Sunday Times (Johannesburg) - October 5, 2003
Claire Keeton

The health director responsible for the implementation of the plan in Gauteng, Dr Nomonde Xundu, said this week that the province was already making plans for treatment.

She said: "While we wait for Cabinet's decision, we are making plans for training of staff, identifying laboratory facilities and meeting with key stakeholders, including the pharmaceutical industry."

But she said the province needed the national go-ahead and a budget allocation before it could begin implementing its plans.

At present antiretroviral treatment is available only at research or pilot sites, and in the private sector.

Gauteng, along with the Western Cape, is expected to have about a dozen sites - from tertiary hospitals, through to clinics - able to offer treatment.

Xundu said: "We are looking at a mix of sites."

She warned, however, that the implementation of treatment was an ambitious plan, which would stretch Gauteng's existing health capacity.

"Our capacity is thin on the ground. This is a major programme which will require a lot of work, building up capacity and skills."

An estimated 1.2-million people are HIV-positive in Gauteng, which has an HIV prevalence rate of 31.6% among pregnant women at antenatal clinics.

Among Gauteng's successes in expanding access to HIV/Aids programmes are:

Doubling the number of voluntary counselling and testing sites from 41 to 84, with 38 000 people tested in the past year;

Increasing the prevention of mother-to-child- transmission of HIV, with a total of more than 100 000 women accessing this service since May 2001 and 60% agreeing to be tested for HIV;

Distributing 7 million condoms a month;

Running 69 home-based care projects;

Training more than 10 000 volunteers to visit 4.6-million people at home on World Aids Day.

Head of the HIV/Aids directorate, Dr Liz Floyd, said her budget was R75-million - of which about 90% was spent by 31 March 2003.

While the directorate has under-spent slightly, the province's academic hospitals - which provide mother-to-child HIV prevention programmes - have overshot their budget.

The health department as a whole overspent its R7.5-billion budget by R220-million, with the biggest overspend - R175-million - by its four academic hospitals.

The Democratic Alliance has raised concerns about expenditure records, since the annual report inaccurately indicates that the HIV/Aids directorate had under-spent its R91-million budget by R26-million.

Floyd admitted that the problem was in the record-keeping: "The R75-million is correct, not the R91-million. Our delivery is good. The problem is the recording."

Gauteng Democratic Alliance health spokesman Jack Bloom slammed poor report-keeping, while giving credit for improved access to HIV/Aids services.

"The controls are not as tight as they should be. Six months after the end of the financial year, Gauteng is still puzzling about what was spent and un-spent."

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