SOUTH AFRICA: Government backtracks on AIDS treatment promise


Patrick Bond, Johannesburg

South Africa's Treatment Action Campaign on February 12 criticised South African President Thabo Mbeki in the wake of more government prevarication on providing treatment for the country's 5 million people who are living with HIV/AIDS. The TAC's Zachie Achmat accused Mbeki of AIDS "denialism".

The African National Congress (ANC) government's commitment last November to provide life-prolonging anti-retroviral (ARV) medicines, which are too expensive for the majority of South Africans, through the public health service was a long-fought for victory for the TAC activists and their allies.

However, the TAC's activism was not the only catalyst for the ANC government's apparent backdown. A general election is looming, now set for April 14, and Mbeki and the ANC apparently feared that apathy could mar an expected easy victory by the ANC.

However, the confidence that some ANC leaders have in Pretoria's low-key approach to the AIDS crisis was reflected in health minister Manto Tshabalala-Msimang's announcement on November 9 that the promised roll out of ARVs would be delayed indefinitely.

Pretoria had originally promised to distribute AIDS medicines to at least 50,000 people within a year, and to reach everyone in need of treatment within five years. Tshabalala-Msimang blamed slow drug procurement and the lack of qualified health personnel.

TAC strategist Mark Heywood countered that "many hospitals have the capacity, they just don't have the medicines".

This situation is Pretoria's fault because the government did not invite pharmaceutical companies to tender to supply drugs until February 6. The finance ministry also cut the budget required for medicines purchases dramatically.

Controversially, Tshabalala-Msimang suggested that while HIV-positive people wait for medicines, a diet of lemons, beetroot, (extremely expensive) olive oil and garlic would improve the body's immune system.

Supporting his minister, Mbeki told the South African Broadcasting Corporation that inaccurate mortality statistics made it impossible to know whether AIDS was as fatal as claimed. Diabetes is also an epidemic, and he questioned why no-one talks about diabetes.

In reply, Achmat pointed out that "drugs for treating diabetes are heavily overpriced; there should be a campaign for a reduction. But, unlike HIV [before November], ... diabetes is treated in the public health sector. However, the president should be aware that according to an initial investigation ... released in 2003 by the Medical Research Council, AIDS was responsible for 39% of lost life-years in 2000 — more than the next 10 worst diseases. Diabetes is the 12th worst disease and is responsible for slightly more than 1% of lost life-years. The two diseases are incomparable in scale."

Achmat ridiculed Mbeki's claim that "few countries can hold a candle to South Africa's HIV/AIDS program": "A number of developing countries do much better than South Africa when it comes to HIV prevention and treatment, often with far fewer resources. Currently, South Africa treats approximately 1500 people in its public sector, who are not on drug trials, paying for their own medicines or being sponsored. By contrast, Brazil's government treats more than 100,000 people and has less than a quarter of South Africa's HIV infections. Botswana is treating approximately 15,000 and Cameroon approximately 7000 people."

Tshabalala-Msimang's and Mbeki's backtracking on HIV/AIDS treatment is further evidence that the ANC government lacks the political will to address the worst health holocaust South Africa has ever known. Tellingly, Mbeki made only a single passing reference to AIDS in his February 6 state of the nation address to parliament.

From Green Left Weekly, February 18, 2004.
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