Despite High HIV Infection Rate, South Africa Maintains ‘Ambivalence’ Toward Antiretrovirals, Washington Post Reports
The South African government continues to resist efforts to supply its citizens with antiretroviral drugs, the "only medicines known to slow the replication" of HIV, the Washington Post reports. One recent example involved the eviction of the Greater Nelspruit Rape Intervention Project -- a rape crisis center that supplied the drugs to those who might have been exposed to the virus through sexual violence -- from two Nelspruit public hospitals. The project began operating out of vacant offices in the two hospitals 18 months ago, supplying victims of sexual assault with counseling, antibiotics to treat STDs, emergency contraception and, in cases where HIV was suspected, antiretroviral drugs that may cut HIV transmission rates if taken immediately after exposure. When local authorities learned that GRIP was supplying the antiretrovirals, they quickly moved to evict the group from the hospitals, saying in eviction papers filed in court, "It is at this stage not the policy of the government to supply (antiretrovirals) and it causes problems for the department to try and explain to ordinary people ... the reason why it is not supplied while (the two hospitals that house the project) do supply those medicines."
The eviction is the latest in a series of events that reflect the South African government's "ambivalence" about HIV/AIDS and antiretroviral drugs, the Post says. President Thabo Mbeki sparked the controversy almost two years ago when he publicly questioned the causal link between HIV and AIDS. Since then, he has "repeatedly emphasized the role of poverty in the spread of HIV," the Post reports. Last year, the government filed a lawsuit against the world's largest pharmaceutical companies for the right to manufacture or import generic versions of the expensive anti-HIV drugs, but since settling the dispute, it has not moved to offer the drugs to its citizens. It has only recently begun to offer nevirapine, an antiretroviral that can reduce mother-to-child transmission of HIV, to pregnant women in 18 pilot projects, despite the fact that the drug is being donated free of charge by manufacturer Boehringer-Ingelheim. Observers have said that the African National Congress-led government's reservations stem partly from "deep racial suspicions" resulting from forced sterilizations of black women and chemical weapons used against blacks under apartheid. A government spokesperson earlier this year said that a Cape Town group providing antiretrovirals to low-income blacks was using the patients as "guinea pigs." GRIP leader Barbara Kenyon said that the provincial health official who notified her of the group's eviction said that GRIP was "poisoning" blacks. The government's inaction, in a nation with the world's highest concentration of HIV-positive people, has angered former allies who fought on the side of the African National Congress to end apartheid. The Treatment Action Campaign, an AIDS advocacy group led by people who "supported the ANC's liberation struggle against the white minority's apartheid regime," recently filed a lawsuit against Health Minister Manto Tshabalala-Msimang over the health department's decision to not provide nevirapine more broadly. Rhoda Kadalie, a former anti-apartheid activist, last week wrote an open letter criticizing the government, stating that when she travels abroad, instead of "bask[ing] in [Nelson] Mandela's reflected glory," she has to "explain Mbeki as whites used to have to explain apartheid." She added that the current situation is "not what [she] fought for" (Jeter, Washington Post, 10/1).