NHI could see government paying contractors for Aids treatment

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