Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
Mail & Guardian (Johannesburg) - September 20, 2002
Drew Forrest
The plan is spearheaded by the South African Medical Association (Sama), representing 16 000 doctors. It throws down the gauntlet to the government, which continues to stonewall state anti-retroviral provision for the estimated six million HIV-positive South Africans -- close to 500000 of them with full-blown Aids.
Currently about 20000 South Africans -- just more than 4% of those who qualify -- receive anti-retrovirals, overwhelmingly through private medical aid schemes.
However, few medical aids cover more than a fraction of Aids drug treatment.
The Sama project will be launched on December 1 -- World Aids Day -- at a gala dinner in Johannesburg.
Sama chairperson Kgosi Letlape confirmed he had met Mandela on three occasions in recent weeks, and asked him to serve as patron of the scheme. The former president had "shown willingness" and "was very keen to get involved". Mandela had since toured the country calling for a treatment programme and for the sick to come forward.
Mandela's international standing would give a huge fillip to Sama's fund-raising efforts. Letlape said the Nelson Mandela Foundation, which had its own HIV/Aids programme, would also be approached for funding.
Neither Mandela nor his spokesperson, Jakes Gerwel, could be reached this week.
A practising doctor and outspoken critic of the official Aids policy, Letlape said government was undermining the battle against the epidemic on a range of fronts.
He said he had recently told the Minister of Health, Manto Tshabalala-Msimang, the authorities were committing "effective genocide". The minister replied that there was no budget for a treatment programme.
Letlape made no bones about his desire to jolt the government into action. "We must reverse this policy of no treatment. If they set up just one pilot site it would send a message of hope to ordinary people."
His long-term vision for the Sama scheme was of "a private-public interface" that the state could plug into "when it wakes up".
Letlape said in its first year the scheme would target 9 000 poor people with HIV/Aids at an estimated outlay of R80-million, covering doctors' and laboratory fees, monitoring, and the cost of the drugs and their delivery. However, the number of patients and treatment sites would expand if more money was raised.
The plan was to use the testing and counselling infrastructure of the state, which would refer patients for private treatment once their HIV status had been established. Sama would draw up a register of suitable doctors.
On funding, Letlape said chari-table organisations and private corporations would be approached.
However, United Nations Aids funding might also become available. The obstacle, Letlape said, was a UN Global Aids Fund rule -- inserted last year at the South African government's behest when the fund was launched -- that all funding pass through national governments.
This is at the crux of the unresolved spat over a R600-million UN grant to a project in KwaZulu-Natal, which the government blocked as unprocedural. The project included anti-retroviral provision.
Letlape said at the recent World Summit he had told UNAids chief Peter Piot the fund should be "freed up", given the South African government's inaction on anti-retroviral treatment for ordinary people.
At a subsequent press conference, Piot had announced that the UN would consider direct funding for suitable projects.
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