Health department considers six-month supply of ARVs

The health department is considering a policy change to provide people living with HIV with six months’ supply of medication as it seeks to boost the number of patients on treatment, health minister Joe Phaahla said Thursday.

SA has the world’s biggest HIV/Aids burden with 7.8-million people living with the disease. While it is on track to meet the UN target of ensuring 95% of people living with HIV know their HIV status by 2025, it is lagging behind on efforts to ensure 95% of people diagnosed with HIV are on sustained treatment, and that 95% of those on treatment are virally suppressed.

Just 76.4% of people living with HIV will be on treatment in 2025, according to projections from the Thembisa model run by researchers at the University of Cape Town.

Speaking on the sidelines of a high-level meeting convened in Cape Town by the US President’s Emergency Plan for Aids Relief (Pepfar), Phaahla conceded the health department was not meeting its HIV treatment targets, a point flagged by the National Treasury in Wednesday’s budget.

Figures submitted by the health department to the Treasury show only 5.5-million people were on treatment by March 31 2023 and 6-million are estimated to be on treatment now. The uptake of antiretroviral treatment (ARV) was “running significantly below target”, the Treasury said in the Estimates of National Expenditure.

Phaahla said it was not clear why so many people diagnosed with HIV were not on treatment and this was an area under discussion at the meeting. “Is it that at our facilities we take too long confirming the diagnosis and initiating treatment? If that is not the case, is it follow-up?” he said.

“There has been improvement: there was quite a knock during Covid-19, where we went down to around 73% of people on treatment. We have now recovered to just under 80%, but the fact of the matter is there is still a gap,” he said.

Providing patients with pills for six months instead of a supply of one to three months — as is the case at present — would help people stick with their treatment. But other measures were needed too, he said.

Pepfar ambassador John Nkengasong said SA was integral to efforts to end HIV/Aids as a public health threat by 2030, because it had such a large HIV burden.

“We will not win the battle against HIV if the battle is not won in SA,” he said. “SA has made tremendous progress, but still has tremendous challenges,” he said, noting that SA had a very high rate of new infections among young women. 

The Thembisa model puts HIV incidence (the rate of new infections) among girls and young women aged between 15 and 24 at 0.97% in 2023, and at 0.26% among boys and men in the same age bracket.

kahnt@businesslive.co.za