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Date Posted: 19:49:54 07/24/02 Wed
Author: moonotter
Subject: South African AIDS Crisis Goes Unabated

South African AIDS Crisis Goes Unabated


Reuters Health Information 2002. © 2002 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.


By Deborah Mitchell
BARCELONA, Spain (Reuters Health) Jul 11 - In the absence of a significant breakthrough in prevention or therapeutic technologies, the South African Department of Health predicts that the cumulative AIDS mortality may reach 4.5 million by 2010.

Zackie Achmat, founder of the Treatment Action Campaign in South Africa, spoke to members of the XIV International AIDS Conference at a plenary session on Wednesday. His message was heard via videotape because he was too ill to attend the conference. Achmat, who is HIV-positive, has refused to take antiretroviral drugs until these drugs become available to his fellow countrymen.

In addition to the predicted high death toll, the Department of Health reports that in 2000, AIDS-related illness accounted for 628,000 hospital admission, amounting to 24% of all public hospital admissions. The associated costs add up to at least 3.6 billion Rand annually, or 12.5% of the nation's budget.

Achmat pointed to evidence for the feasibility of providing antiretroviral therapy to South Africans. Since the last International AIDS conference 2 years ago in Durban, M dicins Sans Fronti res began to offer antiretroviral therapy to HIV-infected patients in Khayelitsha, outside of Cape Town.

Most of these patients presented with CD4+ counts <48 cells/ L and HIV RNA loads >170,000 copies/mL, Achmat said. Yet after 6 months of treatment, 90% of the patients achieved undetectable viral loads and improved immune responses.

These findings, Achmat pointed out, follow the success achieved in Haiti by Dr. Paul Farmer of Partners in Health. Dr. Farmer, who is also affiliated with Brigham and Women's Hospital in Boston and a professor at Harvard Medical School, and his colleagues have implemented in Haiti a program of directly observed therapy with highly active antiretroviral therapy (DOT-HAART). The strategy is similar to the approach that has been used with tuberculosis with great success.

"Treatment does work; treatment is cheaper than letting people fall ill and die; and treatment is attainable," AIDS activist Judge Edwin Cameron of South Africa told conference participants. Cameron, who also has AIDS, echoed the call to action that energized the Durban conference.

"Treatment for the world's people with HIV living in resource-poor settings is an obtainable goal," Cameron continued. What is now needed, he said, is the $10 billion per year for the Global Fund.

"We also need to appeal to the drug companies to issue voluntary licenses with small royalties" to poor countries, he added.

"It is expected in 2002 that 300,000 people in South Africa will die of AIDS," he said. "Thousands, and eventually millions, of South Africans like myself will die because they do not have access to these treatments."



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