Resource Logo
Associated Press

South Africa launches AIDS treatment program


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 difficult choices.

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 son.

"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 now."

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.


Copyright © 2004 -Associated Press, Publisher. All rights reserved to Associated Press. Reproduction of this article (other than one copy for personal reference) must be cleared through the AP Permissions Desk.

Information in this article was accurate in April 1, 2004. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.