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) - August 10, 2003
S'thembiso Msomi And Claire Keeton
In a statement released on Friday, after a day-long special Cabinet meeting on the issue, the government said it "shares the impatience of many" on the need to strengthen the fight against Aids and said it had roped in the Clinton Foundation Aids Initiative and local experts to help the health department develop an operational plan.
The Cabinet's decision to adopt the recommendations of the Joint Health and Treasury Task Team - that antiretroviral drugs be made available to those who need them at public hospitals - comes after what has been termed a "week of progress" in the fight against Aids.
Earlier in the week, during South Africa's first Aids conference held in Durban, government officials and civil society organisations - which have been critical of the government's HIV/Aids policies - seemed to find each other on a number of issues .
On Thursday, the government finally put an end to its 18-month delay in signing an agreement with the Global Fund to Fight Aids, TB and Malaria - giving South Africa access to $41-million for the fight against the pandemic.
On the same day, Tshabalala-Msimang issued a conciliatory statement acknowledging that antiretrovirals "can help improve the condition of people living with Aids". The statement was a major departure from earlier utterances in which she indicated that she doubted the efficacy of the drugs.
The Cabinet said on Friday it had noted the task team's assertion that the government's primary challenge "is to ensure that the 40 million South Africans who are not infected with HIV stay that way; and that those who are infected but have not as yet progressed to an advanced stage of Aids, lead a normal life through proper nutrition".
The report says South Africa is "well-placed to offer a comprehensive package" that includes antiretroviral drugs. It describes four scenarios - ranging from not rolling out antiretroviral treatment to a 100% roll-out - and concludes that although providing the drugs is costly, it has high social benefits for the country.
The report says not providing them would cost the country R6.7-billion by 2010, while a 100% roll-out would cost anything between R16.9-billion and R21-billion by 2010.
"The introduction of antiretroviral therapy would have a significant impact on Aids mortality, reducing considerably the number of deaths from Aids during the next decade," it says.
The 100%-provision scenario would result in 1.7 million deaths being deferred until after 2010, the report says. It says that in all the scenarios, a comprehensive health sector prevention programme will be required which would cost an additional R550-million a year for the rest of the decade.
Tshabalala-Msimang said she would abide by the government's decision. "W e will ensure that the package of services as determined by Cabinet is effectively rendered to those who are infected and affected," she said.
"HIV and Aids are a major challenge facing all of us and require all parties to work together."
The move was welcomed by the UN special envoy for HIV/Aids in Africa, Stephen Lewis. "I'm thrilled by this announcement and I can't welcome it too strongly," he said. "This is hugely important not just for South Africa but for the rest of the continent."
Lewis hailed it as a victory for the Treatment Action Campaign, which held a demonstration demanding treatment at this week's conference.
Campaign leader Mark Heywood said the announcement was an "irreversible turning point". He added: "The challenge will be to have a serious plan ready in a month and we have committed ourselves to assist in this and in its implementation."
The conference's scientific chairman, Professor Jerry Coovadia, said the news was uplifting. "We had a sense when the conference ended that we had reached so much agreement, but not for a second did we think this would come so quickly.
The best part is the timeline and the specific mandate to act," he said.
Dr Eric Goemaere, head of M decins Sans Fronti res - which runs South Africa's largest antiretroviral treatment programme in Khayelitsha - said his organisation was celebrating the announcement.
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