Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
Sunday Times (Johannesburg) - June 30, 2002
Kerry Cullinan
This will allow Cosatu to declare a dispute with government and business should no agreement be reached in the National Economic, Development and Labour Council on implementation of the treatment plan.
The Department of Health's chief director of HIV/Aids, Dr Nono Simelela, said she welcomed the move as "every organisation and person must be involved in the fight against Aids".
A key aspect of the plan involves making antiretroviral drugs available through the public health system to those infected with HIV.
Preliminary estimates by the Treatment Action Campaign put antiretroviral treatment at R400 to R700 a month for adults, depending on the person's medical condition, and around R583 for children.
Although the drugs are expensive and the campaign's Mark Heywood admits their introduction "will not be easy", the TAC and Cosatu believe South Africa cannot afford the social costs of not doing so.
"It is more cost-effective to manage HIV properly than to let people get sick and die," Heywood said.
Cosatu secretary-general Zwelinzima Vavi told the 700-strong treatment conference that government could produce generic antiretroviral drugs for the whole of Africa and "then we can start to see a real Nepad.
"Increased generic production for sub-Saharan Africa is also likely to result in economies of scale which will reduce costs, insulate antiretroviral therapy from currency fluctuations, stimulate the local pharmaceutical industry and provide jobs," he said.
The TAC and Cosatu say their plan aims to "keep people alive for as long as possible" while government's strategy ultimately aims at "shunting people towards home-based care and preparing to live with the social consequences of millions of deaths".
They say the cost of the drugs can be offset against savings as people on antiretrovirals will remain in productive employment and be able to care for their own children rather than the state having to bear the burden of Aids orphans.
Medical Research Council president Dr Malegapuru Makgoba told the conference that actuarial projections showed that the introduction of antiretroviral drugs could halve the number of Aids orphans by 2014, resulting in a million rather than two million orphans.
TAC chairman Zackie Achmat also warned that unless the drugs were introduced, the massive demand for care coming from people with Aids would "destroy the healthcare system".
According to the Department of Health, in 2000 some 24% of all hospital admissions were for Aids-related ailments, yet deaths due to the epidemic were only expected to peak in about 2010.
By 2004, government could expect to spend R7-billion a year on managing Aids in hospitals.
Dr Des Martin of the HIV Clinicians Society said that international research by Johns Hopkins University showed that patients on anti-retroviral drugs reduced their hospital costs by 46% on average.
In Brazil, the introduction of the antiretrovirals in public health reduced HIV-related hospital costs by 80%.
The Cosatu-TAC plan proposes a "triangle" of interventions, with HIV prevention and improved treatment of other sexually transmitted diseases forming the base and anti-retroviral drugs and home-based care at the apex.
A beefed-up South African National Aids Council, with a permanent secretariat and proper resources, could monitor the implementation of the plan.
"People with asymptomatic HIV don't need drugs. It is only when the CD4 count (measure of immunity in the blood) is less than 200 copies per millilitre of blood that people need drugs," Martin said.
020630
ST020604
Copyright © 2002 - The Sunday Times. Reproduction of this article (other than one copy for personal reference) must be cleared through the Sunday Times Permissions Desk.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Elton John AIDS Foundation UK, the National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.
Always watch for outdated information. This article first appeared in 2002. 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, 2002. 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. .