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South Africa Revamping AIDS Strategies

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South Africa's National AIDS Council is to be restructured as part of a new plan to strengthen the country's response to HIV/AIDS and will now include a deputy chairperson drawn from civil society. The panel is expected to finalize and announce an HIV/AIDS strategy for the next five years sometime next month.

The new plan will likely include targets to treat up to one million people with AIDS drugs in a much shorter period than is currently planned.

Mark Heywood, of the AIDS Law Project, says if the government accepts recommendations from AIDS organizations, the new plan will also scale up current prevention campaigns in an attempt to reduce the 400,000 new HIV infections in South Africa each year.

Few experts and activists are critical of the current strategy, known as the Comprehensive Plan, put in place three years ago. But they are generally scathing about how it has been implemented and particularly charge that actual policy has been obstructed and obscured by Health Minister Manto Tshabalala-Msimang.

"South Africa has gone through at least six years where there has been a politically driven confusion about HIV and it [has] gone through various stages, such as suggestions that HIV may not cause AIDS, questioning of the scale of the epidemic; and questioning, public questioning of the safety of anti-retroviral medicines; the promotion of medicines other than anti-retrovirals as cures for HIV; a failure to make sure that charlatans and people who claim that they have cures for HIV are clamped down; and that the public understands what is most important about medicine and HIV," said Mr. Heywood.

The health minister has been dubbed Dr. Beetroot, because rather than clearly articulating policy, she has devoted public appearances to advocating a diet rich in beetroot, garlic, lemon, and olive oil.

The crises of confidence came to a head last August at the International AIDS Conference in Toronto, when the U.N. special envoy for HIV/AIDS in Africa, Stephen Lewis said South African policy was immoral and indefensible. Soon thereafter, President Thabo Mbeki ordered an urgent review of the policy by the new inter-ministerial council headed by the Deputy President Phumzile Mlambo-Ngcuka.

Since then, the deputy president, who is South Africa's National AIDS Council chairperson, has held a series of meetings with a wide range of groups and individuals, from officials to activists, seeking their views on policy, and plans for treatment and prevention.

Heywood says that for the first time in years, AIDS activists are feeling much more confident about South Africa's ability to treat people living with AIDS, and combat HIV, the virus that causes AIDS. He says that in just six weeks, Ms. Mlambo-Ngcuka has taken South Africa quite a distance.

"So my reading of it is that at a very high level of government and most noticeably from the deputy president of South Africa there is now a determination to try to unite the country around the HIV epidemic, but also to try to make sure that policies and programs are put into place that have a real impact,” he added.

Heywood says that the test of the government's new approach to the AIDS pandemic will come in the implementation of new plans.

"I think if we do get to the end of this period successfully, that is to the end of this year successfully, then South Africa faces the real challenge around HIV, which is going to be the implementation of big scale programs and the need to measure those programs against lives saved,” he explained.

This view was echoed by Deputy President Mlambo-Ngcuka who told the SANAC meeting that success will come when South Africans unite to combat HIV and assist those who are already ill.

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