Free AIDS Drugs in Africa Offer Dose of Life

The vast majority of South Africa's AIDS patients die because they cannot afford AIDS drugs common in the West. But over the last two years, the number of private initiatives offering free or low-cost AIDS drugs has slowly but steadily increased. In Khayelitsha, a gritty township near Cape Town, the relief agency Doctors Without Borders provides free triple-therapy to about 330 people and reports remarkable results.

DWB, which runs the largest free program, started treating the poor here in 2001. In August, corporate giants Anglo American and De Beers announced that they would provide AIDS drugs to their employees, joining companies like DaimlerChrysler, which already offered treatment. Meanwhile, the number of patients receiving AIDS drugs through their health insurance has doubled in the last two years as drug prices have begun to fall. About 25,000 of South Africa's 4.7 million HIV-positive people are believed to have access to treatment. Most are covered by health plans.

In its first year, DWB found that three-quarters of its patients suffered mild drug reactions, including nausea, rashes and low white blood cell counts during the first three months of treatment. Of 159 program participants, three dropped out during the first year. Thirteen people, very sick at treatment onset, died that year from illnesses including chronic diarrhea and Kaposi's sarcoma.

The vast majority, after six months of treatment, showed dramatic improvements. Mild drug reactions, which never resulted in hospitalization, diminished sharply after three months. And regimen adherence has been excellent, doctors say. Within three months, HIV was undetectable in 90 percent of patients. They also got sick less often, suffering an average of one illness a year instead of four.

President Bush's State of the Union announcement that the United States would finance AIDS treatment for 2 million mostly African patients gave an unexpected lift to the continent. But demand for AIDS drugs far exceeds supply. The UN estimates that 4 million Africans need AIDS drugs now. Even with the initiative, nearly 2 million people would probably die for lack of medicine.

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