MESSAGE FROM EXECUTIVE.html


    
        
            

            
                Message from the Executive

                In late March 2012, all the elected members
                of the Board of the Southern African HIV Clinicians Society met for the
                first time under my leadership to discuss the way forward. We decided
                that our objectives would now include partnering with governments to
                implement optimal HIV programmes and policies. For South Africa, this
                means doing all we can to assist the government to achieve the goals of
                National Strategic Plan 2012 - 2016.

                In line with this objective, we faced the following challenge
                in the ensuing weeks: We received reports from a number of sites that
                there were some medication stock-outs, including Tenofovir. Concerned
                healthcare workers wanted to know how they could provide for their
                patients. Knowing that treatment interruptions have long-term
                consequences in terms of resistance as well as other complications,
                many healthcarers were not sure how to handle drug shortages. Some
                patients can have treatment substitutions, so we convened a virtual ad
                hoc committee of the brains trust of the Society. Within a matter of
                days, we drafted a consensus statement that was sent to the
                Director-General of Health (and is included in this issue). As we went
                through this process, I was struck by the depth of experience we have
                in the Society. Our brains trust must be unequalled anywhere in the
                world.

                To now assist the Department of Health, we are implementing an SMS
                stock-out line for healthcare workers to report drug shortages. All
                reports will be submitted to the Department of Health every second week
                of each month. We will monitor shortage trends and the progress towards
                resolution. Enclosed is a stock-out report form that includes details
                of applicable drugs and information on how to report shortages.

                Another area we have agreed to focus on is the improvement of
                TB diagnosis, care and prevention within the context of the HIV
                epidemic. We have made many remarkable achievements in the diagnosis,
                care and treatment of HIV infection, and we need to repeat this for TB.
                The overlap between the two epidemics is very substantial. For the
                first time in my career, there have been some new and exciting
                developments. The GeneXpert technology has been adopted in a bold move
                for the diagnosis of TB. The Department of Health has announced that
                ART should be provided for all HIV-infected individuals who get TB,
                irrespective of their CD4.

                It seems to me that we are now at a stage in the TB epidemic
                where we were about 10 years ago in the HIV epidemic. We are on the
                brink of new interventions and there is renewed drive within the
                Department to tackle the problems. But the task ahead is huge. About 1%
                of South Africans contract TB every year. Will we achieve the NSP goal
                of a reduction of this incidence rate by half within 5 years? To my
                mind, we can only do so if we apply the same determination that we did
                in the HIV arena. TB is our next battle, and looming behind that is the
                ever-increasing burden of drug-resistant TB.

                Finally, please don’t forget that we have a conference
                coming up at the end of the year in Cape Town from 25 - 28 November.
                Entitled ‘Striving for Clinical Excellence’, this is a
                conference that I think all southern African HIV clinicians should
                attend. There is no better way to spend the last week in November than
                in the Mother City – rubbing shoulders with the best extant HIV
                healthcare workers.

                
                

                Francesca Conradie

                President

                Southern African HIV Clinicians Society

                Johannesburg

            

            
                
            

            
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