Analysis: Where we are with NIMART 13 years later

Once South Africa had closed the door on state-sponsored AIDS denialism in 2008, a critical question was how to offer HIV treatment to as many eligible people as possible as quickly as possible. Given that the health system did not have enough doctors for the job, it was decided in 2010 to rope in nurses to help out. Tiyese Jeranji asks where things stand with Nurse Initiated and Managed Antiretroviral treatment (NIMART) 13 years later.

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Opinion: SA can’t afford proposed cuts to HIV funding

National Treasury has proposed a R1 billion cut to HIV funding. This has come about because – rather than seeing the reduced price of antiretroviral treatment as an opportunity to scale up treatment coverage and strengthen other interventions to address the HIV epidemic – the Department of Health has seen it as an opportunity for cost-containment. However, the HIV epidemic is not over and savings owing to cost reductions should not simply be returned to Treasury, argue Matshidiso Lencoasa and Mila Harding.

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OPINION: A new African HIV Control Working Group to propel African voices in the global HIV response

It is estimated that over 65% of the global HIV burden is in sub-Saharan Africa. Now, in an attempt to propel African voices and perspectives in the next phase of the HIV response in Africa, a group of Africans established an African-led HIV control working group (HCWG). They are all experts from the continent who have come together to develop consensus perspectives on the long-term sustained control of HIV and prioritise the systems and capabilities to achieve it. Drs Yogan Pillay and Izukanji Sikazwe explain the thinking behind the new working group and set out their objectives.

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In-depth: The court ruling that gives qualifying pharmacists the green light to provide HIV and TB meds without a script

Specially trained and accredited pharmacists in South Africa will now be allowed to dispense medicines to prevent HIV and TB and to treat uncomplicated HIV without a doctor’s script. This is because the North Gauteng High Court this week ruled against an application by a private doctors’ association attempting to block the initiative. Catherine Tomlinson unpacks the judgment and rounds up some responses.

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Over 4.7m people in SA placed on new HIV med in four years

In what is likely one of the largest treatment rollouts in South African history, well over four million people living with HIV have started taking the antiretroviral dolutegravir since its introduction around four years ago. Now, according to a recent study published in the Lancet medical journal, use of dolutegravir in South Africa is associated with more people staying on treatment and higher rates of viral suppression. Elri Voigt unpacks the study findings and assesses progress in the country’s switch to dolutegravir-based HIV treatment.

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OPINION: With the right interventions we can help many more men start and stay on HIV treatment

June is Men’s Health Month and while the focus is on men’s attitudes about their health, we have also been reflecting on the health sector’s attitudes about men. Men are not indifferent about their health and they are not inherently poor health-seekers. If many of them are avoiding healthcare services, let’s consider that it may be because they are not getting what they need from the healthcare system, writes Shawn Malone.

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New policies aim to integrate mental health support into HIV services

Research suggests that people living with HIV are more likely to have mental health conditions than the general population. There seems to be consensus that HIV programmes would benefit from including better mental health screening and support services. Two new policy documents – the Mental Health Policy Framework and the National Strategic Plan for HIV, TB, and STIs – have a lot to say about providing such integrated services, but will they result in actual changes on the ground? Thabo Molelekwa reports.

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Courts to decide whether pharmacists can start HIV medicines without a doctor’s script

In August 2021, the South African Pharmacy Council published legislation in the Government Gazette to enable pharmacists to prescribe and dispense antiretroviral medicines for the treatment and prevention of HIV. A legal challenge then put the brakes on the initiative and the courts are now set to decide whether it can continue. Catherine Tomlinson reports.

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