JOHANNESBURG, South Africa (AP) - In a blaze of publicity,
a few dozen public hospital patients
collected their first free AIDS medicines Thursday at the start
of what South Africa promises will be the world's largest and
most comprehensive national treatment program.
South Africa has more people infected with HIV, the virus that
causes AIDS, than any other country -- about 5.3 million of its
45 million population. An estimated 600 South Africans die each
day from AIDS-related complications.
Clutching the precious bottles of pills, a 27-year-old father
surrounded by photographers and television cameras listened
intently as a pharmacist at Johannesburg Hospital explained how
to take the life-prolonging anti-retroviral drugs.
"To me, it means a lot," said the frail man, whose girlfriend and
2-year-old daughter have also tested positive for HIV. "I have a
child to raise. ... I want to take her to her first day of
school, and I can only do that if I am healthy."
He asked not to be identified because of the stigma still
attached to the disease.
In wealthy countries like the United States, anti-retrovirals
have turned HIV from a death sentence to a chronic illness. But
despite dramatic price reductions in recent years, they remain
out of reach to all but 8 percent of those who need them,
according to the World Health Organization. Botswana is the only
African country that currently guarantees treatment.
Under mounting public pressure, the South African government
approved a plan in November to provide free AIDS medicines to all
who need them within five years.
Gauteng, the most densely populated of South Africa's nine
provinces, began providing the drugs at five hospitals Thursday.
Twenty-two other facilities in six provinces are expected to
follow within days.
But the drugs available so far are a fraction of what is needed,
and health workers fear many more people will die without getting
a chance at treatment.
Approval of the program was a major turnaround for President
Thabo Mbeki's government, which previously refused to provide
AIDS medicine through the public health system, saying it would
be too expensive and questioning the effectiveness of the drugs.
The prices of the drugs have come down dramatically in recent
years. Major pharmaceutical companies in the United States and
elsewhere have agreed to lower their prices for government
treatment programs in developing countries, and cheaper generic
treatments have come on the market.
But it will take years to upgrade the country's shaky health
facilities, recruit and train staff, and purchase enough drugs to
treat everyone, health officials say.
Activists with the Treatment Action Champaign have accused the
government of dragging its heals and even threatened to take
Health Minister Manto Tshabalala-Msimang to court over the delay.
"It is one thing to say this is what we want to do. It is another
to have the capacity and resources to do so," Gauteng Premier
Mbhazima Shilowa said as he visited some of the hospitals
dispensing anti-retrovirals. "I can't promise something which I
can get accolades for, but which I can't sustain."
Frustrated by the delay, the Western Cape province has used some
of its own funds and worked with aid groups to get an estimated
2,700 people on treatment. About 20,000 others across the country
pay for the drugs themselves or get them through private medical
aid schemes, according to the TAC.
Gauteng aims to get 10,000 patients on treatment within a year,
but health officials estimate as many as 10 times that number
need the medicines. Managing who takes precedence will involve
There was a festive atmosphere at Chris Hani Baragwanath
Hospital, as mothers waited in a clinic full of toys and drawings
to receive counseling and collect medicine for their children.
Trembling with excitement, a woman named Betty arrived at 7 a.m.
to be the first to collect medicine for her ailing 7-year-old
"I think it is going to help my child a lot," said Betty, who did
not give her last name. "Maybe he is going to reach 60 years
The supply of anti-retroviral drugs is one part of the
government's strategy, which also includes counseling,
nutritional support, monitoring of the progress of the disease
and treatment of opportunistic infections.
Prevention remains the cornerstone of government policy.
"Forty-million remain HIV-negative, and we want to keep them that
way," said Shilowa, the provincial leader.