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Free State patients ‘€˜will die’€™ after being refused treatment

Written by Health-e News

Free State doctors say some patients denied antiretroviral treatment because of the financial crisis in the province will die, and fear that they might face court action.

A doctor working at a treatment site in Bloemfontein said he was ‘€œpetrified’€ that the situation had been allowed to get to this point.

‘€œWe are waiting for a letter Dr Tshabalala (head of HIV in the province) promised us, which would indemnify us from any future legal action,’€ he said, confirming that some of the patients would die while waiting for treatment.

Head of the Free State Health Department Professor Pax Ramela has confirmed that his province had stopped placing about 400 patients on ARVs since the beginning of November, but denied that this was due to financial mismanagement.

‘€œI am angry that they never warned us that there was a problem, that they left it to the last cent before they told us there was a problem and told us in the same breath that we could not start patients on treatment,’€ said a doctor from the Northern Free State, who asked to remain anonymous for fear of victimisation.

He said he had turned away 30 patients on Monday alone despite the fact that they had ‘€œpatiently sat in queues and gone to clinic in the early hours in preparation for their treatment’€.

‘€œThey feel terribly let down,’€ he added.

Paediatricians had run out of Kaletra two weeks’€™ ago, he added. Kaletra is a drug administered to children as part of the second line regimen.

‘€œThat’€™s it. There was nothing we could do. There was no stock, so we simply had to stop giving it to children who were using it. There was no replacement until new stock arrived this week,’€ he said.

The doctor claimed that his clinic was due to run out of some drugs for patients currently on treatment by December 15, which would see patients developing drug resistance and lead to treatment failure.

Reports of drug shortages and e-mails ordering sites to not start new treatment surfaced recently after the Treatment Action Campaign (TAC) released correspondence between the Dr Mvula Tshabalala ‘€“ the province’€™s manager of its ARV programme – and the chief pharmacist.

Tshabalala ordered that all treatment sites cease placing new patients on ARVs and to also not continue monitoring them so no expectations were created.

The revelation was slammed by the TAC which called for an investigation.

National Treasury denied at the time there was a shortage of funds and said it was baffled as to why the province was saying that it had run out of money to start treating the hundreds of people on waiting lists.

Days later Health Minister Barbara Hogan dispatched a high level team to the province and released R9,5-million as well as securing funds from the United States President’€™s Emergency Programme for AIDS Relief (Pepfar).

According to Ramela, the Treasury had given the Free State R63-million less than what was needed to cover activities such as ARV treatment, the Prevention of Mother-to-Child Transmission (PMTCT) programme, home-based care, voluntary counseling and testing, step down care and training.

He also said that by the end of September the province had exceeded its target of having 27 000 patients on ARV treatment by an additional 2 291 patients.

The Northern Free State doctor said the situation had become desperate. ‘€œWe need to panic. The advance (R9,5-million) won’€™t solve the problem in the long term. They need to own up that they made a mess and find ways to get patients on treatment and continue the treatment of those who have already started. We are at the mercy of bureaucrats,’€ he said.

‘€œThe aftermath is that our patients have lost trust in us. How will they ever trust us again?’€ he asked.

Free State Health Department spokesperson Elke de Witt failed to respond to a request for comment.

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