South African Drug Program Treating More People Than Previously Reported Despite Staff, Drug Shortages, Health Minister Says

More HIV-positive people in South Africa are taking antiretroviral drugs than had been previously reported despite staff shortages and difficulties in acquiring the drugs, Health Minister Manto Tshabalala-Msimang said at a press briefing following a parliamentary debate over President Thabo Mbeki's State of the Nation address, South Africa's Star reports (Smetherham, Star, 5/28). The government hopes to have 1.4 million people on the drugs by 2009, at a total cost of $700 million (Kaiser Daily HIV/AIDS Report, 4/27). Although all of the country's nine provinces have "made progress" in implementing the program, only Gauteng, KwaZulu-Natal and Western Cape currently provide antiretroviral drugs to patients, according to the South African Press Association. However, the other provinces have started actively enrolling patients by conducting testing, counseling and education in preparation for treatment, a process that can take several weeks, Tshabalala-Msimang said, the South African Press Association reports.

Drug Supply
The government has made interim arrangements for provinces to buy initial drug supplies on their own while it completes the "complex and lengthy" process of determining which companies will supply drugs for the program, Tshabalala-Msimang said, according to the South African Press Association. However, the limited supply of generic drugs has led to high prices, and there have been long lead times between orders and deliveries, the South African Press Association reports (South African Press Association, 5/27). "As a result, provincial health departments have taken a cautious approach to initiating treatment, knowing that it is dangerous to interrupt it," Tshabalala-Msimang said. Ten pharmaceutical companies soon are expected to make presentations in a final bid for contracts to supply the drugs nationwide, BuaNews reports. In addition, the number of generic suppliers likely will increase following the completion later this week of the Medicines Control Council's registration process and as more manufacturers secure voluntary licenses, according to BuaNews (Pretorius, BuaNews, 5/27). Nono Simelela, head of the Ministry of Health's HIV/AIDS programs, said that the program's implementation is "bringing to the fore things that we have known about our health system, and it reflects in how much provinces are able to move." She added, "We are working as hard as we can but you can't put doctors where there are not doctors ... and the issue of drug supply is also a serious problem (Bell, Reuters, 5/27).

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