Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
South African Press Association (Johannesburg) - September 5, 2003
That did not mean all people in need of ARVs would get them straight away though, Ira Magaziner, chairman of the William Jefferson Clinton Foundation's Aids initiative, told reporters in Pretoria.
Experts are assisting a 16-member local task team in drawing up the plan, as requested by the Cabinet a month ago.
The plan would outline the roll-out week by week, Magaziner said.
"But it can't all happen on day one."
Dr Anthony Mbewu, chairman of the team, said it was difficult to put a firm figure on the time needed to provide ARVs to 100 percent of the people suited to use them.
A number of facilities, like training hospitals, were ready to administer the drugs, he said.
Magaziner said at least eight or nine things needed to be in place simultaneously to make the whole programme work. If staff had been trained, but part of the drug supplies had not arrived, it could not happen.
The task team's deadline is September 30.
"Things are going well," said Mbewu. "The process is on track."
Ten work groups, all headed by task team members, had been established to look into different aspects.
One of them dealt with provincial resources and training. Small groups had visited all nine provinces to assess their capacity, needs and constraints, Mbewu said.
Provincial plans were now being prepared. They would be presented at a meeting on Wednesday and then collated into the overall plan.
"There is a lot of excitement about this in the provinces."
A second working group was investigating the procurement and distribution of resources, while a third looked into the human resources aspect.
This was one of the major constraints, Mbewu said.
One group was determining what research would be necessary during the roll-out, and others dealt with patient information systems, nutrition and communication.
The job of another was to probe surveillance mechanisms necessary during the roll-out of ARVs -- to ensure that side-effects and toxicity were detected. The Medical Research Council had set up a unit at the Medical University of SA to monitor issues like viral resistance to drugs.
It was also necessary to determine the scale of laboratory services needed. One group looked into budget matters. A very detailed budget plan would be submitted, Mbewu said.
"It is important to ensure that the interventions are cost-effective and sustainable. There is no point in starting a massive roll-out of antiretrovirals and then the money runs out in year two."
According to Magaziner, the major challenges included dealing with matters like side-effects and viral resistance. Testing had to be done properly, and training was vital.
"All these can be met. It is just a question of proper planning and implementation."
He believed the programme could be rolled out everywhere, although it might take longer in some places. The foundation would offer expertise to help.
"The commitment the government has expressed to do this, but to do it in the right way, is what impressed (former US) president (Bill) Clinton. He said we would help in every way we can."
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