South Africa has begun giving free AIDS drugs to patients in five public hospitals in Johannesburg and Pretoria. This is the first step in the long-awaited rollout of a national AIDS treatment program.

All five hospitals are now making the anti-retroviral drugs available to anyone who needs them. Health officials are careful to point out that not everyone with HIV needs the drugs. They are only appropriate for people who have actually started displaying symptoms of AIDS.

Four of the hospitals have already been dispensing anti-retrovirals to a very limited number of patients as part of a national pilot project aimed at testing and refining the administration of the drugs. The fifth is prescribing the lifesaving medicines for the first time.

Provincial health department spokesman Popo Maja says it takes time to get ready for the complex process of prescribing and monitoring anti-retroviral drug therapy.

"We had to do a lot of preparations which included identifying clinicians who will work there, and identifying counselors who will also work there," he said. "Similarly, that is why we do not roll out in all the institutions, we roll out only in those institutions in which we have immediate capacity."

Mr. Maja says the goal is to have the drugs in 23 public hospitals and clinics in Gauteng province by this time next year. Gauteng is the province that includes Johannesburg and Pretoria.

National health officials had hoped to begin dispensing anti-retroviral drugs on a wide scale at the beginning of this year. The original plan called for reaching 53,000 people nationwide by the end of March. But unexpected bureaucratic problems have delayed the government's purchase of the drugs. AIDS treatment activists say only about 2,500 people are so far enrolled in the national treatment program, most of them in the Western Cape province, which started its dispensing anti-retrovirals on its own several years ago.

Gauteng Province is South Africa's smallest province but also the richest. Mr. Maja says Gauteng health officials have followed the Western Cape's lead and purchased their anti-retroviral drugs separately, budgeting more than $14 million to pay for the program over the next year.

"Yes, we are using our own procurement systems, while the national is still finalizing the tender for the procurement of drugs," said Popo Maja. "But at the moment we do have drugs available in our institutions that will be providing these anti-retroviral drugs."

The anti-retroviral rollout has been controversial and has taken years to organize.

The activist group known as the Treatment Action Campaign has accused the government of stalling and has threatened to take the national minister of health to court if the drugs are not made available nationwide soon.

Doctors and nurses have largely supported the Treatment Action Campaign's work, saying they are tired of watching their patients die while there are medicines available that could save their lives.

Mr. Maja and several other provincial officials visited two of the hospitals as they began dispensing the medication, and he says health care providers were thrilled to finally get the program off the ground.

"It was quite overwhelming," he said. "There was a lot of excitement, a lot of enthusiasm by clinicians and nurses working there and also counselors. It was really, really great."

Mr. Maja says the patients responded positively to the arrival of the drugs, but were afraid of the media attention and have requested privacy.