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About Right to Care Right to Care is a non-profit organisation (Section 21) that supports and delivers prevention, care, and treatment services for HIV and associated diseases. Through technical assistance, Right to Care supports the Department of Health at national level. Support at provincial level is provided primarily in five provinces: Gauteng, Mpumalanga, Northern Cape, Western Cape, and Free State. In addition, through direct service delivery, Right to Care treats patients for HIV, TB, cervical cancer, and sexually transmitted infections.
Support for clinical programmes is delivered through development of clinical best practices, research, training, mentoring, participation in technical committees, provision of facilities and equipment, and secondment of staff, among others.
Funding and revenue Funding and revenue streams: • The President’s Emergency Plan for AIDS Relief (PEPFAR), which is managed by USAID • Global Fund to Fight AIDS, Tuberculosis, and Malaria • Private sector donors • Revenue from the private sector for provision of employee wellness services (through Right to Care Health Services)
HIV care and treatment Right to Care’s Adult HIV and Paediatric HIV programmes supports the clinical care and treatment of individuals infected with HIV and associated diseases. Care and treatment is accessible through an integrated model that includes prevention, transition into care, treatment adherence, and nurse initiated and managed ARV treatment (NIMART). Loss-to-follow-up is minimised using innovative approaches, such as automated text messages and patient transfers with electronic records. On-site and didactic training are provided to clinicians in the public and private sectors. In each province, centres of excellence are hubs for mentoring and training and for referrals of complicated cases.
In its first ten years of operation, Right to Care initiated over 230 000 patients on ARV therapy.
TB Right to Care’s TB programme provides integrated TB/HIV services for both drug-sensitive and drug-resistant TB. Components of Right to Care’s TB strategy include use of the ‘‘3 Is’’: Intensified case finding; INH Preventative Therapy (IPT); and Infection control in health facilities.
TB symptom screening is done at all healthcare visits. Sputum induction facilities reduce by 10% the number of patients who cannot produce sputum, leading to improved testing rates.
Right to Care has spearheaded the use of the Cepheid GeneXpert MDR TB Rif for rapid diagnosis of TB and of drug resistance.
The diagnosis and management of Multidrug and Extensively Drug-Resistant TB is supported, in particular at Sizwe Tropical Diseases Hospital, Johannesburg. On an on-going basis, Right to Care collaborates in TB research studies.
Cervical cancer At present, our most important weapon against cervical cancer is an effective screening and treatment programme to detect and remove early cervical dysplastic lesions. Right to Care trains medical officers to perform colposcopic biopsies and large loop electrical excisions (LLETZ). These cost-effective procedures have resulted in greatly improved access to treatment.
Mobile clinics take screening and treatment services, and other women’s health services, to remote areas.
Prevention Right to Care’s prevention programmes include treatment as prevention, medical male circumcision (MMC), HIV counselling and testing (HCT), and prevention of mother-to-child transmission (PMTCT).
Right to Care advocates treatment as prevention. Among discordant couples, ARV therapy has been shown to reduce by 90% the rate of transmission from one partner to the other.
Annually Right to Care conducts over 300 000 HIV tests. Through technical assistance and direct service delivery, Right to Care is supporting the DoH in the delivery of MMC services. MMC is offered as a comprehensive package of services that includes HCT, the provision of condoms, and education for behaviour change.