A statement by the South African cabinet promising an 80% increase in HIV expenditure by 2004 has been hailed by treatment activists as “most significant and welcome.” The statement also includes key policy announcements on treatments regarding pregnant women and survivors of rape and sexual assault.
In a comprehensive statement covering all areas of HIV prevention, treatment and care, the South African government has committed itself to increasing current HIV expenditure of R1 billion to R1.8 billion by 2004/05. The cash will be used to fund, amongst other things, the Government’s undertaking to comply with a Constitutional Court decision that it must provide nevirapine to HIV-positive pregnant women whilst it continues its trial at 18 state-run hospitals into the feasibility and safety of the drug.
In addition it has promised that it will extend the nevirapine treatment programme “where demands of research dictate and where there is capacity” and to make a final decision in December “using research results whether to introduce universal access to nevirapine.”
Other key policy announcements include an undertaking to provide rape survivors access to antiretrovirals. A national protocol on the provision of anti-HIV treatments to people who have been sexually assaulted will be issued shortly, but in its statement the cabinet said “survivors will be counselled on the use of antiretrovirals as a preventative drug for HIV so that they can make an informed choice…If they so choose they will be provided with such drugs at public health institutions.”
Although the South African cabinet reiterated its commitment to provide treatment at state run hospitals for HIV-related opportunistic infections, its statement on the provision of antiretroviral drugs to people with HIV was somewhat more guarded, using very cautious words to describe the success antiretroviral drugs have had at extending the life and improving the health of many people with HIV, saying they recognise “that anti-retroviral [sic] drugs can improve the quality of life of People with AIDS, if administered at certain stages in the progression of the condition and in accordance with international guidelines.”
The South African government goes onto say that antiretrovirals are “too costly for universal access” and said that pressure will be maintained on drug companies to reduce the cost of treatments and there will be an “investigation into the possible production of generic drugs.”
Treatment activists have welcomed the statement, with the Treatment Action Campaign hailing the document as “most significant and welcome.” Noting weaknesses in specifics it expressed confidence that “we can and will work to overcome them.”