TAC Electronic Newsletter

20 August 2003


Contents



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New NEC Elected at the Second TAC National Congress

The Treatment Action Campaign elected a new National Executive Committee at the Second TAC National Congress. The new committee is:
A full report of the Congress, including the resolutions, can be downloaded  from:
http://www.tac.org.za/SecondNationalCongressReport.pdf

[END OF NEW NEC - BACK TO CONTENTS]

TAC Offers Assistance to National and Provincial Departments of Health

The TAC has offered assistance to the national and provincial departments of health with the development and implementation of the operational plan for the rollout of antiretroviral therapy. Below is the text of the letter sent to the Director-General of Health and Chief Director of  HIV/AIDS and TB. Similar letters have been sent to the Minister of Health, the Deputy-President,  all MECs for Health and heads of provincial departments of health. A similar letter will be sent to Dr. Anthony Mbewu, head of research at the MRC, who has been selected by the Department of Health to head a team to develop the operational plan.

Dr. Ayanda Ntsaluba (Director-General of Health)
Dr. Nono Simelela (Chief Director HIV/AIDS and TB Cluster)
Department of Health
Private Bag X828
Pretoria, 001
By Registered Mail and Fax: 012 326 4395
12 August 2003

Dear Dr. Ntsaluba and Dr. Simelela

OFFER OF ASSISTANCE WITH THE DEVELOPMENT AND IMPLEMENTATION OF OPERATIONAL PLAN

The Treatment Action Campaign (TAC) warmly welcomes the Cabinet Statement of Friday, 8 August. Government's intention to develop an operational antiretroviral rollout plan gives hundreds of thousands of people with HIV/AIDS real hope that their health can be restored and that they can live full productive lives.

We have carefully studied the Summary Report of the Joint Health and Treasury Task Team and agree with most of its findings and recommendations. We also believe that the introduction of appropriate anti-retroviral treatment for people with AIDS, will strengthen other components and objectives of the government-led national HIV/AIDS plan.

The TAC has 7,000 active volunteers in rural and urban communities in most Provinces. We have strong linkages with trade unions, faith-based organizations, the health professions and NGOs/CBOs. Internationally many organizations have contacted us expressing a desire to provide practical assistance. To this end the TAC offers its full resources to ensuring that this programme is a success.

Therefore we would like to request to meet with the Department of Health at the soonest opportunity. Please confirm a date, time and venue for this meeting to take place.

With regard to the development of an operational plan, the TAC can offer the following:

With regard to the implementation of the rollout, the TAC would be happy to assist with the following:


We would also like to hear from you, your ideas about areas where TAC could provide assistance.

We assure you these are not hollow promises. We have both the capacity and the determination to work with you to make prevention and treatment programmes a success
The TAC has for years campaigned for the development of a treatment and prevention plan. There is now a heavy burden of duty upon us to ensure the success of such a plan. We are ready to meet this challenge and look forward to a productive relationship with the Department of Health. While we have had difficulties in the past and, no doubt, there will be areas of disagreement in the future, we now consider the major points of conflict between us to be resolved. It is for the benefit of a successful HIV/AIDS treatment and prevention plan that will save millions of lives that we now must work productively together.

Regards



Mandla Majola
TAC National Secretary


Zackie Achmat
TAC Chairperson

[END OF LETTER OFFERING ASSISTANCE - BACK TO CONTENTS]

Letter to the MCC by Doctors Involved in the Treatment of People with HIV/AIDS Regarding the Unacceptably Slow Registration of 600mg Efavirenz Pills


Mrs. Precious Matsoso
Registrar of Medicines
Medicines Control Council
Pretoria
By fax: 012 323 4474

Dear Mrs. Matsoso

REGISTRATION OF 600MG EFAVIRENZ

This letter comes to you after a number of enquiries to the Medicines Control Council (MCC) from health care personnel with a legitimate interest regarding the registration status of the 600mg pill of efavirenz. The responses received from the MCC have been uninformative to date.

Currently the 200mg efavirenz pill is registered for use in South Africa by the MCC. It is frequently used in first-line highly active antiretroviral regimens (HAART) for people with HIV/AIDS. Antiretroviral treatment for people living with HIV/AIDS allows them to live longer, healthier and more productive lives. Efavirenz could be considered an essential medicine albeit that, as with other antiretroviral medicines, it does not yet appear on the South African Essential Drugs List.

At present, patients taking efavirenz have to take three 200mg pills a day. However, a 600mg efavirenz pill has been registered with the FDA and has been in use in Europe and the USA for some time. This 600mg pill has two important advantages over the 200mg version:
The distributor of the 600mg pill sells it at a significantly cheaper price than three 200mg pills

The number of pills per day that patients would need to take would be reduced. This has been shown to improve adherence to treatment, which is linked to significantly improved patient outcomes.

We are aware that a 600mg version of efavirenz was submitted to the Medicines Control Council to be considered for registration some time ago. We cannot understand why the registration process for another formulation of an already registered medication, submitted by the same manufacturer, should take so long. While we fully comprehend the need for the MCC to be vigilant in ensuring the safety and efficacy of medicines before registering them, this should not be used as an excuse for tardiness. The obligation for the MCC to ensure the speedy registration of essential medicines is as critical as its duty to prevent the distribution of unsafe or ineffective medicines.

There is a legitimate public interest in this matter, which must override any issues of confidentiality around the registration process. We therefore call for you either to register the 600mg version of efavirenz or provide scientific reasons to the public why you are unable to register it at present.

Signed by concerned medical and nursing staff

Doctors Catherine Orrell, Karen Cohen, Kwezi Matoti, Linda-Gail Bekker, Eve Subotsky, Ruth Corncik, Jennifer Pitt, Francoise Louis; Sisters Pat Meyer, Mary Sihlangu, Precious Nxara.

[END OF OPEN LETTER TO MCC - BACK TO CONTENTS]

Letter to Minister of Health by Rural Doctors Association of South Africa (RuDASA) Appealing for Political Will and Resources for Managing HIV in the Public Sector


Dr M Tshabalala-Msimang
Minister of Health
Department of Health
Private Bag X828
Pretoria
0001

cc Deputy Minister R Schoeman, Dr A Ntsaluba, Dr N Simelela, Dr Kgosi Letlape, TAC

Honourable Minister

Re: RuDASA Conference Declaration

RuDASA applauds the decision by Cabinet to go ahead with a comprehensive antiretroviral treatment plan. We are however aware that there are many other aspects of the fight against HIV that need attention, especially in the rural areas of our country.

Please find attached a letter signed by the delegates at the 7th annual RuDASA conference, on Friday 8 August 2003.

We would like to emphasize that we want to work constructively with the Department of Health.


Yours in serving the health needs of the nation



Dr Elma de Vries
Chairperson; RuDASA


To: the Honorable Minister of Health, Dr Tshabalala - Msimang

We, the undersigned health care workers attending the annual RuDASA conference (Rural Doctors Association of Southern Africa), would like to express our extreme frustration at the circumstances under which we have to provide care to HIV+ people. We are only too aware of the urgency of the situation, being at the coalface of the pandemic and having to care for large numbers of very ill and dying patients. We believe that HIV infection can be transformed into a chronic, treatable illness, with a commitment by all stakeholders.

We believe the following are essential requirements to provide the citizens of South Africa with an acceptable standard of care:

1. A clear demonstration of political will and vision at the highest level of government, including the Dept of Health.

2. Provincial support for HIV care, in the form of posts, appropriate budget and resource allocations. For example in Mpumalanga province there is no HIV programme director, which affects the roll out of programmes such as PMTCT.

3. Prevention Programmes, namely:

4. An appropriate Care Package / Treatment Programme

5. The provision of ARVs in the public sector will necessitate attention to many of the current infrastructural problems compromising the health care system.

As RuDASA we undertake to support pilot sites and the training of health workers and would like to commit ourselves to engage and work with stakeholders at district, provincial and national level.

As health care workers we are all committed to providing an excellent standard of care to the communities we serve. We urge you to show courage and leadership in this crucial struggle affecting our country.

[END OF LETTER BY  RuDASA TO MINISTER OF HEALTH - BACK TO CONTENTS]

Judgment by Press Ombudsman in Complaint Against The Sowetan Newspaper


On 24 April, the Sowetan published an article by ANC Youth League spokesperson, Khulekani Ntshangase that contained false, defamatory allegations against TAC. Subsequently, Hassan Lorgat lodged a complaint with the Press Ombudsman of South Africa. The original ANC Youth League article and TAC's response to it were published on 22 April and 5 May respectively in the TAC electronic newsletter. They are available in the Newsletters section of the TAC website (www.tac.org.za). Here is the Press Ombudsman's ruling.

PRESS OMBUDSMAN OF SOUTH AFRICA

JUDGEMENT

Mr Hassan Lorgat - Mr Zackie Achmat - Mr Mark Heywood
 vs.
Sowetan


Judgement in the complaint by Mr Hassan Lorgat, with whom are associated
Messrs Zackie Achmat and Mr Mark Heywood of the TAC, against Sowetan

1 The complaint is against an article published in Sowetan on April
22, 2003, headed "PAGAD and TAC two sides of the same coin".

It reported statements by Khulekani Ntashangase, ANC Youth League spokesperson, critical of the TAC as, among other things, paid marketing agents for toxic AIDS drugs from America.

There was no attempt to get comment before publication from the TAC, as required by  para 1.5 of the press code.

After publication The TAC sent a letter to the editor rejecting the criticisms.

 2. Sowetan, in reply to the complaint, said it had published a letter in reply from Mr Heywood, national secretary of the TAC, on May 16 and an
article by Mr Achmat.

This letter, as I read it, is in the main a reply to an editorial article published in Sowetan on April 9, almost two weeks before
the article of April 22.

Towards the end of the letter there is one paragraph which reads:

"Are the 'suggestions' (that TAC's real motive is to form a new political party) coming from the same people who have previously suggested
 in the pages of this newspaper that the TAC is' poisoning' the people, that the TAC is an 'ultra-left' organisation in the pay of pharmaceutical
companies, that the TAC and the People against gansterism and drugs(PAGAD) are two sides  of the same coin? If so, you should say so."

That is clearly a reference to Ntshangase's criticisms.

The article by Mr Achmat was published on April 30 on the same page and with equal prominence and at least equal length as Mr
Ntashangase's article. The letter and the article constitute sufficient right of reply for the TAC.

3. FINDING:
The Sowetan contravened paragraph 1.5 of the press code by failing to get
comment from the TAC before publication of the seriously critical comments
by ANC Youth League spokesperson Khulekani Ntshangase.  A meaningful right
of reply was subsequently given to the TAC..

The debate over prevention and treatment of HIV/AIDS has been heated and
newspapers are fully justified in giving space to it provided they stay
within the guidelines of the Press Code.

Press Ombudsman
E H LININGTON
PRESS OMBUDSMAN OF South Africa
13 August 2003

[END OF JUDGMENT BY PRESS OMBUDSMAN - BACK TO CONTENTS]

[END OF NEWSLETTER]