Green light for national treatment plan

The South African cabinet's approval of a plan to start a national antiretroviral (ARV) programme could mean that within a year, ARVs will be available in at least one service point in all of the country's 56 health districts. Within five years, the government's treatment plan envisages that all HIV-positive South Africans requiring ARVs will be able to get the drugs from a facility in their local municipality within five years. Details of the final draft plan drawn up by a department of health task team remain unclear, but an estimated 53,000 people are set to receive treatment by the end of the current financial year. This would grow to 188,000 by 2004/05, and close to a million by 2007/08, health officials said. An estimated 5.3 million South Africans are believed to be HIV-positive. According to a cabinet statement outlining the main features of the plan, the treatment programme would also include a scaling-up of its prevention campaign, "so that the 40 million South Africans not infected stay that way." HIV-positive people who had not reached the stage at which they required ARVs would also be targeted under "improved efforts" to treat opportunistic infections. The National Association of People Living with AIDS (NAPWA) welcomed the announcement. "We are quite excited about this, especially the fact that the issue of ARVs will not be considered in isolation. The needs of our families, and those who choose not to take the ARVs, have been considered," NAPWA national director, Nkululeko Nxesi, told PlusNews. But this kind of care won't come cheap. The government plans to spend more than US $1.8 billion on HIV/AIDS over the next three years, according to Finance Minister Trevor Manuel's Medium Term Budget Policy Statement, delivered in parliament last week. Manuel announced that the US $288 million initially allocated for the rollout of free ARV treatment will be supplemented by US $485 million in the next financial year, rising to US $621 million in 2005 and US $727 million the year after. "Over half of the total budget will be spent over the next five years in implementing the programme, and will go towards upgrading health infrastructure, emphasising prevention and promoting health lifestyles," the cabinet statement noted. The country's ailing public health system will be bolstered by the recruitment of health professionals and a training programme for nurses, doctors, laboratory technicians, counsellors and other health workers. Nxesi called for a greater involvement of people living with HIV/AIDS (PWAs) in the rollout. "For something like this to work properly, PWAs can not just be seen as passive recipients - they need to be a part of the campaign from day one." The international medical aid organisation, Medecins Sans Frontieres (MSF), celebrated cabinet's approval, saying it was committed to work with the government in implementing the plan. MSF runs four of the 70 sites targeted by government to carry out the first phase of the operational plan. MSF head of mission Dr Eric Goemaere said in a statement: "Nevertheless, we have not seen the full text of the plan yet, and the information available is still unclear about critical points, such as concrete time lines, involvement of people living with HIV/AIDS and role of running centres." PlusNews Chronology of HIV/AIDS treatment access debate PlusNews Factbox on antiretroviral therapy