This posting by the Africa Policy E-Journal of Africa Action contains the executive summary of a new white paper from Physicians for Human Rights, on the transmission of HIV in Africa through unsafe medical care, including unsafe injections and blood transfusions. The paper concludes that AIDS prevention efforts need to take into account significant evidence that transmission through unsafe medical care has been significantly underestimated, and urgently recommends increased investment in adequately protecting blood supplies, preventing re-use of needles for injections, and taking other health care precautions that are considered standard in developed countries.
Equity in Health
A government programme to provide anti-AIDS drugs to HIV-positive Zambians had ignored those who needed it most and was simply "a lot of hot air", activists told PlusNews. Last year, the government announced that up to 10,000 people living with HIV/AIDS (PWAs) would receive free antiretroviral (ARV) drugs in nine provincial treatment centres. The project would also provide a team consisting of a physician, faith healer, counsellor and social worker in each centre.
The cost of a state supported anti-retroviral programme in South Africa in its most expensive year could be below R10-billion and still be highly effective, according to calculations by the Treatment Action Campaign (TAC) and researchers at the University of Cape Town (UCT). TAC manager, Nathan Geffen, presented these figures to Parliament’s Portfolio Committee on Health last month.
Between six and nine million people in developing countries currently urgently need anti-retroviral treatment while in reality only between 230 000 and 300 000 have access to these drugs, according to a report by HealthGAP, a US-based human rights group.
Inequities in health systematically put groups of people who are already socially disadvantaged (for example, by virtue of being poor, female, and/or members of a disenfranchised racial, ethnic, or religious group) at further disadvantage with respect to their health; health is essential to wellbeing and to overcoming other effects of social disadvantage. Equity is an ethical principle; it also is consonant with and closely related to human rights principles. The proposed definition of equity supports operationalisation of the right to the highest attainable standard of health as indicated by the health status of the most socially advantaged group. Assessing health equity requires comparing health and its social determinants between more and less advantaged social groups. These comparisons are essential to assess whether national and international policies are leading toward or away from greater social justice in health.
This Briefing document is intended to help TAC activists and supporters to understand the background to TAC's decision to embark on a civil disobedience campaign in March 2003. Hundreds of pages could be written about TAC's efforts to persuade government to work with civil society on an HIV/AIDS treatment programme - but this is just a summary. In addition, although there is a great deal of independent research and information that could be cited to support TAC's demands, this document refers only to government's own research and policy statements to show how, in reality, the reluctance to commit to a treatment plan, including anti-retroviral medicines, contradicts its own findings, policies and constitutional duties.
The Zambian army's decision to turn away HIV positive applicants has been angrily criticised. Health Minister Brian Chituwo said the new policy was introduced because "with the excessive physical military activity recruiting HIV positive staff would be sending them to the grave faster". But this reasoning is rejected by medical experts who say good nutrition and effective medical treatment, including anti-retroviral drugs, will solve this dilemma.
The United Nations Population Division on Wednesday lowered its estimated world population projections for 2050 by 400 million, largely due to the effects of the HIV/AIDS pandemic and "lower than expected" birthrates. The "World Population Prospects: The 2002 Revision" report attributes about half of the decrease to a rising number of deaths due to AIDS-related complications and the other half to the fact that three out of four countries in less-developed regions will have fertility rates below replacement levels by 2050.
A coalition of UK and European investment funds with $943 billion under management are calling on pharmaceutical companies to take swift steps to ensure that poor countries have access to essential medicines. As major pharmaceutical company shareholders, the pension funds are concerned that the value of their investments will decline. If the companies fail to address criticisms over patents and pricing, they will face greater regulation that could ultimately damage profits and also face more comprehensive threats to the current global patent system, in the view of some investors.
Drug companies are continuing to sell anti-retrovirals at hugely inflated prices in South Africa with some branded drugs selling for up to eight times more than generic versions available worldwide but that are not yet manufactured locally. The price for an annual course of triple therapy consisting of AZT, 3TC and Nevirapine in South Africa would cost around R20 000 (around R1 700 per month) before VAT and the chemist’s mark-up is added. In contrast, the same course of generic ARVs would cost around R3 300 year (or R275 a month). The huge profit margins of the drug companies forms the basis of a complaint lodged last year at the Competition Commission by a group of people living openly with HIV/AIDS, health workers, labour and civil society.