HIV Treatment

HIV/AIDS treatment must not be narrowed down to anti-retroviral drugs – Health minister

Written by Health-e News

Health minister Dr Manto Tshabalala-Msimang this week addressed the United National General Assembly Special Session on HIV/AIDS in New York. She said singling out the issue of anti-retroviral drugs was undermining the efforts made by many developing countries in dealing with pandemic. This is the full speech she delivered to the assembly.

“GLOBAL CRISIS – GLOBAL ACTION”  

Mr. President, Secretary General, Chairperson, Your Excellencies, Ministers, Leaders and Members of Delegations, Ladies and Gentlemen

Our country South Africa is one of the most affected by HIV and AIDS. We have come to New York not just because we care about our people and country but also because in a real way the destiny of nations and the peoples of the world will take a turn for the better or the worse depending on how we elect to conduct this important gathering.

South Africa has to contend with this catastrophe against the background of pervasive poverty, underdevelopment and a range of other public health challenges.

Clearly, our response to the challenge we face has to be rooted in this reality.

There is a lot which we know, helps to mitigate the impact of HIV and AIDS. Most of these strategies are eloquently covered in the draft declaration before us. Fundamental amongst these, is the need to anchor our efforts in strong preventive programmes, with a specific focus on the Youth; in the empowerment of women and the girl child and in ensuring that MEN become part of the solution.  

The national programme we pursue incorporates all these elements.

Some of the key prevention programmes we have in place are:  

  •  The Life-skills programme which is a compulsory component of our schools curriculum  
  •  Free supply of quality condoms  
  •  Public awareness campaigns that target all sectors of our society.

Although still at the beginning of a long journey, we are encouraged by some of the results from some of these programmes.  

Many HIV/AIDS prevention programmes have additional benefits that may be overlooked. Many of these interventions involve many role players and target communities with wide spread positive outcomes.

For example, condom programmes also prevent other STI’s that are spread in the same way as HIV. Life-skills programmes in schools and encouragement of condom use among adolescents who engage in sex will complement efforts to postpone sexual debut, reduce teenage pregnancy and abortion and as a result improve school completion rates among young girls. Young girls will thus be able to acquire skills, be productive and have a better quality of life.

Although these benefits are difficult to quantify, they should not be overlooked.  

Programmes to reduce mother-to-child transmission of HIV pose significant challenges in developing countries where breastfeeding is the norm and lack of access to safe water and sanitation is a reality. In order to unravel these challenges, South Africa has embarked on a programme to provide a package of care for pregnant women who are HIV positive at selected sites in all our nine provinces.

We have learnt through the preparation of these sites, that indeed there is far more to this programme than the mere administration of an anti-retroviral drug. Concerns raised about the emergence of resistant viral strains following exposure to this drug, will also be examined in these pilot sites. We, however, see this challenge posed not so much as a deterrent but a call for an intensified effort.

But let me stress that the solutions we seek are those that are rooted in our reality and which will enhance the capacity of our countries and more specifically help secure our health systems in order to better respond to the many public health challenges that accompany HIV and AIDS. In our country, for example, where we face both an HIV/AIDS and TB epidemic, it is clear that one of the major determinants of our overall success relates to our ability to scale up our TB programmes, secure high full treatment rates, reduce treatment interruptions and contain the rise in Multidrug Resistance TB. (MDR TB).  

As we continue to act on the basis of the best evidence available to us today – let us also continue to support research and scientific enquiry into this complex phenomenon. Let us also not forget that some simple interventions such as the management of opportunistic infections and the provision of nutritional support for HIV infected individuals has a significant impact on the quality of life. Let us not shy away from the simple truth that much as we know a lot today, there are many facets of both the HI virus and the syndrome of AIDS that need further elucidation. Amongst these efforts we include the international search for appropriate vaccines in which our country actively participates.

Needless to say, the millions already infected and affected cry for care and support now. We need to move with a greater sense of urgency – all of us! We support the view that prevention care and support are sides of the same coin and mutually reinforce each other.

Our task is to mobilize for the requisite resources to provide a comprehensive programme.

We need to assist formal and informal social support networks as may exist. In addition, greater involvement of communities especially People Living With AIDS is key to our success.  

Mr. President, AIDS constitutes a global crisis. No one country has the luxury to opt out. What may seem to be an act of generosity may in fact be nothing but enlightened self-interest.

In this regard, we should try to leverage and strengthen regional efforts. In our own region the SADC Heads of State and Government have endorsed a regional multisectoral strategy on HIV/AIDS.

We welcome the growing number of pledges that have been made to the global AIDS and health fund and eagerly await an escalation in both the number and size of contributions in keeping with the scale of the problem. We are, however, a little concerned that the lack of finality around its actual working may be presenting an obstacle to additional pledges.  

Since it is not in our collective interest to have the generosity of the international community restrained by issues of process, we would lend our voice to calls for the Secretary General, Mr. Kofi Annan, to continue his leadership role and to assist us in navigating the final stages of this course. In the meantime, Chairperson, we would be quite content to hear from others that the cheque is in the mail.  

Let me conclude by thanking the international community for the support given to us during our recent court case against some elements in the pharmaceutical industry. In particular I wish to recognize the efforts of the Secretary General, Mr. Kofi Annan and my President Mr. Thabo Mbeki. Let me also signal my governments determination to forge enduring and constructive partnerships with the pharmaceutical industry-an undeniable key stakeholder in health care delivery.

Affordable access for the majority is a basic requirement if this century is truly to be an African century. This calls for a better balance between creating a system of incentives to drive innovation and strategies to ensure that advances translate into benefits for those most in need. Let us be bold and think more creatively. This session and the creation of a fund are small but very important first   steps. We pledge the full support of our government for this important initiative.

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