1. Provincial expenditure performance: HIV/AIDS programmes 7 th Meeting of the 21 and 22 November 2011 Daygan Eagar

2. Introduction ● What was spent in select provincial departments in 2010/11 ● Explaining expenditure performance ● Allocations for 2011/12 ● Expenditure as of July 2011 ● Explaining expenditure performance

3. Expenditure 2010/11

4. Allocations for 2011/12

5. Factors affecting spending 2011 ● Slow spending particularly EC, NC, NW and WC ● Slow or delayed internal supply chain and procurement processes in provincial health departments ● Poor internal capacity in CFO functions ● Need to clarify national guidelines for the training of service providers ● Service providers do not comply with PFMA and Treasury Regulations ●

6. Expenditure to July 2011

7. What do the AG's reports tell us? ● GP: Underspending of R1.18 Billion but accruals of R2.16 Billion. So overspending of R980 million ● Failure to pay service providers within 30 days ● Weak financial management and extensive non-compliance with relevant laws ● Unauthorised expenditure of R1.17 Billion and irregular expenditure of R2.25 billion

8. Eastern Cape ● Qualified opinion first in more than 5 years ● Accruals of R1.1 billion ● No adequate systems to track inventory ● Unauthorised expenditure of R1.2 billion largely due to the compensation of employees ● Procurement processes not in line with PFMA and Treasury regulations

9. KZN ● Qualified opinion ● Irregular expenditure of R409 million ● Underspending of R1.4 billion primarily on infrastructure ● Procurement processes did not comply with the PFMA

10. Western Cape ● Unqualified opinion ● But problems with procurement remain and in many instances did not adhere to PFMA regulations

11. What about services? ● GP: Clients on ART increased from 274 927 in 2009/10 to 415 461 in 2010/11 ● ART initiating sites from 79 to 265 ● Vertical transmission from 8% to 2% ● EC:Clients on ART from 102186 to 152 257 ● Tested for HIV from 471 484 to 1 055 775 ● WC: Patients initiated from 75002 to 98 284 ● Clients tested 397 294 to 747 139

12. Services cont. ● KZN: 1 589 723 clients tested in 2010/11 ● People qualifying for ART receiving treatment up from 60% in 2009/10 to +- 81% 2010/11 ● Total number on ART increased from 148 000 in 2007/08 to 408 328 in 2010/11

13. What is the message? ● Resources that are available are not being used effectively ● In many instances they are not being used appropriately. ● While scale-up is happening, it is clear that more can and should be done to make services available to those who need them.