/ 9 August 2003

The government’s back flip on Aids

The government has reversed its long-standing Aids policy, with Cabinet instructing the health department to urgently develop a detailed operational plan for a national anti-retroviral treatment programme. Earlier, the health minister had announced her support for the use of anti-retroviral drugs in public hospitals.

On Friday, the Cabinet instructed the health department to urgently develop a detailed operational plan for a national anti-retroviral treatment programme, said the Government Communication and Information System (GCIS) .

Tshabalala-Msimang was jeered at a national Aids conference earlier this week, and activist groups have conducted civil disobedience campaigns to press for the drugs to be made available to all South Africans.

Yesterday she said: ”Anti-retroviral drugs can help improve the conditions of people living with Aids when administered in accordance with international standards.

”Appropriate support systems and a caring environment are critical for the success of such a programme, and our constitution dictates that public health services should be accessible to all.”

Her new stance came the day after the government finally signed an agreement to receive $41-million from the UN Global Fund to fight Aids. The government delayed signing for a year, apparently because it was reluctant to agree to treatment policies such as use of anti-retrovirals which are stipulated by the fund.

The department will be assisted by South African experts as well as specialists from the Clinton Foundation Aids Initiative.

GCIS said it was expected that the department’s work would be completed by the end of September.

”Government shares the impatience of many South Africans on the need to strengthen the nation’s armoury in the fight against Aids. 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.”

This follows a special meeting by the Cabinet on Friday to consider a report of the joint health and treasury task team on treatment options to enhance comprehensive care for HIV/Aids in the public sector.

The report deals with various challenges, including a programme to administer anti-retrovirals to enhance the quality of life of those who have reached an advanced stage of Aids and it proposes various scenarios in dealing with the matter.

The Cabinet meeting reiterated the government’s principled approach that anti-retrovirals did help improve the quality of life of those at a certain stage of the development of Aids, if administered properly.

It was also noted that, as it considered details pertaining to the enhanced treatment programme, it was critical that South Africa did not lower its guard as there was no cure for Aids.

”It also noted the assertions in the report that a primary challenge in our situation is to ensure that the 40 million South Africans who are not infected with HIV stay that way, and that those who are infected but have not as yet progressed to an advanced stage of Aids lead a normal life through proper nutrition, healthy lifestyles and treatment of opportunistic infections.

”In other words, not everyone who is infected with HIV would need anti-retroviral treatment,” the Cabinet said.

South Africa has the world’s highest number of Aids cases, estimated at nearly five million, one in nine of the population, and the government’s reluctance to approve anti-retrovirals has attracted considerable criticism.

Just last week the president, Thabo Mbeki, voiced his disapproval of accepted Aids treatments.

Activists welcomed the move, but said it was long overdue. The ANC national health secretary joined the Treatment Action Campaign in welcoming the decision by the Cabinet to phase in a national anti-retroviral programme.

”I believe that this decision will drastically improve the lives of millions of South Africans. Furthermore, it will lead to a major economic cost savings as the need to treat opportunistic infections will be decreased as well as improving the lives of the economically active part of the population,” said African National Congress national health secretary Saadiq Kariem.

And the Treatment Action Campaign applauded the decision, stating: ”There is cause for celebration and optimism”.

Kariem said it would be important to call on pharmaceutical companies to immediately reduce their prices of not only anti-retrovirals but also of other treatments used for HIV-positive people.

”These companies have for far too long been making incredible profits at the expense of the poor. One of the aspects that needs to be stressed is the fact that we absolutely have to focus on comprehensive programmes for HIV-positive people.

”It is essential that such a comprehensive programme focuses on issues of good governance, infrastructural support where this is needed, as well as the treatment of patients with opportunistic infections.

”We cannot simply focus on the treatment or the preventive option — we have to implement both of these programmes as they are clearly inter-dependent on each other,” Kariem said.

He said the programme should also be implemented with an adequate nutritional component and human resource development.

Meanwhile the TAC said: ”This is a critical step to develop a more comprehensive treatment and prevention plan for managing the HIV/Aids epidemic.

”If properly implemented, this will restore hope, dignity and life for millions of people in our country, and hope throughout the continent.”

The TAC pledged 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,” the TAC said. ‒ Sapa, Guardian Unlimited Â