- South Africa has sub-Saharan Africa's biggest economy and is a leading contributor to peacekeeping on the continent, having big deployments in the Democratic Republic of Congo and Burundi. But with about 4.7m of its 45m population HIV positive, US officials have privately expressed alarm about the impact of AIDS on its armed forces. An international league table in the UN's Human Development Report, published last month, showed South Africa sliding backwards into underdevelopment, primarily because of the economic impact of HIV/ AIDS. (source: Financial Times (London), August 11, 2003)
- HIV/AIDS remains the single greatest cause of death in South Africa, with nearly 2,000 new infections occurring each day. (source: UNAIDS)
President Mbeki responds in Parliament to strong criticism of his HIV/AIDS policies.
- In August 2003, after years of delays, the government agreed to begin planning a national treatment program. (Read their official statement.)
- That same month, activist Zackie Achmat announced that he would begin antiretroviral treatment. He continues to lead TAC's campaign to ensure that the government's pledge is put into action.
- Two days after the announcement of the plan, there were calls from politicians for Health Minister Manto Tshabalala-Msimang to resign and be put on trial for by the Human Rights Commission for gross human rights violations (and) for her stubborn refusal in rolling-out treatment for AIDS sufferers. There has also been concern about her ability to implement the new government plan on HIV and AIDS. (source: Agence France Presse, August 10, 2003)
- Just one week after the announcement of the government plan, Health Minister Tshabalala-Msimang warned that there may be delays in rolling out the anti-AIDS plan. (source: NY Times, August 18, 2003)
- On August 22, The Chattanooga Times Free Press (Tennessee) reported that Alec Erwin, South Africa's minister of trade and industry, told a visiting delegation of six U.S. senators headed by Sen. Bill Frist, R-Tenn., he does not believe international studies that show AIDS is reducing life expectancy and slowing economic growth in South Africa. The senators, in southern Africa to study AIDS prevention and treatment programs, will play a key role in determining whether $15 billion in anti-AIDS funding for Africa are appropriated on schedule and where they go. President Mbeki was not in the country at the time of the visit, and Health Minister Manto Tshabalala-Msimang had not scheduled a meeting with the group.
- In early September, the new head of the World Health Organization Jong-Wook Lee expressed doubts about the depth of South African President Mbeki's commitment to the plan.
After his August 31 meeting with Mbeki, Lee said that the president talked at length about how HIV and AIDS were taking too much attention away from other diseases, such as malaria and tuberculosis, that are rooted in poverty. "To me, he wanted to see more numbers and quality information" about the impact of AIDS in South Africa, said Lee. (source: The Boston Globe, September 1, 2003)
- Lee spent three days in South Africa, during which he also addressed health ministers from around the continent and visited the National Institute for Communicable Diseases, Africa's Centers for Disease Control. At the institute, Lee received sobering news that a study of mothers who take the drug nevirapine to prevent the transmission of HIV to their newborns shows a 40 percent resistance rate to the drug. The finding, although preliminary and not yet released by the Ministry of Health, is likely to raise difficult questions about the viability of the mother-to-child transmission initiative. The Bush administration has been planning to make the program one of the cornerstones of its $15 billion AIDS initiative. The results, if proved true, mean that after giving birth mothers who are treated for AIDS will not be able to use combination therapy that includes nevirapine. (source: The Boston Globe, September 1, 2003)
- Also in September, the World Trade Organization broke eight months of bitter deadlock when it agreed to let poorer nations import cheaper generic drugs to fight killer diseases such as AIDS and malaria. (The Daily Telegraph, (London), September 01, 2003)
Other Resources
- Treatment Action Campaign
- UNAIDS
- World Health Organization: Africa: HIV/AIDS
- AIDS Education Global Information System
- AIDS & Africa
- AIDS: The Agony of Africa - Pulitzer Prize-winning series by Mark Schoofs published in the Village Voice
- Live and Let Live: World AIDS Campaign 2002
- For more information on this developing story, check out the resource section and click on "news portals."
Update on People in the Film
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Mary, Chipho, and Gift continue to receive antiretroviral treatment. They are doing relatively well, though Chipho is still occasionally sick. |
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In August 2003, Zackie Achmat announced that he would begin antiretroviral treatment. He continues to lead Treatment Action Campaign's fight to ensure that the government's pledge is put into action. |
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Lucky Mazibuko continues to challenge the stigma surrounding HIV/AIDS and to advocate for treatment in his weekly column in Sowetan. |
On the 8th August 2003, Cabinet requested the Ministry of Health to develop as a matter of urgency a detailed operational plan on an antiretroviral treatment programme by the end of September 2003.
Dr ME Tshabalala-Msimang, Minister of Health
Accordingly, I have appointed a National Task Team to co-ordinate the drafting of an operational plan on behalf of the government. The task team comprises mainly senior officials from the Department of Health and experts in the health sector to complement the skills of the Department of Health.
Dr Anthony D Mbewu, the Executive Director for Research at the Medical Research Council of South Africa, will chair the Task Team. Dr Nono Simelela, the Cluster Manager for HIV & AIDS, Tuberculosis and Sexually Transmitted Infections in the Department of Health will continue to co-ordinate the activities of this plan. Other members of the Task Team include:
- Dr Lindi Makubalo - Cluster Manager for Health Information Systems, Research Coordination, Epidemiological Surveillance, Monitoring and Evaluation.
- Ms Mandisa Hela - Director for Access to Affordable Medicines.
- Mrs Precious Matsoso - Registrar and CEO of the Medicines Control Council.
- Mr Vishal Brijlal - Director for Health Finance and Economics.
- Mrs Cynthia Mgijima - Director for Nutrition.
- Mrs Rose Mdlalose - Acting Cluster Manager: Human Resources.
- Mr Thanduxolo Doro - National Association of People Living with AIDS.
- Ms Hasina Subedar - Registrar and CEO of the South African Nursing Council.
- Prof Tanyane Mariba - Dean of the Faculty of Medicine at the University of Pretoria and Chairperson of the Health Professions Council of South Africa.
- Prof Barry Schoub - Professor of Medical Virology at the University of the Witwatersrand and Director of the National Institute for Communicable Diseases.
- Dr Ashraf Grimwood - A Clinician and National AIDS treatment expert.
- Philip Onyebujoh - A Clinical Immunologist coordinating TB/HIV Research at the World Health Organization (WHO) in Geneva.
- Dr Mokhethi Radebe - Major General in the South African Military Health Services.
- Private Sector - (AID for AIDS Programme and Chamber of Mines)
Some members of the task team will comprise a core team and work full time on this project while others will assist to convene focused consultations with relevant stakeholders and also act as a reference advisory group to the Task Team.
In addition, the National HIV and AIDS Treatment Task Team will be assisted by a team of experts from the Clinton Foundation AIDS Initiative, established by former U.S. President, William Jefferson Clinton, which is led by Mr Ira Magaziner.
Over the next six weeks National HIV and AIDS Treatment Task Team will work closely with provincial health authorities and will consult broadly with national and international experts and various South African stakeholders.
During this period, the National HIV and AIDS Treatment Task Team will develop a detailed operational plan and implementation schedule. Amongst others, the Task Team will address the following areas in developing a plan for approval by cabinet:
- The development of provincial implementation plans, including a resource and training centre in each province to help ensure the delivery of high quality treatment and care, a schedule for rollout across district hospitals and health centres and a forecast of staffing requirements. These provincial operational plans will be based on the district health systems within each province.
- Procurement and/or production of necessary medications and consumables at as low a price as possible and an increase in the capacity and security of the drug distribution system.
- Upgrading of the national health laboratory system to handle a significant increase in diagnostic testing and monitoring of patient safety.
- Elaborate an integrated nutritional programme for people with HIV & AIDS.
- Development of a research agenda to support the programme, including engagement of South African academic centres and research institutions.
- Establishment of a robust system to monitor efficacy of intervention, adverse drug events, resistance and improvement and coordination of patient information systems.
- Development of staffing norms and standards for the delivery of antiretroviral therapy and assessment of human resource needs, including health system managers, physicians, nurses, pharmacists, nutritionists and counselors.
- Creation of a Programme Management Unit to coordinate the implementation of the programme and recommendations for its functions, structure, staffing and cost.
- Development of a communications plan for health providers and the public, including what to expect from the proposed treatment programme.
- Development of a detailed five-year programme budget and an estimated ten-year budget to implement the treatment programme.
- Development of a detailed implementation schedule.
- As a result of this work, the Task Team will produce an operational plan detailing the tasks to be performed, a schedule for their performance and a clear designation of responsibility for each task. This will help ensure that safe and effective HIV & AIDS treatment, care and support is brought to all South Africans.
— Dr ME Tshabalala-Msimang, Minister of Health, 20 August 2003