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According to
Department of Health Director General, the findings of a controversial joint
report by the Treasury and Department of Health
– commissioned to investigate the state’s
provision of ARVs – has signalled a shift from
“if, to when, how … and at what pace.”
Addressing a plenary session at the conference,
she highlighted the challenges that government
faced. Human resources are a major obstacle.
Alarming findings from a national study of
health-care workers, conducted by the Human
Sciences Research Council (HSRC) and publicly
released on Monday, showed rising HIV-prevalence
among young health-care workers, poor clinical
practice and inadequate sterilisation
facilities. The epidemic was also exacting a
heavy psychological toll on health-care workers,
with more than
half of them saying they were
exhausted and 39% saying they were suffering
from low morale.
Meanwhile in Addis Ababa, at a meeting hosted by
the
UN’s World Health Organisation (WHO),
African governments were encouraged to divert
more resources to their decrepit and crumbling
health services. But the continent needs a
staggering US $38 billion to bring its health
facilities up to scratch. Fourteen nations are
holding a key five-day summit to draw up plans
for tackling the health crisis on the continent,
and to achieve the crucial UN 2015 Millenium
Development Goals. The strategy – under the
African Union’s (AU) Commission on
Macroeconomics and Health – aims to boost
investments by African governments and by rich
nations. The commission estimates that
developing countries need to commit around US
$40 per person per year to provide adequate
health care. “This level of investment is beyond
the reach of very many poor countries in Africa
in the foreseeable future,” Ethiopia’s Health
Minister, pointed out. He urged rich
nations to provide greater financial support to
prevent social and economic collapse due to
inadequate health facilities. Developing
countries at the conference complained that
often their health experts left the country
after receiving training –
lured by the incomes
they could earn overseas. Many said that rich
nations often funded projects and initiatives
for
a short time – leading to their collapse
when the
funding dries up.
According to Botswana’s ARV Programme Manager,
Dr Ernest Darkoh, “Finance is but one of a
series of numerous bottlenecks that developing
countries will face when it comes to
implementing effective national health
programmes.” Along with HIV/AIDS treatment goes
the need for pre-test counselling, laboratory
capacity, post-test counselling, the management
of opportunistic diseases and tracking those
found to be HIV-positive but not yet eligible
for ARV therapy. To build capacity, Dr Darkoh
proposed that greater emphasis should be placed
on 10 critical “streams”: planning and
preparation; monitoring and evaluation;
information, education and communication;
recruitment; training; laboratory capacity;
physical infrastructure; information technology;
pharmaceutical logistics, and
ARV therapy
services.
But capacity constraints are not solely
responsible for exacerbating HIV/AIDS; other
factors identified by officials administering
the ARV programme include the status of women,
poverty, alcohol abuse, and stigma and denial.
Research has found that disclosure of a person’s
HIV status has major positive implications for
access and adherence to treatment, including
changes in sexual behaviour and constant use of
condoms to prevent re-infection.
According to a study presented at the Durban
conference patients who remained silent about
their status did not respond positively to
available help because of the stigma and
discrimination in communities. South African
Constitutional Court judge, Edwin Cameron,
stated that for people living with HIV and AIDS
in South Africa, “the difficulties of stigma and
discrimination have been immeasurably compounded
by the continuing absence of
a coherent,
rational and comprehensive national policy on
the treatment of AIDS.” |
