Mbeki Says in State of the Nation Address That Fight Against AIDS Will Continue to Focus on Prevention, Not Antiretroviral Treatment
South African President Thabo Mbeki this morning in his state of the nation address said that the government will increase its efforts to halt the spread of HIV, but added that the efforts will focus on prevention and not the use of antiretroviral drugs, the Associated Press reports. AIDS activists, who recently won a lawsuit to force the government to create a plan for dispensing the antiretroviral drug nevirapine to HIV-positive pregnant women to prevent vertical HIV transmission, had hoped the government, which is appealing the ruling, would agree to dispense the drugs through the national health care system. However, Mbeki's speech "dashed hopes" that a widespread treatment program would begin any time in the near future. "Continuing work will be done to monitor the efficacy of antiretroviral interventions against mother-to-child transmission in the sites already operational and any new ones that may be decided upon," Mbeki told the South African Parliament, referring to several test sites run by the government that provide nevirapine. He added that, for now, the government will focus on prevention, education, treatment of AIDS-related illnesses and the development of an HIV/AIDS vaccine (Cohen, Associated Press, 2/8). South Africa's vaccine research program has been described by UNAIDS Executive Director Peter Piot as "the largest and most comprehensive in Africa and one of the largest in the world." Mbeki added that the multi-pronged approach is necessary because "[a]ny focus on one issue, at the expense of others, may have the effect of undermining what we all seek to achieve." An estimated 4.7 million -- one out of every nine -- South Africans have HIV/AIDS (Agence France-Presse, 2/8).
Not Going Far Enough?
HIV/AIDS activists this week had expressed concern that Mbeki would not address the epidemic in his speech, which opened this year's parliamentary session, and opposition party leaders urged him to "clear up any lingering confusion about whether HIV causes AIDS." Mbeki has in the past questioned the causal link between the virus and the disease. Although Mbeki did not address his beliefs on a causal link in his speech today, New National Party leader Marthinus van Schalkwyk said that Mbeki "had to show he fully understood HIV and AIDS, and compromise where he has faltered," while United Democratic Movement leader Banu Holomisa warned Mbeki that his "continued denial that HIV causes AIDS will lead to South Africans giving him a 'dignified exit' from office." Pan African Congress MP Patricia de Lille added that "[m]ost of the people affected by AIDS are really not interested in the philosophical debate of what causes [AIDS] and what does not. All they want are drugs and a cure, which hospitals are ready to provide but cannot because the government won't allow them to" (Xako, Business Day/allAfrica.com, 2/7). Former President Nelson Mandela also made a "thinly veiled rebuke" of Mbeki at an awards ceremony yesterday honoring two University of Witwatersrand professors who co-founded the perinatal HIV research unit at Chris Hani Baragwanath Hospital. Mandela, who presented Drs. James McIntyre and Glenda Gray with the 2002 Nelson Mandela Award for Health and Human Rights, said "some fundamental issues [involving HIV/AIDS] unfortunately continu[e] to rage in manners that detract attention from what needs to be our core concern. However, I have reason to believe that insofar as this debate affects our country, it's likely very soon we will solve the problem, and many people, especially in government, are thinking very seriously about the observations that have been made in regard to the policy of the government" concerning HIV/AIDS (South African Press Association, 2/7). He added that he believed "beyond argument or doubt" that prevention of mother-to-child HIV transmission "must be central" to any government HIV/AIDS prevention program (Associated Press, 2/7). Former U.S. U.N. Ambassador Richard Holbrooke, who now heads the Global Business Council on HIV/AIDS, added that the disease is "going to be a great test of [South Africa's] leadership" and that the government must "step up to the plate and deal with this problem head on" (South African Press Association, 2/7).