God, AIDS, Africa & HOPE

Reflections / Gedanken

HIV & TB: Supply problems in South Africa

English: Coat of Arms of South Africa Deutsch:...

English: Coat of Arms of South Africa – Wikipedia)

HIV activist groups in South Africa are calling on the Minister of Health to address drug supply chain problems which are causing HIV and tuberculosis (TB) drug stock-outs in the country’s Eastern Cape province. According to a report launched at the 6th South African AIDS Conference by a coalition consisting of the Rural Health Advocacy Project (RHAP), Doctors Without Borders (MSF), the Treatment Action Campaign (TAC) and SECTION 27, 40% of the 70 facilities surveyed by MSF and TAC during May 2013 in the Mthatha catchment area in the Eastern Cape province had experienced HIV and/or TB drug stock-outs. More than 100,000 people, on antiretrovirals (ARVs) or TB treatment, depend on 300 facilities served by the Mthatha depot. Medical staff at 24% of the affected facilities were forced to send patients home without treatment because they experienced stock-outs of essential HIV and TB drugs. These stock-outs were reported to last, on average, 45 days at a time and have been ongoing since October 2012. The organisations estimated that at least 5494 adults were not able to take some of their ARVs and 561 children were sent home without treatment since September 2012 when the drug supply issues began. Lamivudine (3TC), tenofovir, nevirapine, efavirenz, paediatric ARV formulations and Rifafour (a fixed-dose combination of four TB drugs) are the main medications affected. “This situation is catastrophic. It means many thousands of people living with HIV have risked treatment interruption for months now. The stock-outs consequently undermine clinical benefits of life-saving ARV treatment. Over time, more deaths will occur as a result and the likelihood of increased drug resistance is significant,” says Dr Amir Shroufi, Deputy Medical Co-ordinator for MSF in South Africa. There have been a number of reports of patients receiving dual or even monotherapy in the Eastern Cape and Gauteng. “I have been taking ARVs since 2008. Each year this [a stock-out] happens at least six times. I go to the clinic and they tell me there is no medication for me,” said a 36 year-old unemployed man who lives in a rural village in the Eastern Cape. “It is very difficult for patients. We are telling them to adhere, but when they arrive at the clinic, which can take up to two hours to access by car in the rural Eastern Cape areas, they are told there is nothing for them and that they must come back another time,” said Vuyokazi Gonyela, the TAC Eastern Cape District Organiser. On 10 October 2012, staff at Mthatha depot in the Eastern Cape staged a strike, following which 29 individuals were suspended, leaving the depot with only 10 working employees. Coupled with chronic supply chain issues, this precipitated widespread drug stock-outs in the region. The survey followed an intervention by MSF and TAC volunteers during December 2012, which continued for three months, to respond to the burgeoning Mthatha depot crisis by supporting staffing, managing and ensuring drug delivery at the depot. This intervention helped to clear the backlog of drug orders and to bring the depot closer to normal levels of functioning. “The MSF/TAC emergency intervention in the Mthatha depot from December 2012 to March 2013 has shown that it is possible to correct a disastrous situation with limited resources, even if the impact remains short-lived without large systemic  changes and action from the provincial Department of Health”, said Gonyela, who led the intervention. The main causes for the drug supply problems are the lack of an early warning system for facilities to be able to report potential shortages, drug suppliers failing to meet tender quotas, government failing to pay suppliers, and poor ordering practices at health facilities and medicine depots. South Africa has one of the largest ARV programmes in the world with over 2 million people initiated on ARVs in the public sector. However, drug stock-outs are occurring across the country and are not limited to HIV and TB medication, but extend to other basic chronic medication such as hypertension (blood pressure) and diabetes medication, according to Dr Francois Venter, Deputy Director of the Wits Reproductive Health and HIV Institute (WHRI). This was reiterated by a number of healthcare workers attending the conference. “The national Department of Health should create an emergency team to respond to stock-outs – given the extent, importance, and frequency of essential drugs stock-outs nationwide,” said John Stephens of SECTION 27. The organisations are recommending that when stock-outs are identified, the underlying reasons must be established for each and appropriate action undertaken, and the individuals responsible for the stock-outs must be clearly identified. In response to the drug supply problems, the organisations have set up a civil society monitoring group which will focus on solving the drug supply problems and continue monitoring drug supply across the country. “We are aware of the drug stock-outs across the country and share your concerns,” said Helecine Snyman, Head of Affordable Medicines at the South African Department of Health.

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Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Politics and Society, , , , , , , , , , , , , , , ,

980 Millionen

English: BRICS counties. BRICS - Brazil, Russi...

English: BRICS counties. BRICS – Brazil, Russia, India, People’s Republic of China, South Africa. Português: As Potências regionais. (Photo credit: Wikipedia)

980 million Euro – that was more or less the contribution of the EU to South Africa as special development money in the last budget circle. And when I traveled to Brussels last month, the question was, how much the European Union might give in the new budget. There are countries like Germany advocating for zero Euro. Simply because South Africa falls short the markers set by the World Bank for being categorized a developing country. Being a preferred partner for the EU also doesn’t help nor does joining the BRICS countries. Corruption and attitude of some representatives of the political sector also doesn’t help a lot.

This money is not even one percent of the South African annual budget, but still: it was used in the past to try new approaches, it was the money used for going new ways of governance, health care, development of democracy and much more which never otherwise would be part of the normal budget provided by government. On the request of the South African Representation to the EU I tried to lobby for a new round of developing money as I believe that South Africa, stripped of attitude and corruption is in urgent need of assistance from outside. Go to the Eastern Cape and I visited Sterkspruit last year deep into the eastern part of the fairest Cape – and you feel beamed back into a third world country. And government and NGO’s depend on the goodwill of others – putting aside political talk about an “African Renaissance” and “new colonial treads” – even in the sector of HIV and AIDS we would not have come that far without the assistance of the Global AIDS Fund. So politicians are asked to set aside ideology or party politics and concentrate to better the life of the people. And to establish a good governance to be entrusted with resources from those who are able to donate and give.

980 million Euro – it is for sure that there will be not that amount of money given again for the new budget circle. But lets lobby that there is more than zero – European Embassies are called to look realistically at South Africa and report back honestly about the situation where still people starving, living under the minimum to sustain their lives, where housing, clean water, health are not accessible for all.  And the NGO sector also needs still that kind of support even if most of the money is anyhow given to government, some is essential for the work of civil society organizations and NPO’s.

There is no decision yet, but there remains hope that the EU will consider South Africa as what it is: a country which came a long way but is still not able to run its affairs without assistance from partners outside.

Filed under: Politics and Society, Society and living environment, Uncategorized, , , , , , , , , , , , ,

Sex instead love in South Africa

Most teenage girls in South Africa start having sex to prove their love to their boyfriends. This is according to new research presented by Neloufar Khan from the Department of Social Development at the Carnegie III conference which took place in Cape Town last week.  “Baby, you’re not faithful. You don’t trust me.” According to Khan this is the phrase men use to coax young girls into having sex with them. Carnegie III was held at the University of Cape Town and presenters focused on strategies to overcome poverty and inequality.  “The fact that girls place their health and welfare second to the needs of their boyfriends is proof of the gender inequality in these communities,” Khan said.
The whole article you can find under here

Filed under: General, HIV and AIDS, HIV Prevention, Reflection, Society and living environment, , , , , , , , , , , , , , , ,

Follow up…

The reader might remember the trip to Sterkspruit in the Eastern Cape before Easter and since then things are moving a bit at least: The water from the mountains is in Cape Town and awaits analysis about content and quality. Sam, our trustee have had a meeting with the representative of the SA-German Chamber of Commerce and Industry and is now going to Johannesburg with Fr Jo to investigate the possibilities of training with the Chamber’s head of training services. Just to give you an idea about the place we visited some pictures:


Filed under: General, HIV and AIDS, HIV Prevention, Networking, Reflection, Society and living environment, Uncategorized, , , , , , , , , , , , , , , , , , ,


Do you know where Sterkspruit is located? Or Herschel? I did not know till I visited it: Eastern Cape – Diocese of Aliwal North – somewhere close to Lesotho – and arriving there after a long drive from Bloemfontein feels like getting in a forgotten corner of South Africa. On invitation of Sam, one of our trustees of the HOPE Cape Town Trust, who is coming from here, I meet different people like Fr Joe and his flock with 30 chapels and churches. I hear of the plight of the people, their attempt to make the best of their lives, of mismanagement of the environment, of crime, abuse, hopelessness, poverty and all the credentials which one would hope to defeat in the new South Africa. And once again I encounter the ABCD programme of the Catholic Student movement, which puts being HIV positive on the same level like being a criminal or a drug addict. Nobody thought about it really – coming from the official church side, nobody questioned it.

After 25 hours intense listening and trying to take in the situation of the people I am out again – with proposals in my bag of projects, with thousand thoughts how people can exist like this for ages, with admiration for my fellow priests keeping the hope up in these circumstances and with the determination to make things happen as much as I am able to from a distance. Most of our HOPE Community Health worker are coming from the Eastern Cape and I heard many times how much assistance is needed – now I know first hand…

I first have to reflect on it more – good that there is the Easter break – time for reflection in the light of the unconditional love of God. What does it mean for those people I left in Sterkspruit?

By the way: If you read this and you have skills like bricklayer, electrician or whatever practical professional skills and you have some weeks time to go there and teach those skills to young people in the area: let me know…

Filed under: HIV and AIDS, HOPE Cape Town Association & Trust, HOPE Cape Town Trust, Networking, Reflection, Society and living environment, , , , , , , , , , , ,

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