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AIDS Treatment for South Africans Delayed Owing to Federal Lethargy

By Sharon Lafraniere

The New York Times -- JOHANNESBURG, South Africa

Three months ago, the South African government promised to provide free anti-retroviral medication to people with AIDS, planning to supply as many as 1.4 million of them within five years.

But only last Friday did the government solicit proposals from pharmaceutical companies that supply the life-prolonging drugs, pushing back the start of treatment for thousands of patients.

A chart in the government’s plan, released in November, estimated that as many as 53,000 people would be receiving the drugs by the end of March. But the country’s controversial health minister, Manto Tshabalala-Msimang, now denies that the government ever promised that the program would begin before April.

Sibani Mngadi, the health minister’s spokesman, said the delay was caused by the need to check out clinics where drugs will be dispensed, set up a system to track patients and write training manuals for health professionals.

“This is a major project,” he said. “We need to make sure we do the groundwork. We can’t take shortcuts.”

The delay has drawn furious criticism from AIDS patients and their advocates, who say it may be several months before the government begins to treat patients.

“There is no excuse for the program continuing to be delayed,” said Nathan Geffen, director of the Treatment Action Campaign, which lobbies for AIDS treatment. “The money is there. Everything is ready. All that needs to happen is for the government to purchase the drugs. That has taken way too long.”

South Africa has one of the biggest AIDS epidemics in the world. An estimated 12 percent of its population, or 5 million people, are infected with HIV. No one knows for certain how many South Africans die of the disease each day, but estimates range from 600 to nearly twice that.

After years of questioning whether HIV causes AIDS, the government of President Thabo Mbeki announced in mid-November that it would more than triple its AIDS budget to about $1.7 billion over the next three years. Much of that is marked for anti-retroviral drugs.

Geffen said the Health Ministry had at least $14 million on hand that it could use. He said the provincial government of the Western Cape had demonstrated that it was possible to act faster to save lives.

There, 1,800 patients are being treated with anti-retroviral drugs at 13 different clinics and hospitals, said Fareed Abdullah, deputy director of the provincial Health Department. In the next year, Abdullah said, the number of treatment sites should be tripled, with the eventual goal to treat the 5,000 to 10,000 people in the province.