Supply is significantly lower than the demand for treatment in the state health sector, according to a Treatment Action Campaign study of the government's anti-retroviral roll-out plan, released at the Second South African Aids Conference in Durban on Wednesday. Despite proof that the intervention is working where anti-retrovirals are made available - including in Cape Town where a study found that people with a CD4 count of 200 had an 80 percent survival chance after three years of taking the drugs - only 42 000 state patients are receiving anti-retrovirals 18 months after the adoption of the government's operational plan, the TAC study said.
The most significant barriers were identified as:
- The lack of trained doctors, nurses, pharmacists and other healthcare providers was hampering implementation. Several treatment sites were capping patient numbers, and long waiting lists were the result.
- Nutrition, although loudly and consistently supported by the health minister as an alternative form of treatment, was getting little attention. As at April this year, the adults and child patients at one Gauteng treatment site had not received a single food parcel.
- There have been a number of reports in the past months regarding problems with drug availability in various parts of South Africa, especially of efavirenz, apparent evidence of the manufacturer's inability to meet demand.
The TAC report called for a national mobilization to treat 200 000 people by next year, pointing to the targets as necessary and possible considering they were endorsed by the cabinet as part of the government's comprehensive treatment plan.
The report said that while the national total of 42 000 state patients on anti-retrovirals seemed at first glance to demonstrate significant progress, the figures were misleading.
Only a few provinces, including the Western Cape, KwaZulu-Natal, Gauteng and the North West, were responsible for the bulk of people on treatment. While KwaZulu-Natal and Gauteng may have the highest numbers on treatment, the programme's pace and reach were areas of concern.
(Source: IOL, June 9, 2005)