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:
- Zackie Achmat, Chairperson (Tel: 021 788 3507)
- Sipho Mthathi, Deputy-Chairperson (Tel: 072 194 1601, 021 788 3507; email:
sipho@tac.org.za)
- Mandla Majola, Secretary (Tel: 072 424 7181, 021 788 3507; email: mandla@tac.org.za)
- Mark Heywood, Treasurer (Tel: 011 717 8600; email: heywoodm@law.wits.ac.za)
- Edna Bokaba, Health Care Workers Representative (Tel: 082 429 2629)
- Lydia Cairncross, Health Care Workers Representative (Tel: 082 786 7014;
email: lydiacairn@hotmail.com)
- Joyce Pekane, Labour Representative (Tel: 011 339 4911; email: nonhla@cosatu.org.za)
- Gary Thompson, Faith Based Organisations Representative (Tel: 072 415
7758; email: gth@sacc.org.za)
- Buyi Mdhlovu, Children's Sector Representative (Tel: 072 236 2750; email:
20055716@worldonline.co.za)
- Arthur Jokweni, Youth Sector Representative (Tel: 031 304 3673; email: arthur@tac.org.za)
- Gosiame Choabi, TAC Mpumalanga Province Representative (Tel: 083 722 4291;
email: gosiame66@yahoo.com)
- Gugu Mpngose, TAC Kwazulu-Natal Province Representative (Tel: 072 679
9793)
- Sindiswa Godwana, TAC Eastern Cape Province Representative (Tel: 083 691
4411)
- Luyanda Ngonyama (co-opted to assist with faith based sector) (Tel:
083 484 1097; email: luyanda@sacbc.org.za)
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:
- Operational experience with the rollout of antiretroviral therapy in
resource poor areas gained from our work in Khayelitsha and Lusikisiki;
- Expertise based on our costing and demographic analysis of a treatment and
prevention plan based on our work with the University of Cape Town Economics
and Actuarial Science Departments;
- Legal expertise on what will constitute a reasonable plan;
- Pressure on pharmaceutical companies, both generic and brand-name
manufacturers, to reduce their medicine prices;
- Pressure on business to develop partnerships with government with the
rollout of treatment, thereby relieving some of the financial and logistical
burden from the Department of Health;
- Pressure on medical schemes to improve their coverage of treatment
benefits so as to reduce the burden of treatment on the Department of Health;
- Pressure on international institutions and donors to contribute skills and
finance to the success of the rollout.
With regard to the
implementation of the rollout, the TAC would be happy to assist with the
following:
- Treatment education in clinics and hospitals for doctors, nurses,
counselors and support groups;
- Community mobilisation on issues ranging from prevention through to
treatment, especially the benefits of taking up voluntary counseling and
testing;
- National, local and provincial campaigns to break down the stigma around
HIV;
- Assisting with ensuring that clinics and hospitals are stocked with
appropriate medicines, equipment and diagnostics;
- Providing volunteers to assist overburdened health workers with chores
that will relieve their workload;
- Assisting with the training and development of new counselors;
- Helping develop infrastructure in clinics and hospitals which do not yet
have the appropriate infrastructure for running antiretroviral programmes.
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:
- Community education programmes regarding risk-reducing behaviour
- VCT available at all clinics, including rural clinics
- Post exposure prophylaxis for occupational exposure and sexual assault
- Commitment to the ongoing rollout of the PMTCT programme in all the
provinces. We would like to express our dismay at the possible de-registration
of NVP
- Improve condom distribution programmes including female condoms
4. An appropriate Care Package / Treatment Programme
- Availability of adequate medication to treat Opportunistic Infections at
all levels, including rural clinics
- National Treatment Guidelines for the use of ARVs, similar to the National
TB and STI guidelines, to be drawn up by a panel of experts and to be widely
circulated.
- Training programmes to be implemented for all categories of staff, to
prepare them for the use of ARVs.
- Pilot sites to be identified and capacitated with the necessary
infrastructure, including lab facilities for the monitoring of ARV use.
- Provision of generic ARV drugs, starting at the pilot sites (including in
rural areas) and with time to be rolled out to other sites as they meet
predetermined criteria to provide ARVs.
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]