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AIDS Drugs Help South Africa's Poor - 2003-05-27

The humanitarian group, Doctors Without Borders, says giving AIDS drugs to the weakest of patients – even in the poorest of conditions – can save lives. The group says in its fight against HIV/AIDS in South Africa, treatment programs have proven to be a success.

For the past two years, Doctors Without Borders has been treating HIV/AIDS patients in Khayelitsha Township, some 30 kilometers from Cape Town. About 500-thousand people live there. The HIV prevalence rate in Khayelitsha is about 20 percent, twice that of the general population.

The original goal in a planned five-year program was to treat 180 patients with drugs known as anti-retrovirals, or ARVs. But Marta Darder (DAR-deh) - coordinator of the Access to Essential Medicines Campaign in South Africa – says that number has grown.

She says , "We have 400 people on ARVs. At the moment, most are adults, some of them are children and we have achieved great clinical success. Ninety percent of the patients have viral loads below detectable levels after three months on treatment and that remains over time. We have observed weight gain of about nine kilos after about six months of treatment."

Having viral loads below detectable levels means that HIV – the virus that causes AIDS – is few in number and has difficulty replicating. That allows the body’s immune system to rebound and fight opportunistic infections, such as tuberculosis, meningitis, certain cancers and the parasitic disease, toxoplasmosis.

Ms. Darder says the number of patients reached 400 when it was possible to purchase generic drugs.

She says, "We are paying at the moment one dollar per patient per day. And if we were buying the drugs from a wholesaler we would be paying four times more."

Patients have a very simple treatment regimen to follow, four or five pills a day - some taken in the morning, others at night.

Ms. Darder says despite the success of the Doctors Without Borders program, its goal is not to treat everyone infected with HIV. The goal, she says, is to prove that ARVs can be effective even when given to weak patients living in poverty. She says it is up to the local and national governments to provide treatment to all who need it.

However, the scope of treatment has been the subject of many legal battles between the Mbeki administration and health activists. Many of the treatment programs under way have been started by local officials.

Ms. Darder says in South Africa, where five million people are believed to be HIV positive, an AIDS policy cannot be based solely on prevention.

She says, "You have a huge population that is already infected and you need to do something about them. So, it’s imperative to have some kind of medical intervention, and the best kind of medical intervention that we know about. And that includes other components, such as management of opportunistic infections and prophylaxis but also anti-retroviral treatment."

Doctors Without Borders says, “Providing care has also changed the way HIV/AIDS has been perceived in the community.” It says, “As long as there was no treatment, people never got tested.” Now, each year, many thousands are willing to learn their HIV status.