Cape Town, 8 August 2003 - The international medical aid organization Doctors Without Borders/Médecins Sans Frontières (MSF) today welcomed with enthusiasm the South African government's announcement that it would roll-out a national HIV/AIDS treatment plan. In a statement issued today, the South African Cabinet instructed the Department of Health to develop a detailed implementation plan by the end of September 2003 that includes the provision of antiretroviral (ARV) therapy in the public sector in South Africa.
"This is extremely good news, and we are definitely celebrating today with all people affected by HIV/AIDS in South Africa," said Dr Eric Goemaere, head of mission for MSF in South Africa. "This statement clearly acknowledges the gravity and urgency of the challenge ahead, and symbolically unblocks a situation of denial that has lasted for too long. There is no going back. Now the hard work of scaling up finally begins."
MSF has been working in Khayelitsha, a poor township of 500,000 people outside of Cape Town, to provide care and treatment for people with HIV/AIDS since 1999. MSF has witnessed first-hand the daily devastation caused by the AIDS epidemic in South Africa, the clinical benefits of ARV treatment, and the hope that the availability of treatment brings to the community. In April 2000, in collaboration with the provincial government of the Western Cape, MSF set up three dedicated HIV/AIDS clinics within Khayelitsha's primary health centers, and in May 2001, began providing ARV therapy for people with advanced stage of HIV infection.
Today, MSF is treating 500 people, mostly with affordable quality generic ARVs from Brazilian and Indian manufacturers. This community-based program, which involves people living with HIV/AIDS at all levels, has long demonstrated the feasibility of providing ARV treatment in public clinics in South Africa. On 29 July 2003, MSF announced the launch of an HIV/AIDS care and treatment program in Lusikisiki, a rural area located in the former Transkei with extremely fragile health care infrastructure. The program, which started in January 2003, is supported by MSF and the Nelson Mandela Foundation, and will include ARV therapy in addition to other AIDS services.
MSF highlighted the government's openness to working with experts in the medical and scientific community to roll-out the national ARV plan, emphasizing the importance of exchanging information about implementing ARV treatment.
"We are eager to share our experiences in Khayelitsha and Lusikisiki with those developing and implementing a treatment plan," continued Dr Goemaere. "A national ARV plan in South Africa would not only transform South Africa, it could have a catalytic effect throughout Africa and the rest of the developing world."
If fully implemented, a national ARV program in South Africa would be the largest in the world, as South Africa is home to the largest number of people with HIV/AIDS; nearly 5 million are currently infected. In order to stretch financial resources and treat the largest number of people possible, local production of ARVs will be key, as it has been for Brazil's national AIDS program. MSF will soon be using the locally produced version of the drug stavudine (d4T) for its projects in South Africa, and will continue to support local production and other strategies for ensuring access to low-cost quality medicines. The locally produced d4T is as much as 41% less expensive as the price offered by the originator company, Bristol-Myers Squibb.
"You treat more people with less expensive medicines," said Dr Goemaere. "It's that simple."
