About 90 non-governmental organisations (NGOs) in South Africa's KwaZulu-Natal province have teamed up to work with the government in rolling out antiretroviral (ARV) drugs, in the first structured civil society response of its kind in South Africa, and possibly even on the continent. When the government announced a national rollout plan for free ARVs in September 2003, Cati Vawda, director of the Durban-based Children's Rights Centre, and a number of her NGO colleagues, quickly realised that "government alone cannot do it".
Equity and HIV/AIDS
South Africa Civil society network ready to help ARV rollout
Strengthening health systems for treatment access
This summary document presents: The principles for ensuring universal treatment access through sustainable public health systems; The major findings and issues from the work carried out in southern Africa on equity in health sector responses to HIV and AIDS, particularly in terms of access to antiretroviral treatment; The key challenges for follow up work identified at the southern African regional meeting on 'Strengthening Health systems for treatment access and equitable responses to HIV/AIDS' in Harare, Zimbabwe, February 2004.
Antiretroviral therapy in Africa
The experience of tuberculosis treatment in Africa shows that the potential short term gains from reducing individual morbidity and mortality may be far outweighed by the potential for the long term spread of drug resistance, says an article in the British Medical Journal. Given the high levels of HIV prevalence and the lack of resources and infrastructures, HIV/AIDS antiretroviral therapy is likely to be introduced to Africa in a random and haphazard way, with inconsistent prescribing practices and poor monitoring of therapy and adherence: this risks the rapid development and transmission of drug resistance.
Bush accused of blocking access to cheap AIDS drugs
International health charities have accused George Bush's administration of trying to block developing countries' access to cheap AIDS drugs by questioning the quality of "three in one" generic combination drugs. At a meeting last month in Gaborone, Botswana, the US global AIDS coordinator, Randall Tobias, said that the World Health Organisation's drug pre-qualification programme is not a sufficiently stringent approval process to ensure consistency and quality of fixed dose combination drugs. Médecins Sans Frontières and other non-governmental organisations working with AIDS patients in Africa accused the US government of trying to escape the 2001 Doha agreement on affordable drugs by the side door.
Haart alone not enough to stop spread of HIV
Less than 10% of HIV-positive individuals in South Africa will be eligible to receive antiretroviral therapy if World Health Organisation guidelines which mandate the use of anti-HIV therapy in patients with a CD4 cell count below 200 cells/mm3 are followed, according to a French-funded study published in the May 1st edition of the Journal of Acquired Immune Deficiency Syndromes. The study also found that this would have only a limited impact on the spread of HIV.
The global response to Aids: Ten years on
Stigma and discrimination are still huge obstacles to progress on AIDS: the association of HIV/AIDS with marginalised populations has consistently been a major factor impeding action. Furthermore, the involvement of HIV positive people in policymaking and programme delivery is essential to success, and such involvement requires partnership and respect, not sympathy and tolerance. This is according to an article by the International HIV/AIDS Alliance (2003) that presents an assessment of the successes and failures of the global response to AIDS from 1993-2003.
African Aids drug plan faces collapse
A United Nations plan to provide three million HIV-infected patients in Africa with anti-retroviral drugs by 2005 is in danger of collapsing owing to lack of funds, UN and World Health Organisation officials said. Some countries, particularly the United States, are balking at supporting the project, Aids workers say, partly because the plan intends to use a form of medicine called fixed-dose combination antiretroviral drugs whose use is opposed by large pharmaceutical companies.
Generics challenge brand-name anti-AIDS drugs at Botswana meeting
US officials attending a major conference on anti-AIDS drugs in Botswana this week have dismissed allegations that they want to use the meeting to question the quality and safety of more affordable generic fixed-dose combinations (FDCs) of antiretrovirals. "We want to see use of internationally accepted scientific principles that will be used in evaluation of Fixed Dose Combination drugs for HIV, tuberculosis and malaria. The concern is the risk of resistance, because good drugs are not good enough with this disease," said Dr Mark Dybul, head of the US government's President's Programme for AIDS Relief (PEPFAR).
Malawi National HIV/AIDS policy: a call for renewed action
This recently published national policy document has eight chapters covering, inter alia, a multi-sectoral response to HIV/AIDS; issues of prevention, treatment and care; the empowerment of People Living with HIV/AIDS and of vulnerable populations; traditional and religious practices and services; HIV/AIDS in the workplace and research questions. Will also be of interest to organisations outside Malawi.
Scaling Up Access to Treatment in Southern Africa: A Way Forward
PATM conference statement
"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."
Further details: /newsletter/id/30343