The South African Medical Association has thrown down the gauntlet to the state
Former president Nelson Mandela has thrown his considerable weight behind an R80-million private sector plan to extend free antiretroviral drug treatment
to thousands of poor people with HIV/AIDS.
The plan is spearheaded by the South African Medical Association (Sama), representing 16 000 doctors. It throws down the gauntlet to the government,
which continues to stonewall state antiretroviral provision for the estimated six million HIV-positive South Africans - close to 500 000 of them
with full-blown AIDS.
Currently about 20 000 South Africans - just more than four percent of those who qualify - receive antiretrovirals, overwhelmingly through private
medical aid schemes. However, few medical AIDS cover more than a fraction of AIDS drug treatment.
The Sama project will be launched on December 1 - World AIDS Day at a gala dinner in Johannesburg.
Sama chairperson Kgosi Letlape confirmed he had met Mandela on three occasions in recent weeks, and asked him to serve as patron of the scheme.
The former president had shown willingness and was very keen to get involved Mandela had since toured the country calling for a treatment
programme and for the sick to come forward.
Mandela's international standing would give a huge fillip to Sama's fund-raising efforts. Letlape said the Nelson Mandela Foundation, which had
its own HIV/AIDS programme, would also be approached for funding. Neither Mandela nor his spokesperson, Jakes Gerwel, could be reached this week.
A practising doctor and outspoken critic of the official AIDS policy, Letlape said government was undermining the battle against the epidemic on a
range of fronts. He said he had recently told the Minister of Health Manto
Tshabalala-Msimang, the authorities were committing effective genocide The minister replied that there was no budget for a treatment
programme.
Letlape made no bones about his desire to jolt the government into action. We must reverse this policy of no treatment. If they set up just one pilot
site it would send a message of hope to ordinary people. His long-term vision for the Sama scheme was of a private-public
interface that the state could plug into when it wakes up
Letlape said in its first year the scheme would target 9 000 poor people with HIV/AIDS at an estimated outlay of R80-million, covering doctors' and
laboratory fees, monitoring, and the cost of the drugs and their delivery However, the number of patients and treatment sites would expand if more
money was raised.
The plan was to use the testing and counselling infrastructure of the state, which would refer patients for private treatment once their HIV status had
been established. Sama would draw up a register of suitable doctors. On funding, Letlape said charitable organisations and private corporations
would be approached.
However, United Nations AIDS funding might also become available. The obstacle, Letlape said, was a UN Global AIDS Fund rule - inserted last year
at the South African government's behest when the fund was launched - that all funding pass through national governments. This is at the crux of the
unresolved spat over a R600-million UN grant to a project in KwaZulu-Natal, which the government blocked as unprocedural. The project included
antiretroviral provision.
Letlape said at the recent World Summit he had told UNAIDS chief Peter Piot the fund should be freed up, given the South African government's
inaction on antiretroviral treatment for ordinary people. At a subsequent press conference, Piot had announced that the UN would consider direct funding for
suitable projects. (Source: The Mail & Guardian, 20 September 2002)
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