An end to the madness?
EDITORIAL: Finally there is a small light flickering at the end of the dark tunnel. The political will and urgency, so severely lacking for nine long years while Thabo Mbeki and his health minister Manto Tshabalala-Msimang were in charge, is on the face of it slowly starting to emerge.
The health department is telling us that the national health minister and his provincial counterparts will next week discuss providing antiretrovirals (ARVs) to patients at an earlier stage of their illness, ensure all HIV-positive infants get the drugs at diagnosis and dispense ARVs to all patients infected with both HIV and TB.
These interventions are not new science, we have in some cases known for many years that this is what needs to be done, but our leaders have put forward all kinds of lame excuses. We have allowed in some cases almost half of babies born HIV positive to die before they are one year old. We have condemned thousands to a painful tuberculosis induced death while we have a cure.
We have acknowledged best practice guidelines telling us that we should place people with HIV on ARVs long before their CD4 counts, a measure of their immunity, plunge below 350 ‘ yet at our health facilities most people are starting treatment with CD4 counts well below 100 when it is too late and most of them die.
While it is critical that the national health department leads the way, the crunch will come when these policies are fed down to provincial level where drug stock-outs, shortages of doctors and nurses, ARV moratoriums, overworked pharmacists and bureaucratic processes hamper desperately ill people’s access to these lifesaving drugs.
With the highest number of people co-infected with HIV and TB in the world while sharing top spot with India for the largest number of people living with HIV and branded one of a handful of countries where the infant mortality rate is sliding ‘ these moves are long overdue.
Motsoaledi’s urgent and decisive leadership to tackle the AIDS epidemic needs to be applauded and supported – and maybe, just maybe we can start to overcome the legacy of Mbeki and Tshabalala-Msimang. The future gives us a opportunity to not repeat these crimes against humanity.