Accelerating response to AIDS

Accelerating its response to the AIDS challenge, the Swazi government announced on Wednesday it had selected preferred suppliers of antiretroviral drugs, while the national AIDS funding agency said it had applied for a US $48.5 million grant from the Global Fund. "The nearly $50 million we have requested is for a five-year period, with $7 million going toward our first-year projects, and the funds will enable us to significantly step up interventions, particularly our programmes directed toward youth, which are currently under-funded," National Emergency Response Committee on HIV/AIDS (NERCHA) director Dr Derek Von Wissell told PlusNews. Swaziland has one of the world's highest AIDS prevalence rates and the Global Fund is expected to approve the fund application in June. Von Wissell said NERCHA, which distributes government, private sector and Global Fund monies to health care groups, had purchased ARVs since their introduction in the country via a pilot programme last year, but the process up to now had been informal. The awarding of competitive tenders by the Ministry of Health would bring even greater savings. "The bidding process for ARVs has dropped prices significantly. For the cost to treat 1,000 patients a year ago, through competitive bidding we can now treat 1,500 patients, 50 percent more than we budgeted for," said Von Wissell. As its preferred suppliers, the National Drugs Advisory Council selected Abbott Laboratories (South Africa), Merck Sharp & Dohme, and the generic producers Hetero Drugs and Ranbaxy Laboratories. The Global Fund, which helps underwrite the country's ARV drug purchases, has been notified of the selections. Global Fund monies will be directed by NERCHA toward programmes to assist orphaned and vulnerable children, home care for AIDS patients, and educational programmes. Particular attention will be given to the nation's under-18 population in an effort to forestall possible HIV infections. "One of the most vulnerable groups is out-of-school youth. They are poor and hard to reach - they don't read newspapers or listen to the radio. But worse, they have no vision of life; where they want to go in life," Von Wissell said. Team sports programmes, which are under-funded by government, will be financed to foster the socialisation of impoverished and out-of-school youth, while new community centres, to be built at the kraals of local chiefs, the traditional community meeting places, will encourage other games, such as chess, darts and cards. Life-skills training, health interventions, and arts and crafts studies will also be offered. Swazi youth will be introduced to drama and theatre, with some shows staged by AIDS education groups, and the venues will also be utilised by local and touring entertainment troupes. Von Wissell defended the UN Secretary General's Special Envoy on HIV/AIDS in Africa, Stephen Lewis, who stirred controversy last month when he noted during a visit with King Mswati that Swaziland's adult HIV prevalence rate of 38.6 percent was the world's highest. "[The] report he made to the UN on Swaziland was positive. He praised our AIDS initiatives here, and he highlighted our HIV prevalence rate in an effort to bring Swaziland to the world's attention, so the international community can respond with assistance," Von Wissell said. On Wednesday former health minister Dr Phetsile Dlamini, under whose watch the official HIV infection rate grew from single digits to 32 percent, criticised the official figures as flawed. The Swazi Observer newspaper, owned by the royal conglomerate Tibiyo TakaNgwane, has also attacked the health ministry's figures as unreliable, and complained that they gave Swaziland a bad name at a time when King Mswati was seeking foreign investment. Health officials told PlusNews the ministry's figures were out of date, having been compiled in 2002 via a Serio-Survelliance Study of pregnant women and lactating mothers at health clinics. A new survey has been scheduled for June, with the possibility that the HIV prevalence rate may have risen. "It is the press that is making an issue of this. Talk of numbers is a distraction from the real issue. Let us talk about the problem, and not argue about the size of the snake that is eating us," Von Wissell said. Tying its AIDS initiatives into the government's poverty alleviation efforts, NERCHA announced that AIDS had shaved one percent off Swaziland's annual GDP growth. Earlier this year Finance Minister Majozi Sithole said GDP growth for 2004 was projected at two percent. The Central Bank of Swaziland said a three percent GDP growth rate was needed to keep pace with population growth and prevent Swazis from slipping further into poverty. About two-thirds of Swazis live below the poverty line, a condition exacerbated by AIDS, health officials said.