[Pharm-policy] SA Government Statement on Expert Panel for HIV/AIDS

[James Love]

Ian Roberts sent me this note on the South Africa Government's
announcement of an Expert Panel on HIV/AIDS.  I also welcome comments on
this issue from others, including TAC leader Zackie Achmat
<zackie@pixie.co.za> and MSF's Eric Goemaere <goemaere@mweb.co.za>.

 Jamie

<--------------------------------------------------------------->
>From irobmoh@icon.co.za Thu Mar  2 08:57:49 2000
Date: Thu, 2 Mar 2000 15:20:43 +0200
From: Dr Ian Roberts <irobmoh@icon.co.za>
To: James Love <love@cptech.org>
Subject: Expert Panel
 

Hi Jamie

This is the official version

regards

Ian

Statement on the proposed establishment of an Expert Advisory Panel on
HIV/AIDS

Issued by the Minister of Health, Dr Manto Tshabalala-Msimang

2 March 20001. The HIV/AIDS epidemic is the most serious health
challenge
facing South Africa and the region.

2. Given the social, cultural, historical and economic circumstances of
South Africa, a successful intervention strategy is likely to be
different to the experiences of other countries of the world.

3. The Department is therefore exploring the appointment of
approximately
30 local and international experts who will be asked to augment the
Department's HIV/AIDS Strategic Plan.

4. The panellists, who will hopefully be representative of the wide
range
of views on the HIV/AIDS issue, will be encouraged to explore all
aspects
of the challenge of developing prevention and treatment strategies that
are appropriate to the African reality.

5. The Department is currently canvassing a number of experts to
determine if they are prepared to participate in the project.
Suggestions
for candidate participants are welcome.

6. It is intended that the participating specialists will meet in South
Africa as soon as possible to agree their terms of reference in
consultation with the Department.

7. They will then be encouraged to publish their views over six to eight
weeks. These will be available on the Internet.

8. The panel will then meet again to try and thrash out a consensus
recommendation to the Department.

9. Some of the issues that the panel will be encouraged to review
include:

* Treatment of HIV/AIDS and opportunistic infections;

* General prevention of the disease;

* Prevention of mother-to-child infections;

* Prevention of HIV infection following rape or "needle stick" injuries;

* Local evidence regarding the causes and diagnosis of AIDS and
opportunistic infections.

10. The Department is mindful of the complexity and sensitivity of the
HIV/AIDS issue. We are totally committed to developing a response
strategy that is effective, appropriate and supported by the majority of
South Africans.

11.We are taking urgent action based on the best available scientific
evidence and suited to our unique health and welfare circumstances in
South Africa. There are no simplistic or easy answers and the Department
will therefore keep an open mind on the debate surrounding HIV/AIDS.

The following are some of the questions that have been posed to the
Department recently by various stakeholders. I am including my responses
in an attempt to clarify our position:

 

Does the establishment of this panel and the possible inclusion of
so-called "dissidents" mean that you still have doubts about the
existence of AIDS?

Of course not. The dreadful statistics on HIV and AID speak for
themselves. There is a clearly established body of scientific evidences
that guides our strategies. But we would be foolish to exclude anybody
from the debate.

Will "AIDS dissident" Professor Peter Duesburg be a panel member?

My Department is talking to a wide range of specialists to see who is
willing and available to participate. In many ways, the panel will be
self-selecting because the panellists themselves will influence its
final
composition. My personal view is that those with more extreme views will
be unwilling to participate because we are looking for a consensus view.

What is the main reason for the establishment of the panel?

Of course, we would expect them to re-look at the latest scientific and
medical evidence but our primary objectives if to get their
recommendation on an intervention strategy that is appropriate for
Africa.

Why have you not consulted more widely on the idea?

We were caught unawares by the media attention, which was triggered by
early contact with some of the prospective panellists. Public interest
and wider consultation is welcome.

Does this mean you will revisit your refusal to supply anti retro-viral
drugs to pregnant women?

That decision was taken in the light of the best available evidence and
the special social and economic circumstances of our country. I still
think it is the right decision. Nonetheless, we are awaiting with
interest the results of South African research on this matter.

Should the expert panel came to another conclusion, I would give it
serious consideration. We would, however, require an ingenious solution
to the funding challenges.

Will the National Aids Council have a say in the appointment of the
panel?

Their input will be most welcome. As we have said previously, they are
bound to play an important role in advising Government on this issue.

Will the panel be given the freedom to come to its own conclusions?

I can't imagine that top scientists will accept anything else. Our
Department will of course debate with them the terms of reference. We
will emphasise that we are looking for practical solutions that take
into
account the African reality. In the final analysis, the South African
Government will have to consider their recommendations and make a final
decision.

Are you unhappy with the spin that the media has put on your
announcement
- i.e. that it is an attempt to justify withholding treatment for
pregnant women with HIV?

This interpretation is quite incorrect. I hope that the work of the
panel
will demonstrate that we have no hidden agendas. Our sole objective is
to
get the best practical solution for combating and treating HIV and AIDS
in this country.

 

 

In addition to this official statement I should like to clarify my
position.

 

A number of statements about HIV/AIDS have been incorrectly attributed
to
myself in the media.

Anyone who knows me will know that I am not part of the AIDS dissident
group, nor am I one of their supporters.

On the contrary, I am convinced that AIDS exists, that there is more
than
ample evidence that it has a viral aetiology and that it is killing our
people.

I believe we can fight this disease successfully if we develop effective
local solutions. These must take into account that most of our people
are
poor and most of our infrastructure is still under-developed.

I am fully aware of the positive impact of AIDS treatment for those in
developed countries who are HIV positive. In developing countries such
as
our own, however, poverty, inadequate health structures and the high
cost
of treatment limits what we can do for people living with AIDS.

I therefore believe that we need to develop therapeutic interventions
that are affordable and workable within our healthcare system.

 

Dr Ian Roberts

irobmoh@icon.co.za


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