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- W1611492036 abstract "The South African Cabinet statement on anti-retroviral (ARV) access in early August this year overcame or at least indicated the political will to overcome what appeared to be the biggest obstacle to a stepped-up programme of care for HIV/AIDS in South Africa - mobilising and allocating the financial resources to pay for such a programme. The work of the Joint Health and Treasury Task Team 1 was thorough going beyond a simple calculation of drugs costs to an assessment of the investments required to build health system capacity. For the time being at least money is not the problem to scaling up. In addition a number of well-documented ARV projects in poor communities have shown conclusively that socio-economic status in and of itself is not a barrier to long term adherence to drug therapies. These developments have allowed the other challenges of scaling up to become foregrounded. These challenges are two-fold and can be summarised into the demand and supply sides of the health system. On the demand side stigma discrimination and widespread mistrust of the public sector will delay presentation for care by potential beneficiaries to the point where the risks of initiating treatment are considerable. As generic ARVs become available many will seek care from private practitioners preferring to pay out of pocket for drugs than face long queues and often hostile reception in the public sector. However as has been shown with other conditions such as sexually transmitted infections (STIs) issues of affordability may compromise standards of care in this sector especially where long-term therapy is needed. On the supply side is a health system that has historically managed chronic diseases poorly is beset by inequities in capacity and resources and staffed by a stressed and demotivated workforce that is increasingly being lured to the industrialised world. (excerpt)" @default.
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- W1611492036 date "2004-01-01" @default.
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- W1611492036 title "Systems and software: principles and implementation strategies for the scaling up of anti-retroviral therapy." @default.
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