Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.

Reuters NewMedia - November 20, 2003
Andrew Quinn

Thousands of doctors and nurses must be trained, hundreds of millions of dollars spent on drugs, and new networks set up to ensure patients comply with treatment guidelines--or risk breeding drug-resistant strains of the disease.

South Africa has the world's highest HIV/AIDS caseload with more than five million of its 45 million people infected. Analysts say the disease kills 600 South Africans each day.

"It is a huge challenge and we are not underestimating it," Dr. Nono Simelela, the Health Department chief AIDS official and a member of the team that drafted the plan, told a news conference. "But we're hitting it with all guns. Everything that we can find, we're throwing at this virus."

The plan, approved by Cabinet Wednesday, calls for the gradual introduction of antiretroviral drug therapy in the public sector, a major about face for President Thabo Mbeki's government, which had long resisted the drugs, claiming they are too expensive, hard to take and potentially toxic.

Activists, joined by business leaders and opposition politicians, have demanded more aggressive action against AIDS--prompting the government in August to drop its opposition and call for an urgent plan to include antiretroviral drugs in the national strategy to tackle AIDS.

STRATEGY

Officials described an ambitious program to improve the health care infrastructure, particularly in poor and rural areas. "The commitment is actually to reach everybody, but we can't reach everybody within a year," Simelela said.

Prevention remains the cornerstone of South Africa's AIDS strategy, and that treatment will only be offered to those in late stages of HIV infection, the officials said.

There is no shortage of potential patients. Simelela said about 50,000 people could receive drug treatment in 2004, rising to as many as 1.4 million by 2009. The total budget will rise from $44 million next year to $666 million in 2009.

Simelela said officials were confident they could set up 50 "service points" around the country by the end of 2004 to administer the drugs and monitor patients. She conceded the broader objective of setting up such clinics in every town and municipality would take time.

Time will also be required to source the drugs. While officials say talks are under way with pharmaceutical companies, they were unable to give details. "I don't want to give a timeline," Simelela said.

Last month four generic drug companies, including one from South Africa, announced a global deal to make antiretroviral drugs available in Africa and the Caribbean for about $140 per person per year, about half the current price.

Former U.S. President Bill Clinton, who helped to broker the deal, said in a statement South Africa's new AIDS program could pave the way for even more price reductions in future.

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