Financing antiretroviral treatment and primary health care services : cross-cutting health systems issues

This chapter focuses on estimating financial and human resource requirements for scaling up two key health programmes in South Africa: Primary Health Care (PHC) and Antiretroviral Treatment (ART). Estimates are compared with current conditional grants in the case of ART or current estimated expenditure levels in the case of PHC services. Results show that Conditional Grants are approximately sufficient to deliver ART to 50 000 patients by April 2005, but that budgetary constraints will be encountered if the programme meets the patient targets contained in the National Department of Health's 'Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment.' Results from costing comprehensive PHC services show that national and provincial departments should aim to increase per capita spending to just over R300 in order to provide rural and scarce skills allowances, increase community health workers and environmental health services, and meet target PHC utilisation rates.