Health Management HIV and AIDS

Trying to understand Manto Living with AIDS # 232

Written by Health-e News

The health minister Dr Manto Tshabalala-Msimang, denied in Parliament that she ever said that traditional medicines, nutrition and vitamins should be offered as an alternative to antiretrovirals. Health-e, spoke to the health department’s Director-General Thami Mseleku, and asked him what point the Minister seeks to make when she talks about AIDS treatment.

THAMI MSELEKU: The message of the Minister is clear. The message of the Minister says ‘€˜we will give you information about what works and about what is on the table. Let’€™s talk about ARVs. You’€™ve got this treatment. You can actually take it at a certain point, but it does have side-effects. Full stop.

KHOPOTSO: That can be managed.

THAMI MSELEKU: That can be managed if you say so. I’€™ll add another word ‘€“ ‘€˜in some instances’€™ ‘€“ because in others it’€™s not manageable. We cannot deceive our people. We must be very clear about what we are saying to our people. You yourself saying ‘€˜that can be managed’€™ is not actually completely true. It’€™s partly true. So, let’€™s not try and get to the Minister to say you must say it this way. She says nutrition and I’€™ll stand by nutrition and no one can challenge the Minister on nutrition’€¦ There’€™s nothing wrong with that. I don’€™t understand where the mixed message is.                      

KHOPOTSO: The thing is you can take nutrition, however much of it as you want. But, ultimately, you’€™re going to need’€¦

THAMI MSELEKU: That’€™s fine. If you need ARVs know that there are side-effects. That’€™s fine. What’€™s the issue?

KHOPOTSO: What are you saying to people ‘€“ are you saying to people ‘€˜take ARVs’€™ or are you saying to people ‘€˜don’€™t take ARVs’€™?

THAMI MSELEKU: No, we are saying to people the government provides you the possibility, if you need to take ARVs, take them. But those people that are actually working in the forefront will tell you about the side-effects that they have. That’€™s all we’€™re saying. We have never said don’€™t take ARVs. The Minister has never said so, otherwise this Plan wouldn’€™t be rolling out. So, I don’€™t know what the issue is about. Just because she says I will not stop to say ARVs have side-effects? That’€™s what you’€™ll hear also when you go to any site. They’€™ll tell you that we must observe you this way, that way, that way because these things have side-effects. But that doesn’€™t mean I’€™m saying don’€™t take them’€¦

If you have to take ARVs, here, they are available, but you have got other alternatives, too. So, I don’€™t know what the confusion is, where this mixed message is. We’€™re just imagining a mixed message. There’€™s nothing mixed about that. Where is the mix?                          

KHOPOTSO: The Medicines Control Council is currently investigating allegations of impropriety against vitamin businessman Dr Matthias Rath, who feeds high doses of

multi-vitamins as an alternative to antiretrovirals to people with AIDS in townships of the Western Cape. Two families have each reported the loss of a loved one shortly after being on Rath’€™s pills. I put the scenario to Mseleku, thus:

KHOPOTSO: Allegations that are actually levelled against Dr Rath are quite damning. The people that are being persuaded to take these pills are uneducated, they are poor, they are very vulnerable and they will take anything to actually get respite.

THAMI MSELEKU: Our people are poor, vulnerable, they are everything. But they also are very intelligent. They know what works for them. If you asked me, for example, 80% of South Africans currently will consult a traditional healer before they go to a hospital. We, as the Department of Health, have a responsibility to our people to look at all the options that are available to them, especially in the context of there being no cure for HIV and AIDS.                

KHOPOTSO: At the end of the interview with Mr Mseleku, it was clear to me that it’€™s up to me and you, the listener, who are either infected or affected by HIV and AIDS to figure out government’€™s stance on the care, management and treatment of the infection. Furthermore, we will live or die as a result of whatever we read into the messages that government provides us.    

I found some momentary comfort, however, in the Department of Health’€™s own National Guidelines on Nutrition for People Living with TB, HIV and AIDS, and other Chronic Debilitating Conditions. The book has a section on ‘€œScientifically unproven nutritional treatments.’€ In short this part states that ‘€œvitamins are expensive and are sometimes even harmful when too much is taken’€. It further goes on to say, in no uncertain terms, that ‘€œthere are a number of other treatments on the market, including traditional and alternative treatments that people living with HIV/AIDS are encouraged to follow. People with HIV/AIDS are vulnerable to try all sorts of treatments, which are claimed to be beneficial, but may sometimes actually be dangerous’€. And it cautions that you should ‘€œalways discuss treatments with a health worker’€.

I shudder to think what decisions HIV-positive South Africans make who don’€™t have access to such information.

E-mail Khopotso Bodibe

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