Knights Commander of the Order of the Bath
South Africa launched a revamped national AIDS plan on Wednesday as new research showed the high cost of government inaction on the epidemic -- 1 500 South Africans are infected with HIV every day.
The Treatment Action Campaign (TAC) has singled out President Thabo Mbeki and Health Minister Manto Tshabalala-Msimang for criticism in a hard-hitting report to the African Peer Review Mechanism lashing on the government's response to the Aids pandemic.
Address of the President of South Africa, Thabo Mbeki, at the Second Joint sitting of the third Democratic Parliament, Cape Town, 11 February 2005
Address at the Second Joint Sitting of the Third Democratic Parliament Cape Town
South Africa's long-delayed national rollout of Aids drugs will begin in April when the government makes funds available to all nine provinces, the health ministry said on Wednesday 2(24 March 2004)
Anglican Archbishop of Cape Town Njongonkulu Ndungane has challenged President Thabo Mbeki and government ministers to speak out about HIV/AIDS at every public engagement. Ndungane issued this challenge shortly after prominent health economist Alan Whiteside, addressing clergy at a public lecture on HIV/AIDS, said the church should demand better political leadership in the fight against the disease. Responding to Whiteside, Ndungane said President Thabo Mbeki should tell every minister that whenever you speak, you must speak about HIV/AIDS - just as we've told our clergy they must talk about it from their pulpits. Whiteside, director of the Health Economics and HIV/AIDS Research Division at the University of Natal, spoke to about 100 clerics at St Cyprian's Anglican Church in Retreat on the causes and consequences of HIV/AIDS. He said the church, which itself provided leadership to society, should put pressure on political leaders at the most senior levels - the president, ministers and our provincial governments - to tackle the HIV/AIDS crisis. He referred to Uganda, where President Yoweri Museveni curtailed the HIV/AIDS epidemic by speaking about HIV at every opportunity. Whiteside said antiretrovirals were not a panacea, but rather part of the response to the HIV/AIDS pandemic. The antiretroviral debate had been oversimplified, with the Treatment Action Campaign on one side calling for the drugs and the government balking on the other. The truth was somewhere between the two positions. One of the obstacles to providing the treatment was that some people would rather die of AIDS than come out in the open about their disease. Others were the inadequate health infrastructure in some areas and the development of drug-resistant strains of HIV/AIDS. Problems could arise because South Africa and Botswana could afford to provide antiretrovirals, but other countries in the region could not. What happens if we see medical migrants - people coming here for treatment? Whiteside said. He challenged the church to come up with innovative responses in fighting HIV/AIDS. One possibility was to establish treatment centres at churches where people taking antiretrovirals could be counselled to ensure they took the drugs. (Source: (Source: The Cape Times, 2 September 2003).
By 2011 South Africa will have an estimated shortfall of 19 000 nurses, and while the country trains enough doctors to serve the population, the problem of a huge shortage of doctors in the public sector will probably not be solved in the near future. These are some of the conclusions in a range of studies on skills development and shortages commissioned or conducted by the HSRC’s Human Resources Development research programme. The studies aim at providing the best empirical overview of the nature and extent of the scarce skills issue and form part of the Human Resources Review 2003, which will be published later this year. This research falls within the ambit of one of the key development challenges facing South Africa, as identified by President Mbeki. The issue has been taken up elsewhere in the government too, most notably in the development of the new Immigration Act, where a new strategy for attracting such skills from outside the country has been developed. In a preview of the Human Resources Review’s findings in two areas, namely health and engineering, researchers Johan Erasmus and Elsje Hall of the HSRC’s Economic and Employment Policy Research (EEPR) programme, examines the likely extent of shortages of doctors and nurses in the next decade. Even with recruitment to address the 25% vacancy rate in the public system, Erasmus and Hall predict a shortfall of nearly 19 000 nurses by 2011. Erasmus and Hall found that the supply of new doctors from medical schools is likely to slightly outweigh the loss of staff through retirement, illness and emigration. However, this positive picture needs to be carefully qualified: firstly, recent statements by representatives of junior doctors and medical students suggest that the already high levels of migration of doctors may increase significantly; secondly, the projected growth in supply of doctors would not address the major problem that 27% of posts for doctors in the public sector are unfilled; and thirdly, the projections assume that the current disparities and weaknesses within the health system will not be addressed. This would leave unchanged a ratio of doctors to overall population and a situation where only 29% of doctors meet the needs of the 84% of the population not covered by medical aid schemes. It would also not redress the massive inter-provincial and rural-urban disparities in the supply of doctors. In the case of the nursing profession, the bulk of nurses have remained within the public system and have more successfully been deployed across the country. The ratio of nurses to overall population is also more favourable. (Source: Simon McGrath, HSRC Review Vol1 no 2) Dr Simon McGrath is a research director in the Human Resources Development research programme. The Human Resources Review 2003 will be published towards the end of 2003.
President Thabo Mbeki has called for continuing work to be done to monitor the efficacy of anti-retroviral interventions against mother-to-child transmission in the sites already operational as well as new ones being rolled out in several provinces. Delivering his State of the Nation address during the opening of parliament, Mbeki broke his silence on the HIV/AIDS epidemic, calling for the focus to remain a massive prevention campaign directed at ensuring that the high rates of awareness translated into a change of lifestyles. He added that the focus should also be on caring for the affected and infected, treatment of all diseases, including those associated with AIDS and research into vaccine. Mbeki applauded the pharmaceutical companies for responding very positively to discussions on new ways of making drugs more affordable and to strengthen the health infrastructure. Proceeding form the accepted premise that there was no cure to AIDS, Mbeki said he was convinced that, besides the individual and collective responsibility for us to take care of our own lives, protection and enhancement of the immune system is a critical intervention in both the prevention and management of AIDS. By implication, therefore, poverty reduction and appropriate nutrition constitute an important front in this campaign. Moving to other health matters, Mbeki said that in each Province of the country, intense water and sanitation programmes were being implemented to improve hygiene, with emphasis on schools and cholera-affected localities in KwaZulu-Natal and the Eastern Cape. Mbeki said the work that was being done by various institutions within or related to government on the health profile of the nation - the burden of disease, regional and local trends, mortality statistics and so on - was critical in fashioning a comprehensive response both in the public and private sectors. A common thread throughout Mbeki’s speech was the urgent need to alleviate poverty. Hinting that the basic income grant will not get the nod, Mbeki said all those who were eligible for the child grant and other social allowances needed to be registered within the next three years. He said that there would also be an increase in allocations to both old age pensions and child grants by far more than the rate of inflation. (Source: Health-E, 08 February 2002)
A Parliamentary committee has come out openly against President Thabo Mbeki and the health ministry's current thinking on HIV/AIDS, by supporting, among other things, the use of antiretrovirals (ARVs), despite their toxicity. The joint monitoring committee on the improvement of the quality of life and status of women held public hearings in October and November on how best South Africa could address the impact of HIV and AIDS on women and girls. The hearings started from the same premise as the government's - that HIV caused AIDS, and the committee had not entered into a debate between dissidents and conventional scientists on the matter. The committee found rich and middle-class people in South Africans who were HIV-positive or had AIDS could choose to access antiretroviral treatment, and had access to good nutrition and a healthy lifestyle. On the use of ARVs, the report said that on the basis of the range of evidence presented to it concerning mother-to-child-transmission (MTCT), the benefits outweigh the risk and it is affordable. The committee recommended the department of health should develop its operational plan in relation to MTCT, as required by government's HIV, AIDS and STD strategic plan. It should have a clear timetable, implementation programme and budget. On ARV therapy for raped women, the committee noted they could get post-exposure prophylaxis in the private sector. The committee said an expert committee needed to be urgently convened by government to examine recommendations for best practice, and develop a guideline for use of ARVs as post-exposure prophylaxis for rape. The report will be tabled in Parliament. (Source: SAPA, 14 November 2001)
Calls for the release of the AIDS report by the Medical Research Council (MRC) grew louder yesterday after Gauteng and Free State announced HIV/AIDS was the biggest killer in these provinces. Gauteng Department of Health subsequently released a statement disassociating itself from this announcement [SAPA, 3 October 2001]. President Thabo Mbeki also came under scathing attack from political parties for his questioning of AIDS being the biggest cause of deaths in SA. The Pan Africanist Congress general secretary Thami ka Plaatjie said Mbeki was not qualified to debate the AIDS issue and should leave it to experts. Ka Plaatjie called on government to release the MRC report so its findings could be used as a basis to fight the scourge appropriately. The Democratic Alliance health spokesman Kobus Gous said the two provinces deserved praise for their courage to come out openly about the seriousness of the situation, although it was contrary to government's line of thought. Gous said government's failure to release the report was ridiculous. Despite this body of evidence, Gous said, government persisted in believing it could hide embarrassing information from the public indefinitely. Inkatha Freedom Party (IFP) MP Ruth Rabinowitz said government was downplaying the AIDS problem. Rabinowitz said that, although the IFP endorsed the call for the release of the MRC report, there was sufficient evidence to conclude AIDS was claiming more lives than any other cause. (Source: Business Day, 4 October 2001)
The Bush administration is studying a donor-funded multibillion-dollar action plan intended to provide antiretroviral medicines to HIV-positive Africans who cannot otherwise afford them, even at generic prices. The plan, unveiled yesterday by Harvard economist Jeffrey Sachs and signed by more than 100 Harvard faculty members, aims to have one million AIDS patients in SA and other African countries receiving closely monitored antiretroviral therapy within three years, rising to three million within five years. The unveiling of the plan coincided with the release by the SA cabinet of a report by President Thabo Mbeki's controversial AIDS advisory panel. The international trust fund, overseen by the World Health Organisation and UNAIDS, would purchase drugs at cost as well as finance infrastructural improvements and research to ensure safe and effective delivery of treatment. Recipient governments would set funding priorities. (Source: Business Day, 5 April 2001)