“We can treat opportunistic infections [associated with HIV] and we must work harder to diagnose and treat these,” said Simelela.

However, many healthworkers had qualified before HIV was “the most significant communicable disease” and lacked the skill to manage opportunistic infections, added Simelela. Their skills and knowledge needed to be improved.

She warned that the formal healthcare system could not manage the HIV/AIDS epidemic alone and said there was a need for multisectoral teams that included doctors, nurses, priests and psychologists.

Simelela added that unless South Africa managed the TB epidemic, “we will never be able to manage HIV/AIDS care”.

Speaking in the morning, Director-General in the health department, Dr Ayanda Ntsaluba said South Africans tended to “judge ourselves harshly” in the face of transformation of which the scale and pace has few equals.

He said the Health Summit was not as a result of any crisis, but was borne from concern about the gap between policy framework and actual delivery.

Commenting on quality of care, Ntsaluba said there needed to be a balance between the rights of the workers and that of the users. He reiterated a comment by the health minister on Sunday that there was great value in small interventions that may seem insignificant.

Ntsaluba urged delegates to grapple with the real root of the negative work ethos and to look at mechanisms to keep senior professional personnel in rural public facilities.

Turning to public private interactions, Ntsaluba warned that if these interactions increase inequality “they have undone the democratic project.

He said a private sector that contributed to the total health system was strengthened in the longer term.

“An affordable private sector is in the interest of the public sector,” Ntsaluba said. The Summit ends today (Tues).
– Health-e News Service