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Another ART moratorium expected in the Free State

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Almost a year subsequent to the last ART moratorium in the Free State, during which the HIV Clinicians Society estimated that an additional thirty people a day died from AIDS due to their inability to access antiretroviral treatment (ART), the CEO of the province’s HIV programme has stated that another moratorium is likely to be implemented this month.

TAC learnt last week that the Free State Department of Health has a budgeting deficit of R252 million, and that approximately R50 million of the R70 million HIV programme budget for the entire financial year has already been spent. The Free State has the lowest national levels of ART coverage, at around 26% according to official figures.

At the Free State Health Summit, held between 16 and 17 July 2009, different figures were reported for the number of people currently receiving ART. The province’s figures for people accessing treatment ranged between 27,000 and 40,232, a discrepancy which points to the failure to adequately manage and account for the provincial ART programme.

The Free State’s prevention-of-mother-to-child-transmission (PMTCT) programme also falls drastically short of the Department of Health’s recommendations. TAC is aware of numerous cases in which women who have tested HIV-positive at antenatal clinics were not offered access to PMTCT services. Their HIV-positive children now risk having their ART regimens interrupted due to drugs shortages, or of not gaining access to the treatment at all. Moreover, numerous clinics are not providing immunization for infants due to alleged shortages of both syringes and vaccines.

There are province-wide shortages of many other essential medications, including drugs for diabetes and hypertension. The Free State has also experienced drastic condoms shortages for the last few months, as previously documented by TAC. This undermines government’s HIV prevention targets.

It is government’s responsibility to make ART accessible and sustainable, as stated in the National Strategic Plan (NSP), to which government has committed. The NSP aims to treat 80% of people who need ART by 2011, and to reduce HIV transmission by 50%. The shortage of drugs in the Free State points to a crisis in the implementation of the NSP.