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While South
Africa has an impressive HIV/AIDS awareness
programme, the government has been accused of
dragging its feet on implementing a
comprehensive treatment plan,
in the face of an
estimated 4.7 million South Africans
living with
the disease; the largest number in any
country
worldwide.
Currently around 1 000 people, 400 of them
children, are receiving antiretrovirals (ARVs)
in programmes run by
local health departments in
conjunction with overseas donors
and
non-governmental groups. The Treatment Action
Campaign (TAC), which has been at the forefront
of efforts to pressure government into making
ARVs freely available through the public health
system, estimates that about
600 South Africans
die of AIDS related illness every day. ARVs are
drugs that alleviate the effects of HIV/AIDS,
prolong life and reduce the spread of the
disease. A turning point came after the release
of a report by a government task team, which
found that South Africa could afford to provide
ARVs and that this could save between 500 000
and 1.7 million lives over the next five to ten
years.
After the first South African AIDS conference
held in cabinet gave the go ahead to
start a national ARV programme, but South
Africa's national and provincial health
departments now face the daunting challenge of
drawing up a strategy to distribute the drugs to
millions suffering from the pandemic. Senior
health department officials met to discuss a
plan to roll out ARVs to public hospitals, a
health department spokesman told IRIN, the UN
information network. The meeting followed
instructions by the cabinet to develop
a plan
for a national treatment programme by 30
Sept 2003.
A joint Health Department and Treasury task team
called for the establishment of a "strong"
national negotiating team and strategy to obtain
the drugs at the best possible prices. The task
team also recommended encouraging patent holders
to voluntarily grant licences for local
manufacture of ARVs. The local pharmaceutical
company, Aspen Pharmacare has launched
Aspen-Stavudine, a generic version of Zerit made
by Bristol-Myers Squibb, and confirmed that it
would be immediately available to any
HIV-positive citizens needing it. Stavudine is
one of the key drugs used in a
triple therapy
cocktail. Anti-HIV and AIDS activists are
eagerly waiting to see details of the
government's plan, especially how many people
they intend to reach and how fast they will roll
out the treatment programme.
The Health Ministry of the Western Cape is
setting an example and aims to double the number
of people receiving ARVs by the end of 2003. The
head of AIDS in the province, Dr Abdullah,
declared that they have already secured an
additional R32 million from overseas donors to
pay for ARVs, sufficient to kick-start a rapid
roll out programme. According to Abdullah their
aim is to establish 10 new dispensing sites for
ARVs with the ultimate aim of one site per
health district. He estimates that a universal
treatment plan will require an additional 600
doctors and 2 000 nurses, based on the need for
at least one doctor per treatment site.
Although he could not estimate the cost of the
roll out in the Western Cape, Abdullah pointed
to the joint health/treasury task team report,
approved by cabinet, that states between R100m
and R300m would be needed this financial year
for treatment nationally. Experts have estimated
that with between R100m and R200m about 20 000
people could be treated in 2003. "The first
principle is to get these people on treatment as
soon as possible. The second principle is to do
the treatment right, first time round. That
means a large investment in preparing patients
for treatment, and strengthening counselling
services and other infrastructure," he noted. By
2010 about 35 000 people are likely to need ARVs
in the public health sector in the Western Cape,
"and by that time we're planning to have a large
portion of those people on treatment," Abdullah
said. |
