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Free AIDS treatment delayed in South AfricaJOHANNESBURG: Three months ago, the South African government promised to provide free antiretroviral medication to people with AIDS, planning to supply as many as 1.4 million of them within five years. But only on Feb. 13 did the government solicit proposals from pharmaceutical companies that supply the life-prolonging drugs, pushing back the start of treatment for thousands of patients. A chart in the government’s plan, released in November, estimated that as many as 53,000 people would be receiving the drugs by the end of March. But the country’s controversial health minister, Manto Tshabalala-Msimang, now denies that the government ever promised that the program would begin before April. Sibani Mngadi, the health minister’s spokesman, said that the delay was caused by the need to check out clinics where drugs will be dispensed, set up a system to track patients and write training manuals for health professionals. “This is a major project,” he said. “We need to make sure we do the ground-work. We can’t take shortcuts.” The delay has drawn furious criticism from AIDS patients and their advocates, who say that it may be several months before the government begins to treat patients. “There is no excuse for the program continuing to be delayed,” said Nathan Geffen, head of the Treatment Action Campaign, which lobbies for AIDS treatment. “The money is there. Everything is ready.” South Africa has one of the biggest AIDS epidemics in the world. An estimated 12 percent of its population, or five million people, are infected with HIV. No one knows for certain how many South Africans die of the disease each day, but estimates range from 600 to nearly twice that. After years of questioning whether HIV causes AIDS, the government of President Thabo Mbeki announced in mid-November that it would more than triple its AIDS budget to about $1.7 billion over the next three years. Much of that is marked for antiretroviral drugs. Geffen said that the Health Ministry had at least $14 million on hand that it could use. He said that the provincial government of the Western Cape had demonstrated that it was possible to act faster to save lives. There, 1,800 patients are being treated with antiretroviral drugs at 13 different clinics and hospitals, said Fareed Abdullah, deputy director of the provincial Health Department. In the next year, Abdullah said, the number of treatment sites should be tripled, the eventual goal being to treat the 5,000 to 10,000 people in the province. He said that the provincial government was sharing the cost with Western donors and building on three years of pilot projects. “We know which drugs to use, how to buy them, how to keep records, how to employ the staff, the doctors and nurses, “he said. But Mngadi, the Health Ministry spokesman, said that South Africa’s other eight provinces were not so well equipped. And Dr. Kgosi Letlape, who heads the South African Medical Association, said he did not want to criticize the government’s program before it got off the ground. Critics say the delays are symptomatic of the lack of political will in South Africa to confront AIDS. Geffen said that Mbeki and Tshabalala-Msimang continued publicly to play down the seriousness of the problem to sow confusion about the disease. Source: International Herald Tribune, February 21-22, 2004 posted by Prawate on Wednesday, March 10, 2004 |
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