[Ip-health] Phila. Inquirer: S. African AIDS activists see new government attitude

[Charlene Smith]

Not all South African AIDS activists are seeing a new government attitude.
Government promised to roll out "with immediate effect" Post Exposure
Prophylaxis to rape survivors. As a journalist and rape survivor who has
pushed for this for the last three years and who constantly tracks this, I
can find no evidence of PEP being made available anywhere - other than the
few clinics and hospitals, mostly private that were providing PEP before the
announcement. On Saturday, as an example, I was contacted by three rape
survivors: one had gone to Chris Hani Baragwanath hospital, another to
Johannesburg hospital and yet another to a hospital in Port Elizabeth - none
had received PEP, they had not even received scrips for PEP or counselling
on the risks of HIV infection. All had been gangraped.
I have asked police officers (those who first come into contact with rape
survivors) and medical staff around the country to let me know when PEP
becomes available at government hospitals. All have said none is yet
available.
Doctors at Chris Hani Baragwanath are now making plans to issue PEP to
children - only.

We need to monitor this new policy carefully to see if there is indeed a
change of heart, or merely a way to reduce heat and a reliance on us being
sloppy about monitoring.

Charlene Smith
Johannesburg, South Africa
(also a member of SpeakOut!, Rape Action Group and Media Against Violence)



----- Original Message -----
From: "Paul Davis" <pdavis@critpath.org>
To: "healthgap" <healthgap@critpath.org>; "ip-health"
<ip-health@venice.essential.org>; "aidsact" <aidsact@critpath.org>
Sent: Monday, May 13, 2002 10:18 PM
Subject: [Ip-health] Phila. Inquirer: S. African AIDS activists see new
government attitude


> Mon, May. 13, 2002
> S. African AIDS activists see new government attitude
> By Andrew Maykuth
> Inquirer Staff Writer
>
>
> JOHANNESBURG, South Africa - President Thabo Mbeki's dramatic reversal on
> AIDS policy last month appears to be a genuine shift from the government's
> oft-criticized detachment toward the disease in the past, AIDS activists
> say.
>
> Since Mbeki's cabinet announced in mid-April that it was tripling its AIDS
> budget and halting opposition to treating rape victims and newborns for
the
> AIDS virus, activists say they have encountered a new attitude among
public
> health officials.
>
> "Some people think the cabinet's change was a cynical ploy to reduce
> pressure on the government," said Mark Haywood, head of the AIDS Law
Project
> in Johannesburg and a frequent government critic. "But people we know at
> public hospitals say the atmosphere has changed in government, that more
> drugs are being made available and there are fewer obstacles. Things are
> stirring."
>
> The government's rollout of a program to treat newborns with the
> antiretroviral Nevirapine, which is shown to reduce transmission from
> HIV-positive mothers, is still in the planning stages. And the government
> still has no plans to provide antiretrovirals to adult patients.
>
> But Haywood believes a fundamental change is under way. "Our feeling is
that
> once you publish the change in a cabinet statement, it's hard to reverse
> course," he said.
>
> The shift in attitude comes none too soon for South Africa, where about
one
> in eight adults - 4.7 million people - is believed to be HIV positive.
>
> The South African government has been widely perceived to be insensitive
to
> the AIDS pandemic. The health ministry balked at authorizing treatment on
> technical grounds, citing the severe side effects caused by
antiretrovirals.
> And Mbeki's government appeared to be immobilized by fears about the
> potential cost of AIDS, preferring to treat no one rather than provide
> inequitable treatment.
>
> Making things even worse was Mbeki's embrace of discredited AIDS
dissidents,
> who deny that HIV causes the disease and who say the AIDS crisis is
nothing
> but a fabrication - a racist Western conspiracy designed to frighten
Africa.
>
> The president's mixed messages buttressed impressions among the populace
> that AIDS was no threat - even rumors that antiretrovirals caused, rather
> than treated, AIDS.
>
> The government reacted defensively to criticism. When former President
> Nelson Mandela and Anglican archbishop Desmond Tutu suggested AIDS should
be
> attacked more aggressively, Mbeki reportedly declined to return Mandela's
> telephone calls for a month.
>
> Despite escalating international pressure, the government's turnaround
> appears to be a response to an erosion of support among key domestic
> constituencies, particularly labor unions. While they are close allies of
> the ANC, the unions increasingly had been supportive of those suing the
> government to provide AIDS drugs. In addition, some provincial governments
> found themselves compelled to defy Pretoria by allowing greater access to
> treatment.
>
> South Africa's courts repeatedly sided with AIDS activists and ordered the
> government to treat newborns with Nevirapine, most recently last month
when
> a Constitutional Court ruling said the government is constitutionally
> obliged to try to save children's lives.
>
> That led to one more burst of defiance from Mbeki - then, less than two
> weeks later, the about-face by his government. Officials reportedly
> disassociated themselves from the AIDS dissidents, asking them to remove
> Mbeki's endorsements from their Web sites. ANC supporters of the
unorthodox
> AIDS theories were instructed to keep their opinions private.
>
> "I think we are beginning to turn a corner in our country," Health
Minister
> Manto Tshabalala-Msimang told reporters last week.
>
> The health ministry continues to appeal the court case ordering it to
> provide treatment - not because it wants to challenge the order but
because
> it wants a higher court to define the limits of the judiciary's power to
> order the executive in the future.
>
> But not everyone is convinced that the shift is authentic.
>
> "It's not clear yet that the government is going to own up," said Thabani
> Masuku, a constitutional analyst for the Institute for Democracy in South
> Africa in Cape Town.
>
> Some private health workers also are skeptical about the government's
change
> of heart.
>
> At the Cotlands Baby Sanctuary in southern Johannesburg, Executive
Director
> Jackie Schoeman is impatient with the government's promise to provide
> Nevaripine to babies - upon completion of a pilot program at 18 hospitals.
>
> "They say they're worried about the side effects of Nevirapine, but I
don't
> know what side effects could be worse than dying," said Schoeman, whose
> hospice serves about 60 children at a time.
>
> Each day at the hospice, more HIV-positive babies arrive whose deadly
> infection might have been prevented had they been given a single dose of
> Nevirapine at birth.
>
> "We see more and more children who are coming to us to die," said
Schoeman.
> "We need to get something in place soon."
>
> Paul Davis
> pdavis@critpath.org
> Health GAP Coalition
> ACT UP Philadelphia
>
> +1.215.833.4102 mobile
> +1.215.474.6886 tel.
> +1.215.474.4793 fax
>
>
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