A R16
billion ($1.2 billion) investment announced by the United States through PEPFAR
President’s Emergency Plan for AIDS Relief initiated by the George W Bush
administration in 2004 to support South Africa’s HIV epidemic control effort –
is now under threat of being reduced to $400 million with PEPFAR’s core
treatment programme in the country being described as “grossly sub-optimal and
insufficient to reach epidemic control”.

development has emerged from media reports announcing that senior Department of
Health (DoH) officials will be in Washington later this month in an attempt to
prevent the funding from being reduced.

In what
has been described as a strongly worded mid-January letter to the US mission in
South Africa, US global Aids co-ordinator Deborah Birx alluded to the fact that
the PEPFAR programme had demonstrated extremely poor performance in ensuring
every person who started on treatment was retained.

Birx, who
only a month before had been quoted as saying “Controlling the HIV epidemic is
not only possible, it is happening – country by country, community by community
– across Africa” when announcing the two-year investment, reportedly made the
point in the letter that there were more people stopping treatment than
starting in 2018.

on these observations in both newspaper and television interviews this week, DoH
deputy director-general responsible for HIV/AIDS, Yogan Pillay, said his
department was surprised and concerned about the content of Birx’s letter
despite knowing that a number of people had stopped treatment. Problems
retaining patients on treatment were exacerbated, he acknowledged, as the
programme expanded.

He added,
however, that these problems were being addressed with, for example, with the Health Minister giving health MECs and
department heads a 10-point plan for their HIV/AIDS programmes. The plan included
ensuring HIV patients start treatment the day they are diagnosed and creating more
pickup points for patients to collect their medicines.

The US
health attaché Steve Smith, had explained in media reports that the
funding figures in Birx’s letter were preliminary and gave the assurance that
there would be scope for an increase if local health officials could show that
they were taking remedial action.

SOURCE: Business
Day, 11 April 2019/The Citizen 4 December 2018