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Heal th Minister Dr Manto Tshabalala-Msimang says she is satisfied with the pace and progress made so far in the implementation of the Comprehensive Plan for Care, Management and Treatment of HIV and Aids.

Briefing the media at Parliament yesterday, she described the plan as complex, and said "what we are seeing is exactly what we anticipated" when it was originally announced.

That aspect of the plan involving antiretroviral (ARV) treatment for people with Aids whose immune systems were severely depleted, had required special preparation.

While other aspects - such as treatment of tuberculosis, and nutrition - were built on existing services, ARVs had not been offered previously in the public sector.

"It is a treatment that requires good, patient record systems; effective laboratory services; and pharmaceutical supply systems that are reliable and secure.

"It also depends to a huge extent on engaging the patient as a partner in treatment," Tshabalala-Msimang said.

All provinces had made progress in providing the ARV option to patients who met the medical criteria for treatment.

However, the pace had differed from area to area, in accordance with the groundwork that had been done to meet the national standards set for designated service points.

Gauteng, KwaZulu-Natal and the Western Cape had fairly large numbers of patients receiving ARVs, but the other provinces were not yet providing antiretroviral drugs to patients on any significant scale.

They were all actively enrolling patients, which meant conducting tests, counselling, and educating patients in preparation for ARV treatment, a process which took several weeks, she said.

An indication of the volume of patients being enrolled across all nine provinces was that of 11 800 CD4 blood tests done during April, 6 700 had revealed CD4 counts under 200.

A count of under 200 indicates advanced Aids.

Tshabalala-Msimang said because the tender process for ARVs was complex and lengthy, interim arrangements had been made for provinces to buy initial supplies of drugs.

These interim measures had also not been entirely trouble free, with the range of generic drugs currently available being limited, which meant prices were relatively high.

There were also long lead times between order and delivery, imposing certain constraints. Paediatric drugs were in particularly short supply.

"As a result, provincial health departments have taken a cautious approach to initiating treatment, knowing that it is dangerous (for the patient) to interrupt it."

However, the tender process for long-term supply of ARVs was well under way, Tshabalala-Msimang said. - Sapa  

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