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2008 SERIES

EPISODE 23 - National Strategic Plan

The TeamAdolescents & ARVsHerpes & HIVCelebrities & HIVSero-disordant coupleRelationships & sex Breast, bottle or cup?VCTHate crimesMDR & XDR TBCircumcisionGender violenceInfants on ARVsSexual negotiationsSocial grantsCervical cancerSubstance abusePMTCTFarm workers & HIVPEPTeen pregnancyDisclosureNSPStigma and predjudiceWater and sanitationHuman rights

A New Dawn. A New Plan.

Nomfundo with CJ Amanda Funani

With a shift in the political landscape recently the government has started to address HIV/AIDS with urgency.  It will, however, take unprecedented effort and people to repair the damage caused by inaction, incompetence and in some cases downright denial.  The figures too appear overwhelming: 345 000 AIDS-related deaths last year, 1 in 10 South Africans are HIV positive and 30% of pregnant woman at government facilities are HIV positive.  The waiting lists for ARVs are too long and clinics are too often understaffed with only 370 of the accredited 4000 able to administer ARVs.  This week on Siyayinqoba Beat It! the National Strategic Plan (NSP) is under the spotlight as we discuss all the aspects of this potential lifeline to millions.  Joining Shalom and the Support Group is Mark Heywood who is the deputy chairperson of SANAC, the South African National AIDS Council.  Some of our Community Journalists go out onto the street to find out if the average person has even heard of the NSP, most of us in our communities sadly haven't. We speak to Busiswe Maqungo in Cape Town who teaches school kids about the NSP.  She explains all the aspects of the NSP to them and they then share the knowledge they've learnt back at their respective schools.  Back in the studio Mark takes us through the 5-year goals as laid out in the NSP and tries to take the mystery out of the rather daunting looking document.  The NSP has to be led by the government but must have a buy-in from the private sector, civil society and every member in our communities.

Our next insert from KwaZulu Natal, looks at Caprisa, a program that focuses on nurses and getting ARVs to rural communities. Patients seem willing to accept ARVs from nurses and not just doctors. Although Caprisa is working well in that area, we need many more like them and we realise back in the studio that we're still quite a long way from realising the successes of Caprisa nationwide. It is suggested a pocket version of the NSP be made for the people in much the same way our Constitution was after it was adopted in 1996.

Our next stop is in the Eastern Cape where we meet Nomfundo Mnyaka, a woman who has to travel quite a distance to obtain her ARVs.  Because ARVs are not available at her local clinic she must take a trip to Grey Hospital, which is a round trip that costs R24.  It further highlights the need this country has to make ARVs and clinics accessible in every community.  We then find out why the clinic near Nomfundo's house does not have ARVs to administer. The clinic faces a staffing problem pointing to the need more nurses to be trained to administer anti-retrovirals.

The overwhelming impression is that there are many problems to be faced and overcome, but with passionate people bringing the right treatment and care to people who need it; there's no need for the NSP's targets to not be reached.

IT'S A FACT

SANAC Deputy Chair Mark Heywood

School pupils learn about the NSP

Dr Frolich on the NSP

School pupils learn about the NSP

 

 In 2007, South Africa adopted a National Strategic Plan (NSP) which set goals and targets for fighting HIV until 2011.
The NSP is the first comprehensive response which unites government and civil society to combat the epidemic.
Goals of the NSP include:

To have 25% of the South African adult population test for HIV each year. Everyone who tests for HIV should also test for TB, and the other way around.

To increase access to voluntary counselling and testing (VCT).

To half the number of new HIV infections from 527 000 to less than 260 000 a year.

To reduce HIV transmission through increasing uptake of prevention of mother to child transmission (PMTCT) services. Currently 330 000 pregnant women, living with HIV, give birth every year. Roughly 60 000 (18%) have babies which test positive. These children are either exposed to HIV in the womb, at birth or in breast milk. By increasing the uptake of ART and PMTCT, the NSP aims to reduce this number to less than 15 000 (5%) each year.

To extend antiretroviral treatment (ART) to those in need. Roughly 1.5 million adults, are currently receiving treatment in the public sector.
All of these goals are very challenging and require a united effort from government and civil society, using the best scientific methods in combating HIV.
In 4 years, from 2004 to 2008, South Africa managed to get 500 000 people on treatment. It is now aiming to get a million people on treatment over the next 3 years. To achieve this objective, the NSP recommends that people starting on ART should be initiated by nurses. Doctors would then see cases with serious complications as recommended by nurses.
Without task-shifting to nurses, the South African government will be unable to meet the targets set in the NSP. Although this task shifting hasn't happened yet, government's new commitment to the NSP is likely to change this.
A lack of hospitals and clinics offering ART is a major issue in achieving ART targets. People often have to travel large distances at great expense to get their medication. Access to ART needs to be brought closer to the people.
Currently there is a central committee in Pretoria which certifies health facilities to distribute ART. Government needs to decentralise this process to provinces, allowing more ART sites to be opened.