DESPITE the tight fiscal environment, the health sector will receive additional funding over the medium term to compensate for a drop in US donor support for HIV/AIDS programmes, expand HIV treatment and improve the diagnosis of tuberculosis (TB).

Consolidated government health expenditure is set to rise from R138bn in 2013-14 to R148bn in 2014-15 and R157bn in 2015-16.

An extra R800m has been allocated to the baseline for the provision of antiretroviral drugs over the medium-term expenditure framework, with the government planning to put an extra 500,000 people on treatment each year. Currently, about 2-million people receive treatment.

Another R484m has been allocated to offset the anticipated cut in funding for HIV/AIDS programmes supported by the US President’s Emergency Plan for AIDS Relief. And an additional R338m has been allocated to provinces to buy more GeneXpert machines for diagnosing TB.

Medical research gets a boost too, with an extra R440m earmarked for the Medical Research Council in the next three years.

The Department of Health has not been spared the Treasury’s instruction to find savings, and will cut infrastructure spending by R531m over the medium term. The National Health Insurance (NHI) grant also gets R26m less.

The budget also introduces two important shake-ups to the infrastructure conditional grants overseen by the department. The reforms will give the department greater power over the way these funds are spent by the provinces, and allow provinces some capacity to shift funds from delayed infrastructure projects, said Treasury health and social development chief director Mark Blecher.

The three health infrastructure grants — hospital revitalisation, health infrastructure and nursing colleges and schools — have been consolidated into a single grant called the health facility revitalisation grant.

The second reform is the establishment of the national health grant, which will have a component for NHI and one for health facility revitalisation. The national health grant has been allocated R5.3bn over the medium term, with R1.1bn in 2013-14, R2.1bn the year after and R2.1bn in the next.