Mail & Guardian (Johannesburg) - Thursday, April 17, 2002

According to the report South Africa's women, with a life expectancy of 54 in 1999, will only survive until the age of 37 in 2010, while men would survive until 38.

"The population of those aged 15 and below will be relatively large, as will the population of seniors aged 50 and above," the report said.

"The pandemic will take a dramatic toll on the most productive members of the population, those in their 20s, 30s and 40s."

The report predicts that close to 30% of South Africa's work force will be HIV positive in 2005.

It said by 2010, one million South Africans would be sick with Aids, while six million would already have died from Aids-related diseases.

The report, now in its 20th year, is seen as a reliable barometer for comparative and predictive purposes. Information and analysis are assembled in three sections -- labour relations developments, employee developments and human resource management. Each contribution is written and researched by experts in the field.

In other news, rape victims are to be provided with anti-Aids drugs at public health institutions as soon as possible, the government announced on Wednesday.

"Government will endeavour to provide a comprehensive package of care for victims (of sexual assault), including counselling, testing for HIV, pregnancy and sexually transmitted infections," Health Minister Manto Tshabalala-Msimang said in Pretoria.

Counselling would include pointing out the risks of using antiretrovirals.

"If they so choose, they will be provided with such drugs."

Cabinet agreed to the new approach at its fortnightly meeting.

Tshabalala-Msimang told reporters a national protocol on the treatment of victims of sexual assault would first have to be developed.

"I can't see this being finalised in less than six months," said Arts, Culture, Science and Technology Minister Ben Ngubane.

Ngubane, Tshabalala-Msimang, and Minister in the Presidency Essop Pahad would form part of a new presidential task team on HIV/Aids.

Ministers who served on the SA National Aids Council (Sanac) would also be members of the new team, to be chaired by Deputy President Jacob Zuma.

"There was self-criticism with regard to the effectiveness of that structure (Sanac)," government representative Joel Netshitenzhe said.

This was "quite rare" in Cabinet, he added.

Tshabalala-Msimang said plans were on track for a universal roll-out of nevirapine to HIV-positive mothers, hopefully from next year.

General distribution depended on the outcome of current research on the use of the drug to curtail mother-to-child transmission of HIV.

Meanwhile, the government would continue complying with a Constitutional Court ruling that nevirapine be provisionally provided to pregnant HIV-positive women at public health facilities with the capacity to do so.

The ruling was made pending the government's main appeal against a Pretoria High Court ruling that it put in place plans to make the drug freely available.

Asked if the interim provision of nevirapine would be stopped if the government won its appeal, Tshabalala-Msimang said: "I think we must wait until the 2nd and 3rd of May (the date of the appeal). We will take it from there."

The ministers said the general provision of anti-retroviral drugs to HIV-positive people was not an option at this stage.

"Cabinet noted that they (the drugs) could help improve the conditions of people living with Aids if administered at certain stages in the progression of the condition."

However, these drugs were too costly for universal access, and could cause harm if incorrectly used and if health systems were inadequate, as was currently the case in South Africa.

"Government will continue (pushing) for the lowering of the cost of these drugs, and intensify the campaign to ensure that patients observe treatment advice given to them by doctors," Tshabalala-Msimang said.

Health Department director-general Dr Ayanda Ntsaluba estimated the treatment of 100 000 people would cost the government in the region of R700 million.

Alongside poverty alleviation, the government would encourage research into alternative treatments, particularly on supplements and medication boosting the immune system.

Tshabalala-Msimang said the state programme of home-based and community-based care would be improved. More than R94 million had been allocated for this purpose this year, which would rise to R138-million in 2004/2005.

Emphasis would also be placed on treating HIV-positive people for opportunistic diseases such as tuberculosis, oral thrush, and meningitis.

Up to now, the tendency was not to treat a patient suffering, for example, from tuberculosis if he already had Aids, Pahad said.

"Whilst noting the complications (in freely providing anti-retroviral drugs), we are saying something can be done in the meantime," Netshitenzhe said.

He said the gist of the new approach was that individuals had to accept responsibility in the quest to curb the spread of HIV/Aids, and that the government would continue tackling the disease with a sense of urgency.

"Society doesn't have to go into a depression. The problem is huge, but there is hope if we all work together," Netshitenzhe said. - Sapa
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