Prior to large-scale availability of antiretroviral treatment (ART) in South Africa public inpatient facilities were reporting an increase in the number of HIV infected patients presenting with serious HIV-related complications and AIDS . ART was first made available in South African at public health facilities in 2004 and since then the treatment program has grown to be the largest in the world with over 2.6 million on ART . It is commonly assumed that broad access to ART will reduce the
UNAIDS has set a worldwide goal for the year 2020: for 90% of people with HIV to know their status, 90% of those diagnosed with HIV to be on ART, and 90% of those on ART to have viral suppression. Researchers at National Health Laboratory Service (NHLS), HE2RO and Boston University (BU) have been working to set up systems to monitor and evaluate the evolving HIV response in South
When the South African national antiretroviral therapy (ART) program began in 2004, it relied primarily on hospital-based HIV clinics with services delivered by doctors . In 2010, in the face of increasing demand for care and limited personnel, South Africa revised its treatment guidelines to allow the initiation and management of patients on ART by nurses at both hospitals and primary health clinics under a program known as Nurse Initiated and Managed Antiretroviral Therapy (NIMART) . NIMART
One of the most persistent operational challenges facing South Africa’s antiretroviral therapy (ART) programme is late presentation of patients for care and high rates of attrition from care between HIV testing and ART initiation. Even among those who have been diagnosed and found to be treatment-eligible, loss to care before starting ART has consistently been estimated at a third to a quarter of patients1,2. There are multiple causes of loss to care before treatment initiation, but one
The RapIT study was conducted from 2013 to 2015 at two clinics in Johannesburg, South Africa. It was a randomized controlled trial of rapid ART initiation that allowed patients to have treatment eligibility determined, all treatment preparation steps performed, and ARV medications dispensed on the day of their first HIV-related clinic visit. Although it took place at only two clinics, both in urban areas in a single province, the RapIT trial showed that it is possible to start nearly all
In October 2012, an automated dispensing system (ADS) for dispensing antiretroviral medications (ARVs) was installed in the pharmacy in an outpatient HIV care and treatment site located in a public hospital in Johannesburg, South Africa. This site dispenses ARVs to almost 300 patients per day. The Health Economics and Epidemiology Research Office (HE2RO) evaluated the introduction of the ADS in this facility. In this policy brief, we report the estimated cost per script dispensed under manual
On Mar 22, 2016 the reports for Phase 1 of the South African HIV and TB Investment Case were launched by the Deputy President during the World TB Day celebrations. HE2RO staff were heavily involved in all aspects of the development of the Investment Case, from devising the analytical framework to reviewing evidence for interventions and enablers to developing the novel optimisation method driving the model analysis to writing the
On Mar 22, 2016 the reports for Phase 1 of the South African HIV and TB Investment Case were launched by the Deputy President during the World TB Day celebrations. HE2RO staff were heavily involved in all aspects of the development of the Investment Case, from devising the analytical framework to reviewing evidence for interventions and enablers to developing the novel optimisation method driving the model analysis to writing the
Abstract The South African Government (SAG) has made commendable progress in fighting HIV/AIDS and TB by mobilizing financial resources for the response to these diseases. The SAG has managed to scale antiretroviral treatment access, with over 2 million people on antiretroviral treatment which has led to a decrease in AIDS mortality and an increase in life expectancy (UNAIDS, 2012). A district-level patient satisfaction survey of the Centre for Economic Governance and AIDS in Africa (CEGAA)
Abstract The period following the first democratic elections of 1994 introduced significant changes in the public budget process in South Africa. The Constitution of the Republic of South Africa, endorsed in 1996, calls for specific laws and regulations regarding the implementation of measures to improve fiscal transparency and participation and commits government departments to the progressive realization of various socio-economic rights within the constraints of available resources. The
As stipulated in the South African Constitution and the National Development Plan, health is one of the priority areas to be addressed by government resources and effort. The national budget for health continues to show a strong public commitment to funding the HIV/AIDS response. Commendable developments in health policy, HIV programming, and resource allocation are particularly evident in the increasing allocations of public funds to HIV, accompanied by increased capacity to spend. HIV funding
