Dr. Nono Simelela, the Health Department chief AIDS official and a member of the team that drafted the plan, told a news conference, ”It is a huge challenge and we are not underestimating it.”
“But we’re hitting it with all guns. Everything that we can find, we’re throwing at this virus.”
Thousands of doctors and nurses must be trained, hundreds of millions of dollars has to be spent on drugs, and new networks need to be set up to ensure patients comply with treatment guidelines designed to prevent the development of drug-resistant strains of HIV.
But officials see the steps as necessary. Already, South Africa has the world’s highest HIV/AIDS caseload with more than 5 million of its 45 million people infected.
Activists, business leaders and opposition politicians demanding more aggressive action against AIDS prompted the government in August to call for including anti-retroviral drugs in the national strategy to tackle AIDS. Mbeki’s government had previously argued that the drugs were expensive, hard to take and potentially toxic.
Zackie Achmat, the vocal leader of the AIDS activist group Treatment Action Campaign, hailed the decision as a “really an enormous victory” during an interview with the BBC.
“I danced the whole morning,” he said.
Former U.S. President Clinton, who helped to broker the deal, said the program could help drive down the price of AIDS drugs and become a model for other nations.
“I applaud President Mbeki and his government for their leadership and commitment to stopping the scourge of AIDS in South Africa,” he said in a statement.
The United Nations’ top AIDS officials also praised the plan.
“South Africa’s bold move to ensure that millions of HIV-positive people have access to treatment should mobilize other African governments to make treatment a reality for those infected,” said Dr. Peter Piot, the executive director of UNAIDS.
Simelela said about 50,000 people could receive drug treatment in 2004, increasing to as many as 1.4 million by 2009. The total budget would also increase from about $44 million next year to some $666 million in 2009.
Government officials are confident they can set up 50 “service points” around the country by the end of 2004 to administer the drugs and monitor patients, Simelela said. She also conceded that setting up such clinics in every town and municipality would take time.
When announcing the plan, Health Minister Manto Tshabalala-Msimang explained that “once identified as HIV-positive, patients will be assessed for the stage of their illness and referred into appropriate medical care.”
Treatment would focus on slowing the progression of the disease to full-blown AIDS and maintaining good health through prompt treatment of opportunistic infections, she said.
It will take time for South Africa to find sources for lower-cost drugs. Government officials say they are in talks with pharmaceutical companies, but they were unable to give details. “I don’t want to give a timeline,” Simelela said.
Last month four generic drug companies, including one from South Africa, announced a deal to make anti-retroviral drugs available in Africa and the Caribbean for about $140 per person per year, about half the current price.