TAC Electronic Newsletter


7 June 2005

Contents


MSF/TAC Conference

Building a Better Public Health Care Service for All

Durban City Hall, 8 June 2005, 10am to 1pm


Medecins Sans Frontieres (MSF) and TAC are co-hosting a satellite conference at the 2nd South African AIDS Conference. It takes place at Durban City Hall on 8 June 2005 from 10am to 1pm. It will be followed by a march past the International Convention Centre, where a memorandum will be handed to Professor Lynn Morris, the South African AIDS Conference chairperson.

The satellite conference will be attended by over 1,500 activists from Kwazulu-Natal, who will express community perspectives on HIV prevention and treatment.

Also to be presented at the conference:

Agenda

10:00 – 10:15    Opening

TB and HIV: Divided patients/divided care.

10:15 – 10:25 Being co-infected with HIV and TB
10:25 – 10:35 Imperative of integrating TB and HIV care
10:35 – 10:55 Open discussion: What needs to change?

Children - neglected patients

10:55 – 11:05 The struggle for treatment for my child. Testimony of a mother/caregiver
11:05 – 11:15 Barriers to access to mother-to-child transmission prevention and paediatric antiretroviral treatment
11:15 – 11:35 Open discussion: What needs to change?

Crisis of human resources

11:35 – 11:45 Can one person do the work of three?
11:45 – 11:55 Where is the South African plan for Human Resources in Health?
11:55 – 12:15 Open discussion: What needs to change?

Status of the implementation of the treatment plan

12:15 – 12:30 Scaling up mother-to-child transmission prevention and antiretroviral treatment: Where are we?
12:30 – 13:00 Summary and closing remarks


Why TAC says Treat 200,000 by 2006

By calling for at least 200,000 people on treatment by 2006, we are holding government to its own commitment in the operational plan.

Join TAC in community events on 7 June 2005 to encourage people to get tested for HIV.

A briefing document for TAC's members and supporting organisations


TAC has called for at least 200,000 people, including at least 20,000 children, to receive antiretroviral treatment in the public health sector by the beginning of 2006. This short briefing explains why.

According to the best available estimates (provided by the Actuarial Society of South Africa and Statistics South Africa):
South Africa has a large HIV epidemic. Many people have died of AIDS and many more will die unless treated. When people with HIV develop AIDS, they must begin taking antiretroviral treatment to reverse the effects of the disease and allow them to live much longer. Good nutrition, support and care from family and friends and treatments for opportunistic infections such as TB and pneumonia are also very important. Some vitamins taken in combination as supplements are also useful, and are provided by public health clinics.

But without antiretroviral treatment most people who develop AIDS will die within two years after experiencing many avoidable illnesses and much suffering.

With antiretroviral treatment, the vast majority of people with AIDS can resume normal lives. We do not yet know the average number of additional years of life that antiretroviral treatment gives, but it is at least five and probably much more, especially for people who adhere to treatment and refrain from substance abuse. Many people who take antiretrovirals experience some side-effects. A small number experience serious side-effects and consequently have to change their antiretroviral regimens. A very small number of people die from the side-effects.

However, the benefits of antiretrovirals far outweigh the disadvantages. Without antiretrovirals, people with AIDS will die. With antiretrovirals, they have an excellent chance of regaining their health.

The Cabinet committed to rolling out antiretroviral treatment in August 2003. On 19 November 2003, the Department of Health published its operational plan that catered for rolling out antiretrovirals, hiring an additional 22,000 health-workers by 2008, providing better nutrition to people with HIV and continuing to roll out the mother-to-child HIV transmission prevention programme, amongst other interventions.

The plan committed to treating approximately 50,000 people by end of March 2004, an additional 135,000 people by end of March 2005 and another 215,000 people by March 2006 (table 0.2, p. 52 of the plan). This would still have left many without treatment, but it would have been a good start and saved many lives. TAC therefore welcomed the plan. Yet at the end of March 2005, only about 42,000 people were on treatment in the public sector (source Dept. Health). We estimate that another 60,000 are being treated in the private sector. This is not good enough. If government had met its target, there almost would be 200,000 people on treatment already, and about 380,000 people would be on treatment by March 2006.

Sufficient funds have been set aside for the rollout by Treasury, but the rollout's pace has been hampered by a lack of leadership by the Minister of Health. Her confusing public messages on AIDS have undermined the programme.
By calling for at least 200,000 people on treatment by 2006, we are holding government to even less than its own commitment in the operational plan. We ask you to join us in our activities to help government meet this target. This will include encouraging people to get counselling and testing and putting pressure on the Department of Health to provide the necessary resources to clinics that need to start providing treatment.

Case Study: Antiretroviral Treatment in Khayelitsha

Three Khayelitsha clinics treat nearly 2 000 adults and children with antiretrovirals. The average CD4 count when patients started treatment was below 100 (i.e. advanced AIDS). After three years on antiretrovirals, four out of five patients are still alive. Without antiretrovirals half would have died within a year. Almost all deaths were due to the advanced stage of disease. In three years, only one in ten patients had to change their drugs due to side effects. Only four of the deaths were due to drug toxicity.

Source: Medecins Sans Frontieres

The difference that antiretrovirals make

An analysis of people in South Africa in stage 4 of HIV (i.e. AIDS) found that after two years, only about 20% of patients without antiretroviral treatment were still alive. But about 75% of patients who received antiretroviral treatment were alive. (Source: Badri M., Bekker L. G., Orrell C., et al. (2004) AIDS. 18(8): 115)

What's needed to achieve 200 000 by 2006?

Organisations across South Africa need to step up our campaigns on HIV. Here are some suggestions:

Contact your nearest TAC office for more details


Why TAC is calling for government to Treat 200 000 by 2006 National office: Rukia, 021 788 3507
Johannesburg: Luyanda, 011 339 8421
Polokwane: Pholokgolo, 015 291 5448
Nelspruit: Msanyana, 013 755 2298
Cape Town: Thembeka, 021 447 2593
Khayelitsha: Mandla, 021 364 5489
Durban: Xolani, 031 304 3673
Pietermaritzburg: Richard, 033 394 0845
Mandeni/Stanger: Sfiso, 083 474 8449
East London: Philip, 043 722 2645
Lusikisiki: Nombeko, 039 253 1951


Sowetan apology over Rath defamatory comments

TAC welcomes Sowetan's integrity


Sowetan and TAC have reached a settlement agreement about the running of defamatory attacks on TAC by the Rath Foundation as adverts in the Sowetan. In a nutshell, the terms of the agreement are that Sowetan will run an apology (including information on the ASASA ruling and TAC's positions on antiretrovirals, multivitamins and nutrition) and two further TAC public information advertisements, one on nutrition and one on antiretrovirals. TAC welcomes Sowetan's integrity for agreeing to apologise. Sowetan is an important newspaper in South Africa and has a long tradition of representing the voices of Africans. It is also read by many TAC members. TAC will certainly continue to work with Sowetan. We consider this matter closed.

The text of the apology which was run in Sowetan on 30 May is as follows:

"The Sowetan regrets the publication of defamatory allegations against the TAC and other entities contained in adverts placed by the Dr Rath Health Foundation in the editions dated 28 January 2005, 4 March 2005 and 11 March 2005. The Sowetan apologises to the TAC and other entities defamed in the adverts for any harm which they suffered as a result of the publication of the adverts by the Sowetan.

In particular,  Sowetan accepts that:


Regaining my health after testing positive


By PM

As told to Sibongile Mashele (written 12 May 2005)

My name is PM and I am 22 years old. I was born at Emagweni, a rural area near Malelane in Mpumalanga. I  grew up there and still live there. In my family there are 8 children and I am the 6th born. My mother died of TB in 2003 and my father died in 2004. We now live with my grandmother. To be honest we didn’t live with my father so I would say I didn’t have as strong a relationship with him as my mother.

In October 2003. I had experienced swollen legs and felt tired every day so I decided to have an HIV test. It was 30 October 30 2003 when I went for a test at Magweni clinic. I was given counseling by a nurse and I was told that I am HIV-positive. At first I didn’t understand what was happening. I felt confused, alone and very scared that I was going to die. But after a month I began to understand exactly what was going on with me. On 5 April 2004 I went for a CD4 count test and it was 136. I was told that I qualify for a disability grant and referred to Rob Ferreira Hospital. I was given a form that I took to home affairs.

When I entered the room in Rob Ferreira, I met people who were also HIV- positive and they were very healthy, strong and positive in spirit. I then told myself that I am not alone and I’m not going to die. I was given cotrimoxazole, vitamin B and Folic Acid tablets to take everyday. After 3 months I went back to have a CD4 count test. I was told that I need to take antiretrovirals. Actually I can’t remember what my CD4 count was then, but it was very low. I attended antiretroviral counselling sessions for 3 weeks in Shongwe hospital and continued to take cotrimoxazole and the other pills. On the 3rd week I was given antiretrovirals: efavirenz, d4T and lamivudine. I was advised to take 3 tablets of efavirenz at night everyday and take one of d4T and one of lamivudine in the morning, and the same in the afternoon.

I didn’t have any serious side effects but I had bad, scary dreams for the first 2 weeks of taking treatment and I was vomiting once every month. I consulted Dr Black of Shongwe hospital and he told me that it will go away. And it stopped after 3 months. Now I am on antiretrovirals and still receive a grant. I was told that the grant will expire by end of April but I received it this month (April). I don’t know my CD4 count now because I went to the clinic for results and they told me that they have misplaced my file! One thing that I don’t forget is to take my pills. I even bought a phone with the grant that I receive just to set a reminder to remind me to take my pills!

To all the people who are living with HIV, please don’t be afraid to disclose your status because you will get more support from people who are positive as well, that will help you to live a positive life.

[END OF PM'S STORY]

[END OF NEWSLETTER]