Mail & Guardian (Johannesburg) 26 September 2003
Vicki Robinson
As the HIV/Aids crisis worsens, independent medical relief organisation Médécins Sans Frontières (MSF) has released a report on how countries can gain access to cheap anti-Aids drugs.
The report was released on Monday at the 13th International Conference on Aids and STIs (sexually transmitted infections) in Africa. It is designed to help governments procure "low-cost quality anti-retrovirals [ARVs] effectively and efficiently ... [and to] scale up access to treatment".
South Africa is one of 10 countries in which MSF has run pilot HIV/Aids treatment projects. The South African pilot site, in Khayelitsha in Cape Town, began its Aids programme in 1999. The political clatter surrounding the issue meant that the project was particularly difficult. "There was no national HIV/Aids plan that included ARV treatment ... and no government support," said Marta Darder, the coordinator for the Khayelitsha project.
But, says the report, "as the price of [ARVs] in low- and middle-income countries has fallen in recent years, governments, international agencies and non-governmental organisations have been able to start developing treatment programmes."
Such programmes have, however, been hamstrung in South Africa by the "lack of generic policies; limited information available about internationally publicised prices; and countries' eligibility for differential prices".
South Africa's lack of a "public sector national guideline" has "seriously handicapped access to low-cost ARV drugs". For the Khayelitsha project, MSF had to import generics from Brazil.
MSF said what was needed was a "strong public procurement agency ... local drug production ... or private sector distributors". In sub-Saharan Africa, only 1% of the four million people in need of ARVs receive them.
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