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South Africa: Solving HIV treatment bottlenecks
In the Mhlontlo District today, about 1,600 patients are receiving ARVs, with an average of about 60 new patients beginning ARV treatment each month.
MTHATHA, 4 January 2008 (PlusNews) - The monthly "Improvement Meeting" at Qumbu Health Centre, 50km from the Eastern Cape province town of Mthatha, is supposed to start at 9am, but rarely starts before 10am.
Many of the nurses attending work at remote rural clinics scattered across Mhlontlo District and have to travel along rudimentary roads using the mini-bus taxis system to reach the meeting, so no-one complains about late arrivals.
Once seated, they begin calling out figures to Kholeka Mhlakaza, the HIV/AIDS treatment programme manager for Mhlontlo, who writes them on a whiteboard.
The figures reflect how many patients at each clinic have begun antiretroviral (ARV) treatment in the past month as well as how many suspected TB patients and children born to HIV positive mothers have been tested for HIV.
Although the numbers look deceptively modest, what they represent is an extradorinary achievement for a district where only three doctors provide HIV care for 200,000 residents, an estimated 25,000 of whom are HIV positive, and where only 75 patients were initiated on ARVs in the first eight months after treatment began rolling out here in July 2004.
Today, about 1,600 patients are receiving ARVs, with an average of about 60 new patients beginning ARV treatment each month. The story of how Mhlontlo District achieved this without any significant increase in resources is one that South Africa needs to learn from.
South Africa's minister of health, Dr Manto Tshabalala-Msimang, regularly describes the country's ARV programme as the largest in the world (about 370,000 people were on treatment as of September 2007), but others point out that with the world's largest burden of HIV infections, treatment scale-up is still happening too slowly.
In a recent presentation, Dr Andrew Boulle, a public health specialist from the University of Cape Town, said that in South Africa's Free State Province, 87 percent of HIV-patients who died during a 20-month period had never received ARVs.
Many HIV-positive South Africans are not coming forward for testing and treatment, but others are dying while waiting for ARV treatment to begin.
Read the full article here http://www.plusnews.org/Report.aspx?ReportId=76096
