South Africa: Treasury Blamed for Shortage of AIDS Drugs

As more people with HIV seek antiretroviral treatment in South Africa, the Treasury is falling behind in funding the program. Provincial health departments have had to choose between denying ARVs to new patients or overextending their budgets, officials recently said.

"We are anticipating a big problem as the ARV program is not going to be rolled out as intended," said Thami Mseleku, Health Department director-general. "The numbers [of new patients] are very huge and are rising fast. As a country we will get to a stage where we will never be able to afford the figures required for treatment, but that is a challenge we are going to have to face."

The estimated number of patients enrolled in the program is expected to rise from 700,000 now to 1.8 million by 2011.

By September, provinces will likely be reporting program budget overruns because the Treasury has not made adjustments to meet the growing number of patients, Mseleku said. The Health Department received from the Treasury only R200 million (US $19.9 million) of the R1.4 billion (US $139 million) requested for 2009-10. Last year, a R300 million (US $29.9 million) adjustment was granted instead of the R938 million (US $93 million) requested to cope with higher demand.

In November, Free State refused treatment to 15,000 new patients because ARV funding was depleted. The province eventually received help from the US President's Emergency Plan for AIDS Relief (PEPFAR). Other provinces also reported stopping treatment or cost overruns, Mseleku said.

"Contact is being made with donor agencies to assist with the funding gaps," Mseleku said. "We are also looking at redirecting funds from other programs such as home-based care to [ARV] treatment." PEPFAR is being asked to divert more of its support services allocation to treatment.

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