Western Cape setting the trend with treatment clubs and preventative therapy for newborns

Minister Theuns Botha

Western Cape Minister of Health

Based on the various challenges faced by Youth and Men, who feel that health services are not geared to meet their needs, or feel discriminated against by staff, Western Cape Government Health decided to make these two groups the focal point for World Aids Day.

In the main the Department’s awareness plans started a week ago and will continue across the Province in the form of screenings and HIV awareness campaigns. The focus on men and youth is mainly in the form of educationals on Aids and TB, as well as the continuation of educationals on male medical circumcision.

In the past year progress in the Province has been shown through the introduction of Antiretroviral Treatment (ART) adherence clubs, as well as the dual combination ARV preventative therapy to new-borns.

With 156 703 public sector patients on ART at present in the Western Cape, the growing number of patients place increasing pressure on already stretched human-resource capacity at clinics that result in long waiting times and can impact on the quality of care provided. In turn, the cost to patients of having to return to facilities regularly, the long waiting times at facilities, competing demands on time, including work and family responsibilities, and dissatisfaction with the quality of care, all affect long-term retention, which require innovative strategies.

Metro District Health Services adopted the ART-adherence clubs (piloted by Médecins Sans Frontières (MSF)) in Khayelitsha as a service model to promote long-term retention of patients on treatment.

The ART-adherence club model encourages patients to stay on treatment. In the model, 30 patients are allocated to an ART club. The group meets either at a facility or community venue for less than an hour every 2 months. A lay club facilitator facilitates group meetings, provides a quick clinical assessment and referral where necessary, and dispenses pre-packed ART.

From January 2011 to December 2012, Western Cape Government initiated 1,148 ART clubs in the Metro District, providing ART care to over 30 000 patients. This is a rapid rollout-model that has demonstrated significant success in the Western Cape.  The Province also won an Impumelelo Social Innovation Platinum Award in 2012 for “ARV Clubs Managing Large Numbers of Patients on ARVs”.

For those patients failing second line ART, the Western Cape is the only province that introduced third line ART treatment. The Western Cape is the only province to have a decentralized process in place for third line treatment.

Simultaneously, the Province introduced dual combination ARV preventative therapy to new-borns from HIV-infected high-risk mothers in July this year.

In this year we have reduced the mother to children transmission rate to 1.3%, which is the lowest in South Africa.

It remains important that every person gets tested and knows their HIV-status. Western Cape Government is investing in research and medication to eradicate HIV, but every person should take responsibility for their sexual health. We are committed to provide ART therapy to patients, but our priority remains to prevent people from becoming infected. Every responsible citizen must play their part.