The Free State health department controversially implemented a moratorium on HIV treatment late last year and only lifted it after then health minister Barbara Hogan secured donor funds to finance the programme until the new financial year kicked in earlier this year. However, by then the waiting list had grown to over 15 000 and an estimated 30 patients were dying every day.
Free State health department officials told a provincial health summit last month that patients should expect another moratorium on initiating new patients on ARVs from next month, according to reliable sources who attended the summit. Head of health in the province Professor Pax Ramela has also quietly been suspended and the national health department is again considering sending a task team to the beleaguered province.
A report from the provincial health summit held in mid-July reveals that the Free State health department is R252-million short for its HIV/AIDS programme. The province has budgeted far too little for ARVs, as it has already spent R50-million – almost all this financial year’s budget for ARVs. There is no clarity on how many people are currently on treatment with figures varying between 27 000 and over 40 000.
Subsequent to the earlier moratorium, Hogan set up the Integrated Support Team to investigate the causes of over-expenditure in the province and the budgeting and financial management systems. These investigations were completed in May and the reports are with Health Minister Dr Aaron Motsoaledi, but are yet to be released.
Members of the Free State Health Coalition – a group of activists, healthcare providers, legal experts, people living with HIV and religious organisations ‘ have reported shortages of medicines everywhere in the province. ‘The Prevention of Mother to Child Transmission (PMTCT) programme is in disarray,’ said a report from the coalition.
The AIDS Law Project is in the process of gathering affidavits from mothers who were not given the PMTCT regimen and whose babies are now HIV positive. Some of the children had already died.
Lack of needles and vaccines have led to reports of no vaccinations of infants taking place and condoms are constantly out of stock across the province. There is also a massive shortage of insulin for diabetic patients and no hypertension medication at Pelonomi Hospital in Bloemfontein. Similar reports have been received from other parts of the province including Harrismith and Welkom.
Thapelo Mlonyeni (6) hit the headlines during the moratorium earlier this year when Hogan stepped in and personally paid for his ARVs. Earlier this month Mlonyeni , who has since been receiving his ARVs from Pelonomi , was turned away from the hospital and told to return a month later. His family is now buying his ARVs from a private chemist until his next scheduled appointment at the end of the month. They are struggling to afford it.
Meanwhile, an outspoken AIDS activist in the province, Sello Mokhalipi, was threatened by four men, of which at least two were armed. Rubbing a firearm against his own nose, one of the men told him: ‘You’re talking too much and we won’t come to warn you again. You should consider this a serious warning and you should decide between what you’re doing and your life ‘ which comes first?’
‘I asked them what was it that I was doing, but they told me that were not here to negotiate anything with me, but to warn me and I should consider myself warned,’ said Mokhalipi..
The men then sped off in a white Golf with Gauteng registration plates. However, police at Mangaung refused to take a statement from Mokhalipi claiming they would need the registration number of the car.
A state doctor in Bloemfontein who asked to remain anonymous confirmed that there were constant stock-outs and that some drug companies had suspended trading with the province over unpaid bills.
‘I am extremely frustrated with the government people who seem to not grasp the importance of what they are doing, who cannot see that their lack of commitment to our people is leading to human rights abuses. There is simply no urgency and in the meantime patients are dying. It seems as if they have decided there are too many people who need help, that it is impossible for them to help everybody and they have made peace with it,’ said the doctor.
Trudie Harrison of the Mosamaria Project in Bloemfontein had a 29-year-old man die in her car recently after he had been turned away from several health facilities and told to return later. He had been trying to access help at the MUCPP clinic since March. He knew he was HIV positive and tried on several occasions to access treatment, but was turned away at Pelonomi Hospital and told to return weeks later for baseline tests.
He died in Harrison’s car earlier this month as she was rushing him to a hospice.
The Free State provincial cabinet recently spent R11-million on new vehicles including a R1,3-million Mercedes Benz S600 for Premier Ace Magashule. Over R7-million was spent at the opening of the provincial legislature.
Several attempts by the coalition to meet with the MEC have been unsuccessful.
Dr Yogan Pillay, Deputy Director General in the national health department confirmed that they were aware of the ‘fiscal challenges’ that the Free State health continues to face in this financial year.
He said there was less funding available in the current financial year as the debt of the previous financial year needed to be paid before new expenditure can be incurred.
He said health minister Dr Aaron Motsoaledi was also liaising with the provincial political leadership to explore strategies to support the province.
‘With respect to the ART programme, the National Department is working with the Free State Department of Health to stabilize the programme,’ said Pillay.
He gave the assurance that measures had been put in place to ensure that the province should not experience a shortfall until additional funding is mobilized by provincial and national governments to fund this programme until the end of the financial year.
The Free State health department failed to comment.