AIDS advocates are "heading for confrontation" with the South African government over delays in the roll-out of the country's national HIV/AIDS treatment program, the Financial Times reports. Advocates had expected drug distribution to commence within weeks of the health minister's approval of the program, but treatment may not be available in state hospitals until April, the Times reports (Degli Innocenti/Reed, Financial Times, 1/21). The South African Cabinet in November approved the treatment program, which includes the distribution of free antiretroviral drugs through service points in every health district within one year and in every local municipality within five years. The program aims to treat 1.2 million people -- or about 25% of the country's HIV-positive population -- by 2008 (Kaiser Daily HIV/AIDS Report, 12/17/03). However, a team responsible for negotiating drug procurement contracts with pharmaceutical companies has not yet convened and does not plan to request proposals until Feb. 1. The team then must review the proposals before purchasing the drugs, the Times reports. "It will be a slow and cumbersome process, but with good reason. We must play by the rules and ensure our choice is beyond reproach," Dr. Humphrey Zokufa, the team's coordinator, said. Mark Heywood, secretary of the Treatment Action Campaign, said, "The request for proposals could have been done six months ago. It is a totally unwarranted delay, with the result that it could be months before any antiretrovirals get to hospitals." Sharon Ekambaram of the AIDS Consortium said that provincial governments have been working to implement the program and are "ready to go," adding, "Once again, national government is hampering their efforts" (Financial Times, 1/21).

The Times on Tuesday examined other challenges that South Africa may encounter in implementing the drug program (Degli Innocenti/Reed, Financial Times, 1/21). The complete article is available online.

Program Could Become "Model" for Developing World, Editorial Says
Although "belated," South Africa's national antiretroviral drug program "can show the way" throughout Africa and the developing world and could solve one of the "great inequalities" of our time, a Financial Times editorial says. Making the program successful will be "no simple task," and the difficulties involved in establishing "training, facilities and public awareness ... should not be underestimated," the editorial says. However, South Africa is on the "front line in the battle to overcome" the "injustice" of limited access to antiretroviral drugs in developing countries and has a "greater capacity than anywhere else in the continent to mobilize people and resources," the editorial says, concluding, "If [South Africa] does this quickly and well it will become the model for others to follow" (Financial Times, 1/22).

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