Book contents
- Frontmatter
- Contents
- List of Contributors
- Foreword: Peter Piot
- Foreword: Nelson R Mandela
- Acknowledgements
- Section 1 Birth of a rapidly growing epidemic
- Section 2 The virus, the human host and their interactions
- Section 3 HIV risk factors and prevention strategiess
- Section 4 Focal groups for understanding the HIV epidemic
- Section 5 The impact of AIDS
- Section 6 Treating HIV
- 27 Tuberculosis and HIV
- 28 Prevention of opportunistic infections in adults
- 29 Nutritional prophylaxis
- 30 Challenges in managing AIDS in South Africa
- 31 Antiretroviral therapy
- 32 The challenges of implementing antiretroviral treatment in South Africa
- Section 7 What does the future hold?
- Index
32 - The challenges of implementing antiretroviral treatment in South Africa
Published online by Cambridge University Press: 07 September 2011
- Frontmatter
- Contents
- List of Contributors
- Foreword: Peter Piot
- Foreword: Nelson R Mandela
- Acknowledgements
- Section 1 Birth of a rapidly growing epidemic
- Section 2 The virus, the human host and their interactions
- Section 3 HIV risk factors and prevention strategiess
- Section 4 Focal groups for understanding the HIV epidemic
- Section 5 The impact of AIDS
- Section 6 Treating HIV
- 27 Tuberculosis and HIV
- 28 Prevention of opportunistic infections in adults
- 29 Nutritional prophylaxis
- 30 Challenges in managing AIDS in South Africa
- 31 Antiretroviral therapy
- 32 The challenges of implementing antiretroviral treatment in South Africa
- Section 7 What does the future hold?
- Index
Summary
THE MEDICINE MANAGEMENT CYCLE is an essential component when considering implementation of antiretroviral treatment in South Africa. This is traditionally portrayed as a cycle in which choosing medicines must be followed by procurement, distribution and use. These processes must be used to learn from each cycle and ensure its continuation.
The disconnect between the public and private sector in South Africa continues to complicate all parts of this cycle. Examining all aspects of the medicine management cycle is essential when considering the most effective way to implement antiretroviral treatment in South Africa.
As with any other highly contested terrain, debates around the provision of antiretroviral treatment in South Africa, and in particular in the public health sector, have been characterised by starkly stated and firmly held opinions. Such opinions have reduced the space for meaningful debate about the very real challenges of implementing antiretroviral treatment in the country. The debate has instead become a contest between notions of toxicity and/or infrastructural deficiencies on the one hand, and the moral and ethical imperative to take immediate action on the other. This chapter will try to clarify some of the challenges facing the health system as a whole. The framework for discussion will be the medicine management cycle. However, this should not be read in any way as detracting from the very real challenges in related areas, such as human resource management, laboratory services and clinical services.
- Type
- Chapter
- Information
- HIV/AIDS in South Africa , pp. 551 - 566Publisher: Cambridge University PressPrint publication year: 2010