Baltimore Sun (10.14.03) - Thursday, October 16, 2003

With an estimated 5.3 million HIV-positive people, South Africa faces the challenge of creating the largest national antiretroviral treatment program in the world. Six hundred South Africans die of AIDS-related complications daily.

To meet the mammoth demands of a program that activists expect the government to approve this year, the government needs to train doctors, nurses, counselors and other health care workers to treat and monitor patients; expand existing clinics and laboratories; and build new ones.

Social factors, including poverty and the stigma attached to HIV/AIDS, create other challenges to successful treatment. Many HIV/AIDS patients are reluctant to reveal their status to family and friends and so have little support for adhering to strict treatment regimens. Activists believe a nationwide education program should accompany the treatment plan.

"Who is going to support the people receiving treatment?" asked Tembeka Majali, head of the Western Cape Province's Treatment Action Campaign, the country's largest AIDS lobby group. "We want support from the families, from the church leaders, from the community leaders. We want support from everyone." Although details of the treatment plan are sketchy, the price tag is clear. A recent government study said the cost to treat all HIV/AIDS patients in the country by 2010 would be $2.4 billion to $3 billion per year. The study also found that if all South Africans who need treatment receive it by 2010, 1.7 million lives will be saved, and 860,000 children will not be orphaned.

"I am very anxious. But it must happen," said Linda-Gail Bekker, head of the University of Cape Town's Infectious Diseases Unit. "We must find a way to do it."