25 March 2004

TAC Electronic Newsletter


MinMEC Agrees to Interim Procurement of Antiretroviral Medicines

Court Action Averted at Last Moment

The Minister of Health has responded to the Treatment Action Campaign (TAC) letter of demand. Her response commits government to implementing an interim antiretroviral procurement mechanism so that provinces that are ready to provide treatment may begin doing so.╩ Until the national tender process is finalised in late June or early July 2004, government will procure antiretrovirals using a price quotation system.╩ This is a much quicker and simpler process that will ensure the delivery of antiretrovirals within the shortest possible time.

The TAC welcomes this decision.╩ There are many patients waiting for treatment at public health facilities that have the capacity to provide╩ treatment. These patients must now begin to receive antiretroviral medicines. The decision by the Health MinMEC to adopt an interim procurement mechanism means that the rollout may finally begin throughout the country. ╩Every province now has an obligation to buy antiretroviral medicines for facilities that are ready.

In committing to an interim procurement mechanism, government has put an end to an unnecessary delay. However, the decision to procure medicines on an interim basis should have been taken when the plan was released on 19 November ╩2003. The TAC is therefore disappointed that we were compelled to initiate legal proceedings for the Minister of Health to╩ agree to meet government's minimum obligations to the Constitutional rights to life, dignity and access to health-care. Purchasing medicines on an interim basis will save many lives. An expert affidavit for the court action explained that by implementing the interim procurement mechanism and thereby avoiding a three-month delay of the treatment programme, approximately 6,000 excess deaths could be avoided.

We are also╩ disappointed that we are yet to receive a response from Minister Tshabalala-Msimang to our letter sent on 20 February requesting to meet her (see previous TAC newsletter for text of these letters).╩

The TAC in conjunction with other organisations will continue to monitor the treatment rollout. Particular attention will be paid to these issues:

  • Urgent procurement of medicines
  • Speedy accreditation of sites
  • Ensuring that sites that cannot yet commence treatment are given the resources they need to become ready
  • Clear, accurate and appropriate Department of Health messages and public education on counselling, testing, treatment, prevention and nutrition
  • Urgent hiring of staff at health facilities to meet the demands of the programme according to the commitments of the operational treatment plan published on 19 November 2003

  • Furthermore, in our letter to the Minister on 20 February, we requested her to make annexure A of the operational treatment plan publicly available. In early March we╩ requested this annexure in terms of the Access to Information Act. This annexure contains the timetable for the implementation of the treatment plan. We call on the Minister to publish╩ this timetable immediately in the public interest of monitoring government's delivery of treatment. ╩If the Minister fails to publish this timetable, it will be necessary for the TAC to use the provisions of the Access to Information Act to compel her to make it available.

    The TAC will publish a further update on the progress of the treatment rollout at the People's Health Summit conference, which will take place in late May.

    ALP and TAC to Present Submission to Pricing Committee on Friday 26 March

    ALP and TAC support transparent pricing mechanism Tomorrow, the AIDS Law Project (ALP) and Treatment Action Campaign (TAC) will present a joint submission on the draft medicine pricing regulations to the Department of Health and its Pricing Committee.╩ In so doing, we will once again express our support for the adoption and implementation of a transparent pricing system that has the potential significantly to increase access to affordable medicines for all people in South Africa.╩ While the ALP and TAC have for some time been particularly critical of health policy development and implementation, this is one issue in respect of which we are in agreement with government.

    We note that in the main, however, public criticism of the draft regulations has been both unwarranted and unfair.╩ In particular, we note the comments made by Mr Paul Stewart of Boehringer Ingelheim, as reported in Business Day on 24 March 2004.╩ We are concerned about his company's unjustified threats to disinvest from South Africa because of dissatisfaction with the regulations.╩ The TAC and ALP wish to know whether Mr Stewart's views represent those of industry generally.╩ We are aware of at least one multinational pharmaceutical company that has publicly stated that it has no intention of disinvesting and, for the most part, supports the new regulations.

    Mr Stewart should be aware that these regulations are similar to those found in many developed countries where Boehringer Ingelheim currently operates.╩ Further, he has an opportunity to address his company's concerns by also making a submission to the Department and the Pricing Committee.╩ We trust that he will make use of this opportunity to provide evidence to justify his concerns.

    While the ALP and TAC recognise and support the principled basis underpinning the draft regulations, we nevertheless believe that they do not give full and proper effect to the National Drug Policy of 1996, the Medicines and Related Substances Control Amendment Act of 1997, and most important, the constitutional right of access to health care services. In respect of pharmaceutical manufacturers in particular, the ALP and TAC believe that the draft regulations simply do not go far enough.

    In our submission, the ALP and TAC will make detailed proposals regarding the strengthening of the draft regulations. We will show that if implemented in their current form, the draft regulations will only go some way towards solving the problem of high medicine prices.╩ In particular, we will explain how and why the proposed transparent pricing system can and should become a necessary component of the range of regulatory tools available to the state for ensuring affordable medicine prices.

    Resolutions of the PATAM Conference, "Scaling Up Access to Treatment in Southern Africa: A Way Forward."

    March 3-5 2004, Harare, Zimbabwe

    We, members of the Pan African Treatment Access Movement (PATAM) who have gathered here in Harare from 3-5 March 2004 to draw up civil society strategies to ensure rapid scale-up of anti-retroviral therapy in Southern Africa understand that everyone in the world is vulnerable to HIV infection and know that HIV-positive people in Africa, particularly women and other vulnerable groups, experience great challenges that must be addressed urgently.

    We know and understand that there are numerous factors and actors that hamper the provision of affordable life-saving medicines. Some of these include profiteering by pharmaceutical companies, inequitable international trade relationships, poverty, extreme stigma, imbalance of power within patriarchal societies, macroeconomic policies that constrain spending for health care and other social services and a lack of commensurate political commitment by our governments and other leaders to match the scale of the HIV/AIDS pandemic.

    While we recognise that there are multiple factors with complex interactions influencing access to treatment in Africa and all over the world, we maintain that our governments as the primary bodies we entrust in ensuring our welfare, whether by direct provision of services or creating an enabling environment for service provision, hold first line responsibility in the response to the HIV/AIDS pandemic. Too many of our sisters, brothers, friends, fathers and mothers have died needlessly as we have debated ad nauseam and otherwise been in meaningless conflict with each other. We cannot afford to dither any longer.

    Therefore, while we welcome reports from country representatives across Southern Africa that treatment rollout is either on the verge of, or has commenced in most countries across the region, we demand an immediate roll-out and rapid scale up of treatment across the continent. Together with our national, regional and international allies we stand ready to provide any support necessary, but also reserve the right to resort to any other available tools--specifically our collective power--if treatment continues to be but a dream for too many of us.

    In particular, we commit ourselves:

      to adhere to PATAM's mission statement asserting the right of anti-retroviral therapy and other essential medicines for all,
    • to mobilising all peoples irrespective of career choice, age, gender, or geographic representation to ensure that PATAM has a powerful presence in each country across the continent,
    • to ensure that our communities have correct and complete information on the function, usage and importance of Anti-retroviral therapy,
    • to work with the media to help convey accurate information on access to treatment,
    • to better coordinate our efforts nationally, regionally and internationally, and to continuously revise our advocacy strategies as the need arises,
    • to monitoring all regional and international trade agreements to ensure they do not undermine access to treatment or destroy our health systems,
    • and to monitoring national treatment plans for quality and scale.

    We demand:

    • genuine political leadership from our governments and other people in positions of influence,
    • greater and respectful representation of people living with HIV/AIDS (PLWHAs) and other vulnerable groups in all decision-making processes pertaining to access to treatment,
    • that rollout of anti-retroviral therapy be entwined with rebuilding our health systems,
    • that the World Health Organisation (WHO) and the Global Fund to Fight AIDS, TB and Malaria (GFTAM) develop a model proposal to be made publicly available to support development of stronger GFATM proposals,
    • and that international institutions such as the World Trade Organisation (WTO), International Monetary Fund (IMF) and the World Bank Group cease in constraining responses against HIV/AIDS at country level.

    • 5 March 2004, PATAM delegates in Harare

      AIDS Law Project Wins Department of Trade and Industry Consumer Champions Award for Civil Society 2003

      On 17 March 2004, the AIDS Law Project (ALP) won the Department of Trade and Industry (DTI) Consumer Champions Award for Civil Society, 2003.╩ The award was handed over by the Deputy Minister of Trade and Industry and the Director General.

      The award was particularly in recognition of the work done around reducing prices of medicines and the successful complaint to the Competition Commission against pharmaceutical companies Glaxo Smith Kline and Boehringer Ingelheim.

      The TAC congratulates the ALP, who represented our organisation in this matter, for deservedly winning this prestigious award.