health portfolio committee annual report 2006-2007

Health Portfolio Committee

Annual Report

2006-2007

Purpose and mandatePurpose and mandate

• Provide cost-effective health laboratory services

• Provide training for health science education

• Support health research

NHLS Sites

[PMG note: Diagram not included]

Head Office & NICDHead Office & NICD

PMG note: Diagram not included]

OfficesOffices


StructureStructure

NHLS Board

Operations Corporate Surveillance

Central RegionNontombi Mbelle

Coastal RegionSipho Mahlati

Northern regionVacant

Finance & AdministrationGeorge Sentoo

Human ResourcesHarriet Kwinda

Information TechnologyStelios Michas

Quality Assurance &

Academic AffairsMartin Hale

NICDBarry Schoub

NIOHVacant

CEOJohn Robertson

Kwazulu NatalNelly Mkhize

National Cancer Registry

NHLS Services

Primary Healthcare Clinics

District Hospitals

Regional Hospitals

Tertiary Hospitals

National Institute for Communicable Diseases

National Institute for Occupational Health

NHLS Service ModelNHLS Service Model

Fee for Service

Sole Provider

Training

Research

FacilitiesFacilities

Laboratories

268 laboratories across nine provinces

Personnel

5591 Total personnel

2029 Technologists and Technicians

181 Pathologists

197 Registrars

Financials

HighlightsHighlights

Unqualified Audit Opinion 2006/2007Unqualified Audit Opinion 2006/2007

Real Revenue Growth YOY - 18.2%Real Revenue Growth YOY - 18.2%

KZN Integration successfully achievedKZN Integration successfully achieved

Increased cash from R40m (2003) to R 296m ( 2007)Increased cash from R40m (2003) to R 296m ( 2007)

Emphasis of matter

• Title deedsThis emphasis of matter will appear again as we are still in the process of transferring titles in the name of the NHLS

• Completeness of external research grant program

This is a technical emphasis of matter which is unique to research organisations

• Tender RegulationsTenders are advertised in the Government Gazette but adjudicated internally

Summary of Group Results Summary of Group Results

R'000's12 months

200712 months

200612 months

200512 months

200418 months

2003

External Revenue 1,745,558 1,323,500 1,060,670 891,056 919,168Cost of Sales (1,057,521) (751,339) (649,993) (592,719) (527,115)Gross Profit 688,037 572,161 410,677 298,337 392,053Operating Expenses (550,689) (440,411) (398,857) (369,830) (469,425)Other Operating Income 115,963 94,165 86,694 58,350 38,836Operating Profit/(loss) 253,311 225,915 98,514 (13,143) (38,536)Transfer payments for CCTP 0 0 20,000 20,000 0Income from NHLS Trust 0 0 0 0 30,000Investment Income 19,753 5,955 (158) 70 7,367Provision for post retirement medical aid (89,830) (61,447) (20,945) (25,309) (103,269)Net profit/(loss) 183,234 170,423 97,411 (18,382) (104,438)Release of revaluation reserve 3,833 3,833 3,833 3,422 0Surplus for the year 187,067 174,256 101,244 (14,960) (104,438)

Summary of Cash flows Summary of Cash flows

12 months 12 months 12 months12 months18 months

2007 2006 2005 2004 2003

Net profit (loss) 183,234 170,423 97,411 -18,382 -104,438

Investment in P, P & Equipment -126,647 -56,376 -56,859 -22,583 -16,842

Working capital change -203,283 -369 -82,495 47,517 -38,303

Non-cash items 64,696 24,094 18,861 14,747 12,724

Provision for PRMA 89,830 61,447 20,945 25,309 103,269

Acquisitions/(Disposals) of investment 0 0 0 4 69,485

Loans raised 0 0 1,261 0 0

Increase in Finance Lease obligations 609 696 0 2,582 0

Net increase in cash 8,439 199,915 -876 49,194 25,895

R'000's

Financial Financial DimensionsDimensions

Income 0.3% Derived from teaching

2.0% Research grants

2.8% Derived from govt grants

90.5% Derived from fees

4.4% Other income

Expenditure 2.2% Teaching and Research

1.8% Occupational Health

5.0% Surveillance & Epidemiology

80.3% Laboratory Services

10.7% Administration

NHLS

Ave Price Revenue Volm (06/7) Ave Price RevenuePrice

Change **

Ave Price

RevenuePrice

Change **

Anatomical 93.61 129,188,176 1,380,079 98.29 135,648,407 5.00% 104.89 144,752,470 6.71%Chemical 33.32 713,843,866 21,425,846 34.52 739,678,387 3.62% 35.16 753,267,958 1.84%Genetics 430.47 19,535,579 45,382 466.84 21,185,949 8.45% 495.37 22,480,879 6.11%Haemotology 35.92 320,583,061 8,925,149 37.48 334,521,606 4.35% 38.43 342,950,047 2.52%Microbiology 51.78 579,368,445 11,188,242 53.22 595,412,005 2.77% 53.91 603,161,934 1.30%

Total 41.02 1,762,519,127 42,964,698 42.51 1,826,446,355 3.63% 43.45 1,866,613,288 2.20%

05/06 07/0806/07

State

Change in Price

NHLS

Volm (06/7) Ave Price Revenue Ave Price Revenue

Anatomical 1,380,079 108.56 149,823,997 10.5% 113.90 157,185,889 8.6%Chemical 21,425,846 44.75 958,712,082 29.6% 46.93 1,005,479,645 33.5%Genetics 45,382 486.78 22,090,914 4.3% 510.63 23,173,369 3.1%Haemotology 8,925,149 64.56 576,184,004 72.2% 67.72 604,439,778 76.2%Microbiology 11,188,242 79.09 884,828,073 48.6% 82.97 928,337,092 53.9%

Total 42,964,698 60.32 2,591,639,070 41.9% 63.28 2,718,615,773 45.6%

CMS

Change in Price

06/07CMS v STATE

07/08CMS v STATE

Tariff DevelopmentTariff Development

Top 20 Tests – Rand Value

Rand Value %Rank Test Description State 07 Difference CMS 08

1 EasyQ Viral Load 300.00 128% 685.02 Full Blood Count Incl Platelet 42.10 103% 85.373 Profile Discrete Analyser U&E 62.50 106% 128.694 CD4 PLG 60.00 186% 171.495 Micro TB Misc. Fluor 31.00 160% 80.536 HIV Elisa 84.70 35% 114.577 Creatinine - Automated 22.30 32% 29.418 Alanine Transaminase - A 34.00 29% 43.859 Histology 1 Additional Block 89.40 15% 102.98

10 Diff Count and Comment Manual 23.10 118% 50.3811 Aspartate Transaminase - A 33.30 32% 43.8512 C-Reactive Protein Nephelometer 53.50 26% 67.2513 Albumin - A 29.50 32% 39.0014 HIV PCR 365.00 67% 609.4215 R/M Culture TB No Growth 68.90 27% 87.8016 Hepatitis Per Antigen 91.50 29% 117.7317 Glutamyl Transpeptidase - A 33.30 32% 43.8518 Phosphatase Alkaline - A 31.80 33% 42.1619 Histology 1 Block 154.20 15% 177.4920 Bilirubin Total - A 25.90 50% 38.79

Top 20 Tests – Volume

Volumes %Rank Test Description State 07 Difference CMS 08

1 Full Blood Count Incl Platelet 42.10 103% 85.372 Creatinine - Automated 22.30 32% 29.413 Micro TB Misc. Fluor 31.00 160% 80.534 Diff Count and Comment Manual 23.10 118% 50.385 Profile Discrete Analyser U&E 62.50 106% 128.696 RPR Slide Test 14.30 28% 18.237 Alanine Transaminase - A 34.00 29% 43.858 Albumin - A 29.50 32% 39.009 CD4 PLG 60.00 186% 171.49

10 Bilirubin Total - A 25.90 50% 38.7911 Potassium - A 22.30 32% 29.4112 Urea - A 22.30 32% 29.4113 Aspartate Transaminase - A 33.30 32% 43.8514 Sodium - A 22.30 32% 29.4115 Phosphatase Alkaline - A 31.80 33% 42.1616 Chloride - A 15.90 32% 20.9717 Glutamyl Transpeptidase - A 33.30 32% 43.8518 Protein Total-A 19.10 32% 25.3019 Micro TB Misc. 19.00 28% 24.3520 Bilirubin Direct Automated 19.70 49% 29.41

Total spend BEE Spend % BEEConstruction 23,029 13,425 58%

Cleaning, security & garden services 9,941 8,889 89%

Medical waste 5,292 5,292 100%

General medical supplies 22,492 15,880 71%

Couriers 29,216 24,603 84%

Information Technology 43,282 35,132 81%

Printing, stationery, office equipment 20,360 20,360 100%

Office furniture 3,552 1,743 49%

TOTAL 157,164 125,324 80%

Category R 000's2006-07

ProcurementProcurement

The above excludes procurement from internationals

Laboratory ServicesLaboratory Expenditure by Province 2006/7

GP WC FS MP NW NC EC KZN LP RSA

067 Budget 10,404R 6,323R 3,250R 2,912R 3,428R 1,291R 6,893R 11,737R 5,448R 51,686

067 Conditional grant 1,610R 979R 503R 451R 531R 200R 1,067R 1,817R 843R 8,000

067 Billing [incl VAT] 670R 329R 155R 131R 144R 49R 231R 300R 120R 2,128

Population [Mid-year estimate 2005] 9,018 4,646 2,953 3,220 3,824 902 7,039 9,651 5,635 46,888

# of NHLS laboratories 40 22 12 17 27 5 54 52 36 265

Population per laboratory 225 211 246 189 142 180 130 186 157 177

Health expenditure per capita 1,332 1,572 1,271 1,044 1,035 1,653 1,131 1,404 1,116 1,273

Lab expenditure per capita 74 71 52 41 38 54 33 31 21 45

Lab expenditure % Budget 5.6% 4.5% 4.1% 3.9% 3.6% 3.3% 2.9% 2.2% 1.9% 3.6%

Provincial Spend and per Provincial Spend and per Capita SpendCapita Spend

R 0

R 50

R 100

R 150

R 200

R 250

R 300

R 350

GP WC KZN EC FS LP NW MP NC

R m

-

10

20

30

40

50

60

R p

er

pe

rso

n

NHLS Invoicing incl Vat Lab Expenditure per Capita

Human Resources

Human ResourcesHuman Resources

OverviewOverview• Headcount:Headcount:

– March 2003: 3 509March 2003: 3 509

– March 2004: 3 797 March 2004: 3 797

– March 2005: 3 880March 2005: 3 880

– March 2006: 4 132March 2006: 4 132

– March 2007: 5 591March 2007: 5 591

• Payroll:Payroll:

– March 2003: R 489 971 millionMarch 2003: R 489 971 million





Human ResourcesHuman Resources

Achievements 2006 to 2007Achievements 2006 to 2007

• Successful transfer from KZN - 999 employees.

• Final phase of the Broadband and remuneration and career management system

• Successful recruitment drive visiting majority of universities

Workforce ProfileWorkforce Profile

WORKFORCE PROFILE: EXECUTIVE MANAGEMENT: 2005 TO 2008

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Africanmale

Africanfemale

Colouredmale

Colouredfemale

Indianmale

Indianfemale

Whitemale

Whitefemale

Per

cen

tag

e Mar-05Mar-06Mar-07Jan-08


WORKFORCE PROFILE: SENIOR MANAGEMENT: 2005 TO 2007

0.0

5.0

10.0

15.0

20.0

25.0

30.0

Africanmale

Africanfemale

Colouredmale

Colouredfemale

Indianmale

Indianfemale

Whitemale

Whitefemale

Per

cen

tag

e

Mar-05

Mar-06

Mar-07


WORKFORCE PROFILE: MEDICAL SCIENTISTS: 2005 TO 2007

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Africanmale

Africanfemale

Colouredmale

Colouredfemale

Indianmale

Indianfemale

Whitemale

Whitefemale

Pe

rce

nta

ge

Mar-05

Mar-06

Mar-07


REGISTRARS: 2005 TO 2007

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

Africanmale

Africanfemale

Colouredmale

Colouredfemale

Indianmale

Indianfemale

Whitemale

Whitefemale

Per

cen

tag

e

Mar-05

Mar-06

Mar-07


WORKFORCE PROFILE: LABORATORY MANAGERS: 2005 TO 2007

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

Africanmale

Africanfemale

Colouredmale

Colouredfemale

Indianmale

Indianfemale

Whitemale

Whitefemale

Pe

rce

nta

ge Mar-05

Mar-06

Mar-07


WORKFORCE PROFILE: MEDICAL DOCTORS AND SPECIALISTS: 2005 TO 2007

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

Africanmale

Africanfemale

Colouredmale

Colouredfemale

Indianmale

Indianfemale

Whitemale

Whitefemale

Pe

rce

nta

ge Mar-05

Mar-06

Mar-07

TrainingTraining

• Affiliated to 9 Medical Universities

• Affiliated to 11 Universities of Technology

• Successful signing of the umbrella agreement

Registrar Appointments by year per discipline

12

8

21

16

6 65

128

11

2

6

1

910109

0

45

11

3 32

11

56 3

8 8

11

00 01

0 100 0 00

5

10

15

20

25

2001 2002 2003 2004 2005 2006 2007

No o

f reg

istra

rs

Anatomical Pathology

Chemical Pathology

Haematology

Microbiology

Clinical Pathology

Oral Pathology

Registrar appointments by year by discipline 2001 - 2007

Registrars in posts as at April 2007 by year of appointment by Discipline

9

20

16

9

65

13

5

910

2

7

110

7

3

0

86

11

6

9

1 1

0

13

1

6

13

4

1 002

01

00 00

5

10

15

20

25

2001 2002 2003 2004 2005 2006 2007

No o

f reg

istra

rs

Anatomical Pathology

Chemical Pathology

Haematology

Microbiology

Clinical Pathology

Oral Pathology

Registrars in posts as at April 2007 by year of appointment by

discipline 2001 - 2007

Graduates 2005-2007

DISCIPLINE Count of SCIENTISTS Count of PATHOLOGISTS

2005 2006 2007 2005 2006 2007

Pathology (Anatomical) 1 1 0 15 5 8

Pathology (Chemical) 1 0 0 2 3 5

Pathology (Haematological) 1 2 2 7 3 7

Pathology (Immunology) 2 0 0 0 0 0

Pathology (Microbiology) 3 0 0 6 6 7

Pathology (Oral) 0 1 0 0 0 0

Pathology (Virological) 4 1 2 5 0 1

NICD 1 1 1 0 0 0

NIOH 0 0 0 0 0 0

Research Units (Prof Klugman) 1 1 2 0 0 0

Research Units (Prof V Mizrahi) 2 0 0 0 0 0

GRAND TOTAL 16 7 7 35 17 28

Research

2001 NHLS Research Trust Capital R30m



2001 NHLS Research Trust Allocation R1.5m

2006 NHLS Research Trust Allocation R5m

2007 NHLS Research Trust Allocation R7m

NHLS Research Trust

6 MRC units6 MRC units

1 NRF Centre of Excellence1 NRF Centre of Excellence

Cancer RegistryCancer Registry

191 Scientists191 Scientists

392 Research publications annually392 Research publications annually

Research

PublicationsNICD 77 67 65 55

NIOH 24 15 21 43

Anatomical Pathology 37 28 36 50

Chemical Pathology 19 15 36 37

Clinical Pathology 6 0 0 0

Forensic Pathology 1 0 0 0

Haematology 28 32 44 29

Human Genetics 19 9 8 0

Human Genomic Diversity & Disease Research Unit 4 0 13 12

Total Immunology 13 5 23 24

Microbiology 30 44 12 50

Molecular Mycobaterial Research Unit 8 6 5 4

Respiratory & Meningeal Pathogens Research Unit 0 0 16 21

University of Western Cape 2 0 4 0

Pathology 4 0 0 0

Virology 40 40 51 67

310 261 334 392

DISCIPLINE2004-20052003-2004 2006-20072005-2006

Publications

Cape Town 60 34 73 64

University of Western Cape 2 0 4 0

Kwa-Zulu Natal - - - 19

Limpopo 0 26 8 21

OFS 8 10 10 12

Pretoria 27 25 28 44

Stellenbosch 33 16 34 50

Walter Sisulu University 0 0 1 1

Witwatersrand 67 62 72 67

Human Genomic Diversity & Disease Research Unit 4 0 13 12

Witwatersrand Molecular Mycobacterial Research Unit 8 6 5 4

NICD 77 67 65 55

NIOH 24 15 21 43

310 261 334 392

UNIVERSITY2004-20052003-2004 2006-20072005-2006

QA DivisionQA Division

Provision of Proficiency Testing Programmes

Protocols for evaluation of systems, methods and reagents

Implementation of Quality Standards to conform with international norms

Guidance with preparation for SANAS accreditation

Training of Auditors

Training of QA personnel

Monitoring effectiveness of the management of laboratories

GOALS of NHLSPROFICIENCY TESTING

To facilitate the implementation of appropriate procedures for all service laboratories and the harmonization of laboratory resultsTo provide analysis of performance data for users and managementIdentify deficiencies with regard to the technical quality of resultsDirect resources in an efficient manner order to correct such deficiencies

Identification ofNon Conformance

Proposed Corrective Actions

& Resolution

Monitor Effectiveness

of Change

MonitoringRelative to

PerformanceCriteria

The Proficiency Testing Process

PT Programmes Currently PT Programmes Currently ProvidedProvided Clinical ChemistryClinical Chemistry

General chemistryGeneral chemistry EndocrinologyEndocrinology Therapeutic drugsTherapeutic drugs Blood GasBlood Gas

HaematologyHaematology General HaematologyGeneral Haematology Differential and slide assessmentDifferential and slide assessment CoagulationCoagulation CD4CD4

MicrobiologyMicrobiology BacteriologyBacteriology MycologyMycology ParasitologyParasitology TB microscopy and cultureTB microscopy and culture Syphilis serologySyphilis serology HIV testingHIV testing

PT Programmes Currently PT Programmes Currently Provided contProvided cont

Utility of PT Schemes in Utility of PT Schemes in the the context of the HIV and TB context of the HIV and TB PandemicPandemicEstablishing the diagnostic efficiency in:

A: Identifying infected individuals

B: Monitoring disease progress

C: Identifying opportunistic infections

D: Monitoring levels of toxicity of therapeutics

E: Monitoring effectiveness of treatment

F: Identification of opportunistic infections

Participating Laboratories Participating Laboratories By SchemeBy Scheme

0

50

100

150

200

250

ChemHaem Bact

Para

– Sto

ol

Para

– Blo

od

Myc

ology

Yeasts

Myc

ology

Moulds

TB Mic

ro

TB Cultu

re R

PR

TPHA

HIV S

erolo

gy

Participating Laboratories

Laboratory AccreditationLaboratory Accreditation

Accredited Labs by Year

4

8

4 5

10

2

11

15

354

12

16

21

31 30

36

51

0

10

20

30

40

50

60

Calendar Year

Nu

mb

er

of

Lab

s

New Accreditations Withdrawn Net Total

NATIONAL INSTITUTE FOR NATIONAL INSTITUTE FOR COMMUNICABLE DISEASECOMMUNICABLE DISEASE

1. Academic & training

2. Surveillance & monitoring of communicable diseases

3. Outbreak response & management

4. International

5. Communication & consultation

6. Research – applied & operational

7. Quality assurance & reference

South African Field Epidemiology and Laboratory Training Program (SA FELTP)

NICD

SOUTHERN AFRICAN CENTRE FOR SOUTHERN AFRICAN CENTRE FOR INFECTIOUS DISEASE SURVEILLANCE INFECTIOUS DISEASE SURVEILLANCE (SACIDS)(SACIDS) Virtual centre/network linking institutions in southern Africa with those in the UK and other science centres of the "North"

• Director: Professor Mark RweyemamuSokoine University of Agriculture at Morogoro, Tanzania; Visiting Professor, Royal Veterinary College, University of London; and nominated as Extraordinary Professor, Faculty of Veterinary Science, University of Pretoria, South Africa

• Deputy Director (Medical): Professor Barry Schoub National Institute for Communicable Diseases, South Africa

• Deputy Director (Veterinary): Professor Rudovick Kazwala Sokoine University of Agriculture, Morogoro, Tanzania

AFRICAN CENTRE FOR INTEGRATED AFRICAN CENTRE FOR INTEGRATED LABORATORY TRAINING ( ACILT )LABORATORY TRAINING ( ACILT )

VISION:

A healthier Africa through quality laboratory practices that support efforts to combat major infectious diseases

MISSION:To provide integrated hands-on training courses to expand laboratory

capacity in Africa for diagnosis and monitoring of major infectious diseases including HIV/AIDS, TB, and malaria

0

100

200

300

400

500

600

700

800

Year and week

Nu

mb

er o

f co

nsu

ltat

ion

s

0

10

20

30

40

50

60

70

80

Nu

mb

er o

f re

spir

ato

ry v

iru

s is

ola

tes

Influenza Virus Isolates

Chronic Respiratory Disease

Influenza

Pneumonia

Influenza Virus Isolates

Influenza Isolates

0%

1%

2%

3%

4%

5%

6%

7%

8%

Year and epidemiologic week

% o

f to

tal a

dmis

sion

s

0

20

40

60

80

100

120

140

Num

ber

of in

fluen

za v

irus

isol

ates

Influenza isolates

% Acute upper respiratory infection

% Influenza-like illness

% Acute lower respiratory infection

▀PMG note: Diagram not included]

Diagnostic Services

Extension of service to all Extension of service to all the communities in the the communities in the countrycountry

• Transport logistics deployed to service the Transport logistics deployed to service the Primary Health Care (PHC) facilitiesPrimary Health Care (PHC) facilities

• Extend consultation and outreach Extend consultation and outreach pprogrammes to rural provinces rogrammes to rural provinces

Primary Health Care Primary Health Care CoverageCoverage

Branch Total number of clinics (Incl small hospitals)

Number

Clinics covered

(daily)

%

Clinics covered (daily)

%

Clinics covered (weekly)

Central 1 084 1 029 95% 100%

Coastal 1 333 799 60% 100%

KZN 509 264 52% 100%

Northern 1 110 812 73% 100%

Total 4 036 2 904 72% 100%

Provincial ProgramsProvincial Programs

• Support both national and provincial health Support both national and provincial health programsprograms

• Information resource to provincial coordinators.Information resource to provincial coordinators.

• Focussed TB, Cervical Cancer Screening, CD4 and Focussed TB, Cervical Cancer Screening, CD4 and Viral load managementViral load management

TB Culture Labs 1LD 2LD

Number of MGITs per Lab

Cape TownGreen Point x x x 18Groote Schuur x 3Tygerberg x 1

Port ElizabethPE Central x x x 11Umtata x x x 2

BloemfonteinPelonomie x 5Universitas x 1

KimberleyKimberley x x 6

DurbanAlbert Luthuli x x x 19

PretoriaTswane Academic x x 6George Mukari x x 4Tsepong x x 4

JohannesburgBraamfontein x x x 19

PolokwanePolokwane x x 3

Ermelo Ermelo x 1

TOTAL NHLS 15 10 5 103

TB Culture FacilitiesTB Culture Facilities

QUALITY ASSURANCE

SOPs

NICD EQA Proficiency Testing

National Blind Re-checking Programme

EQA for Culture and Drug Susceptibility Testing

Indicators (CDW)

Accreditation/Laboratory Check Lists

Training

SURVEILLANCE

Corporate Data Warehouse

MDR-TB/XDR-TB Registers/Notifications

Drug Resistance Survey (Feb 08 – Jul 09)

MDR-TB Centre XDR prevalence

DST Pattern Surveillance

TB Microscopy Volumes

TB Microscopy per 100,000 Population

TB Microscopy % Positive

TB Microscopy - Positive Severities

Sensitivity Tests Adjusted per 100,000 Population & MDR & XDR

DIAGNOSTICS

Rapid Diagnostics Project (FIND) (Jul 07– Jul 08)

Automation of Culture Processes (Sept 07– Jul 09)

Validation/Migration Bactec DST to MGIT

Validation other diagnostics (PCR, QFT, LAM etc)

TB Cultures as % TB Tests

Gauteng: proposed flowchart forPCR diagnosis

Positive smears20

Negative smears80

PCR

Resistant Sensitivie

1MDR

Sizwe

Culture + DST

Treat:Individual

19

Treat:standard

1 week

Still symptoms45

low Index of Suspicion35

culture

15 positive 30 negative

PCR

Resistant2

Sensitive13

Sizwe

Culture+ DST

Treat:Individual

Treat:standard

discharge

Suspect100

Suspect100

TURN AROUND TIMES

Transport coverageCouriers

“in-house”

Intra-laboratoryExtended hours

Indicators

“extended laboratories”

SMS Auto faxing

Accreditation type Corrective Action Sheets

Monitoring

Reporting formats

TRAINING

SA-FELTP

RILTC (SADC countries)

‘In-house’ Microscopy/Culture courses

Nurses/Doctors/Students

Technical Assistance SADC

In-Laboratory TAT

Laboratory Capacity

Number of laboratories Number of systems Test Capacity Test utilizationCD4 tests 56 78 250 800 190 000 (75%)Viral load tests 18 22 63 360 52 000 (82%)HIV PCR tests 10 11 25 740 16 000 (62%)

Province CD4 laboratories Viral load laboratories PCR laboratories Districts with CD4 labsGauteng 11 6 4 5 of 6Free State 4 1 1 3 of 5Northern Cape 1 1 Planned 1 of 5North West 4 1 Planned 3 of 4Mpumalanga 4 1 Planned 3 of 3Limpopo 5 1 Planned 5 of 6Western Cape 4 2 2 2 of 6Eastern Cape 6 2 2 5 of 7KZN 17 3 1 11 of 11 Total 56 18 10 38 of 53

Laboratory capacity in support of the CCMT for HIV and AIDS

Number of labs per province / district with CCMT laboratories.

Number of CD4 tests by month

Number of CD4 tests by month

0

50000

100000

150000

200000

Apr-04May-04Jun-04Jul-04Aug-04Sep-04Oct-04Nov-04Dec-04Jan-05Feb-05Mar-05Apr-05May-05Jun-05Jul-05Aug-05Sep-05Oct-05Nov-05Dec-05Jan-06Feb-06Mar-06Apr-06May-06Jun-06Jul-06Aug-06Sep-06Oct-06Nov-06Dec-06Jan-07Feb-07Mar-07Apr-07May-07Jun-07Jul-07Aug-07Sep-07Oct-07Nov-07Dec-07

Month

Number of tests

Percentage CD4 cell counts

Percentage CD4 cell counts <= 200 cell / ml

0

20

40

60

80

100

Apr-04 Aug-04 Dec-04 Apr-05 Aug-05 Dec-05 Apr-06 Aug-06 Dec-06 Apr-07 Aug-07 Dec-07

<=200

>201

CD4 Penetration

Provincial penetration per million population for CD4 testing: 2004-2007

0

5000

10000

15000

20000

25000

30000

35000

40000

EC FS GP KZN LP MP NC NWP WC NationalProvinces

Q3 2004

Q3 2005

Q3 2006

Q3 2007

Number of Viral Load tests per month

Number of viral load tests per month

0

10000

20000

30000

40000

50000

60000

May-0

4Jun

-04 Jul-04

Aug-0

4Sep

-04Oc

t-04

Nov-0

4De

c-04

Jan-05

Feb-05

Mar-0

5Ap

r-05

May-

05Jun

-05 Jul-05

Aug-0

5Sep

-05Oc

t-05

Nov-0

5De

c-05

Jan-06

Feb-06

Mar-0

6Ap

r-06

May-0

6Jun

-06 Jul-06

Aug-0

6Sep

-06Oc

t-06

Nov-0

6De

c-06

Jan-07

Feb-07

Mar-0

7Ap

r-07

May-0

7Jun

-07 Jul-07

Aug-0

7Sep

-07Oc

t-07

Nov-0

7De

c-07

Viral Load Percentage Trend

Viral Load Percentage Trend

0

10

20

30

40

50

60

<=50 or 400

401 - 50 000

50 001 - 100 000

>100 001

Number of PCR per month

Number of PCR tests per month 2004-2007

02000400060008000

1000012000140001600018000

Sep-04

Oct-0

4No

v-04

Dec-0

4Jan

-05Feb

-05Ma

r-05

Apr-0

5 M

ay-05

Jun-05

Jul-05

Aug-0

5Sep

-05Oc

t-05

Nov-0

5De

c-05

Jan-06

Feb-06

Mar-0

6Ap

r-06

May-0

6Jun

-06Jul

-06Au

g-06

Sep-06

Oct-0

6No

v-06

Dec-0

6Jan

-07Feb

-07Ma

r-07

Apr-0

7Ma

y-07

Jun-07

Jul-07

Aug-0

7Sep

-07Oc

t-07

Nov-0

7De

c-07

PCR Percentage Positive WC vs SA

Comparison between percentage positive PCR in the WCP and the rest of South Africa

0

5

10

15

20

25

30

35

40

Sep-

04Oc

t-04

Nov-

04De

c-04

Jan-

05Fe

b-05

Mar

-05

Apr-0

5 M

ay-0

5Ju

n-05

Jul-0

5Au

g-05

Sep-

05Oc

t-05

Nov-

05De

c-05

Jan-

06Fe

b-06

Mar

-06

Apr-0

6M

ay-0

6Ju

n-06

Jul-0

6Au

g-06

Sep-

06Oc

t-06

Nov-

06De

c-06

Jan-

07Fe

b-07

Mar

-07

Apr-0

7M

ay-0

7Ju

n-07

Jul-0

7Au

g-07

Sep-

07Oc

t-07

Nov-

07De

c-07

Percentage positive all other provinces

Percentage positive WCP

ENDEND

health portfolio committee annual report 2006-2007

Documents

transfer of cash

cumulative12 months

operating cash generated161

achievedincreased cash

cash utilised

cash items70

total cash generated446

operating profitloss253