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South African Government to Revise Its Strategy Against Aids

By Michael Wines


Departing from years of indecision and, on occasion, denial, South Africa’s government is considering a new and sweeping assault on an AIDS pandemic that already includes one in eight of the world’s HIV infections.

Every day, 1,000 South Africans are infected with HIV, and another 800 are killed by illnesses that have become lethal because of AIDS, the government says. With that backdrop, the deputy minister of health, Noziza Madlala-Routledge, said in an interview on Thursday that a new AIDS strategy to be announced in December may include proposals to broaden the distribution of life-extending anti-retroviral drugs, remedy the shortage of health care workers and improve treatment of HIV-positive pregnant women.

The new strategy will be overseen by a restructured national AIDS council charged with halving the number of new HIV infections in South Africa by 2011.

The issues top a list of what AIDS activists and nongovernmental experts have long called serious shortcomings in the government’s AIDS program. In a striking departure from the past, government officials are drafting the plan in close consultation with those same critics, who have long been all but excluded from past considerations.

Madlala-Routledge said critics “have identified blind spots” that the government, preoccupied with building a new nation, had missed.

“We’ve definitely reached a turning point in our country, with civil society and government working in concert,” Madlala-Routledge said. “We recognize that the campaign against AIDS needs all of us.”

Experts and activists outside the government said they were heartened by the government’s new approach, but would wait to see what new programs are announced and how vigorously they will be carried out.

“I don’t think we’re popping the champagne corks quite yet,” Jonathan Berger, who directs the AIDS Law Project at the University of the Witwatersrand, said this week. “There are still going to be, on certain key issues, quite significant differences of opinion.”

The most important change, he said, may be that the two sides are now talking seriously about how to resolve those differences.

Practically, the signal change may be that the government’s lightning-rod health minister, Dr. Manto Tshabalala-Msimang, has been sidelined from day-to-day control of AIDS policy.