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DENOSA concerns on the implementation of new WHO ‘Test-and-Treat’ HIV guidelines in SA from today
Media statement
Thursday, 01 September 2016
The Democratic Nursing Organisation of South Africa (DENOSA) notes that today marks the day where South Africa implements the World Health Organisation’s (WHO) new HIV guidelines on ‘Test-and-treat’, where patients diagnosed with HIV will be initiated onto the Anti-Retroviral Treatment (ART) programme and nurses no longer have to wait for the CD4 count of patients to drop to 500 first to qualify for initiation into the programme.
This is a commendable move by South Africa, but we believe that it should be done holistically for quality results. DENOSA feels that two issues are of great concern to nurses in relation to this, and our fear is that these issues may stand in the way of the success of this new Universal Test-and-Treat (UTT) regime if they are not addressed properly soon.
1. Severe shortage of nurses in facilities and risks of high defaulter rate
As the ART programme in South Africa is led and managed by nurses, the gross shortage of nurses in our facilities is likely to worsen in our facilities as from today. We note that the beginning of the implementation of UTT is not accompanied by any undertaking to take on additional nurses in facilities where there remain vacancies so that patients don’t have to queue for longer. Initiating patients on ART will take slightly longer for patients to be attended to, because nurses have to educate them about the programme while also counseling patients about being HIV. Many patients will remain restless in the queues, and some, including those who collect medication, may give up and go home, thus default on treatment all because of staff shortages.
Shortage of nurses is at crisis levels, and to not address it before this massive additional work is embarked upon will result higher stress levels and fatigue for few nurses whereas vacancies remain unfilled. DENOSA would like for communities to foresee this danger on their part as well.
2. No new protocols for nurses on the new UTT treatment as yet and there’s risk of litigation to nurses if they start implementing without protocols
There has not been widespread distribution of new UTT treatment protocols for nurses in facilities that initiate patients on ART and which will initiate according to the new rules. Many nurses are still applying their work in initiating patients based on the previous guidelines of CD4 count 500 as a detriment (except for pregnant women to whom ‘test-and-treat’ rule had been applying all along). This puts nurses under a compromised position, and it is unnecessary.
From a union and shop steward perspective, in the absence of the new protocols the current guidelines are the only guidelines that nurses have to abide by in treating HIV, because if they don’t and there are medical complications and defaults on patients when applying the new WHO guidelines, nurses could face serious medico-legal challenge, and that may threaten their license to practice as nurses.
We call on government to provide clarity on these issues and assist nurses so that nurses could assist government to achieve these positive health outcomes as spelt out in vision 90-90-90 and NDP respectively. The shortage of nurses have been there way before, and implementing the new guidelines in that environment will result in longer queues and further frustration for both community members and nurses.
End
Issued by the Democratic Nursing Organisation of South Africa (DENOSA)
For more information, contact:
Oscar Phaka, DENOSA Acting General Secretary
Mobile: 060 583 4691
Or
Sibongiseni Delihlazo, DENOSA Communications Manager
Mobile: 079 875 2663
Tel: 012 343 2315
Website: www.denosa.org.za
Facebook: DENOSA National Page
Twitter: @DENOSAORG
