Although South Africa has no ‘policy as such’ to provide anti-retrovirals to people living with HIV/AIDS, it was relying on the private sector to advise it on the implications and complications of such a programme.
Speaking at Parliament’s health committee meeting this week, Minister of Health, Manto Tshabalala-Msimang, said her department needed to be clear about what it wanted to do.
‘It is important that the private sector advises us over and above the government task team,’ Tshabalala-Msimang said.
But the minister cautioned that there was a worrying trend in the private sector where drugs were often not dispensed properly with some patients ending up on mono or dual therapy, a fertile breeding ground for resistance.
‘If we don’t use these drugs properly, we will create resistance and then we will not know how to cope. If we don’t do things correctly, we don’t know what we are doing,’ she warned.
‘Don’t tell me to look at Uganda, they are treating no more than 1000 people. Senegal is treating 800, Botswana 500. Do people want me to stand on the corner of the street and say ‘You come and you come’, just so we can say were are treating 2000 people,’ Tshabalala-Msimang said.
She added that there was a need for a comprehensive approach and ‘not an emotional one’.
Director General for Health, Dr Ayanda Ntsaluba, told the committee that the health department was not raising issues around anti-retrovirals with the private sector because it did not want to offer treatment, but rather because it needed to know how to deal with challenges ‘when we offer treatment’.
Head of the health department’s HIV/AIDS programme, Dr Nono Simelela, said the history of the prevention of mother-to-child transmission (PMTCT) programme in South Africa was ‘sad’.
‘Government had made a policy decision long before the court case to implement this programme. In order to measure the impact of transmission in such a programme one has to wait until the babies are one year old,’ Simelela said.
She added that government had been unable to do this.
‘Now we are in a situation where I am not going to be able to tell the country what has happened to the 70 000 babies (born since the programme started),’ Simelela said.
She said the department had been unable to locate the women who ‘move up and down’ as the incentives that were meant to attract them to return to the clinics did not include money for transport.
‘Should they run out of formula milk and there is no taxi fare, they breastfeed,’ Simelela said.
Mixed feeding (breast and formula) is known to increase the risk of the mother infecting her infant.
Simelela said the country was going to face similar challenges ‘when we bring anti-retrovirals’.
‘The challenge is to get health to the people,’ she said.
