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South African nurses are particularly valuable, because of their experience with a vast burden of disease. Anyone who has visited a health care facility before will know that interaction with a doctor is limited to a few short minutes and revolves around what is medically wrong. It is most often a nurse who checks on you regularly, and builds the personal connection that makes you feel cared for. Many South Africans feel the benefit of their work every day – both in hospitals and in their communities where nurses are regarded as a source of medical support and information. Yet for many nurses, holding down a single job is not an option. An estimated 70 percent of nurses in South Africa do additional work after hours including moonlighting, working overtime, or doing agency work resulting in nurses being overworked and often suffer from burnout. When nurses are overworked and underpaid...

Little things can make a big difference. The mosquito – a tiny insect that spreads one of the most dangerous diseases worldwide – is one example. In fact, it is the even smaller parasites of the genus Plasmodium that live inside the female Anopheles mosquito that cause Malaria. On 25 April, the World Health Organisation (WHO) will be marking World Malaria day. According to the latest WHO estimates, released in December 2015, there were 214 million cases of malaria in 2015 and 438 000 deaths. Yet, in positive news, according to the WHO, between the year 2000 and the year 2015, the number of deaths caused by malaria fell an incredible 60 percent, indicating the positive impact of the myriad of efforts to address this health challenge. During the same period the incidence rate has decreased by 37% globally. Of course, as is the case with many illnesses, not all regions and...

March is TB awareness month around the world, and thus a perfect time to reflect on the work that is being done to eradicate TB in South Africa. A key part of the work is partnership – between Government and the people who work with communities to ensure that strategies are implemented, and therefore effective. South Africa’s TB problem is indeed complex. Treatment can cure the disease within six months, but it requires a particular regiment of treatment and it requires the medicines to be accessible. As well as having high numbers of cases of ordinary TB, there are also increasing numbers of cases of multidrug-resistant TB (MDR-TB). This type of TB is severe, the bacteria are resistant to multiple antibiotics and is therefore more difficult to treat, requiring up to 24 months of treatment. In South Africa, around five percent of TB cases are MDR-TB. The likelihood that someone will contract...

March is Tuberculosis (TB) awareness month around the world. The World Health Organisation has set a target of eradicating TB by 2035. In South Africa, this has particular importance. As of 2013, TB was the number one cause of death in South Africa with 8.8% of all deaths caused by the disease[1] (above HIV, heart disease, pneumonia, and diabetes.) South Africans are contracting TB at the second highest rate of any country in the world (Lesotho is number one). But, TB is curable within six months if treatment is taken,[2] so why the continued high rates? TB is an infectious bacterial disease that most commonly affects the lungs. It is contagious and can be transmitted from person to person via droplets from the throat and lungs of people with the active disease. There are two types of TB – latent and active.[3] Those who have latent TB are not contagious, and don’t...

JPS Africa (previously Jhpiego South Africa) is a non-profit organisation registered in South Africa in terms of Section 21 of the Companies Act of 1973 (as amended). JPS Africa currently works on four major projects which share a common goal of increasing access to high-quality HIV and AIDS services in South Africa. Since 2007, JPS Africa has worked with groups from the community level to the national level in order to build sustainable local capacity through advocacy, policy development, and quality and performance improvement approaches. In addition to this, JPS Africa offers the necessary high-quality experience implementing HIV/AIDS prevention, treatment, care and support programmes and effective management skills to successfully execute and provide technical assistance in related fields. JPS Africa maintains a two-tier capacity with regards to strategic direction, namely at board level and at management level. The JPS Africa Board includes the Managing Director and non-executive board members with strategic...

Imagine you’re trying to sell something. You know that this thing is fantastic. You know that it can change lives, perhaps even change the world. You get together with some like-minded people and they agree to promote this product too. So now you have a team of people, a great thing to sell, and you want other people to know that they can buy it. What is the first thing you think you’ll need to do it? Keep that in mind. Many Non-Governmental Organisations (NGOs) have faced a series of financial crises post-2008. The economic recession means that overseas donors are tightening their belts, and shifting their focus. Donors want clear impact – they want to see that the work they’re funding makes a difference. This makes sense, because many of the donors that fund South African organizations must themselves report to donors elsewhere in the world. But programmes can’t run themselves. They...

Summary The South African Department of Health has published revised TB Infection Control guidelines in 2015, to provide guidance to management and staff in minimizing the risk of TB transmission in health care facilities, congregate settings (e.g correctional services) and communities. When keeping in mind the context of high HIV, MDR-TB and XDR-TB burden in South Africa, it is apparent that the national guidelines on TB Infection control policy are vitally important. According to WHO, South Africa has the second highest number of reported multi-drug-resistant TB (MDR-TB) cases globally. Approximately 10.5% of MDR cases in South Africa have XDR-TB. To address these issues, South Africa has widely embraced the concept of decentralization of DR-TB care and management. Instead of having to make long, and costly journeys to the MDR-TB centres, many patients can now access HIV and MDR-TB services close to their homes. Improved infection control measures will make healthcare environments safer for...

The world is an unequal place demonstrated clearly by the fact that the 62 richest people in the world are as wealthy as the remaining 7 billion. As the number of people on the planet grows, and the amount of resources remains the same, it seems inevitable that the divide between rich and poor will continue to worsen. In South Africa, as around the world, a person’s wealth can significantly impact their health. The Right to Health is enshrined in the Constitution and as of 2015 around six percent of the annual budget was spent on healthcare for the population. However, the quality of healthcare that ordinary South Africans receive is largely controlled by their income. A two-tier system exists, with the small private medical sector servicing the wealthy and the large public sector health system servicing around 80% of the population. Almost 40% of South Africans are unemployed, and few employers...

JPS Africa is collaborating and supporting the World Health Organization (WHO) and the National Department of Health and in undertaking HIV Drug Resistance (HIVDR) surveillance across provinces in South Africa. In recent years, the rapid scale up of ART for HIV infection in resource-limited countries has been identified as an international healthcare priority. Sub-Saharan Africa remains the most affected region with a total of 24.7 million which is 73% of the total number of people estimated to be living with HIV around the globe. At the end of 2015, SANAC estimated that 6.4 million South Africans are living with HIV with approximately 2.8 million on anti-retroviral therapy. Scaling-up ART in SA comprises the use of standardized and simplified treatment regimens that are consistent with international guidelines. The emergence and transmission of HIV drug resistance (HIVDR) is an unavoidable consequence of ART, even when appropriate drugs are prescribed and adherence is maximally...

Medical male circumcision involves the surgical removal of the foreskin, which is important in HIV transmission because the inner part of the foreskin is highly susceptible to HIV transmission. Since 2007 the World Health Organisation (WHO) reported that Medical Male Circumcision (MMC) can reduce the sexual transmission of the HIV virus from females to males by up to 60 percent. The WHO and UNAIDS identified South Africa as one of the fourteen priority countries that need to scale up MMC, through encouraging medical circumcision as part of a comprehensive HIV prevention package. In response to this, the South African Government in 2010 has encouraged boys and men (aged 15 to 49) to undertake Voluntary Medical Male Circumcision (VMMC) and has rolled out large-scale MMC service delivery sites across the country. The target for 2016 is to reach 80 percent of eligible HIV negative men. Like any surgery, MMC does pose risks, but...