KHOPOTSO: The issue of providing prisoners with access to anti-AIDS medication is set to come before the Durban High Court on March 15. But a series of meetings that began last week between government Departments of Correctional Services and Health as well as the AIDS Law Project and Treatment Action Campaign, could ensure that an out-of-court settlement is reached. Deputy Minister of Health Nozizwe Madlala-Routledge, says last week’€™s talks in Cape Town were initiated by the Deputy President, Phumzile Mlambo-Ngcuka, who also chairs the South African National AIDS Council.        

NOZIZWE MADLALA-ROUTLEDGE: We’€™ve been instructed by the Deputy President to start negotiations with the people that are representing the inmates at Westville Prison’€¦ We’€™re trying very hard to resolve this matter as quickly as possible. But most preferably, to resolve it out-of-court because we think that way we’€™ll cut the length it takes for the courts to make decisions on these matters.

KHOPOTSO: Adila Hassim, a lawyer with the AIDS Law Project, which represents the prisoners in the case, shares the sentiment.

ADILA HASSIM: Absolutely! We don’€™t believe in protracted litigation. Justice Thumba Pillay, who issued the judgement earlier on in this case, specifically mentioned that it’€™s in the interest of all the parties and, particularly, the prisoners that protracted litigation does not ensue in this case. So, we’€™re hoping that this will all be resolved by March 15.

KHOPOTSO: On June 22 last year, Judge Thumba Pillay, had ruled that the government had to remove any obstacles to accessing antiretroviral treatment at Westville Prison, to ensure that all prisoners who need ARVs are immediately assessed for treatment, and to state exactly what steps the government plans to take in an affidavit filed with the Court. Judge Pillay also issued an interim execution order last July, compelling Westville Prison to provide ARV treatment to prisoners. Government appealed. But two months later, a different judge (Judge) Chris Nicholson also ruled that the government must start providing ARV treatment to prisoners, while it worked on the instruction by Judge Pillay to file plans with the court on how it will provide ARVs in prison.

Judge Pillay’€™s original order allowed for a court hearing to consider the reasonableness of the government’€™s plan. But to avoid going back to court, the AIDS Law Project opted for negotiations with government. In December, attempts at negotiations failed. But the talks that began last week indicate that the government now recognises its Constitutional duty to prisoners at Westville. Deputy Health Minister, Madlala-Routledge.

NOZIZWE MADLALA-ROUTLEDGE: This is a duty, this is a responsibility we should have carried out as the State’€¦ And in that regard I’€™m happy that we are sitting and talking. But the thing that we all need to recognise is that as we sit and talk there are people at Westville Prison and other correctional centres, who are dying prematurely because we have not reached them on time. It is all our duty. It is all our responsibility.

KHOPOTSO: One of two reasons cited by the Department of Correctional Services on its resistance to providing antiretrovirals to inmates at Westville prison was that they had difficulty accessing public health services. This was despite the fact that the centre is near a large number of accredited antiretroviral sites, such as King Edward, Addington and Mahatma Gandhi hospitals. According to the Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment for South Africa, provision must be made for prisoners who qualify for ARV treatment, but are incarcerated at correctional centres that are not yet accredited to offer anti-AIDS treatment. Although Westville was recently accredited to provide ARVs, very few other prisons have accreditation and this remains one of the obstacles to the efficient roll-out of treatment in the prison community.  

NOZIZWE MADLALA-ROUTLEDGE: Prisons or corrections were not really established to provide health care. Correctional facilities are really there to correct wrong-doing. When people are incarcerated, the idea is to try and help them and re-integrate them into society. So, the issue of provision of health professionals is one of the obstacles that we are experiencing. Just as we are experiencing the shortages in the Department of Health, they are experiencing similar, if not worse, shortages in correctional services’€¦ Of course, the other issue is that (a) correctional facility is a security environment. So, you should imagine the requirements of entering a security facility. Even if we were to go outside of the Department of Health to look for assistance in the private sector we need to organise quite a lot of issues around ensuring security.    

KHOPOTSO: Government is aware that if it wants to avoid being dragged to court on March 15, it needs to remove these obstacles as a matter of urgency.

NOZIZWE MADLALA-ROUTLEDGE: The state lawyers, the Department of Corrections, the Department of Health and the AIDS Law Project have formed a task team. This task team was given very strict guidelines to say we want a report in time, well before the 15th of March’€¦ And it’€™s going to be working very hard to ensure that the frame-work that was provided by the Treatment Action Campaign is a frame-work that we can work with’€¦ to evaluate that frame-work and see how we can move forward. I don’€™t think it should be difficult. Really, as the Department of Health ‘€“ as the main service provider ‘€“ we can look at that document within a few days and say ‘€˜this is where we might have difficulty’€™. But I think, what I’€™ve seen of it, it’€™s not that difficult.        

KHOPOTSO: Government’€™s own figures show that nine prisoners per month have died of AIDS-related illnesses since 2005. The figure on its own demonstrates the urgency of the matter. Whatever decisions are made on the Westville Prison case at meetings held these few weeks to March 15, will affect all prisons throughout the country. The AIDS Law Project’€™s Adila Hassim is pleased with the government’€™s seeming about-turn.  

ADILA HASSIM: It’€™s a very positive indication and it’€™s very heartening to see that the Ministry of Health is responding positively to the case and to, generally, the issue of the roll-out of ARVs in prisons’€¦ We’€™re hoping that this means that the talks that we are going to be engaging in with the government in the next few days are going to be productive and it’€™s going to result in the resolution of the matter.