Struggling to keep up

Struggling to keep up

Given the rate of new infections it is not surprising that ARV treatment provision is struggling to keep up. More than one million people have been initiated on ARVs but this still only represents about 60 percent of adults and 38 percent of children who are eligible for the drugs, according to national treatment guidelines. Those guidelines do not reflect the latest recommendations by the World Health Organization (WHO) to initiate all patients at a higher CD4 count of 350 or less.

Writing in a local newspaper on 7 December, Rachel Cohen, head of mission in South Africa and Lesotho for international medical NGO, Médecins Sans Frontières (MSF), urged the government to implement the new WHO guidelines and translate the policy of allowing nurses to initiate ARVs into practice. Cohen said South Africa also needed a tender system to enable it to negotiate better prices for ARVs.

As well as better monitoring of HIV programmes, the SAHR authors call for each of South Africa's nine provinces to customize their HIV response and for HIV and TB services to be urgently integrated.