Pretoria – South Africa has made significant strides in the implementation of its HIV, TB and Prevention of Mother-to-child Transmission (PMTCT) programmes, an Independent Review has shown.
Released on Thursday, the review was led by the World Health Organisation (WHO) and undertaken by a multi-disciplinary team of 161 South African and international reviewers to assess the performance of the programmes.
The review documented what works and where the programmes need to be strengthened.
The National Department of Health commissioned the first Joint Review in June 2013. It was conducted in 21 of the 52 districts and with visits to 100 health facilities across the country.
Findings show that since the last review in 2009, the country has scaled up antiretroviral treatment (ART) and HIV testing, with over two million people on treatment in 2012. PMTCT services have reached coverage of 90%.
One million boys and men have been circumcised, with voluntary medical male circumcision being integrated with HIV prevention services.
TB
On fighting TB, the review noted that the country has strengthened support to provinces to improve diagnosis and treatment of multi-drug resistant (MDR) TB.
Over three million people have been screened for TB. The rollout of GeneXpert technology has been a major milestone, enabling TB patients to be diagnosed early and treated.
“The number of sites initiating MDR-TB treatment has increased from 11 to 45 since 2009. A rapid scale up of TB screening among people living with HIV (has occurred) and TB case detection has increased. Diagnosis and management of non-communicable diseases among people living with HIV has been integrated in some HIV care/ART settings.
“TB has been integrated into the mandate of the South African National AIDS Council (SANAC) alongside HIV. MDR-TB care (has been) decentralised and waiting lists have been eliminated. There’s a significant scale-up of collaborative TB/HIV activities, facilitated by the expansion of HIV testing and decentralisation of ART through Nurse Initiated Management of Antiretroviral Therapy (NIMART),” the review highlighted.
Better health
The low uptake of HIV testing, particularly among children from two to 14 years, no systems for reporting or managing side effects and lack of confidence of health workers in managing a child with TB, are some of the challenges noted by the review.
A need to further strengthen capacity in the delivery of integrated services at primary health care (PHC) and community level was also identified.
Health Minister Dr Aaron Motsoaledi welcomed the findings and recommendations of the review. He reiterated the department’s commitment and determination to ensure that the recommendations are implemented, according the availability of resources.
“We are undertaking a major health systems reform that will ultimately improve the quality of health care and expand access to services. The National Health Insurance is central to our reform efforts and once fully implemented, South Africans will be able to access health care, irrespective of the socio-economic circumstances they may find themselves in,” Minister Motsoaledi said.
Director of Disease Prevention and Control: WHO Regional Officer for Africa, Dr Francis Kasolo, said South Africa’s achievements have been made possible through strong political commitment, robust funding, adequate planning, adherence to technical norms and integration of services, amongst others.
“We are making progress but there’s no room for complexes. We still need to do more in order to meet the national targets as defined in the NSP 2012 - 1016 on HIV/STI/TB.
“The WHO will continue to work with you all in our continued fight against HIV/Aids and TB and indeed in the fight against all significant public health problems in our health systems,” Kasolo said.
UNAIDS Country Director Frits Lherisson said communities must be mobilised and responsibilities shared to achieve better results.
Ambassador Patrick Gaspard from the US Government commended the country for its work to scale up its HIV and TB programmes.
“Its expertise and scientific capability and its leadership in the region and the world is something to celebrate, and I deeply respect what you have done,” said Gaspard.
He also announced an additional US$11 million for voluntary medical circumcision. – SAnews.gov.za
