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South Africa has
the largest number of HIV infected people in the
world – about 5 million – or more than 11% of
its population of nearly 44 million, according
to the UNAIDS Programme. The figures are even
more staggering for the nearly 24 million people
aged 15 to 49: about 20% of them are infected.
The epidemic poses a major threat to
South
Africa's economy and security as it primarily
affects young, sexually active adults and is
overwhelming the country's extended family
system, which has traditionally cared for sick
and orphaned relatives. So far the epidemic has
orphaned 660 000 South African children.
Panel data in the UN's Human Development Report
2003 shows South Africa sliding backwards into
under development primarily because of the
economic impact of HIV/ AIDS.
At the first South
African AIDS conference in Durban, SA government
came under a huge amount of pressure from
scientists, community workers and academics to
show commitment to HIV/AIDS treatment.
In the
past, the South African President, Thabo Mbeki,
has questioned the link between HIV and AIDS,
and stressed the role of poor nutrition and
housing in reducing the immune systems of many
South Africans. Recently however, the South
African cabinet announced a plan to assess the
financial costs of
a national anti-HIV drug plan
and to explore options for treating those with
the infection. Following a report prepared by a
joint Health Department and Treasury task team,
which found that the public provision of
antiretroviral drugs was now affordable,
the
government has stated that it aims to provide
AIDS infected people with the necessary
treatment by
October 2003.
The South African National HIV/AIDS Programme
received a further boost with the signing of an
agreement between the government and the Global
Fund to Fight AIDS, TB and Malaria,
committing US $41 million to the country over
two years. The country was awarded a total of US
$165.2 m
over five years, with US $72
m of this awarded to
KwaZulu-Natal. The
grants will provide antiretroviral drugs,
as
well as strengthen voluntary counselling and
testing in
KwaZulu-Natal, one of South Africa's
provinces worst hit
by the pandemic. The
agreement also allocates funds to nationwide HIV
prevention programmes, including
LoveLife and Soul City. “Today's grant signing
is a turning point in South Africa – a signal of
hope for those living with HIV and for all
Africans working together to turn the tide
against these deadly co-pandemics," the Global
Funds national director exclaimed.
The government declared that, because not every
infected person needed anti-HIV drugs, its
programme would provide the drugs initially to
people with more advanced cases of AIDS. The
drugs can extend life for many people but they
are not a cure. The government programme is also
expected to provide prevention programmes aimed
at the tens of millions of people who are not
infected.
AIDS activists and the political
opposition applauded the announcement, but
expressed regret that the news had come too late
for the more than half a million South Africans
who have already died of AIDS. Until recently
the government had cited the high cost of the
drugs, side effects and lack of adequate health
care infrastructure to monitor treatment as
reasons for not providing antiretrovirals (ARV's).
Treatment and prevention of mother-to-child
transmission (PMTCT) – including use of the drug
Nevirapine, which is widely used in Africa for
PMTCT – dominated the national AIDS conference.
South Africa’s pharmaceutical regulatory body,
the Medicines Control Council (MCC), announced
that it was considering deregistering Nevirapine
for PMTCT, on
the basis of questions raised
about its efficiency, initially in
a clinical
study carried out in Uganda and then in a major
clinical trial in South Africa. The MCC gave
pharmaceutical giant Boehringer-Ingelheim 90
days to supply additional evidence on the
efficacy of the drug. Nevirapine is used
throughout South Africa to prevent the
transmission of
HIV from pregnant mothers to
their unborn children. The ultimatum has caused
an uproar. Around 8 000 babies are born to
HIV-infected mothers in South Africa each month.
The Treatment Action Campaign (TAC), which has
played
a major role in promoting access to
treatment and greater public awareness of
HIV/AIDS, says that around
600 000 South
Africans are ready to start treatment with antiretrovirals, but only about 1 500 have been
receiving treatment in the state sector. AIDS
activists have now launched a company to sell
cheap antiretroviral drugs to needy people
living with HIV/AIDS after accusing the
government of a ‘lack of political will’. The
company is called the Generic Antiretroviral
Procurement Project (GARPP).
South Africans living with HIV/AIDS will also
begin to benefit from a cheaper AIDS drug,
Aspen-Stavudine, produced by Aspen Pharmacare.
Aspen-Stavudine,
a generic version of Zerit,
made by Bristol-Myers Squibb, will be available
immediately. In terms of the voluntary licence
granted by Bristol-Myers Squibb Aspen Pharmacare
can sell its version of the drug to both public
and private patients across Africa. The drug
will cost from US $3 to
US $4.50 – up to
41%
cheaper than the original –
depending on the
strength of the formulation. |
