One must ask serious questions as to how the ANC led government hopes to look after the health of a whole nation when its provincial government cannot even help a seventh of the HIV-infected people in the Eastern Cape. This lack of commitment poses serious implications for the future prosperity of this province. As we celebrate Womenâ€™s Day today (subs: Sun: 9 Aug) we must not forget that hundreds of thousands of HIV+ women are denied ARV in the Eastern Cape.
Amidst the recent push by the government for a Public Health system, it has emerged that the Eastern Cape cannot pay for the antiretroviral treatment of the 110 000 HIV- patients who are targeted to receive medication in 2009/10.
In reply to a question by the Democratic Alliance, the Eastern Cape Health Department said it had approved a budget of R286 666 million for ARV Treatment in 2009/10. Yet the department admits that that amount is insufficient to cover the medication and laboratory supplies for its targeted 110 000 clients. According to the department, medicines, laboratory supplies and compensation of employees are the mayor cost drivers in this programme.
A simple calculation shows that the minimum cost of R5 500.00 per annum for the ARVs for 110 000 people totals R605 000 000. Therefore the department is facing a shortfall of R318 333 334 million.
The DA is most concerned about this, especially if one considers the projection by the SA Institute for Race Relations, that out of a population of 6 840 719 people in the Eastern Cape, the total HIV infections will be 785 217 in 2010.
If one extrapolates these statistics to the effect on the economy due to the loss of skills and a healthy labour force, it is clear that the ANC government needs to make adequate funding available to ensure that HIV+ people remain active members of society.
Instead of spending over a billion rand eon expanding the national cabinet, expenditure on ARVs needs to be prioritised at national and provincial level. We are now paying the huge prince for the ANCâ€™s denialism and policy blunders when it comes to HIV/Aids. If we had a started earlier with the rollout of ARV treatment, the problem would not be as bad is it is today.
In contemplating reform of the health care system, we need to move away from the problems of the unresponsive and cumbersome bureaucracy in the public sector, as that causes a lack of accountability, slow decision-making, poor quality, and a lack o f innovation and customer-friendliness.
The DA believes that we need a better healthcare system if we engage more in public private sector partnerships.
Please find the question paper from the DA to the Department of Health and their reply herewith:
Question 88 (1)
(a) What was the target in the 2009/2009 financial year for placing people in the antiretroviral programme in the province;
(b) How man y people actually received antiretroviral treatment in the 2008/2009 financial year and
(c) What target has been set for the 2009/2010 financial year?
(a) Target number of patients that was planned to be on ARV treatment for the end of March 2009 was 60 000.
(b) Total number received ART in 2008/09 is 75 919 (Target exceeded by 15 919 patients).
(c) Target set for 2009/10 is 110 000 on treatment.
Total budget approve3d for ART 09/10 = R286 666 m.
Question 88 (2)
Whether there is sufficient budget to meet this target, if not
(a) Why not and
(b) What are the further relevant details?
(a) A budget of R286 666 m is not sufficient to cover medication and laboratory supplies for 110 000 clients. Medicines, laboratory supplies and compensation of employees are the major cost drivers in this programme.
(b) A calculation for the cost of medicines is based on morbidity qualification model developed by pharmaceutical services. This model looks at how many patients will be treated, then breakdown that number according to treatment regimens as per NDOH standard treatment guidelines.
Currently in the province 97% of patients on ARV are on Regimen 1 and 3% of patients are on regimen 2.
Average cost of medicines for each patient on Regimen 2 is R5, 500.00 per annum.
Average cost of medicines for a patient on Regimen 2 is R11, 000.00 per annum.
For further information, please contact Bobby Stevenson, MPL on 0827753444