An expert group has reaffirmed that unsafe sexual practices are responsible for the vast majority of HIV infections in sub-Saharan Africa, and that safer sex promotion must remain the primary feature of prevention programmes in the region. Following a review of evidence, which included recent articles suggesting that a majority of HIV infections in sub-Saharan Africa are due to unsafe medical practices, particularly injections, the experts concluded that such suggestions are not supported by the vast majority of evidence and that unsafe sexual practices continue to be responsible for the overwhelming majority of infections. While a combination of prevention measures are required to tackle all modes of HIV transmission, safer sex promotion must remain the primary feature of prevention programmes in the region.
Equity in Health
The enthusiasm surrounding last month's proposal by US President George W Bush to triple government spending on HIV/AIDS in Africa has been tempered with calls from activists for more practical details. In his State of the Union address, Bush urged Congress to approve US $15 billion in funds to battle HIV/AIDS in the hardest-hit countries in Africa and the Caribbean over the next five years. But activists were cautiously optimistic. "The exact details of the president's plan for global AIDS are still unclear. We could be shipping AIDS medications to hospitals and clinics next month, not promising to treat two million people in five years," treatment lobby group, Act-Up Philadelphia said in a statement.
While the South African Treasury and Department of Health number-crunch to determine whether government can afford anti-retroviral (ARV) treatment in public health, a number of small ARV programmes are already up and running. Several others are in the pipeline, the most ambitious being the SA Medical Association pledge to raise R80-million to set up two ARV pilot projects in each province to treat 9 000 people.
"Let us not be mistaken that the resounding announcement by G.W. Bush, of a 10 billion dollars commitment to the fight against AIDS, serves essentially one objective: to renege on commitments made in November 2001, at the WTO conference in Doha, to allow access to generic drugs," says a statement from lobby group Act Up.
Women's rights advocates are condemning President George W. Bush for using his promised AIDS relief package to expand the so-called global gag rule. Calling the move the latest battle in the administration's war against women, many groups are mounting a campaign to draw attention to what they say are the Bush administration's plans to further restrict abortion rights.
Confusion is the only certain ingredient in government's approach to HIV/AIDS. President Mbeki, his lapel no longer sporting an AIDS ribbon, said government would continue to implement its "comprehensive HIV/AIDS strategy" when he opened Parliament last week. But his two dull sentences on the disease - as over 10 000 people massed outside to demand treatment for people with HIV - did little to convey the impression of a caring government committed to helping its 4,5 million citizens living with the disease.
The latest row about the use of state hospital beds by private medical schemes has raised again a contradiction between expressed constitutional aims on the one hand and government policy and practice on the other. The rights to "healthcare, food, water and social security" are contained in clause 27 of the Bill of Rights. This clause obliges the state to "take reasonable legislative and other measures within its available resources to achieve the progressive realisation of these rights". In essence, this means every effort should be made to ensure that all South Africans have equal access to quality healthcare.
Although a humanitarian crisis had been mitigated in Southern Africa through swift food aid deliveries, a horrifying new disaster was looming in Southern Africa in the form of HIV/AIDS, James Morris, the UN Secretary-General's special envoy for humanitarian needs in Southern Africa has warned. "The impact of HIV/AIDS on this part of the world is enormous and the impact on women and children is devastating," Morris told journalists after a visit to four of the six southern African countries battling critical food shortages affecting over 14 million people.
AIDS Healthcare Foundation, the largest AIDS organisation in the United States has filed a complaint with South Africa’s Competition Commission against GlaxoSmithKline. AHF filed the complaint over the company’s drug pricing and AIDS policies in South Africa, which it described as “having a stranglehold on key AIDS drug patents” and exercising “unfettered monopoly pricing on these life-saving medications.” AHF wants the commission, an independent body ensuring that companies compete fairly and do not abuse positions of power, to overturn GlaxoSmithKline’s sole right of manufacturing drugs in the country.
Although delegates from 22 World Trade Organization member nations failed to break gridlock on the issue of how to relax patent protection to give developing nations better access to drugs to fight public health epidemics, including HIV/AIDS, a proposal by Brazil may offer a "glimmer of hope" in the talks, Reuters reports. Under the new plan, introduced during a three-day meeting in Tokyo, the World Health Organisation would determine if low-income nations have the infrastructure to manufacture generic versions of drugs.