Global AIDS - South Africa

South Africa Says It Will Fight AIDS With a Drug Plan
(By Lawrence K. Altman)

Bowing to regional and international clamour for a more vigorous attack against the AIDS epidemic, the South African government yesterday changed its stand on providing drugs to combat the virus, saying it would develop a plan to offer them to infected people through its public health system by October 1, 2003.

"Government shares the impatience of many South Africans on the need to strengthen the nation's armoury in the fight against AIDS," the South African cabinet said in a statement after a special meeting to assess the financial costs of a national anti-H.I.V. drug plan and to explore options for treating those with the infection.

South Africa has the largest number of H.I.V. -infected people in the world, about 5 million, or over 11 percent of its population of 43.8 million, according to the United Nations AIDS program. The figures are more staggering for the 23.7 million people aged 15 to 49; about 20 percent of them are infected.

The epidemic poses a major threat to the future of South Africa's economy and security by primarily affecting young sexually active adults and incapacitating the traditional extended family system that cares for sick and orphaned relatives. So far, the epidemic has left 660,000 South African children as orphans.

Yet, for years, as the AIDS virus has spread, President Thabo Mbeki and his top aides have resisted national programs to provide anti-H.I.V. drugs, known as antiretrovirals, making him the target of intense criticism at home and abroad.

The South African government said that because not every infected person needed anti-H.I.V. drugs, its program would provide them initially to people with more advanced cases of AIDS. The drugs can extend life for may people but are not a cure. The government program is also expected to provide prevention programs aimed at the tens of millions of people who are not infected.

In the past, Mr. Mbeki and is aides have questioned the safety, effectiveness and costs of the drugs, as well as questioned the very connection between H.I.V. and AIDS. Mr. Mbeki has also emphasized the difficulties that many Africans experience in taking the complicated regimens of multiple drugs every day.

He has stressed the importance of reducing poverty, calling it a major factor in producing the AIDS epidemic, and urging improvement in the diets of poor people.

Of the 42 million people living with AIDS in the world, an estimated 30 million, of 70 percent, are in sub-Saharan Africa, which has a population of 640 million. Women make up about 58 percent of them, the United Nations says.