/ 5 April 2005

SA lags behind global anti-retroviral goal

South Africa is one of three countries lagging behind as the World Health Organisation (WHO) tries to get anti-retroviral (ARV) drugs to three million people with HIV/Aids by the end of 2005.

”If Nigeria, India and South Africa move strongly to significantly increase anti-retroviral therapy, it will make the global target easier to reach,” Dr Yves Souteyrand, a WHO director dealing with HIV/Aids, said on Tuesday.

He was addressing the Seventh International Aids Impact Conference, titled The Moment Is Now.

Souteyrand said the WHO’s ”3 by 5” initiative, as it is known, is difficult but achievable.

At the end of 2004, only 700 000 people were receiving ARV treatment in developing countries.

”[This is] only 10% of the needs, but the number of people on ARV therapy has significantly increased in the last period, with a doubling in sub-Saharan Africa.”

About 5,8-million people currently need treatment in developing and transitional countries.

Of the 20 countries that have the highest ARV need, only Botswana and Brazil have met the interim goals of ”3 by 5”, with South Africa faring the worst.

Souteyrand said this is because the country has the highest prevalence of HIV and a concomitant high need for anti-retrovirals.

He said the main challenges are:

  • political will and sustainable funding;
  • the availability of quality and affordable drugs;
  • accelerating prevention through ”scaling-up” treatment; and
  • implementing a public-health approach to treatment.
  • ”We know that access to ARV therapy is not only a humanitarian and public health priority but also a developmental challenge,” said Souteyrand.

    Dr Ashraf Grimwood, of the South African-based organisation Absolute Return for Kids, spoke on the roll-out of the country’s comprehensive Aids-intervention strategy.

    He said the success of the plan depends on access (or the ability to get therapy for those in need), sustainability (or reliability of continued access to care and treatment) and adherence to the treatment regime.

    Grimwood said about 5,6-million people are infected with the virus in South Africa, many of them women.

    ”The daily number of Aids-related deaths will not be reduced if we are not able to upscale [treatment] to meet this need,” he said of the disease, which kills between 800 and 1 000 people a day.

    By January this year, the total number of patients in the public sector on treatment was 32 385.

    However, Grimwood said data gaps remain with uncertainty about the number of children on therapy, no analysis of numbers by sex, and figures from the private, mining and non-profit organisations not combined with figures from the Department of Health.

    Ongoing challenges faced by the country include a lack of pharmacists, doctors and nutritionists and a lack of infrastructure and facilities. — Sapa