"We, members of the Pan African Treatment Access Movement (PATAM) who have gathered here in Harare from 3-5 March 2004 to draw up civil society strategies to ensure rapid scale-up of anti-retroviral therapy in Southern Africa understand that everyone in the world is vulnerable to HIV infection and know that HIV-positive people in Africa, particularly women and other vulnerable groups, experience great challenges that must be addressed urgently. We know and understand that there are numerous factors and actors that hamper the provision of affordable life-saving medicines. Some of these include profiteering by pharmaceutical companies, inequitable international trade relationships, poverty, extreme stigma, imbalance of power within patriarchal societies, macroeconomic policies that constrain spending for health care and other social services and a lack of commensurate political commitment by our governments and other leaders to match the scale of the HIV/AIDS pandemic."
Equity and HIV/AIDS
The shortfall in extending antiretroviral therapy (ART) to HIV positive people in Southern Africa is "enormous", with mostly educated, urban males benefiting from existing programmes, says a new report. The report was compiled by the Regional Network for Equity in Health in Southern Africa (Equinet) and Oxfam GB, and focuses on equity in health sector responses to HIV/AIDS.
This report (April 2003) was commissioned by the National Emergency Response Committee on HIV/AIDS and UNAIDS. It examines various biologic, behavioural and socio-economic drivers and discusses the impact of the pandemic on health care, education, agriculture and the private sector. It concludes with some innovative responses. This report should be of interest to persons outside of the immediate Swaziland context.
Recognising the need for an Africa-wide movement, a Pan- African Treatment Access Movement (PATAM) has been founded. Zackie Achmat of the Treatment Action Campaign (TAC) of South Africa, and Milly Katana, lobbying and advocacy officer of the Health Rights Action Group in Uganda were among the founders. PATAM is a social movement comprised of individuals and organisations dedicated to mobilising communities, political leaders and all sectors of society to ensure access to anti-retroviral therapy, as a fundamental part of comprehensive care for all people living with HIV and AIDS in Africa. Since its inauguration on August 22, 2002, the movement has been growing. On March 4-6, PATAM will be hosting its third regional conference on Access to Treatment in Harare, Zimbabwe.
Short-term relief followed by long-term disaster is not sound policy. Nonetheless, that could be a result of the Aids strategy being contemplated by the World Health Organisation, which on December 1 - World Aids Day - announced a plan to treat 3-million people with HIV/Aids by 2005. The WHO is proposing that billions of dollars be spent on increasing access to anti-retroviral drugs. That is a noble intention. However, it may not be the most cost-effective way to stem the tide of HIV/Aids: it may even be counterproductive. Let's be clear. Reducing the cost and increasing the supply of medicines to the poor is a good thing. But on its own it is not enough. Nor should it be today's priority. The roots of Africa's health care crisis run far deeper and broader than a mere shortage of drugs.
Owen Mugurungi, program coordinator for the Zimbabwean Ministry of Health and Child Welfare Tuberculosis and AIDS Program, has announced that the government will begin providing antiretroviral drugs to some of its HIV-positive citizens as part of the country's implementation of the World Health Organisation's 3 by 5 Initiative, Xinhua News Agency reports. The $5.5 billion WHO plan aims to treat three million people throughout the world with antiretroviral drugs by 2005.
Even with increased commitment, funding, and coordination, U.S. AIDS treatment efforts will fall far short of what is needed to provide ARV treatment to those suffering from AIDS today, according to a document from the Centre for Health and Gender Equity. Given limited resources, choices will inevitably be made about who will be treated and when, raising the issues of equity in access to treatment for sub-groups of those infected. In turn, these considerations dramatically underscore the need to ensure that specific efforts be made to ensure that treatment programs reach those groups that already face a disproportionately higher risk of infection.
Delays in the drug procurement process and lack of training for doctors are postponing the rollout of antiretroviral therapy (ART) in South Africa, the country’s government has admitted. Except for the Western Cape Province (which has set aside its own funds to buy antiretroviral drugs), the celebrated South African HIV care and treatment programme has yet to treat a single patient. Activists are beginning to question the government’s resolve to put the operational plan into action, citing statements made over the last week by Health Minister Manto Tshabalala-Msimang and President Thabo Mbeki.
What care do sufferers of AIDS receive in sub-Saharan Africa (SSA)? If their lives cannot be saved, are their last days made as comfortable as possible? As more funding is made available for the care of terminally-ill AIDS patients, it is important to look at the level of care currently available. King’s College London, together with the US Office of National AIDS Policy, conducted a survey across 14 SSA countries to discover the end-of-life care AIDS patients are currently receiving. As hospitals cannot cope with the sheer numbers of patients, care must take place in the community. Nevertheless, while home-based care seems the only possible solution due to the scale of the epidemic, communities can be overwhelmed by the burden placed on them.
With pointed jabs at the United States, a U.N. special envoy told a gathering of leading AIDS scientists that wealthy nations must make up for a "decade of financial abstinence'' to battle the global epidemic. Stephen Lewis, a Canadian diplomat who has been the United Nations' special representative for AIDS in Africa, made his case on Sunday for a dramatic increase in spending to fight the disease at the opening session of the 11th Conference on Retroviruses and Opportunistic Infections, held in San Francisco.