Health mulls doubling supply of ARVs
The department of health is considering a policy change to provide people living with HIV/Aids with six months’ supply of medication as it seeks to boost the number of patients on treatment, health minister Joe Phaahla said yesterday.
SA has the world’s biggest HIV/Aids burden with 7.8million people living with the condition. While it is on track to meet the UN target of 95% of people living with HIV/Aids knowing their status by 2025, it is lagging with efforts to ensure 95% of people diagnosed with HIV/Aids are on sustained treatment, and 95% of those on treatment are virally suppressed.
Just 76.4% of people living with HIV/Aids will be on treatment in 2025, according to projections from the Thembisa model run by researchers at the University of Cape Town.
Speaking on the sidelines of a high-level meeting held in Cape Town by the US President’s Emergency Plan for Aids Relief (Pepfar), Phaahla conceded the department was not meeting its HIV/Aids treatment targets, a point flagged by the Treasury in Wednesday’s budget.
Figures submitted by the department to the Treasury show only 5.5-million people were on treatment by March 31 2023 and 6-million are estimated to be on treatment now. The uptake of antiretroviral (ARV) treatment was “running significantly below target”, the Treasury said in the Estimates of National Expenditure.
Phaahla said it was not clear why so many people diagnosed with HIV/Aids were not on treatment and this was an area under discussion at the meeting. “Is it that at our facilities we take too long confirming the diagnosis and initiating treatment? If that is not the case, is it followup?” he asked.
“There has been improvement: there was quite a knock during Covid-19, where we went down to around 73% of people on treatment. We have now recovered to just under 80%, but the fact of the matter is there is still a gap,” he said.
Providing pills for six months instead of the current one to three months would help people stick with their treatment. But other measures were needed too, he said.
Pepfar ambassador John Nkengasong said SA was integral to efforts to end HIV/Aids as a public health threat by 2030, because it had such a large burden. “We will not win the battle against HIV if the battle is not won in SA,” he said.
“SA has made tremendous progress, but still has tremendous challenges,” he said. SA had a very high rate of new infections among young women.
The Thembisa model puts HIV incidence (the rate of new infections) among girls and young women aged between 15 and 24 at 0.97% in 2023, and at 0.26% among boys and men.