Treatment Action Campaign

In late November TAC reported on a national shortage of male latex condoms which threatened to undermine HIV prevention programmes over the holiday season. The condom shortage arose from delays in the national tendering process. TAC has been closely monitoring the situation over the course of the past few weeks. We are pleased to report that we have recently received confirmation from senior National Department of Health (NDoH) officials that the condom shortage has now been alleviated through the urgent importation of several million male latex condoms.

Daily we hear about the horrific conditions in Zimbabwe. In the past three weeks, the complete collapse of public health system and sanitation infrastructure has developed into a major cholera epidemic, which has not only extended to the entire country but also into South Africa. Authorities have closed the country's two main hospitals in Harare, including maternity wards. Essential medicines are not available to treat diseases that the government's gross negligence has exacerbated. Antiretroviral therapy for HIV/AIDS patients and TB treatment has been severely disrupted. Recently, the Medical School of the University of Zimbabwe was closed indefinitely as it has become impossible to continue to teach medical students in non-functioning health institutions. In the same week, Zimbabwean health workers organised a mass protest in Harare over the failure of the government to address both the health system collapse and the cholera outbreak. The country's notorious riot police brutally and violently broke up the peaceful demonstration that was calling for a regional and international crisis response.

At a press conference last month, the Treatment Action Campaign (TAC) called for price deductions on the two Human Papilloma Virus (HPV) vaccines, manufactured by GlaxoSmithKline and Merck.

HPV is a common sexually transmitted infection, and some strains of the disease cause cervical cancer. In South Africa, cervical cancer is the most commonly diagnosed form of cancer. Approximately 7,000 women develop cervical cancer each year, and approximately one in 26 women in South Africans will develop cervical cancer in her lifetime.

But cervical cancer is a largely preventable disease. If women are given access to the HPV vaccine in the public health sector, they can be protected from the disease that causes cervical cancer. Unfortunately, the vaccines manufactured by Glaxo and MSD are far too expensive for South African women to afford, and arguably too costly for the government to purchase for public roll-out.

TAC therefore launched a campaign to reduce the prices of the drug, and our campaign has met with its first success. On Wednesday 3 December, we learnt that GlaxoSmithKline, the manufacturer of the HPV vaccine Cervarix, has agreed to reduce the price of the vaccine by 36%, to R450 per dose. Three doses of the vaccine are required to protect women from the two strains of HPV which the vaccine targets.

The national theme for World Aids Day on 1 December is “Leadership and Unity”. South Africa is finally united in stopping HIV, AIDS and TB, and in fighting for the best treatment and care for all.

TAC calls for all people living in South Africa to get involved in World AIDS Day. At midday on 1 December, there will be a 15 minute work stoppage to show our national commitment to stopping HIV and TB infections and deaths from AIDS. The Minister of Health will address the nation, followed by the Deputy President.

The 15 minute stoppage should be used by people across South Africa, in schools, churches, workplaces and communities, to observe World AIDS Day, and to act together to raise awareness about HIV/TB.

TAC calls for everyone to get involved: now is the time to approach others to plan actions on the day or to join in the many activities which are being planned.

Male latex condoms are the most efficient technology there is to reduce the transmission of HIV among sexually active South Africans. For the past two weeks the Treatment Action Campaign (TAC) has experienced difficultly in accessing an adequate supply of condoms. TAC distributes over 1 million condoms a month in the Western Cape alone. Our HIV prevention efforts are currently being undermined by a shortage of condoms which we have now confirmed to be a nation-wide problem.

The head of the Free State Health Department, Professor Pax Ramela, released a statement on 14 November 2008 which explained that ART shortages in the Free State were not the result of financial mismanagement, but of a lack of funding instead. This allegation was initially leveled by doctors in the province who were shocked to learn that the ART coffers were empty.

TAC calls for further clarification of Finance Minister Trevor Manuel’s medium-term budget adjustments (released 21 October 2008, passed by National Assembly 23 October). While TAC welcomes the additional R300 million for prevention of mother-to-child transmission (PMTCT) and antiretroviral (ARV) treatment, we disagree that decisions around weak social spending, health education and laboratory services were transparent.

TAC is concerned about the budget adjustments in light of South Africa’s high inflation rates, which are eroding critical health response allocations. TAC is also alarmed by the large allocations which appear to prioritise Eskom and the World Cup over basic healthcare services. TAC demands high-level accountability in explaining the previous Ministry’s overspends. Although TAC is still awaiting details of this, the recent ARV shortage in Free State points to mounting evidence of Minister Tshabalala-Msimang’s legacy of incompetence.

Last week, TAC learnt that the Free State was experiencing critical, life-threatening shortages of ARVs and had therefore called for a stop to the provincial ART roll-out. The Manager of the province’s ART programme, Dr. Mvula Tshabalala, instructed provincial healthcare workers to stop initiating new patients on ART with the exception of pregnant women.

• To read TAC's original statement on the issue from 10 November please click here.
• To read TAC's update on the Free State ART shortages from 13 November please click here.

The alleged reasons for the shortages are a lack of funds to support the ART roll-out. The money allocated for the Free State’s ART roll-out was not sufficient to support the range of ARV regimens that healthcare clinics needed to make available to patients. Furthermore, not enough funds were allocated to support the roll-out of dual therapy for the prevention-of-mother-to-child-transmission (PMTCT). The result is that the money was quickly exhausted.

Last week it came to light that the Free State was experiencing critical, life-threatening shortages of ARVs and had therefore called for a stop to the ART roll-out. To read TAC's original statement on the issue please click here. The Manager of the province’s ART programme, Dr. Mvula Tshabalala, instructed provincial healthcare workers to stop initiating new patients on ART with the exception of pregnant women.

The reasons for these ART shortages were alleged financial mismanagement within the provincial Health Department. TAC has since received some clarity on these issues from representatives of the Free State Department of Health as well as from a range of stakeholders who are currently monitoring the situation. The findings have important implications for the national roll-out as a whole.

According to the information that we have received:

Today, Tuesday 11 November, the Treatment Action Campaign hosted a press conference to draw attention to our recent global call for affordable access to HPV vaccines for developing countries.