HIV

South Africa’s move to decentralize the treatment of drug-resistant tuberculosis (TB) has given rise to a crop of nurses equipped not only to initiate patients on HIV treatment, but also to prescribe for and monitor drug-resistant TB (DR-TB) patients. However, experts and government officials say the need for specialist physicians and hospitals will continue, based on research presented at the South African TB conference in the port city of Durban.

The lack of proper sanitation, poor access to health services, malnutrition and HIV/AIDS are all contributing factors to early childhood deaths. Maternal deaths are also increasing, mainly due to HIV infection. This is according to studies done by the United Nations Children’s Fund (UNICEF).

More than seven million children died before their fifth birthday in 2010 - nearly all from preventable causes. One of the reasons for this is mothers not wanting to breast-feed their children. This is according to Dr Siobhan Crowley of the United Nations’ Children’s Fund (UNICEF).

The national health department has contracted additional pharmaceutical manufacturers to make up the critical shortage of the antiretroviral tenofovir across the country.

HIV clinicians and doctors warned last week that the continued stock out of tenofovir and the failure to advise health workers on how to deal with it was a looming disaster.

Reports of stock outs go as far back as October last year with the explanation given that the drug suppliers Aspen Pharmacare and Sonke Pharmaceuticals were not able to meet the demand once they were awarded the tender.

It emerged this week that the national health department had directed provinces to order tenofovir from two additional suppliers.

The KwaZulu-Natal health department is roping in everyone from traditional leaders to school principals, and church elders to private doctors in a quest to make the National Health Insurance (NHI) rollout work in Umgungundlovu and two other districts.

Provincial health MEC Dr Sibongiseni Dhlomo and national Health Minister Dr Aaron Motsoaledi will hold a meeting with traditional and community leaders in Pietermaritzburg next week to discuss the role they can play in promoting awareness.

Provincial department spokesperson Desmond Motha said the main challenge, especially in rural areas and areas where illiteracy is rife, was people not wanting to test for HIV.

The continued stock out of the antiretroviral tenofovir and the failure to advise health workers on how to deal with it is a looming disaster, HIV Clinicians and activists are warning.

Reports of stock outs go as far back as October last year with the explanation given that the drug suppliers Aspen and Sonke were not able to meet the demand once they were awarded the tender.

Dr Francesca Conradie, President of the Southern African HIV Clinicians Society said they had submitted the clinical guidelines for health workers on how to swop out medications in February, but that it has not been ratified by the health department meaning it is not being used.

Attached are important changes to ART guidelines applicable in all state facilities, some of which were already signalled in the NSP 2012-2016.

“To some extent in this document, NHI has become almost like a panacea to solve all the problems in the health system,” Dr Duane Blaauw said during a debate on the ANC’s policy discussion documents at the University of the Witwatersrand, in Johannesburg.

The ANC’s policy discussion document on health focused mainly on NHI, he said. All other health policy processes had been put on hold as a result.

“To some extent, all other policy processes are now on hold... NHI is going to solve all the problems in the health system, somehow it’s a magic bullet and it’s going to fix the weaknesses.”

The report covers the maternal deaths that were reported to the NCCEMD secretariat by 15th April 2011, and that occurred in the triennium 2008-2010. The same definitions used in previous Saving Mothers reports were used in this report.

Key findings

FOURTEEN years ago, Kholekile Shasha joined SA’s nascent doctor training programme in Cuba, unaware of how controversial the state-sponsored initiative would turn out to be.

He came from a poor family, and had finished high school in the Eastern Cape with exam results just shy of the grades needed to study medicine in SA. He leaped at the chance of a free education in Cuba.

"I was disadvantaged in terms of colour, and access to education and finance," he says.

Ministers of Health and representatives from the 22* countries with the most new HIV infections in children have come together to report on progress towards achieving zero new HIV infections in children by 2015 and find ways of stepping up action.