South
African National AIDS Council meets under cloud of mistrust

The head of South Africa's National AIDS Council has voiced optimism that the country is on track to meet its five-year targets for preventing and treating the disease, despite the mistrust and mudslinging that has engulfed the Health Ministry.

Phumzile Mlambo-Ngquka, who is also South Africa's deputy president, gave her upbeat assessment Monday after chairing the first meeting of the council since it launched a new five-year plan in May to halve the number of new infections, around 1,000 per day, and extend treatment to 80% of those in need by 2011.

''We are on track,'' she told a news conference, while stressing that many challenges lay ahead.

An estimated 5.4 million South Africans are infected with the AIDS virus, the largest number in any country in the world, and about 900 people die each day of the disease.

The meeting of the council--which encompasses government ministries, volunteer organizations and AIDS service organizations, trade unions, business leaders, and people living with the disease--took place in the shadow of last month's dismissal of Deputy Health Minister Nozizwe Madlala-Routledge, who was one of the driving forces behind the new plan.

The deputy minister was ostensibly sacked for taking an unauthorized business trip, but most observers said she was the victim of a vendetta by Health Minister Manto Tshabalala-Msimang, who has promoted garlic and beetroot as an AIDS remedy while emphasizing the problems with antiretroviral drugs.

Tshabalala-Msimang was sidelined with health problems for more than six months, and it was during her absence that the new plan was drawn up. Since her return she has been dogged by newspaper allegations of alcohol abuse.

The opposition Democratic Alliance said Monday that it would press ahead with efforts to ask the minister in parliament about her alleged conviction for theft while she worked at a hospital in Botswana in the mid 1970s. An opposition lawmaker was ejected and suspended for five days from parliament last week after he tried to press the question. An African National Congress official has conceded that the ruling party knew of the conviction.

Before Monday's meeting, the Treatment Action Campaign warned that much of the momentum present at the launch of the plan had been lost. ''It worries us that the Ministry of Health's commitment to the many activities, goals, and objectives of the National Strategic Plan is unclear,'' it said.

Mark Heywood, a Treatment Action Campaign activist and vice chairman of the national AIDS Council, said that he was reassured that government was in fact serious about tackling the disease. Six government ministers attended the meeting in the capital, Pretoria.

''I wouldn't say people's fears have been put to rest because there is still political dynamics going on. But I think we have crossed the threshold,'' Heywood said in a telephone interview. ''In the big scheme of things, people who want to deal properly with this epidemic are winning.''

Heywood said the government seemed committed to improving therapy to stop HIV infected mothers passing on the virus to their unborn child by using two drugs recommended by the World Health Organization rather than one, as is currently the norm in many South African hospitals. This has been one of the main demands of the Treatment Action Campaign, but the health minister has balked.

Activists also want the government to increase testing, prevention ,and treatment programs. The government says it is hampered by a lack of capacity and staff.

Heywood said that, according to Health Department estimates at the meeting, it would cost 45 billion rand ($6.2 billion) to implement the plan over the next five years. This is far more than has been allocated by the Treasury.

An estimated 300,000 people have received antiretroviral medicine in public-sector hospitals and clinics since the government started distributing drugs four years ago, and about 200,000 more are likely to begin receiving the medication through the private sector.

But activists and government officials alike say they have no idea of the exact number of people receiving treatment. The country's poor patient-record system makes it difficult to track the frequency of drug side effects or patients who have discontinued treatment. One of the aims of the new plan is to improve monitoring and evaluation so that there is a better understanding of the success of prevention and treatment.

The government's prevention campaign recently took a knock after the Health Ministry recalled 5 million condoms and confiscated millions more from warehouses of a company accused of paying a bribe in order to get a false quality assurance permit. (AP)