Mail & Guardian (Johannesburg) - February 17, 2006

Question 10. What plans do you have to combat Aids and boost the anti-retroviral roll-out?

ANC

The ANC has a comprehensive and practical plan to combat Aids, which includes prevention, awareness-raising, treatment and care. With respect to prevention, the ANC is increasing the number of facilities that provide voluntary counselling and testing, prevention of mother-to-child-transmission programmes and the management of sexually transmitted infections, especially herpes. It will continue the care and treatment of those who are infected and affected through the Comprehensive Plan for Management, Care and Treatment of HIV and Aids. At least 374 000 people have benefited from the nutrition component of this programme. An accumulative number of people initiated on anti-retroviral therapy in the 229 accredited sites in the country was more than 100 000 by the end of December 2005.

DA

A successful HIV/Aids policy must reduce the number of new infections by convincing South Africans of the real and immediate threat of HIV/Aids; back this up with practical interventions to support behaviour changes; keep those who are already infected healthy for as long as possible; and develop strategies to help and support Aids orphans.

A successful Aids-prevention programme must be led by someone who is capable of communicating directly, clearly and candidly, and who is respected enough that people will listen. The surest way to bring about a decrease in infections is to inform teenagers properly about the risks of HIV infection. Conveying the right information, clearly and consistently, must be the first element of a workable prevention programme.

A comprehensive anti-retroviral treatment programme is a key part of South Africa's onslaught on Aids. The DA will set up a panel of experts to develop low-cost, observation-based treatment guidelines. The DA proposes a national, internet-based anti-retroviral expert advice service, based on a nationwide patient register. This would allow many patients to be monitored by a single person.

The DA will create orphan support committees across the country to provide orphans with the practical help that will allow them to adapt to their circumstances successfully. Children, extended family members and anyone else with an interest in any orphaned child or children will be able to benefit from a range of free services.

The DA will provide life-extending drugs to HIV-positive South Africans who need them, without placing a financial burden on taxpayers or compromising other programmes, in terms of a five-year plan that will ultimately treat 500 000 South Africans with Aids -- every HIV-positive person who is sick enough to need anti-retroviral treatment.

The DA will establish a central anti-retroviral treatment centre, with a branch in each province, to manage the implementation of the programme and report on results. Various low-cost alternatives exist to expensive laboratory tests for measuring the progression of HIV. For example, studies have shown that the progress of HIV can be measured accurately by factors such as weight loss. The DA will set up a panel of experts to develop low-cost, observation-based treatment guidelines for South Africa.

The DA also proposes a national internet-based anti-retroviral expert advice service, based on a nationwide patient register. Experts in anti-retroviral drugs would be able to determine treatment regimes from a distance, and many patients could be monitored by a single person. Crucial to the success of the project would be a plan and a budget to get the 50% of clinics that currently do not have an internet connection linked up.

FF+

The FF+ supports an emphasis on morality and abstinence in the fight against Aids. This approach bore fruit in Uganda and there is no reason why it shouldn't succeed in South Africa. We believe that the roll-out of anti-retrovirals can be expedited if the government loosens its grip and contracts private clinics and hospitals (such as mine hospitals) as partners in the roll-out programmes.

PAC

Provide free preventative comprehensive health care in the public health system in communities near where people live. Provide choices of health care that include traditional healers. Provide free medicines for all diseases including tuberculosis and HIV/Aids and all opportunistic infections.

Subsidise nutritional supplements and food parcels as well as anti-retrovirals provided free for anyone who is HIV-positive. Extend assistance to people who are HIV-positive, even if their CD4 count is above 200.

UDM

Another issue that local government does not have direct control over, but which requires urgent attention at national level. The UDM firmly believes that the biggest single obstacle to the national fight against the pandemic is a lack of political will in the ruling party. The current minister of health must be relieved of her duties and be replaced with a person who is willing to unite the nation behind him/her in our fight against the disease. We further believe that it is possible to protect the privacy and confidentiality of individuals while making HIV/Aids a notifiable disease; this will allow for indisputable monitoring of prevalence and incidence rates of the disease and help us to coordinate our response efficiently and in a timely fashion.

UCDP

Promoting abstinence from sexual conduct outside marriage can combat Aids. People need to learn to have control over themselves.

ACDP

We have for a long time talked about abstinence as the only sure way to prevent the transmission of HIV/Aids; Uganda is a case in point where promoting abstinence reduced the prevalence of HIV. Earlier this year, Education Minister Naledi Pandor called for abstinence from sex before marriage to combat transmission of HIV. This is evidence that the government is aware of the gaps in its "abstinence, be faithful, use condoms" approach, which appears reasonable on the surface; however, in reality the government's emphasis on the "use condoms" aspect makes null and void the efficacy of abstinence and being faithful. Mbeki has failed to endorse Pandor's call, much to the detriment of the country.

With regard to anti-retroviral roll-outs, we need to conduct a needs assessment to ascertain the exact figures we are dealing with of HIV-positive individuals. We would want to introduce compulsory testing to accurately assess this and by no means make public an obviously confidential matter. We have a better chance of reducing the prevalence of the virus if everyone knows their status.

South Africa has a large shortage of doctors and nurses that is adversely affecting the roll-out process; we need to utilise the unemployed of the country, many of whom have various degrees, by training them to fill in this gap to provide assistance in delivering medication to those who need it as well as offer counselling, as is already the case. We see the HIV/Aids pandemic on the scale of the crisis a war would bring on any nation; we therefore need to treat it as such and allocate emergency funding to it until the crisis is stabilised.

MF

Aids must be made a notifiable disease to combat it. We should focus on the "KAB" theory -- with knowledge, we get change in attitude, resulting in change in behaviour. The "ABC" [abstinence, be faithful, use a condom] theory has been exhausted. The anti-retroviral roll-out in KwaZulu-Natal is on track because we have our efficient team in KwaZulu-Natal.

IFP

We view the present prevalence of HIV/Aids in South Africa as a national crisis, equivalent to a war in which all the nation's resources need to be marshalled to ensure victory. Unfortunately, the ruling party does not see it the same way, and as a consequence of mixed messages, ambiguity, delays, denialism, reliance on crackpot advisers and the likes people who should live normal lives are dying. The IFP would treat the matter with a great deal more seriousness and would strongly boost the roll-out of anti-retrovirals, especially through municipalities.

ID

The ID believes that the anti-retroviral roll-out needs to be massively up-scaled to meet the needs of HIV-positive people in the country. At present, our anti-retroviral roll-out is only reaching about 5% of those in need, and it is not clear whether the present roll-out is being done in an equitable fashion. For the roll-out to be a success, however, our entire health system needs to be improved and far more human-resource capacity, such as nurses, needs to be employed. It is for that reason that the ID has developed a comprehensive policy on dealing with HIV/Aids, which can be found on our website.

In short

ANC: African National Congress

DA: Democratic Alliance

FF+: Freedom Front Plus

ID: Independent Democrats

ACDP: African Christian Democratic Party

UCDP: United Christian Democratic Party

MF: Minority Front

PAC: Pan Africanist Congress

060217
MG060203

Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2006. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .