Treatment Still Months Away for South African AIDS Sufferers, Government Says

Treatment could be months -- if not years -- away for hundreds of thousands of South Africans with AIDS, the government said Thursday as it unveiled its national treatment plans. The government hopes to reach 53,000 patients by the end of 2004, though it cannot say for certain when treatment would begin, said Dr. Nono Simelela, South Africa's HIV/AIDS program head.

Approved Wednesday by the cabinet, the program requires that hundreds of treatment facilities be identified and upgraded; thousands of medical staff be recruited and trained; and millions of dollars worth of drugs be purchased. The ambitious program aims to strengthen the whole health system, particularly in poor rural areas. The distribution of antiretrovirals is one part of a public health strategy that will also include counseling, nutritional support, and the monitoring of disease progress and opportunistic infections.

Prevention remains the cornerstone of the government strategy. "We wish to ensure that the majority of South Africans who are not infected with HIV remain that way," said Dr. Anthony Mbewu, who chaired the team that drafted the plan.

Provincial governments will administer the program, providing at least one treatment center in every health district by the end of 2004. But Simelela cautioned it would take five years before every municipality had treatment facilities and could ensure adherence.

Antiretroviral treatment will be offered when patients' CD4 cell counts are 200 or less, Simelela said. Negotiations with pharmaceutical companies are underway to supply the drugs, she said, but she could not say when they will conclude.

The plan will cost an estimated $45.4 million in the fiscal year ending March 2004, and grow to about $689.5 million in 2007- 2008.

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