The South African government signaled a further shift in its position on the provision of antiretroviral treatment this week with a commitment towards identifying ways of bringing down the cost of treatment.
On April 17 this year, the South African government accepted the principle that people with HIV should have access to antiretroviral treatments (ARVs), except they were too costly to provide and couldn't be delivered.
Important exceptions included the use of ARVs to prevent mother-to-child transmission of HIV and offering them to victims of sexual violence as post-exposure prophylaxis. The mother-to-child HIV prevention programme - the subject of a lengthy and ultimately successful legal campaign by activists - is now being extended from pilot sites across the country, with guidelines issued to all Provinces. Three Provinces - Gauteng (Johannesburg), North West and the Western Cape (Cape Town) - are already well on the way to implementing that programme.
In a new statement, issued on Wednesday 9 October, the cabinet has shifted in the direction urged by the Treatment Action Campaign, towards defining a national strategy to deliver ARV treatment through the public sector.
The new position is that the South African government will work to reduce the cost of ARV treatments and seek ways to provide them to those who need them.
Civil servants are to study the possibility and implications of much wider introduction of ARVs, urgently investigating the experience of the private sector where an increasing number of employers are supporting treatment access for their staff.
Measures announced in support of these aims will include:
- new regulations, already drafted, to support the import and manufacture of generic versions of essential medicines
- further expansion of professional training programmes for the prevention of mother-to-child transmission
- a combined effort by the Departments of Health and Education to increase the scale of provision of care and support to affected families
- additional measures to alleviate poverty and improve the nutritional status of people living with HIV/AIDS.