NGOs to monitor ARV rollout

Close to 8,000 South Africans are now receiving anti-AIDS drugs, but several provinces are still not doing enough to rapidly roll out the treatment programme, an NGO coalition has said in a new report. According to a joint civil society forum - which includes the AIDS Law Project (ALP), the Southern African HIV Clinicians Society (SAHCS), and the Treatment Action Campaign (TAC) - the demand for antiretroviral (ARV) treatment in all provinces was being "frustrated by long waiting lists" to access ARVs and receive care. The report noted that at one treatment site in KwaZulu-Natal, waiting lists are running into August 2005. The NGOs have launched a project to monitor and evaluate the country's treatment programme in all nine provinces. The coalition said the low numbers of patients on treatment were due to the late rollout of drugs, rather than lack of demand. Transport difficulties meant patients living in rural provinces often had trouble accessing the drugs. Severe staffing shortages, fuelled by inadequate working conditions and the impact of HIV/AIDS, was also a serious problem. In provinces such as Limpopo and Mpumalanga, advertised posts for doctors, nurses and pharmacists were not being filled, the report noted. The monitoring forum expressed concern at the failure of the national department of health and some provincial health departments to publicly release information about the extent of the treatment campaign. Although 10 drug manufacturing companies have been short-listed to procure the medication, tender contracts have not been awarded. "The unnecessarily slow procurement process is frustrating the efforts of some provinces to scale up speedily. It also affects provincial budgetary planning and the continued utilisation of available resources," the report warned. The coalition called for more focus on issues of quality assurance and quality control at some of the National Health Laboratory Service (NHLS) facilities performing CD4 and viral load tests. They recommended that the NHLS outsource services to the private sector in areas where it lacked adequate capacity. Effective site management was still lacking at many sites in wealthier provinces, such as Gauteng and the Western Cape, which could be solved by appointing managers and administrators. "The sheer number of patients that they have to manage is overburdening many doctors and nurses. Therefore, a plan to employ (as opposed to working on a stipend basis) as well as deploy and accredit voluntary counselling and testing (VCT) counsellors to assist doctors and nurses with the day-to-day management of patients is necessary to relieve their burden. In addition, a career path for counsellors to become adherence counsellors in ARV programmes is necessary," the forum suggested. "National government should assist poorer provinces by providing them with comprehensive support and assist with the speedier transference of HIV/AIDS conditional grants," the report concluded. To access the report: www.tac.org.za