20 July 2016

South Africa: SA's HIV Response Restores Donor Confidence

Photo: Abhi Indrarajan/AIDS Society
Activists for sex workers protesting outside the Durban ICC on the morning of the International AIDS Conference.

Pretoria — South Africa's accelerated response to HIV has restored the confidence of international HIV/AIDS financing institution, The Global Fund, as well as the United States in the country as a recipient of funds to help fight the spread of HIV.

This emerged during a panel discussion with representatives from The Global Fund and Health Minister Dr Aaron Motsoaledi about how South Africa will finance its ambitious plan to have an AIDS-free generation by 2030.

The panel discussion was held during the 21st International Aids Conference, underway at the ICC in Durban, on Tuesday night.

One of the most notable areas of improvement is the provision of ARV treatment to HIV positive people. In the 12 years between 2004 and 2016, South Africa has increased the number of people who receive ARVs from 400 000 to over 3.4 million people.

The country runs what has become the biggest HIV treatment programme in the world, with more than 12 million people tested in 2015 and close to 170 000 babies tested at the crucial six weeks stage.

Referring to these achievements, United States Global Aids Coordinator Deborah Birx said: "This is not the time to withdraw HIV/AIDS funding from South Africa. It is a time to support the country in the fight against this pandemic."

Mark Dybul of The Global Fund said the time is right for South Africa to start thinking of other creative ways to raise funds to finance its fight against HIV/AIDS such as targeted taxation and even money markets.

The pledge of support, however, did not come without any conditions.

Donors will now put a lot of emphasis on efficiency as a criterion, determining their financial contribution on how much the necessary intervention should cost, instead of how much it cost in the past.

Responding to this issue, Minister Motsoaledi said South Africa has already moved to ensure optimum efficiency in its HIV/AIDS interventions.

He cited as an example the reduction in the price of ARV drugs from approximately R10 000 per person per year to around R1 728 per person, which South Africa was able to lobby from manufacturers.

This was reduced even further with the introduction of single-dose ARV treatment.

"We intend to do the same in other areas, like in the treatment of cancer, which we believe can be much cheaper," said the Minister.

Other areas the Department of Health is looking to improve efficiencies is in procurement of equipment, pathology services, pharmaceuticals and its human resource policy. These are the four main cost drivers of any healthcare system.

Minister Motsoaledi emphasised the importance of striking a balance between the human resources for health and the burden of disease that the country is facing.

"We cannot let high cost specialist workers do work that can be done by low cost workers. Community healthcare workers, for instance, should be the heartbeat of our primary healthcare system, which in turn forms the basis for the creation of a healthy society.

"What is needed is to right-skill the crop of community healthcare workers that we currently have so they can fulfil this important role."

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