Two of the country’s most powerful figures in health yesterday crossed swords at the Health Summit over whether government should investigate providing anti-retroviral drugs (ARVs) to people with HIV/AIDS.

Health Minister Dr Manto Tshabalala Msimang admonished delegates for suggesting that government should set up a pilot study to see whether it would be possible to provide ARVs.

“The private sector already has these pilots. Government has a pilot on [the anti-retroviral drug] nevirapine for use in mother-to-child-transmission. So I don’t understand why we need another pilot,” said Tshabalala Msimang.

However, Professor Olive Shisana from the Medical University of SA (Medunsa), challenged the minister, saying that there was a need for such a pilot to study “how to remove the barriers of providing ARVs in the public sector”.

Shisana said that while ARVs were not a cure, the drugs could be part of a prevention strategy because research showed that the drugs could reduce the viral load, particularly amongst men, and make them less likely to transmit the virus.

“There is also substantial international data which shows that the use of ARVs can prolong the lives of patients and, in doing so, reduce the number of orphans,” said Shisana, who is also the former director general of health.

KwaZulu-Natal Health MEC Dr Zweli Mkhize said while there was “not any form of reluctance from government not to take this direction [of using ARV drugs]”, there were huge operational challenges which needed to be researched.

“There are inadequate funds, so who do you decide to treat? You have to understand the implications of such a policy. Doctors have to take such decisions. In KwaZulu-Natal we have been taken to court three times over access to renal dialysis,” said Mkhize.

He added that even if government was able to give anti-retroviral treatment, it had to be able to supervise the person taking their “15 to 20 to 30 pills” every day or the treatment would not work.

North West Health MEC Dr Molefe Sefularo said he would like to see research which compared the health of people with HIV on ARVs with that of those who were not on the drugs but who lived healthy lives.

Meanwhile, Tshabala Msimang also expressed her disappointment that the delegates in the group discussing communicable diseases had focused so heavily on HIV/AIDS. This is despite the fact that the briefing document from her department dealt exclusively with HIV/AIDS, TB and sexually transmitted infections.

“I am expecting them to go back and discuss diseases such as cholera and malaria because these are the real issues facing us,” added the Minister.

“If we are not heard articulating ourselves on other communicable diseases, we will not have access to the Global Fund [set up by the United Nations to deal with HIV/AIDS, TB and malaria].”

At the close of the summit later in the day, Tshabalala Msimang pronounced it a “huge success”, and said team that had worked to arrange the summit would also look into implementing its many proposals.

The minister also announced that, as part of government’s commitment to improving standards, it would be making national awards for excellence to health workers from 2002.
– Health-e News Service.