SOUTH AFRICA: Positive mothers, children need more to reach MDGs
Photo: IRIN  | | There is a need to scale up treatment for positive children |
JOHANNESBURG, 23 July 2007 (PlusNews) - Paediatric AIDS and the prevention of mother-to-child transmission (PMTCT) are still stumbling blocks as South Africa hits the halfway mark in its race to meet the 2015 deadline for the UN Millennium Development Goals (MDGs).
The National Consultative Health Forum, which concluded on Friday 20 July, in Johannesburg, brought members of civil society and various government departments together to review progress on the MDGs and discuss specific interventions for hitting the 2015 mark.
The minister and government officials were optimistic about reaching the goals. "I am confident that South Africa is making reasonably good progress in reaching some of the MDG targets," said health minister Dr Manto Tshabalala-Msimang.
Director-General of Health Thamsanqa Dennis Mseleku cautioned that concerns about resource constraints should not limit South Africa's vision of what was attainable.
The review was undertaken after what Tshabalala-Msimang described as "negative reports" in the 2007 report by the UN's MDGs oversight body on Africa's progress towards the MDGs for HIV and AIDS, which nevertheless praised South Africa's progress in extending protection to AIDS-affected orphans.
South Africa's vulnerable children have increased twentyfold in the last seven years, with more than 7.1 million children under 14 years of age living in poverty and the largest number of orphans as a result of HIV and AIDS, according to the UN report.
Despite decreased prevalence levels, due to what government says is a mix of prevention and a natural "plateauing" of the epidemic, participants from various government departments identified the need to scale up treatment for positive children, which was still falling short of needs and goals.
"There is not enough focus on children; we need a specific sub-programme within the existing national framework," said Nthari Matsau, deputy-director of strategic health programmes. Paediatric antiretroviral treatment had to be expanded because studies showed that HIV-positive babies were living longer than expected.
According to South Africa's Medical Research Council, HIV and AIDS accounted for one-third of under-five mortality numbers in 2000.
Nthari and a number of other participants also stressed the need to increase PMTCT coverage. Tshabalala-Msimang said PMTCT was currently available in 90 percent of public clinics, but 2004 health department reports on the country's high maternal mortality figure revealed that at least 53 percent of deaths resulting from non-pregnancy related infections, the leading cause of maternal mortality, were AIDS related.
Maternal mortality figures are highly disputed. Matsau said 2002 marked the most recent year that there was consensus on the numbers, with a ratio of 124 deaths per 100,000 live births. However, StatsSA, the state statistics bureau, calculated a ratio of 147 deaths per 100,000 live births in 2004, with some provinces showing ratios as high as approximately 364 maternal deaths per 100,000 live births.
In its own 2005 MDG progress report, the government acknowledges that a maternal mortality rate of even 124 deaths is considered high for a middle-income country such as South Africa.
However, some high provincial figures were masked by the national average, and pointed to the highly unequal distribution of income in South Africa, one of the problems underlying health concerns.
Tshabalala-Msimang said the forum's recommendations on paediatric AIDS and PMTCT would be presented to parliament, and were likely to form the basis of next year's meeting.
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