South African Democratic Alliance Proposes Providing Antiretrovirals to 10% of HIV-Positive Population Within Five Years
South Africa's Democratic Alliance party on Sunday outlined a plan that would expand access to antiretroviral treatment to 10% of HIV-positive South Africans within five years, the South African Press Association reports. The project would offer antiretroviral therapy to 20,000 individuals in its first year and gradually expand treatment to 500,000 individuals in the fifth year. Additional HIV counselors and monitoring equipment would be procured over the course of the program to meet the requirements of expanding treatment. The cost of the program would grow from $18.1 million in the first year to $154 million in the fifth year, but the DA said that the government should be able to afford it. The government would have to provide $15 million to operate the program in its first year, but this sum is less than half of the amount allocated to South Africa's nine provinces for treatment-related programs for 2002-2003. The government could also devote to the project the $716 million it will save through the cancellation of an arms deal, the DA stated. Funding from international donors, the purchase of cheaper medicines and a reworking of the country's existing AIDS budget could also help finance the program, the party stated. "South Africa, as the wealthiest country in Africa and the one with the most sophisticated health system, has no more excuses" for not expanding antiretroviral treatment, DA spokesperson Sandy Kalyan said. The DA estimated that antiretroviral treatment will cost approximately $864 per patient per year in the first year of the program, dropping to $215 per patient per year in the fifth year. The party said that patients should be asked to pay for part of their treatment, with individual contributions ranging from $27 per month in the first year to $4.50 per month in the fifth year. The party offered to establish a fund for patients who could not afford this cost. The treatment project would be monitored by a Central Antiretroviral Treatment Center with nine provincial branches (South African Press Association, 4/14).
SAMA Presents AIDS Treatment Manual
The South African Medical Association on Friday unveiled a new HIV/AIDS treatment manual for physicians, instructing doctors not to "hamper patients' access to treatment," despite government policies that restrict the distribution of antiretroviral drugs, the South African Press Association reports. Noting the South African government's current restrictions on the distribution of nevirapine to pregnant women in public hospitals, SAMA legal adviser Elsabe Klinck said that physicians "should put their ethical duties first" when treating HIV-positive patients, even when government policy dictates against such treatment. "If a patient needs nevirapine, she has to be given access to it," Klinck said. She added that SAMA would support public doctors who prescribed nevirapine to their patients, although she stated that doctors who are afraid of being punished for prescribing the drug should refer patients to private doctors or non-governmental organizations that could provide it. In addition to offering advice on antiretroviral treatment, the SAMA manual outlines physicians' ethical duties regarding confidentiality, counseling and informed consent (South African Press Association, 4/12).
Supreme Court Justice Speaks of 'AIDS Crisis'
South Africa is facing an "AIDS crisis," the "most fundamental" component of which is the country's "struggle to identify and confront and act on the truth" about the disease, South African Supreme Court of Appeal Justice Edwin Cameron said last week. Cameron stated that not only is the epidemic itself at a crisis level, but that "another crisis ... had been engendered by people in the country who denied the facts about AIDS." He said that this denial "was not only an outrage against the truth but ... an insult to South Africans who are living with and dying from the effects" of the disease (South African Press Association, 4/13).
Peter Mokaba, a senior African National Congress official, denies that he is an "AIDS dissident," although he has doubts about whether HIV has been isolated as the single cause of AIDS, Johannesburg Business Day reports. Mokaba, who was recently profiled in the New York Times as an "AIDS skeptic," said, "I am not an AIDS dissident. If you find that you are an orthodox or dissident, then you are no longer a scientist. You may just (as well) be a religious or superstitious person." Mokaba stated that HIV "has been made a black disease" and represents "a new apartheid." He also said that HIV "has never been isolated" and "has never been seen," adding, "There isn't today a single test for HIV. All the tests that are there look for the presence of antibodies (and) these antibodies could be produced by more than 70 conditions. They are not virus-specific" (Molebeledi/Mothibeli, Johannesburg Business Day, 4/15).