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South African Health Minister Criticizes WHO 3 by 5 Target, Says Good Nutrition as Important in HIV/AIDS Treatment as Antiretrovirals

May 6, 2005

The South African government will not be "pressured" into meeting the World Health Organization's 3 by 5 Initiative targets for antiretroviral treatment, South African Health Minister Manto Tshabalala-Msimang said on Thursday at a news conference on the progress of implementing health programs in the country, the AP/Las Vegas Sun reports (Nullis, AP/Las Vegas Sun, 5/5). WHO has set a target to treat three million people with antiretroviral drugs by the end of 2005. According to the December 2004 "3 by 5 Progress Report," 700,000 people in developing countries were on antiretroviral drugs at the end of 2004. However, WHO HIV/AIDS Programme Director Jim Yong Kim in February at the 12th Conference on Retroviruses and Opportunistic Infections in Boston said the overall target will be difficult to reach, adding that South Africa, India and Nigeria must improve their efforts to provide access to antiretrovirals if the program is to succeed. About 90% of the HIV-positive people in South Africa are without antiretroviral treatment, according to Kim (Kaiser Daily HIV/AIDS Report, 2/23). In addition, an editorial in this week's issue of the Lancet says, "Without South Africa on board, with its 837,000 people affected by HIV/AIDS and its leadership position within Africa, 3 by 5 is but a pipe dream" (Lancet, 5/7). Tshabalala-Msimang on Thursday released figures showing that about 42,000 people are receiving antiretrovirals through the public health sector, a figure that is lower than the government's original target of 53,000 by the end of March. "I don't want to be pushed or pressurized by a target of three million people on antiretrovirals by 2005," Tshabalala-Msimang said, adding, "WHO set that target themselves. They didn't consult us. I don't see why South Africa today must be the scapegoat for not reaching the target." The South African treatment advocacy group Treatment Action Campaign estimates that 500,000 HIV-positive South Africans need treatment.

Nutrition Comments
Tshabalala-Msimang also "insisted" that good nutrition is just as important as antiretrovirals in the treatment of HIV-positive people, according to the AP/Sun. Although studies have indicated that good nutrition is important for HIV-positive people to boost their overall strength and health, nutrition alone cannot substitute for antiretroviral therapy, which helps people live longer and more productive lives, the AP/Sun reports (AP/Las Vegas Sun, 5/5). Tshabalala-Msimang said that the government's promotion of nutrition to fight HIV/AIDS is "vindicated" by a WHO statement saying that nutrition is a key factor in the fight against the pandemic, the SAPA/ reports (SAPA/, 5/5). Tshabalala-Msimang -- who is often called "Dr. Garlic" by critics -- said, "Raw garlic and a skin of the lemon -- not only do they give you a beautiful face and skin, but they also protect you from disease," according to the AP/Sun (AP/Las Vegas Sun, 5/5). She also reiterated that the potential side effects of antiretroviral therapy can be dangerous and possibly cause death, according to Reuters. She added, "When we talk about antiretrovirals, I will continue to educate the people in this country about the side effects of ARVs. ... I have no information that nutrition has got side effects ... your garlic, your lemon, your olive oil, your beetroot" (Bell, Reuters, 5/5).

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