Last week it came to light that the Free State was experiencing critical, life-threatening shortages of ARVs and had therefore called for a stop to the ART roll-out. To read TAC's original statement on the issue please click here. The Manager of the province’s ART programme, Dr. Mvula Tshabalala, instructed provincial healthcare workers to stop initiating new patients on ART with the exception of pregnant women.
The reasons for these ART shortages were alleged financial mismanagement within the provincial Health Department. TAC has since received some clarity on these issues from representatives of the Free State Department of Health as well as from a range of stakeholders who are currently monitoring the situation. The findings have important implications for the national roll-out as a whole.
According to the information that we have received:
A number of our sources claim that the primary reason for the current financial shortfall in the Free State is that the National Department of Health has grossly underfunded the ART programme for 2008/9. The sum of R300 million for essential bridging funding required by provinces was promised by the National Department of Health. However, it was inequitably distributed between provinces, with only four provinces receiving the essential bridging funding they needed to meet the costs of the expanding ART roll-out.
The Free State was one of the five provinces left without bridging funding. As a result of the lack of funding, the Free State has stopped initiating new patients on ARVs. If the current budgeting deficits remain, the Free State Department of Health claims that their stocks of ARVs will only last until January. Unless these critical shortages are addressed, Free State health officials argue that they will not be able to start new patients on ART until April.