Gap between policies and outcomes

Gap between policies and outcomes

Besides the MDGs, South Africa’s National Strategic Plan includes targets to halve new HIV infections and achieve 80 percent treatment coverage by 2011. Progress on these and the MDGs is difficult to monitor, however, because of the very limited availability of routine surveillance data.

“This disconnect between policies, implementation and evaluation is a critical shortcoming in the planning process and a major obstacle in achieving goals,” write the authors.

South Africa's TB epidemic, the fifth most severe in the world, has further set back efforts to achieve the MDGs. The TB disease burden almost doubled between 2001 and 2006 with an estimated 55 percent of patients co-infected with HIV. In the face of poor cure rates in some provinces, increased levels of multi-drug resistant TB and an over-burdened health system, the TB caseload continues to increase.

Since 2009, President Jacob Zuma has announced a number of policies and initiatives aimed at strengthening the government’s HIV/AIDS response, including a national HIV counselling and testing campaign and the decentralization of ARV treatment from doctors prescribing at hospitals to nurses providing the drugs at primary healthcare facilities. The amount of the national health budget allocated to HIV and AIDS has also increased from R4.3 billion (US$627 million) in 2008 to an estimated R5.3 billion ($774 million).

Read more
New ARV tender halves drug prices
Hospitals failing to treat HIV-positive infants
Counsellors to give "the prick"
Who's tracking the world's biggest ARV programme?
HIV incidence rates have dropped slightly but remain high, especially among young women. In rural KwaZulu-Natal, the province with the highest HIV burden, nearly 8 percent of women aged 15 to 49 years become infected per year between 2003 and 2005. Nationally, the HIV incidence rate was estimated at 1.3 percent in 2008.