The South African government has approved a long-awaited treatment plan for HIV and AIDS. The program will eventually distribute free AIDS medicine to anyone in South Africa who needs it. AIDS activists are thrilled about the decision, but the health department is warning that there is a lot of work to do before the plan becomes reality.
Health department officials say it could be several months before the first public hospitals and clinics begin prescribing anti-retroviral drugs.
Several anti-retrovirals taken in combination have been proven to keep many AIDS patients alive longer and can allow them to live relatively normal lives. But the drug regimen must be carefully monitored by doctors and nurses and in many parts of the country the health care system is not ready to begin dispensing them.
The health minister says she hopes to open at least one treatment center in every health district in the country within one year.
But she and other health officials warn there are still several hurdles to get over before people really get the drugs. The head of the national HIV and AIDS program, Dr. Nono Simelela, says people need to learn the basics first.
"I think the most critical challenge is going to be communicating, I think, adequately as to what the comprehensive package includes, what the drugs can and cannot do, who should access the drugs," she said. "And then beyond that, on the true implementation side it is going to be training of healthcare providers as well as ensuring that the laboratory support is in place, and recruiting enough human resources to be able to implement the plan."
The government has budgeted more than $45 million for the treatment program during the next four years. That will include what the health minister calls a massive program for training health care workers and educating the general public.
Activists from the Treatment Action Campaign have been fighting for a nationwide anti-retroviral program for nearly five years. They are ecstatic over the decision to finally launch one. TAC national executive secretary Rukia Cornelius says the group is ready to help the government implement the plan.
"Clinics, doctors, nurses, health care workers, everyone should be educated about what anti-retroviral treatment is," said Rukia Cornelius. "The TAC has been doing this for years, actually. And we are ready to stand by government, work with government, work in partnership with them to make sure that treatment literacy education happens."
Ms. Cornelius hopes the availability of treatment will encourage more South Africans to get themselves tested for HIV, since they can now get help if they test positive.
The health department says a major hurdle in implementing the plan will be simply getting the drugs they need for South Africa's estimated five million HIV-positive people, the largest number of any country in the world.
Nowhere near that number are expected to sign up for treatment immediately, though, partly because the drugs are not usually given to patients until they start showing symptoms of AIDS, which can happen years after they are first infected.
Still, buying enough pills even for tens of thousands of South Africans to take every day will be a challenge.
The Treatment Action Campaign says it will keep the pressure on the government to make sure the plan is implemented on schedule. During the past four or five years, AIDS activists and the South African government have usually been on opposite sides of the battle over anti-retroviral drugs.
When asked how she feels about being able to launch a national treatment plan at last, Dr. Simelela says on a personal level, she is glad the arguing is largely over and the result is a good one.
"Well, I think relief in a way, because it has been difficult," said Nono Simelela. "I do not think that means that the road ahead is necessarily easier. We have to deal with implementation. I think we have excellent policies on paper now, and the challenge is ahead. We have to make this plan work, and that is going to be big. But really on a personal level, it is just relief that I can actually carry on with my life and my work. It has been a stressful four years."
Dr. Simelela calls it a happy day for South Africa and AIDS activists agree with her.