Cabinet yesterday approved in principle the operational plan for the comprehensive treatment and care for HIV and Aids, providing for the rollout of anti-retrovirals (ARVs) in the public health sector.
The plan has been developed by a task team appointed by health minister Manto Tshabalala-Msimang in August, at Cabinet's request that it urgently develop an operational plan by the end of September.
The 14-member team was assisted by a team of experts from the Clinton Foundation Aids Initiative, established by former US President Bill Clinton and led by Ira Magaziner.
According to the approved plan, there will be at least one accredited service point providing the drugs in every health district across the country, within the next year.
And within five years, it is envisaged there will be one accredited service point in every local municipality.
Some areas will be able to start sooner than others, and the Department of Health has promised to keep the public informed on the progress of the rollout.
The facilities - a group or network of linked health facilities operating through a hospital or clinic in a defined catchment area - will provide diagnosis, counselling and treatment for opportunistic infections, nutritional supplements as well as ARVs.
Cabinet explained the plan would be introduced in stages as it called for additional capacity in the national health system, particularly retaining staff and capacitating the country's laboratories.
In this regard, over R750-million is proposed for upgrading systems in the health infrastructure in areas such as drug distribution, patient information systems and monitoring of reaction to the drugs.
The services points will give access to a range of care and treatment, integrated with the prevention and awareness campaign, which remains "the cornerstone of the strategy to defeat HIV and Aids," said Tshabalala-Msimang, briefing the media yesterday, after Cabinet's meeting in Cape Town.
However, government has been quick to warn that while there is no cure for the disease, prevention remains the bedrock of its campaign against HIV and Aids.
The drugs will be administered to people who are symptomatic and/or whose CD4 count is less than 200, said the minister, emphasising that not everyone who was HIV-positive required the drugs. People will then be counselled and offered the option of the antiretroviral therapy, with full information regarding side effects, the benefits of restoring the immune system and improving their quality of life.
The minister said one of the concerns raised was the importance of the drugs taken regularly and correctly.
"Simply because the chances of developing resistance are quite huge if they don't comply".
Tshabalala-Msimang said these "far-reaching" decisions meant stepping up the HIV and Aids prevention campaign so the 40 million South Africans not infected stayed that way.
She said the decision had been necessitated by the fall in the price of drugs, the development of new medicines, growing appreciation on nutrition, the availability of fiscal resources as well as the growing skills in understanding the management of HIV and AIDS in the country. Besides improving the treatment of opportunistic infections, the minister said delivering this kind of treatment across the country would require a major effort to upgrade the national health system.
"This includes the recruitment of thousands of health professionals and a very large training programme to ensure nurses, doctors, laboratory technicians, counsellors and other health workers have the knowledge and the skills to ensure safe, ethical and effective use of medicines," she emphasised.
For this reason, government expects to spend R296-million for the rest of the 2003/04 fiscal year, increasing to nearly R4,5-billion in 2007/8.
"Government is once more strengthening the hand of the nation in the fight against HIV and Aids, in keeping with its mandate to build a better life for all," said the minister.
If correctly implemented, she said, the operational plan provided an "excellent" opportunity to complete the treatment sector of the National Strategic Plan for HIV and Aids while also strengthening prevention. "The challenge is immense but is not impossible," the minister said. – BuaNews.