The unexpected but breakthrough announcement that a national anti-retroviral programme must be developed by the end of September was met with relief and optimism by Aids activists, doctors and healthcare workers.
This long-awaited decision paves the way for anti-retroviral drugs to be administered in the public sector thus providing treatment for people who have full-blown Aids.
The Cabinet on Friday convened a special meeting to consider the costing report of the Joint Health and Treasury Task Team on anti-retroviral treatment options in the public sector.
Government shares the impatience of many South Africans on the need to strengthen the nation’s armoury in the fight against Aids,” said the cabinet in a statement.
“Cabinet will therefore ensure that the remaining challenges are addressed with urgency and that the final product guarantees a programme that is effective and sustainable.” A weekend paper reported that the health department will be assisted by experts as well as specialists from the Clinton Foundation Aids Initiative to draw up an operational plan.
The report which was leaked by the Treatment Action Campaign (TAC) last month was central to cabinet’s decision on whether the country can afford to roll-out the drugs.
The government’s turnaround on anti-retroviral treatment comes in the wake of the first national Aids conference last week where the Health minister and the government came under pressure to take action in the fight against the HIV/Aids epidemic. The TAC also resumed its civil disobedience campaign and marched to the conference calling for the implementation of a treatment plan.
But the cabinet statement came as a surprise even to the TAC who has now decided to suspend its civil disobedience and welcomed the announcement calling on all sectors of society to work together. The TAC had plans to litigate against the government but will reconsider this early next week.
“The end of policy and political vacillation reveals the real hard work to all of us. TAC pledges to put its full weight and support behind the successful implementation of all interventions aimed at alleviating the HIV epidemic. We will work with government to save lives and build a better health service,” says the TAC statement.
The international medical aid organisation Médecins Sans Frontières (MSF) also welcomed with “enthusiasm” the South African government’s announcement.
“This is extremely good news, and we are definitely celebrating today with all people affected by HIV/AIDS in South Africa,” said Dr Eric Goemaere, head of mission for MSF in South Africa. “This statement clearly acknowledges the gravity and urgency of the challenge ahead and symbolically unblocks a situation of denial that has lasted for too long. There is no going back. Now the hard work of scaling up finally begins.”
He says this national anti-retroviral programme — when fully implemented — will be the largest in the world, as South Africa has about five million people who are currently infected. “In order to stretch financial resources and treat the largest number of people possible, local production of anti-retrovirals will be key, as it has been for Brazil’s national Aids programme.”
“You treat more people with less expensive medicines,” said Dr Goemaere. “It’s that simple.”
The next challenge is to call on pharmaceutical companies to lower the prices of the drugs for anti-retroviral programme. The report calculates a year supply of the drugs at the current South African price of R12,232 that includes the laboratory and service delivery costs and the report’s drafters expect the costs to come down.
“The price of patented drugs has come down 10 times in the past five years and we expect them to drop 10 times more in the next five years,” says an analyst. While the initial costing is based on patented drugs, future years anticipate the use of cheaper generics.
Currently there are 24 existing anti-retroviral projects operating nationally with the capacity to scale up says Colwyn Poole from MSF. He says government should place the resources in these projects and harness the experience of about 500 people who have been treating people with anti-retroviral drugs. “These projects represent what needs to be done on a national level,” he says.