Evaluating the scale-up of antiretroviral treatment sites in KwaZulu-Natal province of South Africa: achievements and challenges from 2005 to 2010.

In order to provide care to the increasing number of people infected with HIV, there is a need for scaling up the number of treatment sites. For the public health officials and planners, there is a need for a defined methodology to do this taking into consideration the national targets as enacted by the National Department of Health (NDOH) of South Africa. This commentary is about an evaluation conducted to review the progress made by the Province of KwaZulu-Natal in scaling-up antiretroviral treatment sites (ART). Overall, the prediction that 54 ART facilities were required for equitable distribution of antiretroviral treatment in KwaZulu-Natal had been exceeded as 89 ART sites had been established by 2010. In conclusion, the predicted number of ART sites by Wilson and Blower method was largely exceeded within 5 years of their prediction. Two major challenges are still lurking into the ART program, the accessibility by those who need it and the shortage of professional human resources particularly pharmacy staff. Innovative strategies are needed to address the shortage of health professionals and related disparities in order to increase access to ART.