Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
Sunday Times (Johannesburg) - Tuesday August 05, 2003
Claire Keeton
Medical doctors, academics and people living with the disease made presentations on the efficacy of antiretroviral treatment and the need make drugs accessible in the public health sector, which provides health services to 70% of South Africans.
Pioneering programmes in the Western Cape, which are treating about 1,000 people with antiretroviral drugs, were held up as proof that drug therapy does work.
In Khayelitsha, for example, 500 patients had shown excellent adherence to the rigorous drug regime, averting potential problems with drug resistance, and had a 70 % in opportunistic infections.
Dr Fareed Abdullah, head of the Western Cape's HIV/Aids programme, declared that universal access to treatment was a priority for the province, and should be for the country.
Abdullah said: "It has become clear that no Aids programme will be effective without the widespread use of antiretroviral therapy not only for the prevention of mother-to-child-transmission (MTCT) but also for long-term treatment in adults and children."
He warned that five million South Africans would die in the next eight to 10 years if South Africa did not implement a large-scale treatment programme.
"There are only two treatment options for South Africa: treatment success or treatment failure. A 'no treatment' option does not exist," Abdullah said.
The Western Cape's MTCT programme started in 1999 and it is the only province which has achieved universal coverage, reaching pregnant women with HIV in both urban and rural areas.
Abdullah said, however, they intend to implement more effective interventions than the present programme -- which uses a single dose of Nevirapine or AZT and reduces transmission by about 50%.
"We cannot accept 50%, we are looking at new regimens which bring transmission down to five percent," he promised.
The province also plans to provide antiretroviral treatment to children. "We are calling for the elimination of paediatric HIV in the Western Cape and it is possible rates can be driven down to below 1%," said Abdullah.
The Western Cape official agreed with Health Director General, Dr Ayanda Ntsaluba, that antiretroviral treatment was complex but said this should not be exaggerated, or used as an excuse to delay treatment programmes.
Ntsaluba insisted there was common ground among those working with HIV/Aids in South Africa -- with the differences coming down to the speed and scale of treatment options.
The government had to ensure that any programme it introduced would be sustainable and have positive outcomes, he said, explaining the delays in rolling out treatment.
Another speaker, Bongiwe Mkhutyekelwe from the Treatment Action Campaign (TAC), urged the government to provide treatment now. "The government I voted for is refusing to commit itself to a treatment plan," she said angrily.
Other activists have called on South Africans not to vote for the African National Congress in next year's election unless it agrees to treatment.
Hundreds of TAC demonstrators converged on the conference yesterday (subs: Monday) to demand treatment and appeal to the delegates to support them.
Conference organiser, Professor Jerry Coovadia, said he supported this demand from the bottom of his heart. "We are fighting the same battle... if you asking me whether I support treatment I would say 'yes once, yes a 100 times, yes a 1000 times'," he said.
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