02 j mitchell alternative approach to art

FPD

AN ALTERNATIVE APPROACH TO

ESTIMATING NEED FOR ART PROVISION

IN TSHWANE, SOUTH AFRICA

Janine MitchellFoundation for Professional Development (FPD)

SAHARA Conference

30 Nov - 03 Dec 2009 - Gallagher Estate, Midrand

FPD

Rationale

Insufficient municipal data

= challenge to scale up ART effectively at local level

� Gap Analysis Needed – Why?

1. Better understand need for ART

2. Better understand capacity to deliver ART

3. Build local strategy to close the gap

FPD

Methodology

1. Epidemiological estimate - # of people requiring ART

2. # of people currently initiated on ART in Tshwane public clinics

3. Identify gap in current ART provision

FPD

Results Estimate of the need for ART in Tshwane

2009% estimated persons living with HIV - stage 3 of infection 37%

% estimated persons living with HIV - stage 4 of infection – not on treatment

10%

Population estimate1 351 058

(15-49)

HIV prevalence estimate 15.20%

# HIV+ individuals 205 361

# of people in need of ART 96 230

[i] Dorrington RE, Johnson LF, Bradshaw D, Daniel T. The demographic impact of HIV/AIDS in South Africa. National and

provincial indicators for 2006. Cape Town: Centre for Actuarial Research, South African Medial Research Council and

Actuarial Society of South Africa; 2006.

FPD

ResultsCurrent ART/Estimate of ART Gap in Tshwane

2009

# HIV+ individuals estimated in Tshwane 205 361

# of people estimated in need of ART 96 230

New initiations in 2009 (Public/NGO sites*) 14 777

Current number of persons on ART (Public/NGO sites*) 32 391

Gap in ART initiation 63 839 (66%)

* Foundation for Professional Development - Gauteng Provincial Department of Health – Tshwane ART sites

FPD

Conclusion

� There is a wide gap in provision of ART vs. those in need

� ART Clinics are currently meeting 37% of estimated people in need

� Many HIV+ individuals may not know their status or their eligibility for ART

FPD

Thank You

Janine MitchellHead of Department: Compass Project

Foundation for Professional Development (FPD)janinem@foundation.co.za