DESPITE significantly improved access to ARVs, major challenges remain to reduce HIV-Aids mortality in South Africa from an unacceptably high 180000 deaths a year, Doctors Without Borders (MSF) medical coordinator for SA Dr Amir Shroufi said.
This was in response to a UNAids report on the Right to Health. This report highlighted the importance of ensuring access to health care for all and mentions the substantial progress SA has made in scaling up antiretroviral (ARV) treatment to 4.2 million people.
Shroufi said to reach the 40% of people living with HIV who still have not started ARVs, scaling up public access to new tools such as self-tests would be necessary.
“In Khayelitsha – one of the oldest treatment programmes in sub-Saharan Africa – around a third of people on ARVs for 10 years have disengaged from care at some point,” Shroufi said.
“HIV services across South Africa must be adapted to better retain people in care, and support the return of those who stop accessing services.”
He said longer prescription times and having community pick-up points or organised support groups for receiving medication can allow people to choose what works best for them at a given point in time during their lifelong treatment journey.
“Clinic staff must be equipped with skills to welcome back people who may have temporarily stopped taking treatment and to screen for and recognise when patients have advanced HIV or opportunistic infections.
“In the context of under-resourced environments, nurses and lay counsellors must be capacitated to support this work,” he said.
MSF is calling on UNAids to include mortality reduction targets in reporting and monitoring and help governments like SA’s focus on and invest in measures to achieve these goals.
The report indicated that about 21 million people living with HIV now on treatment.
In 2000, just 685000 people living with HIV had access to antiretroviral therapy. By June this year, about 20.9 million people had access to the life-saving medicines.
Executive director of UNAids Michel Sidibé said such a dramatic scale-up could not have happened without the courage and determination of people living with HIV demanding and claiming their rights, backed up by steady, strong leadership and financial commitment.
“Many people do not remember that in 2000 there were only 90 people in SA on treatment.
“Today, SA has the biggest life-saving treatment programme in the world, with more than 4 million people on treatment. This is the kind of acceleration we need to encourage, sustain and replicate,” Sidibé said.