A majority of South Africans point to the government for "doing little to stop the spread of HIV/AIDS" in the country, according to a survey
conducted by the Washington Post
, the Kaiser Family Foundation
and Harvard University
, the Post
reports. Researchers interviewed in person 2,961 people -- including 1,715 black South Africans, 612 white South Africans, 364 South Africans of mixed race and 265 Indians living in South Africa between Sept. 29, 2003, and Nov. 7, 2003. Researchers conducted the interviews in nine of the country's 11 official languages, according to the Post
. The survey showed that 57% of participants believe that the South African government is doing too little to fight the spread of HIV, 25% feel the government is doing "too much" to combat the disease, 17% believe that the government's response has been the "right amount" and 1% were unsure of the government's response. The survey also showed:
- 67% of respondents believe that HIV/AIDS in South Africa is a "crisis," 27% believe the disease poses a "serious problem but not a crisis," 4% believe the disease is a problem "but not a serious one" and 1% do not see HIV/AIDS as a problem in the country.
- 79% of all respondents were very worried about contracting HIV, compared with 86% of blacks, 72% of participants of mixed race, 66% of Indian respondents and 43% of whites.
- 28% of all respondents have known a close friend or relative who has died of AIDS-related complications, compared with 31% of blacks, 20% of respondents of mixed race, 8% of Indian participants and 17% of whites.
Currently, there are about five million people living with HIV in South Africa, the most of any country in the world, the Post
reports. In addition, the epidemic is expected to reduce the life expectancy in the country from 68 years to 36 years by 2010. According to Alan Whiteside, an economist at the University of KwaZulu-Natal
, "We simply don't know what the outcome will be. One possibility: You could get an unsocialized, uneducated, unloved and probably criminal generation growing up, a breakdown in social order, public services ... at the extreme." He added that another possibility is a "national mobilization on the most basic levels around dealing with the crisis."
Drug Program Rollout
The South African government on Thursday is scheduled to roll out its national antiretroviral distribution program to HIV-positive people through five hospitals in Gauteng province, the Post reports (Morin , Washington Post, 4/1). The South African Cabinet in November 2003 approved a plan for the program, which aims to provide antiretroviral drugs to 1.2 million people -- or about 25% of the country's HIV-positive population -- by 2008. Gauteng is the first of the country's nine provinces to begin dispensing drugs under the government's program. Western Cape started its own program earlier this year, and other provinces are expected to begin programs in the coming weeks. Officials expect 50,000 people to be on antiretroviral drugs by the end of the year and 1.4 million people to be on the drugs by 2009, at a total cost of $700 million (Kaiser Daily HIV/AIDS Report, 3/31). Gauteng province health services spokesperson Papa Maja said that the first part of the rollout in the province -- which includes Johannesburg -- will be conducted at Chris Hani Baragwanath Hospital, Kalafong Hospital, Helen Joseph Hospital, Coronation Hospital and Johannesburg Hospital. He added that patients will have to be tested for HIV and demonstrate "severe" symptoms before receiving antiretroviral treatment, according to BBC News (BBC News, 4/1).
Some observers are concerned that the program will not make treatment "immediately available for everyone," allowing "thousands of AIDS patients" to die, the Baltimore Sun reports. Sue Roberts, AIDS clinic coordinator at Helen Joseph Hospital, said that it is unknown how the hospitals will decide who receives treatment, according to the Sun. Some hospitals could use a "first-come, first-served" rule or distribute drugs based on which patients "are the sickest," the Sun reports. Either way, Roberts said that the situation is "nightmarish." Sydney Rosen, an economist for the Center for International Health at Boston University School of Public Health, said that without a "transparent system" for distributing antiretrovirals, an "arbitrary, unfair and corrupt system" could be established, according to the Sun. He added, "If it's first-come, first-served, what if the person second in line is part of the local political elite -- a chief's nephew, for instance -- and the first person in line is someone unknown? Who will go first? There's lots of evidence that someone's social standing and economic status does influence the allocation of resources." Nathan Geffen, national manager of the South African advocacy group Treatment Action Campaign, said, "I think what's in the plan will be superseded by what happens in practice" (Murphy, Baltimore Sun, 4/1).
The Post on Thursday also examined the economic impact of AIDS on a neighborhood in KwaZulu-Natal, where businesses that "minister to the needs of the grieving" are experiencing "windfall profits." Sungeetha Ramdhin, who manages a coffin shop called Caskets Galore, said, "Business is mushrooming. ... We can't keep coffins for babies in stock. It's the virus and it's very sad, but life goes on" (Morin , Washington Post, 4/1). The complete article is available online.
The survey, titled "South Africans at Ten Years of Democracy," and related resources are available online. Additional information on AIDS in South Africa is available online through kaisernetwork.org's Issue Spotlight on AIDS.
A Washington Post video series produced in conjunction with the survey also is available online.
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Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2004 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.