NATIONAL HEALTH DEPARTMENT

HIV, AIDS and TB PROGRAMME

REPORT TO THE NATIONAL HEALTH PORTFOLIO COMMITTEE

CAPETOWN, 31 MAY 2004

DR N SIMELELA

Financial Report 2003/04

• Original Budget R665 721 000• Add:

– Roll-over R 10 650 000– Adjustment :Compre. Care R 90 000 000

• Total Budget R766 371 000

Financial Report 2003/04

• Total Budget R766 371 000

• Expenditure to date R691 107 681

• Unit spend 90 % (including R90m ) and 95% (excluding R90 m)

• Increased by 67% (R766.3m) from 2002/03(R458.6)

Conditional Grant Exp. FY 03/04

Province Budget R’000 Expenditure R’000 %

EC 38,834 38,713 99

FS 30,144 29,904 99

GP 55,275 53,246 83

KZN 85,591 160,394 187

LP 28,296 27,588 95

MP 26,287 22,278 66

NC 11,268 11,268 100

NW 32,891 35,529 108

WC 24,204 19,157 79

TOTAL 333,556 398,827 114

Financial Report on R90m

• R20m transferred to NHLS to procure diagnostic equipment & training

• Transferred R2,3m ( MEDUNSA- ensure safe use of medicines & assess burden of drug-related morbidity) , R2.3m(UFS- safe use in paediatrics & establish national pregnancy register ) & R1m ( UCT) for the establishment of Pharmacovigilance Units

• R6.5 transferred to MRC to provide Research component of ARV plan

• Transferred R7m to GCIS for communication

Financial Report on R90m cont.

• Training for the amount of R800 000– Development of training module for Nutrition

Supplementation– Conducted training on Nutrition

Supplementation in Mpumalanga & Northern Cape

– Conducted Conference on African Traditional Medicine

Financial Report on R90m cont.

• Training – Workshop on Curriculum Development on

Compr. Care Plan– Workshop with NCCMED , prov. Assessors to

update on ARV therapy & new development

• Computers & Equipment– Purchased server & software for the Siamed

system

Underspending

• Savings Global funds(committed) R5.9m

• SANAC R10m

• Condoms ( committed) R10.6m

• Different Units R6.9m

• Comprehensive Care (Committed) R41.7

• Total under spending R75.1m

Budget 2004/05

• Original Budget R855 968 000

• Add:

–Comprehensive Care R58 200

–Compre. Grant R300 000

• Less:

–Love life Games R 2 000 000

–Total Budget R1 212 168 000

• Increase by 42%

Budget for the National HIV, AIDS & TB programme

Cost Center 2004/05

Core budget of HIV/AIDS &TB Directorate 55,006

Conditional Grants 781,612

HIV/AIDS NGO’s 43,050

Comprehensive Care Management Plan 64,200

Partnership Support 8,420

HIV/AIDS:UN Global Fund Contrib. 20,000

GAAP 60,880

Condoms 132,000

Life Line 12,000

Love Life 25,000

South African Aids Initiative 10,000

Total 1,212,168

Comprehensive HIV & AIDS Grant FY 04/05

Province Enhanced HIV&AIDS R,000

ARV R,000 Total

EC 58,193 40,777 98,970

FS 40,843 29,126 69,969

GP 87,629 46,602 134,231

KZN 122,270 64,079 186,349

LP 42,479 34,951 77,430

MP 38,364 15,479 53,840

NC 17,318 14,463 31,881

NW 41,855 29,126 70,981

WC 34,881 23,081 57,962

TOTAL 481,612 297,684 781,612

Compliance with the DORA in 2003/4

• Business Plans

• All provinces submitted their plans for enhanced budget ( VCT , HBC , PEP, PMTCT , Step Down & HTI

• Addendum for ARV plan still outstanding from the following provinces:

• KZN, EC, FS, MP & NW

Budget 2004/05

• Total Budget R1 212 168 000 Add: Roll-over R56,6mTotal R1,268,793,000Roll-over will be spent on the following: Comprehensive Care R40,1m

R20m to be transferred to NHLS for infrastructureR5.6m to be transferred to HST to strengthen health system systemR13.5 to be transferred to MRC to provide Research component of

ARV plan Soul City & Condoms R16,5

Production of 7th TV series,first batch of 30 episodes & printing booklet on the comprehensive treatment , care & support

Settle order for condoms for R10,6m      

Achievements in the 2003/04 FY• HIV Prevention

– Distributed 302m male condoms & 194 000 female condoms- health facilities & non traditional outlets

– Elimination of stocks out through Logistics Management Information System (LMIS)

– Marketing of public sector condom & new branded product to be launched on 16 June 2004

– Conducted an audit of existing HTA programme in the country

– Conducted a rapid assessment on the Traditional Health Practice

– Developed tender specifications for distance learning short courses on HIV, AIDS, STI& TB management

– Commissioned the the Neisseria Gonorrhea drug resistance study-monitor ciproloxacin resistance

Achievements in the 2003/04 FY...

• Voluntary Counselling and Testing • Over 1000 more service point were added in 2003/4 bringing the

total number to 2 582.

• Establishment of stand-alone service points in process.

• 2 877 counsellors trained and providing services at service points.

• A tender for the procurement of rapid and confirmatory tests currently in second year. Training on new rapid tests completed in all provinces.

Achievements in the 2003/04 FY...

• Home/Community based Care (HCBC)

Number of Projects countrywide: 892

Training: 2 003 care-givers trained

Care kits distributed: 1 430

Adult beneficiaries: over 90 000

Number targeted: 50% of chronically ill adults.

Beneficiaries of HCBC by province: 2003 compared to 2002

Home based care beneficiaries

3079157032562333

18989

16918

52741380

8864

44885367

11470

960

50265

19702

13308

4419

14435

0

10000

20000

30000

40000

50000

60000

Eastern Cape Free State Gauteng KwaZulu-Natal

Mpumalanga NorthernCape

Limpopo North West WesternCape

2002 2003

Provincial distribution of HCBC projects in South Africa 2002 to 2003

466

892

73

160

37

124

4383 65

142

79116

1623 21 44112

162

20 38

0

100

200

300

400

500

600

700

800

900

SouthAfrica

FreeState

Kw aZulu-Natal

NorthernCape

NorthWest

Number of HCBC projects

2002 2003

Achievements in the 2003/04 FY...

PMTCTBy the end of 2003 over 204 hospitals and more than 1055 clinics and CHCs are providing PMTCT in South Africa

1.         In addition, the Health Systems Trust completed a second independent evaluation of the programme. This report is being presented to Cabinet in June 2004.  Results from the first cohort are expected in August 2004

Achievements in the 2003/04 FY...Treatment, Care and Support• Operational Plan for the Comprehensive HIV and AIDS Care,

Management and Treatment in South Africa. The implementation of this plan also places a significant emphasis on health system strengthening.

a. A toolkit for People Living With HIV and AIDS has been finalised, will soon be launched. Other documents and toolkits developed in 2003/4:

b. Palliative Care guidelinesc. Comprehensive Care, Management and Treatment guidelines for adults

and paediatricsc.Siyamkela toolkit for measuring Stigma and Discrimination

Achievements in the 2003/04 FY...

• National TB Control Programme Review of the management of TB patient in 7 provinces. Deloitte and Touche’s forensic audits of SANTA hospitals New TB treatment regimen introduced in all provinces and training

conducted. Training for private sector practitioners

Advocacy and Social Mobilisation Plan launched. The Unit funded 6 NGOs in TB activities in 2003/4 for R 1 368 172.

Achievements in the 2003/04 FY...

• NGO funding and co-ordination• Provincial visits to verify details of the organisations

recommended for funding (85 in total). • A tender awarded in 2003/4 to assist provinces and NGOs with

basic financial management skills. Workshops in 5 provinces.•  Establishment of a National Funding cycle• Strengthening of accountability for expenditure of funds

transferred to organisations• Development and improvement of capacity through the

mentorship programme

Achievements in the 2003/04 FY...• GAAP• First Health Worker Excellence award ceremony•

Promotion on radio and TV of 3 Khomanani campaigns:

Specific mass mobilisation activities (STI Week, World TB Day, World AIDS Day with donations of clothes, toys and non-perishable foods atl Pick ‘n Pay outlets, and distributed to NGOs and CBOs, The Partnership Against AIDS 5th anniversary celebration

Sector mobilisation (Men, Women, Faith based organisations, Transport industry,,etc.)

Achievements in the 2003/04 FY...

SANAC                    Facilitating sector meetings and workshops

•·     Sector representation and participation on World Aids Day•·     Consolidation of the Sector progress reports•·     Appointment of Task Team to deal with HIV Testing in SANDF and special circumstances•·     Signing up ceremony for the Global Fund •·     Submission of the 4TH Round Global Fund Proposal• Strengthening of the SANAC Secretariat •·     Drafting of SANAC Trust Standard Operating Procedures

Plans for 2004/5

• Strengthen current interventions and improve M&E• Increase access to all services (VCT, PMTCT,

HCBC, STI treatment including the package of the compr.care, management and treatment plan)

• Strengthen co-ordination activities through SANAC and NGOs

• Improve integration of TB related activities and strengthen control related interventions

• Refine mass communication and sector participation