The government has thrown a veil of secrecy around the task team appointed to calculate the costs of universal anti-retroviral treatment. The team will report back to the Cabinet at the end of April.
Efforts this week to assess the team’s progress and find out who sits on it met with an official wall of silence. Members are drawn from the Treasury and the Department of Health, but only authorised health officials may give comments. Repeated telephone and e-mail efforts to get official comment were unsuccessful, but those close to the process say the report is almost complete.
The Mail & Guardian, however, independently obtained names of some members of the team. The team was set up last October to investigate the costs of treatment in public hospitals before the Cabinet committed itself to a policy on providing the life-prolonging drugs.
Officials say the team is credible and has consulted researchers from the University of Cape Town, who have produced a set of actuarial costings. The team has also met leading clinicians and constitutional experts.
The government will no longer have a fiscal reason to delay implementing a treatment programme if the team finds that anti-retroviral therapy is affordable.
Though the team seems to be doing a thorough job, statements by ministers over the past year suggest that its political masters have already made up their minds about the efficacy of the drugs.
The crisis in the management of the HIV/Aids pandemic has pitted politicians against civil servants, most of whom are drawn from the orthodox Aids movement. The men and women on the team illustrate this point.
Nono Simelela, chief director of the HIV/Aids and tuberculosis cluster in the department, and Rose Malumba, also from the national health department, lead the team. Treasury officials are Mark Bletcher and John Kruger and the team includes provincial government representatives from the Western Cape, Gauteng and North West province.
The team also has a pharmaceutical procurement unit that is looking at reducing costs of anti-retroviral therapy by the manufacturing of generic medicines. This unit is headed by Humphrey Zondi from the Medicines Control Council.
The Treatment Action Campaign (TAC) has embarked on a nationwide civil disobedience campaign to put pressure on the government to adopt a national anti-retroviral plan. As part of its campaign, the TAC issued a memorandum to the Human Rights Commission demanding that it monitor the task team’s report.
In the memorandum the TAC demanded that the Human Rights Commission ”assist with the right to freedom of information by requesting that the commission be provided with the report of the joint Department of Health/Treasury”.
On Tuesday volunteers marched into the offices of the Commission on Gender Equality and Human Rights to demand that it fulfil its constitutional and legal duties by fighting for the right of HIV-positive people to have access to anti-retroviral treatment.
”We have reason to believe that the sections dealing with the costing of [the] therapy have been completed for at least a fortnight,” said Phologolo Ramothwala, the TAC representative in Gauteng. ”This report should be published as an emergency and in the public interest.”
The TAC sponsored a report by the University of Cape Town’s centre for actuarial research that calculated the costs of anti-retroviral therapy nationwide and presented the report to the health portfolio committee last month. Nicoli Nattras, one of the authors and a lecturer in economics at the University of Cape Town, confirmed that a task-team member had asked for a copy of the study.
Department of Health spokesperson Jo-Anne Collinge this week did not respond to repeated repeated telephonic and e-mail requests by the Mail & Guardian for a list and credentials of task-team members.
Sources say the report could be approved by the finance and health ministries this month before being presented to the Cabinet.
Throughout the investigation the team has consulted clinicians and constitutional rights experts.
Experts say the greatest problem facing the government are the complexities and difficulties from rolling out anti-retroviral therapy rather than committing to a universal treatment programme.
The TAC has given the Human Rights Commission two weeks to report back on its demands to ensure the Cabinet does not stall the report and the task team’s work is made public. ”We have full trust in the credibility of the committee itself and we are confident of its findings,” said TAC head Mark Heywood. ”What we are worried about if the report is not made public is that there will be a long delay in the Cabinet’s considerations.”