E-drug: South Africa stalls again on access to HIV drugs
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[Copied as fair use. KM]
Lancet 2003; 361: 842 (8 March)
South Africa stalls again on access to HIV drugs
Dissatisfaction with the South African government's tardiness in providing
antiretroviral drugs deepened this week with AIDS activists calling for
civil disobedience.
The Treatment Action Campaign (TAC) announced that it will begin peaceful
protest action later this month after the government failed to meet TAC's
Feb 28 deadline to sign a national treatment plan for HIV/AIDS that includes
antiretroviral drugs.
Negotiations on the National Economic Development and Labour Council
(Nedlac) treatment plan, which was drawn up last year by representatives
from labour, government, business, and community organisations, have
stalled.
Health Minister Manto Tshabalala-Msimang said the government cannot finalise
treatment plans until the national Treasury has completed an economic
analysis on providing antiretrovirals in the public sector.
The TAC's Zackie Achmat said he was prepared to wait for the report, but
insisted that other issues already agreed on should be "signed off" in the
meantime. These issues include treatment of opportunistic infections,
sexually transmitted infections, and providing nutrition, voluntary
counselling, and HIV testing.
Before the deadline, Tshabalala-Msimang said that "policy development on
AIDS cannot be dictated by agreements we enter into with our social
partners". She added that the government already had a multisectoral plan,
coordinated by the South Africa National AIDS Council and headed by Deputy
President Jacob Zuma.
The council, whose responsibility includes approving applications from South
Africa to the Global Fund to fight AIDS, tuberculosis, and malaria, excludes
key players such as the TAC. Furthermore, media commentators have noted that
Zuma has been otherwise engaged with ongoing peace talks in Rwanda.
The government has denied there was an agreement on antiretrovirals in what
it calls the "TAC discussion document", but says that it will not abandon
the negotiation process. The TAC, however, says the government has
misrepresented the Nedlac agreement and its own role in it.
On Feb 14, more than 10 000 people--health professionals, health workers,
and people living with HIV/AIDS--vented their frustration when they took
part in a TAC march on Parliament in Cape Town while President Thabo Mbeki
was inside delivering his opening address.
Mbeki's mentioned HIV/AIDS in passing, saying only that the government would
continue to implement its "comprehensive HIV/AIDS strategy". This served to
further anger those outside who demanded a treatment plan that included
antiretrovirals.
Meanwhile, Pieter Dirk Uys, a satirist and AIDS awareness campaigner,
entered the debate by publicly rebuking Mbeki and Tshabalala-Msimang for
their "lack" of leadership.
Uys said that charges of genocide should be made against Mbeki and
Tshabalala-Msimang and they should be hauled before the International Court
of Justice in the Hague.
"Rather this happen now than in 10 years' times, when the world will no
doubt look back at 2003 and the actions of the South African president and
his health minister, and realise that by acting sooner, millions of lives
could have been saved from an unnecessary death from AIDS", he said.
Adele Baleta
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