ZAR

The good news on medical schemes is that the industry is turning around from huge losses. The bad news is that nobody's tracking how much medical costs consumers are carrying. On average, the industry performed pretty well, according to acting registrar of medical schemes Patrick Matshidze.

The probe into pricing malpractice in the private healthcare sector should be extended beyond hospitals to cover all parties, including medical aid funders and drug companies, the Hospital Association of SA said on Friday.

Contrary to expectations about the expense of antiretroviral therapy (ART), using ART in people with AIDS should be cost-effective for South Africa's public health sector according to a study published in January's PLoS Medicine (an 'open-access' medical journal). The cost of not using ART to treat people with AIDS is significantly greater - as patients with AIDS required more expensive time in the hospital and other medical care.

Healthcare spending in 2003 was 4.8% lower in real terms than in 1996, with large inequities still existing between the provinces, a survey by the South African Institute of Race Relations (SAIRR) shows.

While saving the taxpayer more than 4.5 billion rands, Dr Debbie Glencross has developed a cost effective method for monitoring CD4 count in HIV/AIDS patients.

Team Leaders for Programme Planning for ASRH should be competent facilitators of adult learning with specialised knowledge of Programme Planning, Sexual and Reproductive Health and Youth Development (1 month contract). Closing date: 15 August 2002.

Department of Health officials yesterday denied that government had decided not to accept money from the multi-billion rand Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, initiated by United Nations Secretary-General Kofi Annan. This is despite comments made by Finance Minister Trevor Manual in New York this week that South Africa did not need money, but rather required the capacity to address HIV/AIDS and other health problems. Manual was responding to comments made by Harvard University's Jeffrey Sachs that government needed money to buy anti-retroviral treatment for people with HIV/AIDS. Sibani Mngadi, Health Minister Dr Manto Tshabalala Msimang's spokesperson, pointed out that the minister had been part of the Transitional Working Group that facilitated the establishment of the Global Fund. The Minister had worked hard to ensure that the Fund remained focused on the three diseases and has emphasized that the Fund should also be used for improving health systems and capacity in the most affected countries, he added. However, while Mngadi stressed the minister's involvement in the Fund he would not be drawn on whether South Africa would apply for funds, and implied no decision had been taken on this yet. Other health department sources expressed shock and said they were convinced Manual had been misquoted. However, there is considerable tension between the health and finance ministries and it is possible Manual expressed his own personal view which he had not canvassed with the health minister. Meanwhile, the Treatment Action Campaign's Nathan Geffen said that if government claimed the public service lacked the capacity to address HIV/AIDS then this reflected very poorly on the highest echelons of government. Ministries of health in potential recipient countries have already been sent an announcement from the fund calling for funding proposals. The first deadline will be March 10. Proposals received by then will be discussed at the board's next meeting on March 23-24. All proposals will be evaluated by an independent, expert Technical Review Panel which will advise the board. Countries intending to apply for money are supposed to set up country co-ordination mechanisms (CCM) representing all stakeholders to formulate proposals. (Source: Health-E, 6 February 2002)

Objectives: To estimate the incremental costs of an actual program to reduce mother-to-child transmission of HIV and to determine its sustainability.

Two-and-a-half million rands later, the Presidential AIDS Panel has come up with a report that shows little more than the chasm between dissidents and orthodox scientists. The final report, presented to the cabinet in Cape Town on Wednesday, concludes that the rift was so great that the delegates were unable to find common ground on policy matters. The panel could not even provide a single set of recommendations. Its 13 pages of recommendations were split up into two sections according to dissident and orthodox views. The R2,5-million spent on the AIDS panel could have bought 5 million condoms Stark statistics presented by the orthodox scientists included the results of two studies. One, from King Edward VIII Hospital in Durban, shows that the two-year fatality for children infected with HIV is almost 60 percent. Case fatality rates went up from 4,5 percent in 1995 to 22,6 percent in 1999. Another, from Chris Hani Baragwanath Hospital in Soweto, shows the infant mortality rate is more than double in HIV-positive children versus HIV-negative children. HIV incidence at the hospital increased from 26 percent in 1997 to 30 percent in 1999. (Source: The Star, 5 April 2001)