The national defence force will this new financial year spend R48 million on combating HIV/AIDS and associated opportunistic diseases, the Ministry of Defence and Military Veterans says, adding it is difficult to put a price tag to the crisis because of the complexity of the disease.
Answering a question from Democratic Alliance defence shadow David Maynier, the ministry said R26 million was allocated to fighting the scourge in the 2006/07 financial year. This was increased to R32.25 million in the 2009/2010 financial year. “Due to the new HIV and AIDS treatment policy of the National Department of Health to commence treatment at an earlier stage, the costs of antiretroviral treatment have increased. Therefore R33.5 million has been allocated to the SAMHS [South African Military Health Service] for the 2010/2011 financial year and R48 million for the 2011/2012 financial year.”
The ministry adds there are no statistics on HIV/AIDS prevalence in the South African National Defence Force as neither HIV nor AIDS is notifiable and “therefore there is no obligation on members of the SANDF to disclose” their status. Despite this, the Surgeon General, Lieutenant General Vejay Ramlakan last month said the number of military personnel living with HIV and AIDS is significantly lower than the national average.
Ramlakan says since the launch of a comprehensive HIV Counselling and Testing Campaign (HCT) in April this year about 6% of the total Department of Defence population has been tested by the SA Military Health Service and of these only 0.01% tested positive for HIV. The trade union Solidarity, by contrast estimates that one in five – or roughly 19% of – South Africans are HIV-positive.
“The ministry in its answer to Maynier adds the “disease profile of immune-compromised members represents a complex and extensive pattern that includes the treatment of all opportunistic infections and AIDS-related illnesses such as tuberculosis, sarcomas, pneumocystis Jerovicii pneumonia, cytomegalovirus infections, candida, toxoplasmosis and Giardia Lamblia, amongst others. The management of this variety of diseases thus contributes to the overall HIV and AIDS cost drivers but it is extremely difficult to estimate the cost implications due to the comprehensive nature of managing them, as well as the multidisciplinary approach to management.
“The total cost for this programme includes preventative programmes, treatment with anti-retroviral drugs, as well as drugs for the treatment of opportunistic infections of HIV and AIDS. These costs are covered by the South African Military Health Service budget and the conditional grant provided by National Treasury and forms part of the HIV strategy and expansion of the rollout of antiretroviral therapy as prescribed by the National Department of Health.
Ramlakan said test results for the military was “encouraging”. He ascribed the lower prevalence rate to the successes of the military’s Masibambisane awareness campaign and the research done under Project Phidisa. Ramlakan told a World AIDS Day event in Pretoria that it was “heartening” to see a decrease of more than 30% in the mortality rate over the last four years. These successes are also reflected in the research done by Project Phidisa that shows 78% of people with AIDS that are receiving ARVs are converting to almost normal levels of functioning. “It is possible to lead a normal life if you follow the correct medical advice”, he told military personnel.
Cabinet last year November approved a new HIV/AIDS policy for the SANDF. Cabinet spokesman Themba Maseko said at the time the “new policy provides for the recruitment and selective deployment of HIV positive persons into the SANDF.” He added the decision marked “the culmination of a policy review process that was initiated in 2006 and is in compliance with a 2008 High Court decision that ruled that the existing policy was unconstitutional. The old policy excluded HIV positive persons from being recruited and external deployment. The Military Health Services structures will provide the necessary support to SANDF personnel,” he said.
The South African Security Forces Union (SASFU) took the SANDF to court in May 2007 regarding its use of HIV testing with regards to employment, deployment, promotions and transfer, saying that the policies discriminated against HIV-positive personnel. SASFU was assisted by the AIDS Law Project (ALP), whose head at the University of the Witwatersrand, Mark Heywood, said there was no basis for the assumption that HIV infection in itself rendered a person physically unfit or mentally unstable.
When the matter went to court before Judge Claasen in the Gauteng North (Pretoria) High Court in May last year, the SANDF unexpectedly capitulated on a 14-year-old position and conceded its position was unconstitutional. The SASFU application was thus made an order of court. The ALP afterwards said the order meant the SANDF could “no longer automatically exclude HIV positive people from recruitment, external deployment and promotion”. The military was further given six months from May 17 to amend its health classification policy to allow “for individualised health assessments of recruits and current members of the armed forces”.
The deadline – November 2008 – came and went with no policy forthcoming. By September 2009 SASFU was threatening to have defence minister Lindiwe Sisulu arrested for contempt of court.
Ramlakan last December said a better understanding of the virus had made it possible for the military to safely deploy asymptomatic HIV positive soldiers, thereby boosting the number of troops available for internal and external deployments.