Nurses will soon be trained to prescribe pills – under a doctor’s supervision – for mental health conditions such as depression and anxiety, according to South Africa’s new five-year (2023-2028) action plan for HIV, tuberculosis (TB) and sex. contagious infection (IMS).
Nurses may soon be trained to prescribe pills – under a doctor’s supervision – for mental health conditions such as depression and anxiety, according to South Africa’s new five-year action plan (2023-28) for HIV, tuberculosis (TB) and sex. contagious infection (IMS).
The South African National Aid Council (Sanac) launched the final plan in Rustenburg on World TB Day on Friday.
Health Minister Joe Phaahla should change the Nursing Act regulations to allow nurses to prescribe antidepressants, according to Andy Gray, senior pharmacology lecturer at the University of KwaZulu-Natal.
Currently, only general practitioners and psychiatrists can prescribe psychiatric drugs in South Africa. Nurses can be trained to prescribe some drugs, such as antibiotics, but not mental health drugs such as antidepressants because these are classified as schedules five and six, which can only be prescribed by doctors, Gray said.
About one in three people in South Africa will experience depression, anxiety or a substance use disorder at least once in their life, according to the South African Stress and Health Survey 2009. But three-quarters will not receive treatment, 2009 South African Medical Journal learn to meet.
Depression, anxiety and substance abuse are more common among people with HIV and TB than those without the disease, the plan said. Mental health conditions make it harder for people to get medication, and discrimination by health workers can prevent people with mental health problems from getting the help they need.
Anxiety and depression also increase a person’s risk of contracting HIV or TB because people who are anxious or depressed often use coping mechanisms, such as substance abuse, which, in turn, make them more vulnerable to HIV or TB.
That’s why it should be easier for people to get prescriptions for psychiatric drugs, the action plan says.
Professional nurses study for four years and receive a degree.
South African public health workers will also be trained to recognize early signs of mental disorders and substance abuse.
But the new plan, called the National Strategic Plan (NSP) for HIV, TB and STIs – which also aims to get more children vaccinated against the human papillomavirus (HPV) that causes cervical cancer – has a funding gap.
For the first year of implementation, there is R1.7 million available to meet the plan’s targets – and the shortfall is increasing every year. In 2028, the final year of the plan, the cumulative deficit, as it stands now, is R7.2 billion.
Does the budget appear?
The government will finance the majority (77%) of the NSP roll-out.
Another 20.5% of the money will come from international donors such as The Global Fund to Fight Aids, Tuberculosis and Malaria (6%), the US Agency for International Development and the US government’s Aids fund, the President’s Emergency Plan for Aid Relief, PEPFAR , (14, 5%)
The South African private sector will contribute 2.5% of the total cost of the NSP until 2028.
International donors have increased their contributions in the past few years to help South Africa reach the 95-95-95 target, but as the country moves closer to controlling the HIV, TB and STI epidemics, they will begin to reduce funding, the plan says.
This is worrying, according to the NSP, because international partners are investing heavily in improving the operations of the country’s health system (for example, data collection). Donors also fund many public health programs and projects that work with groups of people with high rates of HIV, TB and STI infections, such as sex workers and transgender people.
What else is new at the fifth NSP in South Africa?
● The plan aims to get more people with HIV and TB tested and treated for diabetes, hypertension and cancer. This is to improve the quality of life of people who are HIV positive, especially if they have achieved viral remission. This is when there is so little virus in the body that most laboratory tests cannot pick up the virus; this usually happens within six months of starting to take antiretroviral drugs, if the pills are taken correctly.
● The plan aims to start distributing the HPV vaccine, which can prevent cervical cancer, to non-government schools. Currently, only girls in government schools can get free jabs. Research shows that cervical cancer increases a person’s chances of becoming infected with HIV.
● For the first time, the government will track HPV vaccination in the same way it tracks HIV and TB treatment in the NSP. The goal is to vaccinate 95% of girls aged nine and over with the first anti-HPV vaccine by 2028. Eighty-five per cent of nine-year-old girls should receive a second dose by 2028 as well.
● The health department will push to decriminalize the possession and use of drugs (in the case of personal use). This means that when the police find someone in possession of drugs for personal use, they will not be arrested. Studies show that people who inject drugs have higher rates of HIV infection than those who don’t, often because they share needles. The report says that HIV and TB cases will decrease because when the drugs are not illegal, there will be less stigma around drug use, which will facilitate treatment. People also have a higher risk of contracting tuberculosis if they are in prison, or may not have regular access to HIV medication.
● Sex work will be discriminated. Studies have shown that when sex work is legal, sex workers are more likely to test for HIV and seek treatment if positive, resulting in lower rates of HIV infection. The government will increase screening, testing and treatment for viral hepatitis, an infection that causes inflammation and damage to the liver. Viral hepatitis develops more quickly and causes liver-related health problems among people with HIV than among people without HIV.
● The health department plans to initiate 260,000 close contacts of TB patients for preventive treatment by 2028.
● The government aims to vaccinate 90% of newborns against hepatitis B by 2028.
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