01 December 2009

WC pioneers new Aids initiatives

The Western Cape is planning three pioneering initiatives in the fight against Aids, provincial health MEC Theuns Botha said on Monday.


The Western Cape is planning three pioneering initiatives in the fight against Aids, provincial health MEC Theuns Botha said on Monday.

They were routine HIV testing, earlier initiation of antiretroviral treatment (ART), and triple therapy for the prevention of mother to child transmission (PMTCT), he told a media briefing in Cape Town. 

 This was an effort to "take the fight against Aids to the next level". The province intended to make routine HIV testing standard procedure at all public health facilities.

"There is no plan to make HIV testing compulsory... the patient therefore has the right to opt out." 

Thousands missing out on testing

The emphasis would shift from pre-test counseling to post-test counselingIn an effort to treat people at an earlier stage, ART would be offered to Aids patients when their CD4 count fell below 350.

Currently patients were beginning treatment only when the count had dropped below 200. This change would see between 6 000 and 20 000 additional patients on ART, at an estimated cost of R16 million a year. 

"The conventional VCT [voluntary counseling and testing] protocol used in most public health clinics only screens a fraction  of the patients served, and subsequently every day thousands of vulnerable patients flow through our healthcare system without being offered HIV testing."


ART would also be available to HIV positive children under the age of one no matter what their CD4 count. Botha said the Western Cape had a mother-to-child transmission rate of 4%, which was the lowest in the country, but could be decreased even more.

Funding must come first


The new PMTCT programme would administer three antiretroviral drugs, as recommended by the World Health Organisation, as opposed to the current two. However the province would not be able to provide this type of treatment until sufficient funding had been put in place, Botha said. 

The three initiatives would need an estimated R20 million.

The province would be approaching the national government as well as private funding sources to raise the money. "I wouldn't have made this announcement if I wasn't confident I would find the funding to assist me in this. We will find the money."


The start of these programmes would happen in a "incremental way". The province would only be able to start budgeting for them in April next year. He would like the programmes to be fully operational by the beginning of 2011. 

The province would be the first in the country to implement the measures.


HIV prevalence in the Western Cape was as high as 31% in some communities. The department estimates that as much as 80% of people who require treatment in the province are in fact receiving it. - (Sapa, December 2009)


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Dr Sindisiwe van Zyl qualified at the University of Pretoria before working for an HIV/AIDS NPO in Soweto for many years. She was named one of the Mail & Guardian's Top 200 Young South Africans in 2012.

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