People living with HIV/AIDS are demanding effective and affordable treatment. Mark Heywood reports |
On 21 March – Human Rights Day – people living with HIV/AIDS took part in ‘fasts for life’ in four different cities in South Africa to raise awareness of the need for affordable and effective treatment for HIV/AIDS.
One hundred thousand South Africans die every year as a result of AIDS. There will be many more deaths to come, because there are over 3,5 million people who are HIV-positive.
Zackie Achmat, who is one of the leaders of the Treatment Action Campaign (TAC), points out, however, that ‘AIDS is not a death sentence. While there is still no cure, there are treatments. These treatments can help people live longer and better. The issue is how to get these treatments to the people who need them.’
Commitment
Minister of Welfare, Geraldine Fraser Moleketi, said: ‘It is the duty of all people in South Africa to ensure that people with HIV/AIDS receive affordable treatment.’
However, very few doctors or nurses are being trained about how to treat HIV/AIDS. Essential drugs are not available at most public hospitals and clinics. A specialist HIV/AIDS clinic at the Pretoria Academic Hospital was closed at the end of March, despite protests from the community.
The private sector has an equally bad record. Most medical aid schemes refuse to pay for the treatment of HIV/AIDS. This means that only the rich have access to treatment.
Partnership
The government has made AIDS a national priority for 1999. Recently, members of parliament from all political parties signed a pledge where they agreed to fight AIDS. However, the pledge said nothing about treatment.
The ‘Partnership against AIDS’, which the pledge is part of, is mainly about HIV prevention – raising awareness, promoting safer sex and fighting discrimination. But the ‘Partnership’ is ignoring the needs of the 3,5 million people who already have HIV. For these people, AIDS prevention is what is important. This means:
If these issues are not taken up, people will carry on thinking that AIDS is a ‘death sentence’. Very few people will want to find out if they have HIV. The climate of stigma, fear and intolerance will continue.
Cost
The Minister of Health has told the media that the government cannot afford the most effective anti-AIDS drugs (called combination therapy and protease inhibitors). Last year, these treatments led to a 50% decrease in the number of people dying of AIDS in the United States of America. These drugs cost over R5000 per month per person.
The Treatment Action Campaign has said that it will mobilise public opinion to put pressure on the drug companies to bring down the prices of these drugs.
Alternatives
The cost of the most effective anti-AIDS drugs should not blind the Department of Health to the fact that there are many other drugs that are both effective and affordable.
Recent research has shown that a combination of two drugs (which are called AZT and 3TC) can reduce the chances of a pregnant woman passing HIV to her child by up to 50%. If South Africa used these drugs, the lives of around 30 000 children could be saved each year. The drugs cost less than R400 per person, making them as cheap as inoculating a child against measles.
People who are infected with HIV get certain common illnesses (these are called opportunistic infections ). They end up in hospital, perhaps even in Intensive Care. This costs the government money. The person is also unable to work for weeks or even months – just because they have an avoidable AIDS-related illness.
These illnesses can be prevented by using drugs (known as prophylactics) that are cost effective and affordable.
The Treatment Action Campaign is calling for AZT, 3TC, Bactrim and other drugs to be made affordable and available to all the people in South Africa who need them. This is not a campaign against the government. Instead, it aims to help the government introduce these drugs into the public health system. This will not be easy. It is not just a question of giving out pills, but of paying for them and transforming and improving the health service in general. It is, however, a matter of life and death.
