Aids: Not enough money
South Africa and the eight other African countries hardest hit by HIV/Aids cannot afford to treat every victim of the disease.
A new study by the TH Chan School of Public Health at Harvard University in the US, released last night, shows that if the nine African countries are to treat with anti-retrovirals everyone who needs them they will need considerably increased donor funding or loans.
If South Africa were to offer ARVs to everyone who qualifies under the government guidelines, it would cost R50-billion, more than double the R21-billion the state currently spends, 82% of which comes from its own coffers, the study found.
South Africa has the highest number of people on ARVs. Nearly 3million of the 6.4million people infected get free treatment.
Till Bärnighausen, programme director for health systems for Wellcome Trust Africa Centre for Health and Population Studies, said: "The South African situation is far better than in other countries because it is wealthier. But increasing treatment will come with a significant price tag."
The study noted: "Of all the countries studied, South Africa has the largest resource needs, but it also contributes the largest proportion [82%] at current coverage rates from domestic budgets."
Bärnighausen said the study, published in the journal BMJ Open, showed that "the country needs a debate about where the money will come from as South Africa has political commitment to treat everyone with a CD4 count of 500 or lower".
"To increase treatment we need substantially more nurses. This means a doubling or tripling of health workers. This is an expensive, difficult and time-consuming exercise."
The study's modelling shows that if more people are put on treatment now, fewer will be infected and fewer will need treatment in years to come, ultimately saving money.
"It will pay off if the country invests now in treating more people," said Bärnighausen.
Last year Wits health economist Gesine Meyer-Rath warned: "If we ramp up the treatment to 85% and improve prevention then spending will decrease from 2024."