Health

More than 4.6 million South Africans took an HIV test since April, according to Deputy President, Kgalema Motlanthe.

Speaking at a World AIDS Day event in Mkhondo, Mpumalanga, Motlanthe pointed out that of this number, 800 000 (17 percent) tested positive for HIV.

He explains: "It means that friends, colleagues and families should talk about HIV in their workplaces, homes and communities, and take appropriate action to care for those infected and affected."

To read the article titled, “Motlanthe commemorates World AIDS Day,” click here.

More than 240 million additional children will be immunised in the next five years saving four million lives, but only if the GAVI Alliance receives the funds required to accelerate the introduction of new and under-used vaccines in the developing world.

If fully funded, GAVI will be in a position to vaccinate 90 million children with pneumococcal vaccine and 53 million children with rotavirus vaccine. These two vaccines help protect against pneumonia and diarrhoea, the world’s two biggest killers of children.

Meeting in Kigali, the GAVI Alliance Board today approved a five-year business plan from 2011-2015 setting ambitious but achievable targets expected to cost US$ 6.8 billion.

But while some donors have made advance commitments ahead of a June 2011 pledging conference and US$ 3.1 billion is already assured, GAVI must find another US$ 3.7 billion to save another four million lives.

Representatives from Norway and Sweden announced new commitments to GAVI totalling $55 million. The United Kingdom offered to co-host the pledging conference in London next June and France and the Bill & Melinda Gates Foundation offered to work with the UK to mobilise support for the conference.

Concluding her last GAVI board meeting as Chair, Mary Robinson said: “GAVI offers donors an unbeatable deal in terms of value for money and an opportunity to invest in saving the lives of millions of children – children who will grow up free of disease, attend school and become healthy productive adults.”

The former Irish President and human rights leader will hand over to Dagfinn Høybråten, GAVI’s Chair-elect at the end of the year.

“For 10 years GAVI has had such solid support from many donors who recognise that this is an innovative and results-driven public-private partnership and that immunisation is a very transparent intervention because it’s easily measured,” said Mr Høybråten, a Norwegian member of parliament and former health minister.

“As the proud father of four and grandfather of two, I’m determined that children in the world’s poorest countries will benefit from the same basic vaccines as my own family,”he said. “Those children have a right to health and I will not rest until we have reached them with the power of immunisation.”

In its first decade, the GAVI Alliance’s support resulted in the immunisation of some 288 million children in the world’s poorest countries, preventing more than five million future deaths, according to the World Health Organization.

With full funding, GAVI’s support for vaccines will prevent an additional 3.9 million future deaths in just five years, a critical contribution to the Millennium Development Goals (MDGs), especially MDG 4 which aims to reduce under-five child mortality by two-thirds by 2015.

GAVI’s work on immunisation sits at the centre of both the Muskoka Initiative and the UN Secretary-General’s Global Strategy for Women and Children’s Health.

An evaluation in September by independent and external consultants of GAVI’s work confirms the alliance’s value and business model, finding that the alliance has accelerated the introduction of vaccines and attracted additional funding to immunisation.

“Our board meeting in Rwanda gave us the opportunity to see first-hand this country’s impressive progress in vaccination and health, and celebrate GAVI’s contribution to it,” said Helen Evans, GAVI’s interim CEO. “The meeting provides us with great momentum as we implement our new strategy and raise funds to save a further four million lives.”

With competition between an increasing number of manufacturers since the launch of GAVI in 2000, the price of hepatitis B vaccine has declined by 64 % from US$ 0.59 per dose to US$ 0.20, for example.

“GAVI’s second evaluation highlighted areas where we can improve efficiencies even further and our new five-year strategy reflects this,” Evans said, referring to GAVI’s increased efforts to bring vaccine prices down further and boost the financial sustainability of its country programmes through co-financing by recipient countries.

The GAVI Alliance has been an enormous support to our mother and child health programmes, and our successes in Rwanda show exactly what can be achieved,” said Dr Richard Sezibera, Rwanda’s Minister of Health, who represents developing countries on the GAVI board.

Rwanda’s under-five mortality rate has dropped to 103 child deaths per 1,000 live births in 2008 from 152 deaths in 2005, linked to a range of interventions including immunisation. Routine immunisation of infants in Rwanda includes vaccination against diphtheria, tetanus, pertussis, Hib, hepatitis B, poliomyelitis, measles and pneumococcal disease. The country hopes to introduce rotavirus in 2012 and HPV vaccines next year.

With full funding, GAVI also plans to accelerate the introduction of routine meningitis vaccination and to support campaigns against yellow fever and meningitis.

GAVI’s five-year strategy to 2015 also envisages activities to prepare for new and underused vaccines against meningitis A, Japanese encephalitis, rubella, typhoid, and HPV.

Besides being one of the most cost-effective development interventions, immunisation saves families an enormous amount of time and money that might otherwise be lost on medical treatment and care of sick children.

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The GAVI Alliance is a Geneva-based public-private partnership aimed at improving health in the world’s poorest countries. The Alliance brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry in both industrialised and developing countries, research and technical agencies, civil society, the Bill & Melinda Gates Foundation and other private philanthropists.

GAVI support consists of providing life-saving vaccines and strengthening health systems. Since 2000, more than 250 million children have been vaccinated and more than five million premature deaths averted thanks to GAVI-funded programmes.

For more information, please visit www.gavialliance.org.

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“Now is the time to continue the expansion of the South African response to HIV/AIDS”

South Africa is facing a major and mounting financial challenge as it strives to respond to the HIV/AIDS epidemic in the country. South Africa has 5.7 million people currently infected with the HIV virus, the largest number in the world, and half a million adults and children are becoming newly infected each year (UNAIDS, 2009).

The South African government has made important strides in the expansion of the prevention efforts and the ARV treatment programme, with over 1 million people now on the public treatment programme. The government has progressively allocated new resources to fund the response to HIV/AIDS in the 2009/10–2011/12 medium term period through conditional grants and equitable share allocations. In addition, donors (external development partners) and certain businesses have made important contributions to the response.

Despite these achievements, the national HIV prevalence remains around 17% and new infections continue to occur. With expanded prevention efforts, including male circumcision, the National Strategic Plan (NSP) target of halving new infections can be achieved from 400,000 per annum currently to 200,000 new infections annually by 2020. The HIV prevalence rate should reduce to around 10%. However, this means increasing numbers of people will be requiring treatment in the coming years, between 2.5 and 3 million patients by 2020. A growing proportion of these patients will access ARVs through the private sector, but the largest portion will remain dependent upon the free public service.

Currently the country is spending close to R20 billion annually (including public, external and private sector contributions), in total on HIV/AIDS. This includes the social mitigation and research activities, as well as the treatment and prevention activities. It is estimated that the expanded response required for an impact on prevalence and new infections, will cost an increasing amount to almost double by 2020 per annum (R39billion) in total. The public antiretroviral therapy (ART)programme will increase from around R9 billion currently to R15 billion by 2020, or less with the recent reduced tender prices for ARVs. Other treatment services, such as palliative care and home based care will also need to be provided and these and others will cost another R7 billion in 2020, while mitigation efforts must also be maintained and could cost around R6 billion. The necessary prevention activities will require around R10 billion.

The good news is that if South Africa can continue to expand its response over the next 10 years, then all these efforts will reduce the new infections and prevalence rates, and after 2020 the costs will begin to reduce significantly. Considering also the productivity gains through reduced mortality and morbidity (sickness), the overall amount required for HIV/AIDS will become once again manageable within the public budget.

It is therefore imperative that the external partners and the business sector increase their contributions over the next 5 to 10 years to enable these successes. “We would argue that the donors really need to stay with this, and the next five years are absolutely critical,” said Robert Hecht, another of the report’s authors. In terms of finding alternative public funding sources, “the government needs to think outside the box”, states Teresa Guthrie of the Centre for Economic Governance and AIDS in Africa. She explains that these options include a mandatory contribution from business profits to HIV/AIDS activities, a Financial Transaction Tax (FTT) such as the Robin Hood Tax being considered in Europe, a Currency Conversion Tax (for the purchase of Rands), a small AIDS levy on individuals and businesses, or other levies such as an airline or cell phone tax. Combined, these options could raise significant funds for the government, and could be removed once the impact of an expanded response is felt after 5 to 10 years.

Now is the critical time for the South African government, the external partners and the business sector to increase their commitments to HIV/AIDS, so as not to lose the ground that has been gained, and to ensure the necessary expanded response to HIV/AIDS while also strengthening the health care systems to cope with the additional demands.

Ends/

www.cegaa.org

About Centre for Economic Governance and AIDS in Africa (CEGAA):
CEGAA aims to contribute to improved economic governance, fiscal policy and financial management and accountability, with specific attention to improving the developmental response to HIV/AIDS. CEGAA undertakes research, capacity building and advocacy in the field of financing and budgeting for a multi-sectoral response to HIV/AIDS in Africa.

About Teresa Guthrie:
Teresa Guthrie is a health economist and is the founding Director of the Centre for Economic Governance and AIDS in Africa (CEGAA). Through CEGAA she has provided capacity building and undertaken research for several African countries' NACs, MoHs, parliamentarians and civil society organisations, with regard to improving financial management for health, HIV/AIDS and TB, including costings, budgeting and national AIDS spending assessments (NASAs). Prior to CEGAA, she co-ordinated multi-country projects involving the monitoring of public budgets for health and HIV/AIDS for the AIDS Budget Unit of Idasa.

Medecins Sans Frontieres (MSF), warning of a health emergency in Swaziland, says the twin epidemics of AIDS and tuberculosis are ravaging that country, helping to halve life expectancy to 31 years.

The Geneva-headquartered medical charity points out that, "The co-epidemic has contributed substantially to a halving of life expectancy within two decades - from 60 years in the 1990s to 31 in 2007."

The organisations further says Swaziland has the highest rate of HIV infection in the world at 26.1 percent, adding more than 80 percent of people suffering from tuberculosis have also been infected with HIV.

To read the article titled, “AIDS halves Swazi life expectancy,” click here.