‘€œMaybe this time, in order to avoid the challenges we’€™ve had, we must just work out what the quotas are in terms of numbers and stick to those numbers. If you come and we’€™ve said only 20 and you are number 21 in April, we tell you to wait for next month’€, says Prof. Pax Ramela, head of the Free State Health Department.

He added that ‘€œthe lack of quotas on treatment access in the financial year ending this March, is the reason there was over-subscription of the ARV programme, which led to last November’€™s moratorium to not allow new patients to access treatment’€.

‘€œWe should actually have staggered the intake of patients from the beginning of the year, so that we can come out to March with 27 000 patients. The ones who seem to be saying to us ‘€˜no, but you did not manage this thing properly’€™, managing it properly means we should actually have turned back the patients from the beginning and agreed on quotas for the month from April and said, ‘€˜we will only take so many patients so that by the time we get to March we would have had 27 000 patients’€™. That way we would have had a continuous supply of drugs. We’€™ve got to think about it if there’€™s no additional help coming and our business plan says, ‘€˜you can only take so many people’€™. The needs by far exceed the budgets that are available’€, explained Ramela.

The Free State Health Department requested national Treasury to fund it for a total of R319 million for its HIV and AIDS programme for the financial year 2009 ‘€“ 2010, which begins in April. But Treasury has given the department only R235 million, which is R83.9 million less. The bulk of the shortfall will hit the province’€™s antiretroviral treatment programme the hardest. It’€™s been under-funded to the tune of R63 million this new financial year.


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