Another bizarre year for AIDS policy
by Kerry Cullinan
05.12.2005

       

Unfortunately, 2005 has been another bad year for HIV/AIDS in South
Africa – thanks to Health Minister Dr Manto Tshabalala-Msimang and her
bizarre supporting cast of oddball connections with their props of
garlic, beetroot, olive oil and vitamin concoctions.

While the Minister’s promotion of untested remedies have inspired
hundreds of newspaper cartoons, they have caused confusion for people
living with HIV.

Yet what we desperately need is decisive leadership about HIV and AIDS
as we are very far from beating the epidemic.

An estimated 5.2 million South Africans are living with HIV, according
to latest figures released by the Actuarial Society of SA (ASSA).

There were around 530 000 new HIV infections and 340 000 AIDS deaths
between the mid-2004 and mid-2005, according to ASSA.

Our youth prevention programmes are failing. HIV infection in girls aged
between15 and 24 has jumped by 5% to 17% in just three years, according
to the HSRC/Nelson Mandela household HIV/AIDS survey released this week.

But still the Minister continues to undermine ARV treatment and promote
those – such as German vitamin salesman Dr Matthais Rath and Dutch
garlic promoter Tine van der Maas – who advocate vitamins and diet
rather than medication.

In a clear indication that government’s dilly-dallying about AIDS was no
longer going to be tolerated, Cosatu secretary general Zwelinzima Vavi
accused Mbeki and Tshabalala-Msimang of “betraying our people and our
struggle” for failing to provide leadership on HIV.

"Too many times we hear [the Minister] speaking about spinach,” Vavi
told the Treatmnt Action Campaign (TAC) congress in September.

“There is nothing wrong with encouraging our people to eat healthily and
to live healthily But there is something very wrong when there is
silence about the other government policy such as the need to ensure
that people have access to cheap anti-retrovirals.”
Nobody tells people with hypertension, diabetes or other chronic
diseases that their medication is “toxic”. The Minister herself
encourages tuberculosis patients to swallow their vile tablets.

But for reasons known only to her, she never loses an opportunity to say
that antiretroviral drugs are toxic.

Perhaps there will come a time when someone who has lost a family member
who was too afraid to take ARVs will sue the Minister for spreading
confusion.

After spending two weeks interviewing HIV patients at Durban’s oldest
treatment site, McCord Hospital earlier this year, it would not surprise me.

Almost all patients said that they had been terrified to take ARVs
initially because they had heard they were “poisonous”. But after a few
months on the treatment, they had been amazed at how much better they
had felt.

Sizakhele Ndlovu, a counsellor at McCord who educates those about to
start ARVs says bluntly: “The Health Minister’s approach to ARVs has
impacted so badly on what people think about ARVs. Most patients who
come here are desperate for help. But they come with a lot of myths
about ARVs.”

But Tshabalala-Msimang has stubbornly refused to change her message.

“I know I get attacked if I say it's nutrition or micronutrients or ARVs
because you want me to say ‘and, and, and’ but I think we need to give
South Africans options,” she told the National AIDS Conference in June.

But by elevating complementary treatments such as diet and vitamins to
the same level as scientifically proven medicine, the Minister is
essentially distorting information and undermining the ARV option.

A report released by the International Treatment Preparedness Coalition
(ITPC) this week listed “lack of effective national political
leadership, coupled with denialism and a flirtation with
pseudo-science,” as some of the major barriers to effective AIDS management.

The report urged international organisations and agencies to “consider
the minister’s inaction to be not only scandalous, but deadly - and to
directly confront her and the government as part of an effort to cease
discouraging patients from taking antiretroviral therapy”.

South Africa's proposals to all three of the most recent Global Fund
rounds have been rejected, primarily due to the “substandard performance
of SA National AIDS Council and the health minister’s lack of
leadership”, costing the country up to R2-billion in lost funding, said
the report.

South Africa has abundant expertise in HIV/AIDS. Some of our scientists
are involved in world-class research into the disease.

Some researchers have developed a candidate vaccine for HIV which will
begin phase II (large safety) trials next year. Others are helping to
develop microbicides – vaginal gels that it is hoped will form a barrier
that prevents HIV from entering women.

Doctors and nurses are fast becoming world experts in ARV treatment as
South Africa rolls out what is potentially the world’s biggest treatment
programme.

But instead of drawing on these experts and helping to promote
scientific knowledge about HIV/AIDS, Tshabalala-Msimang has painted
herself into a corner.

Her support for Rath has caused the Treatment Action Campaign and SA
Medical Association to resort to the courts in a bid to force her to
stop Rath’s “illegal activities”.

As belligerent as a cornered animal, Tshabalala-Msimang has become more
strident and provocative in her support for Rath, rather than trying to
bring all stakeholders together and avoid yet another money-wasting
court case.

Cosatu, the SA Council of Churches and the SA Communist Party have since
joined TAC to stop the Rath Foundation.

It seems politically suicidal for her to continue to support the man
who, aside from having incurred the wrath of the ANC’s alliance partners
also contested the German election against the ANC’s traditional allies
in the country.

But last week, Tshabalala-Msimang told Parliament that the health
department’s law enforcement agency had found nothing wrong with what
the Rath Foundation had been doing.

Perhaps she is blinded by her hatred of the TAC, which the Rath
Foundation has been very quick to try to undermine.

Perhaps it is because one of the Minister’s close allies, Professor Sam
Mhlongo, is working with the Rath Foundation.

Whatever the case, her alliance with the Rath Foundation has turned into
a time-consuming waste that is distracting South Africa from ensuring
that people with HIV get the care, support and treatment they need. –
Health-e News Service.

http://www.health-e.org.za/news/article.php?uid=20031345