HIV, AIDS and TB top cost drivers for GEMS

Friday, September 28, 2012

Pretoria - Claims for HIV, AIDS and TB-related conditions are among the top ten cost drivers for medical claims made annually, and employees are accessing disease management packages at an advanced stage of their HIV infection, usually with low CD4 counts, according to the annual key health trends reported by the Government Employee Medical Scheme (GEMS).

The report by the medical scheme for public service employees, noted that employees were being diagnosed late and this was having an impact on their chances of responding well to antiretroviral treatment.

The report further noted that the enrolment into the GEMS disease management programme had increased from the 2010 baseline by 65% (from 32 243 in 2009/10 to 53 495 in 2010/11) as measured by Aid for AIDS (AFA) registration data (GEMS'2010).

Whilst this is an encouraging milestone, the report, however, highlighted that this enrolment does not occur early enough in the course of the HIV disease progression before the CD4 count drops below 350.

The findings showed that 34% of beneficiaries are enrolled at the CD4 count of 200 and a further 22% at a moderately severe immune-suppression. The 2010 report showed that the majority (76%) of AFA registered beneficiaries were principal members of GEMS.

The proportion of employees tested for HIV through private health care service providers in the last year increased by 78%, from 9791 in April 2010 to 86 324 in June 2011.

In all the national and provincial reports reviewed there are three leading conditions, psychiatric illnesses such as depression and anxiety, respiratory illnesses and muscular-skeletal illnesses such as lower back, osteoarthritis and various orthopaedic conditions.

These statistics were released on Thursday by the Department of Public Service and Administration during the launch of Intensification of the HIV Counselling and Testing Campaign in the Public Service.

The campaign aims to get public servants to test, know their status and access treatment early before the current baseline of CD4 count of 200.

Speaking on behalf of the department, Health Minister, Dr Aaron Motsoaledi said that the findings demanded that the public service aggressively popularise regular HIV counselling and testing to increase the number of employees who know their HIV status so that they can access treatment, care and support in the very early stages of their infection. This would ensure favourable treatment outcomes.

"The HCT campaign should be linked to the empowerment of the vulnerable groups, like women, youth, low-income and non-professional groups, in line with the SADC initiative of Mainstreaming of HIV and AIDS into social and health issues.

"It should also be intensified for employees in the Departments of Health and Basic Education, where HIV prevalence has been confirmed to be higher," Dr Motsoaledi said.

During the event at the Union Buildings on Thursday, the Department of Public Service and Administration also launched three guidelines which should serve as entry points towards HIV and AIDS mainstreaming in the public service.

The guidelines, which will be implemented in the public service with effect from 1 April 2013, include:
- Guidelines on Gender Sensitive, Rights Based, HIV and AIDS Mainstreaming Guidelines into Public Service and Administration
- The Guidelines on management of Psychosocial Stressors in the Public Service (The SOLVE Guidelines)
- The Guidelines on Child care Facilities in the Public Service.

"This initiative is a first step to rally all government departments to integrate HCT into their annual operational plans and report on outputs and outcome indicators for their HCT Programme implementation to DPSA, which in turn will submit collated Government Sector report to SANAC," Dr Motsoaledi said.

He said that it was through a healthy, dedicated, productive and responsive workforce that one could collectively work towards the attainment of efficient and effective service delivery.

The intensification of the HCT campaign among government employees is expected to lead to an increased proportion of HIV-infected employees who are enrolled into disease management programme, early in their course of HIV infection before CD4 count drops below 350 to enable them to live longer healthy productive work-lives.

The campaign will also see an increase in the number of employees who know their HIV status, a reduction of the stigma and discrimination associated with HIV testing, and the increase the implementation of all prescribed HCT screening components, and not just HIV testing.

The intensification of the campaign will further lead to the intensified development of targeted prevention messages to promote healthy-lifestyle choices irrespective of one's HIV status as well as accurate monitoring of condoms (males and females) distributed in the Government Sector departments.

A target of achieving a 100% percent coverage of all 1.3 million public servants by 31 March 2016 has been set. This excludes employees of the state owned enterprises and dependents of public service employees

On Thursday Deputy President Kgalema Motlanthe announced that, more than 20 million South Africans have tested for HIV and other diseases since President Jacob Zuma launched the original HCT campaign in 2010.

He said that the intensification of the HCT campaign was a gateway to the implementation of the new guidelines and initiating a culture of taking responsibility for our health and wellness.

"The NSP [National Strategic Plan] for HIV, TB and STIs has defined this intervention as one of the priorities in our response. We want to encourage other sectors to follow this lead and extend services to their employees and the communities in which they work.

"From all these intervention, we are confident that a future of zero new infections, zero discrimination, zero Aids-related deaths and zero new infections due to vertical transmission is within reach," he said.

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