Monitoring access to free ARVs

A South African non-profit organisation has initiated a nationwide network to monitor access to free antiretroviral (ARV) treatment. The project, called the 'Treatment Monitor', collects data from a wide range of organisations throughout the country, which will be used to lobby government, detect shortfalls in research and develop best practices. The Health Systems Trust (HST) began keeping track of access to ARVs and care early this year, and functions as a clearinghouse for treatment information. The Trust saw the need to launch the project because "there is no single monitoring framework available that provides a national picture" of South Africans' access to treatment, said HST senior researcher Rob Stewart. "Access to information is a major hurdle a number of institutions have to overcome, and the government is certainly one of them," Stewart told PlusNews, adding that some government departments held back information that should be in the public domain. The Treatment Monitor is aimed at helping to identify loopholes in the current health system and build consensus among the participating institutions. Groups providing information to the Treatment Monitor include the Treatment Action Campaign (TAC), AIDS Law Project, KZN Monitoring Forum, Medecins Sans Frontieres, South African HIV Clinicians Society, South African universities, government departments and parastatals, such as Eskom, and private sector corporations, including Anglo-American and Daimler Chrysler. "We try to pull the different pieces together and create an environment where information can be shared," said Stewart. Another goal of the Treatment Monitor initiative is to identify gaps in research. According to Stewart, research has not been done in a number of areas, such as service delivery models, the role of community health workers and traditional healers in screening and supporting drug adherence, financing of the national ARV programme and its sustainability, and making structural changes to the health system required for a successful rollout of ARVs. Although HST will only be disseminating the first observations of the Treatment Monitor next year, Stewart could identify some core weaknesses of the South African government's health policy. According to the latest numbers from the Joint Civil Society Monitoring Forum, 18,500 South Africans are currently receiving ARV treatment - just a third of the government's target of having 53,000 people on treatment by March 2005. "We have a long way to go," said Stewart. For more articles on the subject, plus interviews and a comprehensive database on numbers on treatment in sub-Saharan Africa, visit the PlusNews Web Special