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.
Equity in Health
Fury at Zambia army HIV test
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.
hiv/aids causes world population drop
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.
improve access to drugs, investment groups say
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.
PROFITING FROM AIDS
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.
Putting equity in health back onto the social policy agenda: experience from South Africa
Over the past decade, international health policy debates have been dominated by efficiency considerations. There has been a recent resurgence of interest in health equity, including consideration of the notions of vertical equity and procedural justice. This paper explores the possible application of these notions within the context of South Africa, a country in which inequities in income and social service distribution between ‘racial’ groups were systematically promoted and entrenched during four decades of minority rule, guided by apartheid and related policies. The South African experience since 1994 provides useful insights into factors which may facilitate or constrain health equity progress. In particular, the constitutional entitlement to health and civil society action to maintain health equity’s place on the social policy agenda are seen as important facilitating factors. This paper concludes that health equity goals are critically dependent on the central involvement of the disadvantaged in decision-making about who should receive priority, what services should be delivered and how equity-promoting initiatives should be implemented.
RESTRICTIONS IN TB CONTROL STRATEGY LEAVE THE POOREST UNTREATED
Whilst the World Health Organisation-embraced strategy for controlling tuberculosis (TB) has been successful in treating and curing TB, its current format restricts the extension of this success to the poor: although TB treatment is free, diagnosis is not, and so the first gateway to treatment is often shut to the poorest. The restrictions, caused primarily by lack of funds, are outlined in a specially commissioned id21 report by Dr Bertie Squire of the Liverpool School of Tropical Medicine, which points to the tasks ahead if the WHO target to halve TB deaths by 2010 is to be achieved.
Treatment preparedness summit closes
At the closing of the first International Treatment Preparedness Summit (ITPS) in Cape Town, South Africa, last month, participants detailed a number of priority actions to address the inequalities that prevent millions of people living with HIV/AIDS from securing access to treatment. At the end of the four-day meeting attended by over 120 representatives of treatment advocacy groups from 67 countries across the world, delegates agreed that current treatment efforts were insufficient. One of the things they called for was for national governments to develop treatment plans detailing how they intend to implement the World Health Organisation's goal of ensuring ARV treatment for at least 3 million people in the developing world by 2005.
Further details: /newsletter/id/29651
unsafe sex is primary mode of transmission of HIV in Africa, says expert group
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.
AFRICA: Activists cautiously welcome Bush pledge
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.
Further details: /newsletter/id/29596