WOZA (Johannesburg)
Marjolein Harvey
14 July 2000
Johannesburg — People living with AIDS and medical personnel can administer the treatment and monitor patients even in resource-poor settings. The hospitals and clinics, both private and public, are there but "pills are the bottom line and it's their cost, not infrastructure, that impedes their access".
This was said by Treatment Access Campaign member Mark Heywood in a debate at the AIDS2000 conference in Durban on Thursday on whether antiretrovirals can be made available with a poor or non-existent infrastructure.
"We have all the proof we need from countries like Brazil and even locally, in the Khayelitsha, Cape Town pilot project and government and pharmaceutical companies are culpable of not providing the drugs to those who need it," said Heywood.
Even those arguing that without a sufficient infrastructure these medicines should not be made available, agreed that the cost of drugs is an issue that needs to be tackled.
A member of the audience suggested that anyone who is still blocking treatment for mother-to-child transmission of HIV (MTCT) in any way, whether from government, the UN, pharmaceuticals or scientific institutions, should work at her paediatric ward for a month and "see how it feels to see thousands of innocent souls die and having to tell their mothers there is nothing you can do because you do not have the treatment".
A Medicines sans Frontieres representative said "making treatment available drives the creation of the necessary infrastructure - treatment is the key that unlocks the infrastructure".
He said that world hunger and homelessness cannot be solved in one year "but we can actually solve the lack of access to treatment right now".
World Health Organisation representative Mazuwa Banda argued against Heywood by pointing out that to adequately monitor the health or people living with HIV/AIDS on antiretrovirals a sophisticated medical infrastructure (equipment and laboratories) is required.
He pointed out that the main feature of resource-poor settings was the low expenditure on health: in sub-Saharan Africa this is $33 per person per year with the extreme of Kenya at $3 and SA at $246, while in Europe this average is $1 974.
Also, says Banda, there is a shortage of medical personnel with on average less then five physicians per 100 000 persons. "What happens when some of the basics are not in place is treatment failure, increased toxicity, development of resistance, the increase in inequities and increased complacency," says Banda.
Heywood counteracted by saying that in SA we have the hospitals, the medical personnel and "all that is lacking is the pills, because of their high cost".
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