the Comprehensive Plan and provinces agreed to share best practices and to communicate with the public effectively, through the coordination of the National Department of Health.

For additional information, please contact Celicia Serenata (serenc@health.gov.za) or Jo-Anne Collinge (collij@health.gov.za)

Important Dates and Conferences

4-7 April 2004          7^th International AIDS Impact Conference
                             Cape Town ICC
                             bridgette@nelsonmandela.org

9-12 May 2004                   2^nd African Conference on Social Aspects of HIV and AIDS Research
                             Cape Town ICC
                             oshisana@hsrc.ac.za

 

Useful Websites

www.doh.gov.za
www.aidsinfo.co.za
www.aidsdirectory.co.za
www.dpp.org.za
www.hst.org.za
www.global-campaign.org (for news on microbicides)
www.who.int/hiv
www.saavi.org.za
www.afroaidsinfo.org
www.lovelife.org.za
www.childaidsservices.org
 www.learnscapes.co.za
www.hivan.org.za
www.unaids.org
www.caprisa.org
www.hsrc.ac.za
www.foundation.co.za
www.hivsa.com
www.diflucanpartnership.org
 

You are also encouraged to share information on other useful websites.  Feedback on the Department of Health website would be especially valuable.

Compiled by Celicia M Serenata
Project Manager: HIV/AIDS
Tel: (012) 312-0128
Fax: (012) 312-3122
e-mail: serenc@health.gov.za

Red Ribbon Resource Centre

For all requests of HIV/AIDS materials (posters etc.), please contact:

Tel: (011) 880-0405
Fax: (011) 880-8552

Address List for Chief Directorate

Fax: (012) 312-3122