NHI could see gov­ern­ment pay­ing con­trac­tors for Aids treat­ment

Weekend Argus (Saturday Edition) - - FRONT PAGE - ZIMASA MATIWANE

THE pro­posed Na­tional Health In­sur­ance (NHI) scheme will rev­o­lu­tionise the fight against HIV/Aids.

This is the view of Dr Gus­taaf Wolvaardt, a mem­ber of the organising com­mit­tee of the eighth HIV/Aids con­fer­ence in Dur­ban this week.

Speak­ing on the side­lines of the con­fer­ence, Wolvaardt said the NHI would en­sure all those in­fected with HIV/ Aids had ac­cess to ap­pro­pri­ate, ef­fi­cient and qual­ity health ser­vices.

Health Min­is­ter Aaron Mot­soaledi de­scribed the pro­posed health-care sys­tem as a health fi­nanc­ing sys­tem that pooled funds to pro­vide ac­cess to qual­ity health ser­vices for all South Africans ir­re­spec­tive of their so­cio-eco­nomic sta­tus.

Wolvaardt said one of the chal­lenges with the cur­rent health- care sys­tem was pro­vid­ing HIV/Aids ser­vices for spe­cific com­mu­ni­ties like taxi driv­ers, com­mer­cial sex work­ers and for­eign­ers who found it dif­fi­cult to ac­cess gov­ern­ment ser­vices.

“HIV-pos­i­tive men who are work­ing have to take a day’s leave to go to the clinic, los­ing in­come. That is too much of a sac­ri­fice. With NHI, a doc­tor con­tracted to pro­vide Aids treat­ment for unin­sured taxi driv­ers will tailor-make ser­vices to suit their needs.

“It won’t end there: the doc­tor can be paid extra for sup­press­ing the vi­ral load and pro­vid­ing sup­port groups. That is how NHI will pro­vide the best pos­si­ble health care for HIV pa­tients,” he said.

He said the NHI would pri­ori­tise qual­ity be­cause the gov­ern­ment would stop be­ing a provider of health care and be­come a pur­chaser, con­tract­ing ser­vice providers.

“The nice thing where gov­ern­ment starts buy­ing ser­vices is that it can in­sist on a cer­tain stan­dard and qual­ity. That’s what makes NHI a good health-care sys­tem. It says a com­peti­tor who is will­ing to pro­vide a ser­vice at the stan­dard that gov­ern­ment wants is the one who gets the con­tract,” he added.

Wolvaardt also be­lieved Mot­soaledi’s “heart and soul is in the right place” and that un­der Mot­soaledi, the health min­istry was com­mit­ted to im­ple­ment­ing NHI.

“NHI is a pro­gres­sive im­ple­men­ta­tion, it’s not some­thing we can switch on to­mor­row.

“We are not talk­ing about a one-year project. We are talk­ing about some­thing that will take 10 to 15 years to get into place. The full ben­e­fit will not be seen im­me­di­ately,” said Wolvaardt.

He added that the build­ing blocks were com­ing to­gether, in­clud­ing the of­fice for health stan­dards com­pli­ance which was al­ready in place.

“We are get­ting there. What we need are specifics in terms of how we are go­ing to start pulling this thing to­gether,” he said.

The con­fer­ence is the sec­ond-largest HIV con­fer­ence in the world, at­tended by sci­en­tists, med­i­cal prac­ti­tion­ers and rep­re­sen­ta­tives from the pub­lic sec­tor, NGO and faith-based sec­tors and the cor­po­rate sec­tor.

Although South Africa has made com­mend­able strides in the fight against HIV/Aids, the sen­ti­ment at the con­fer­ence was that more needed to be done to erad­i­cate the epi­demic.

Na­tional man­ager of Sonke Gen­der Jus­tice, Du­misani Re­bombo, said South Africa was in ur­gent need of prac­ti­cal changes.

“Where we have won is we have seen a re­duc­tion in mother-to-child trans­mis­sions but un­for­tu­nately in­fec­tions in par­tic­u­lar age groups are now rock­et­ing. This is key for us be­cause it’s mostly young peo­ple,” he said.

Re­bombo said South Africa needed a strate­gic plan to end gen­der-based vi­o­lence as it is in­ter­twined with HIV/Aids.

“Tra­di­tional HIV pre­ven­tion strate­gies won’t work un­less we deal with so­cial is­sues like poverty, su­gar dad­dies, teenage preg­nan­cies and rape.

“HIV mor­tal­ity has the face of men, they don’t ad­here to treat­ment and more men die than women. We need to en­sure that pro­grammes on the ground ad­dress men as well,” he ex­plained.

Lethimpilo HIV/ Aids or­gan­iser, Si­bongile Mbatha, was hes­i­tant to say the coun­try was win­ning against HIV/Aids.

“We are get­ting ahead of the epi­demic. Aids has now be­come a chronic disease. We don’t see a lot of peo­ple dy­ing but we are still see­ing a high num­ber of in­fec­tions. What the con­fer­ence is show­ing us is that the sci­ence around the treat­ment is well-de­vel­oped.

“The area that is highly ne­glected is pre­ven­tion. There is a big need to start fo­cus­ing on pre­ven­tion: how do we in­flu­ence peo­ple’s be­hav­iour, that peo­ple prac­tise a life­style that doesn’t put them at risk?” she said.

She said the con­fer­ence was im­por­tant be­cause it pre­sented op­por­tu­ni­ties to show­case new de­vel­op­ments.

“Given the size of our Aids re­sponse, a lot of the world­class in­no­va­tions hap­pen at the con­fer­ence. But we need a strong fo­cus on pre­ven­tive measures, be­cause if you break that cy­cle, then you start get­ting ahead of the virus,” she ex­plained.

Aaron Mot­soaledi

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