1. NATIONAL HEALTH DEPARTMENT HIV, AIDS and TB PROGRAMME REPORT TO THE NATIONAL HEALTH PORTFOLIO COMMITTEE CAPETOWN, 31 MAY 2004 DR N SIMELELA

2. Financial Report 2003/04 Original Budget R665 721 000 Add: –Roll-over R 10 650 000 –Adjustment :Compre. Care R 90 000 000 Total Budget R766 371 000

3. Financial Report 2003/04 Total BudgetR766 371 000 Expenditure to date R691 107 681 Unit spend 90 % (including R90m ) and 95% (excluding R90 m) Increased by 67% (R766.3m) from 2002/03(R458.6)

4. Conditional Grant Exp. FY 03/04 Province Budget R’000Expenditure R’000% EC38,83438,71399 FS30,14429,90499 GP55,27553,24683 KZN85,591160,394187 LP28,29627,58895 MP26,28722,27866 NC11,268 100 NW32,89135,529108 WC24,20419,15779 TOTAL333,556398,827114

5. Financial Report on R90m R20m transferred to NHLS to procure diagnostic equipment & training Transferred R2,3m ( MEDUNSA- ensure safe use of medicines & assess burden of drug-related morbidity), R2.3m(UFS- safe use in paediatrics & establish national pregnancy register ) & R1m ( UCT) for the establishment of Pharmacovigilance Units R6.5 transferred to MRC to provide Research component of ARV plan Transferred R7m to GCIS for communication

6. Financial Report on R90m cont. Training for the amount of R800 000 –Development of training module for Nutrition Supplementation –Conducted training on Nutrition Supplementation in Mpumalanga & Northern Cape –Conducted Conference on African Traditional Medicine

7. Financial Report on R90m cont. Training –Workshop on Curriculum Development on Compr. Care Plan –Workshop with NCCMED, prov. Assessors to update on ARV therapy & new development Computers & Equipment –Purchased server & software for the Siamed system

8. Underspending Savings Global funds( committed )R5.9m SANACR10m Condoms ( committed) R10.6m Different UnitsR6.9m Comprehensive Care ( Committed )R41.7 Total under spendingR75.1m

9. Budget 2004/05 Original Budget R855 968 000 Add: –Comprehensive CareR58 200 –Compre. Grant R300 000 Less: –Love life GamesR 2 000 000 –Total BudgetR1 212 168 000 Increase by 42%

10. Budget for the National HIV, AIDS & TB programme Cost Center 2004/05 Core budget of HIV/AIDS &TB Directorate55,006 Conditional Grants781,612 HIV/AIDS NGO’s43,050 Comprehensive Care Management Plan64,200 Partnership Support8,420 HIV/AIDS:UN Global Fund Contrib.20,000 GAAP60,880 Condoms132,000 Life Line12,000 Love Life25,000 South African Aids Initiative10,000 Total1,212,168

11. Comprehensive HIV & AIDS Grant FY 04/05 ProvinceEnhanced HIV&AIDS R,000 ARV R,000Total EC58,19340,77798,970 FS40,84329,12669,969 GP87,62946,602134,231 KZN122,27064,079186,349 LP42,47934,95177,430 MP38,36415,47953,840 NC17,31814,46331,881 NW41,85529,12670,981 WC34,88123,08157,962 TOTAL481,612297,684781,612

12. Compliance with the DORA in 2003/4 Business Plans All provinces submitted their plans for enhanced budget ( VCT, HBC, PEP, PMTCT, Step Down & HTI Addendum for ARV plan still outstanding from the following provinces: KZN, EC, FS, MP & NW

13. Budget 2004/05 Total Budget R1 212 168 000 Add: Roll-over R56,6m Total R1,268,793,000 Roll-over will be spent on the following:  Comprehensive Care R40,1m R20m to be transferred to NHLS for infrastructure R5.6m to be transferred to HST to strengthen health system system R13.5 to be transferred to MRC to provide Research component of ARV plan  Soul City & Condoms R16,5 Production of 7 th TV series,first batch of 30 episodes & printing booklet on the comprehensive treatment, care & support Settle order for condoms for R10,6m

14. Achievements in the 2003/04 FY HIV Prevention –Distributed 302m male condoms & 194 000 female condoms- health facilities & non traditional outlets –Elimination of stocks out through Logistics Management Information System (LMIS) –Marketing of public sector condom & new branded product to be launched on 16 June 2004 –Conducted an audit of existing HTA programme in the country –Conducted a rapid assessment on the Traditional Health Practice –Developed tender specifications for distance learning short courses on HIV, AIDS, STI& TB management –Commissioned the the Neisseria Gonorrhea drug resistance study-monitor ciproloxacin resistance

15. Achievements in the 2003/04 FY... Voluntary Counselling and Testing Over 1000 more service point were added in 2003/4 bringing the total number to 2 582. Establishment of stand-alone service points in process. 2 877 counsellors trained and providing services at service points. A tender for the procurement of rapid and confirmatory tests currently in second year. Training on new rapid tests completed in all provinces.

16. Achievements in the 2003/04 FY... Home/Community based Care (HCBC) Number of Projects countrywide: 892 Training: 2 003 care-givers trained Care kits distributed: 1 430 Adult beneficiaries: over 90 000 Number targeted: 50% of chronically ill adults.

17. Beneficiaries of HCBC by province: 2003 compared to 2002

18. Provincial distribution of HCBC projects in South Africa 2002 to 2003

19. Achievements in the 2003/04 FY... PMTCT By the end of 2003 over 204 hospitals and more than 1055 clinics and CHCs are providing PMTCT in South Africa 1. In addition, the Health Systems Trust completed a second independent evaluation of the programme. This report is being presented to Cabinet in June 2004. Results from the first cohort are expected in August 2004

20. Achievements in the 2003/04 FY... Treatment, Care and Support Operational Plan for the Comprehensive HIV and AIDS Care, Management and Treatment in South Africa. The implementation of this plan also places a significant emphasis on health system strengthening. A toolkit for People Living With HIV and AIDS has been finalised, will soon be launched. Other documents and toolkits developed in 2003/4: a.Palliative Care guidelines b.Comprehensive Care, Management and Treatment guidelines for adults and paediatrics c.Siyamkela toolkit for measuring Stigma and Discrimination

21. Achievements in the 2003/04 FY... National TB Control Programme Review of the management of TB patient in 7 provinces. Deloitte and Touche’s forensic audits of SANTA hospitals New TB treatment regimen introduced in all provinces and training conducted. Training for private sector practitioners Advocacy and Social Mobilisation Plan launched. The Unit funded 6 NGOs in TB activities in 2003/4 for R 1 368 172.

22. Achievements in the 2003/04 FY... NGO funding and co-ordination Provincial visits to verify details of the organisations recommended for funding (85 in total). A tender awarded in 2003/4 to assist provinces and NGOs with basic financial management skills. Workshops in 5 provinces. Establishment of a National Funding cycle Strengthening of accountability for expenditure of funds transferred to organisations Development and improvement of capacity through the mentorship programme

23. Achievements in the 2003/04 FY... GAAP First Health Worker Excellence award ceremony Promotion on radio and TV of 3 Khomanani campaigns: Specific mass mobilisation activities (STI Week, World TB Day, World AIDS Day with donations of clothes, toys and non-perishable foods atl Pick ‘n Pay outlets, and distributed to NGOs and CBOs, The Partnership Against AIDS 5 th anniversary celebration Sector mobilisation (Men, Women, Faith based organisations, Transport industry,,etc.)

24. Achievements in the 2003/04 FY... SANAC  Facilitating sector meetings and workshops · Sector representation and participation on World Aids Day · Consolidation of the Sector progress reports · Appointment of Task Team to deal with HIV Testing in SANDF and special circumstances · Signing up ceremony for the Global Fund · Submission of the 4 TH Round Global Fund Proposal Strengthening of the SANAC Secretariat · Drafting of SANAC Trust Standard Operating Procedures

25. Plans for 2004/5 Strengthen current interventions and improve M&E Increase access to all services (VCT, PMTCT, HCBC, STI treatment including the package of the compr.care, management and treatment plan) Strengthen co-ordination activities through SANAC and NGOs Improve integration of TB related activities and strengthen control related interventions Refine mass communication and sector participation