National AIDS Treatment Program Begins in South Africa’s Gauteng Province; 41 People, Including 22 Children, Receive Drugs
As expected, South Africa on Thursday began the rollout of its national antiretroviral drug distribution program at five hospitals in Gauteng province, SAPA/SABC News reports (SAPA/SABC News, 4/1). The South African Cabinet in November 2003 approved a plan for the program, which aims to provide antiretroviral drugs to 1.2 million people -- or about 25% of the country's HIV-positive population -- by 2008. Gauteng is the first of the country's nine provinces to begin dispensing drugs under the government's program. Western Cape started its own program earlier this year, and other provinces are expected to begin programs in the coming weeks. Officials expect 50,000 people to be on antiretroviral drugs by the end of the year and 1.4 million people to be on the drugs by 2009, at a total cost of $700 million. The first part of the rollout in Gauteng -- which includes Johannesburg -- will be conducted at Chris Hani Baragwanath Hospital, Kalafong Hospital, Helen Joseph Hospital, Coronation Hospital and Johannesburg Hospital (Kaiser Daily HIV/AIDS Report, 4/1). In order to qualify to receive the drugs, patients must have a CD4+ T cell count equal to or less than 200 and "be committed to following the [antiretroviral] regimen strictly," U.N. IRIN reports (U.N. IRIN, 4/2). On the first day of the program, 41 patients received treatment, including 22 children, South Africa Department of Health spokesperson Simon Zwane said, according to SAPA/SABC News (SAPA/SABC News, 4/1).
The department hopes to treat approximately 100 new HIV/AIDS patients each week and is aiming to treat about 10,000 people at 23 sites in Gauteng by next year, according to AFP/Yahoo! News (AFP/Yahoo! News, 4/1). Gauteng Health Department spokesperson Popo Maja said that the province "followed the ... lead" of Western Cape and purchased antiretrovirals for the program separately, budgeting more than $14 million for the program over the next year, according to VOA News. Maja said, "[W]e are using our own procurement systems, while the national [program] is still finalizing the tender for the procurement of drugs. But at the moment we do have drugs available in our institutions that will be providing these antiretroviral drugs" (McDonough, VOA News, 4/1). Western Cape currently is providing antiretrovirals to 1,800 people, and KwaZulu-Natal is expected to soon begin another treatment program; however, it remains uncertain when the drugs will be available nationwide, the New York Times reports (LaFraniere, New York Times, 4/2). The country's HIV/AIDS plan also includes counseling, nutritional support, disease monitoring and treatment of opportunistic infections, along with prevention, which is considered the "cornerstone of [the] government policy," the AP/Las Vegas Sun reports. Gauteng Premier Mbhazima Shilowa said, "Forty million [South Africans] remain HIV-negative, and we want to keep them that way" (Zavis, AP/Las Vegas Sun, 4/1). Shilowa added, "I know it is a beginning, and I know that we are in for the long haul" (U.N. IRIN, 4/2).
Although the South African AIDS advocacy group Treatment Action Campaign had threatened to sue the government if it did not take action on implementing the national treatment program, Secretary Mark Heywood on Thursday said that the group would drop the suit "for the time being," according to AFP/Yahoo! News. He added, "We dropped the court action to get drugs to be supplied to facilities that are ready to do so," saying, "We welcome today's rollout and urge the Gauteng government to do more to make sure that sites are ready to start treating more people. At the moment the numbers are far too small" (AFP/Yahoo! News, 4/1). TAC Director Nathan Geffen said, "Gauteng had the political will to do this but the Ministry of Health was holding them back," adding, "Where we are now is where we should have been three years ago. We have waited a long time, and this is really great" (New York Times, 4/2). Shilowa said during visits to hospitals participating in the rollout, "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. I can't promise something which I can get accolades for but which I can't sustain" (AP/Las Vegas Sun, 4/1). Congress of South African Trade Unions spokesperson Patrick Craven said that the "federation hopes that every other province will roll out antiretrovirals without any delay, so that these drugs reach all those who need them as soon as possible" (SAPA/SABC News, 4/1). "We are happy that people finally have access to antiretrovirals in Gauteng," AIDS Therapeutic Treatment Now/South Africa Coordinator Swazi Hlubi said, adding, "However, we are concerned about the slow progress in other provinces. This move brings hope to millions in South Africa, but more can and should be done" (ATTN/SA release, 4/2).