Date: 31/03/2005
Source: Free State Provincial Government
Title: Belot: Free State HIV/Aids Conference


Speech by Mr Sakhiwo Belot, MEC of Health, Free State at the Gala Event held at the conference on Implementing the Comprehensive Care and Treatment Programme for HIV and AIDS patients in the Free State: Sharing Experiences, University of Free State

Master of Ceremonies,
Professor Benatar,
Professor Yvo Nuyena,
Members of the international community,
Delegates and
Ladies and Gentlemen:

INTRODUCTION

It is a privilege and honour to participate in this prestigious conference. This conference is important to us as government as it provides a climate and an environment to reflect on that which faces us in the area of HIV and AIDS. I believe that at the end of this conference we will leave here better equipped to deal with the challenges.

Government and the department of health in particular has a responsibility to provide health care services to the citizens of our land. It is for that reason that government is committed to have healthy communities. It is for that reason that government participates and supports all the aspects of implementing the comprehensive care and treatment programme for HIV and AIDS.

Ladies and Gentlemen, I have been asked to talk about political commitment and its importance in the fight against HIV and AIDS. I want to use the analogy of an army at war. We are an army at war against HIV and AIDS.

Many battles have already been fought in this war. Both by individuals and organized organs of society affected and infected by the virus. This war has also had its casualties – as in every war. Wars are fought by winning or loosing battles. As soldiers in this war, we are all each day fighting a battle with the hope of winning.

Programme Director, ladies and gentlemen, in the Free State, the fight against HIV and AIDS has been given the highest political attention and commitment. As in the rest of the world, government’s commitment in the Free State is underscored by the following programmes:

1) Building partnerships
2) Home based care and step down facilities
3) Voluntary Confidential Counselling and Testing (VCCT)
4) Prevention of Mother to Child Transmission (PMTCT)
5) Management of Sexually transmitted Infections
6) Education and awareness campaigns
7) Funding for non-governmental organizations or NGO’s
8) Distribution of condoms; and
9) The Comprehensive Care and Treatment Programme for HIV and AIDS patients

Master of Ceremonies, allow me to expand on some of these programmes. With regards to partnerships we have been able to put structures in place whose purpose is to advance the battle against HIV and AIDS. These structures assist us in the most crucial task relating to advocacy and social mobilization. They include the following;

* Inter Ministerial Committee on HIV and AIDS
* Interdepartmental Committee on HIV and AIDS
* Provincial Aids Council
* District AIDS Councils
* Departmental focal persons
* Non-governmental/community based organization consortiums
* Women and Men in Partnership against AIDS
* Faith based sector HIV and AIDS forum
* Traditional Healers Forum on HIV and AIDS
* Traditional Leaders task team on HIV and AIDS and
* Partnership with Business.

Ladies and gentlemen, Home Based Care is one of the significant initiatives through which we engage in this fight. As much as this government focuses on strengthening prevention efforts we do acknowledge the fact that many of our people are already infected and are living with the disease. It is against this background that we have a Home Based Care programme in place. We need to ensure that this Home Based Care programme alleviates the burden in the public hospitals. I want to keep on emphasizing that the care that we render at this programme is not sub-standard as we ensure that all those that are rendering this service are adequately and continuously trained.

As regard the Prevention of Mother to Child Transmission (PMTCT) of HIV/AIDS, in the Free State we launched PMTCT in July 2001 at the two research sites of Virginia and Frankfort hospitals, including the 16 clinics which serve as the catchments for these two hospitals. The purpose of these research sites was to gather the necessary data as regard this programme and test the efficacy of Nevirapine drug for the prevention of mother to child transmission of HIV/AIDS.

I am proud to say that the pilot at these two sites were successfully implemented because of the dedication and resilience of our personnel in the face of difficult circumstances sometimes.

Honoured guests, ladies and gentlemen, following the court order that Nevirapine should be made available in all health facilities in the country and in our province specifically we moved as much as we could to implement this order. To attest to this fact the following actions were taken in the Free State:

1) Nevirapine and Rapid Test Kits are now available in all our hospitals and health complexes.

2) Pregnant women who know their HIV status can access Nevirapine from their nearby hospitals and clinics. Those who do not know their status can go for counselling and, if so desire, consent for HIV testing.

3) Health professionals and lay counsellors have been trained to properly support the pregnant women in making decisions regarding their status.

4) Professional nurses from all 5 districts have been trained in PMTCT, counselling and infant feeding to support their districts in building capacity and the expansion process.

Ladies and gentlemen, as regard Voluntary Confidential Counselling and Testing (VCCT) programme we have also had some advances. We have managed to establish 235 medical and 7 non-medical sites in the province. 359 Lay Councillors are currently rendering services in the health districts of the Free State. We are working very hard at mobilising individuals to take part in this programme because we can be able to have concrete statistics regarding levels of infections in the population when people present themselves for counselling and testing in large numbers. Otherwise our data is for now reliant on pregnant mothers who visit our public health clinics. We are now expanding this programme to rural areas. We have mobile clinics that are currently participating in this programme.

Furthermore, following the decision taken by Cabinet on post exposure prophylaxis treatment, which includes the administration of 3TC and AZT, is also being provided to rape victims in our district hospitals and Victims Support Centres. Therefore rape victims who present themselves at these institutions are provided with this treatment.

Honoured guests, the other issue that presents us with enormous challenges is the twin threat of HIV/AIDS and TB. It has been established that many of the people who die from HIV/AIDS are at the same time infected by Tuberculosis (TB) as an opportunistic disease.

We are therefore working very hard at addressing the scourge of TB in our province on its own and as a twin of HIV/AIDS. We have identified Mafube municipality as the Free State TB/HIV/AIDS pilot site aimed to facilitate improvement of collaboration between the HIV/AIDS and TB programmes and improvement of the quality of care to people living with HIV/AIDS including patients co-infected with TB and HIV. The pilot site must implement and evaluate a comprehensive package of HIV/AIDS/STD/TB prevention, care and support. This package includes increasing access to HIV counselling and voluntary rapid HIV testing. It is expected that Belgium donor funds will be made accessible for the pilot program. Business plans have been submitted to the National department for funding consideration. Rollout of the integrated programme to the rest of the provincial districts will be initiated during the next financial year.

Honoured guests, it is clear therefore that our strategy against HIV and AIDS is a guide to action and we have moved mountains in the battle in implementing these elements as contained in the comprehensive strategy. I want to keep on emphasizing that the battle against HIV and AIDS requires direct involvement and commitment from everyone of us.

Master of Ceremonies, political commitment was explicitly shown by this government to implement the antiretroviral drugs. In our province a lot of ground has already been covered in implementing this programme and this conference can attest to that. This is a battle we want to win.

The Free State Department of Health commenced with the implementation of the comprehensive care and treatment of patients with HIV and AIDS programme at the Bongani Regional Hospital in Welkom and three clinics. Today we have successful managed to roll out the programme in all five health districts at 7 sites to 6060 patients (this includes male and female 98 children).

I am proud to announce here this evening that we have just completed the first report on the “Implementation of the Comprehensive Care, Management and Treatment of HIV and AIDS patients – Outcomes of the first year 2004” in collaboration with the University of Cape Town Lung Institute and the Medical Research Council of South Africa. Copies of this are on your table and also available from the Conference Secretariat tomorrow. The findings of the report have enabled us to identify shortcomings in our approach and care network. We need to feverishly address the consistent and secure supply of drugs and medicines and deficiencies identified in the care being provided to patients not yet on ART. As a province we have set plans in motion to ensure that we deal with these challenges.

We also need to address the low numbers of children currently having access to the programme and strategise around the issues of breastfeeding of children by HIV positive mothers or caregivers. Many related issues such as infection control of milk preparation processes, traditional practices, birth attendants and HIV prevention and treatment techniques need to be address in our provincial approach in the war against HIV and AIDS.

Delegates, may I remind you that wars are not won in one day. Political commitment shown by this province is clearly set out however, may I remind you that we as government has always believed in cultivating a society that cares and has often reiterated its unwavering stance against poverty and all its symptoms.

This conference has given the Free State an opportunity to show case its programme but also provide a platform for the sharing of challenges, successes and lessons learned. It is in events like this that we as government and political leaders see the battles being won. However, there is no time for complacency and non-commitment.

Let us all make a personal commitment to fight each battle, strategise to the best of our abilities to ensure a prosperous and HIV and AIDS free future for our country. Let us fight the battles in the board rooms, classrooms, homes, on the streets, in the churches and in the battlefield commit ourselves to an approach that unifies us all against the pandemic.

I thank you.

Issued by: Office of the Premier, Free State Provincial Government
31 March 2005