TAC Electronic Newsletter
7 June 2005
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
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:
- a report on tuberculosis in South Africa prepared for TAC by
Zackie Achmat and Reid Roberts and
- a critical analysis of the progress of the South African
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
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
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.
- Between 1997 and 2002, the number of reported deaths in South
Africa rose from just under 320,000 to just under 500,000, a massive
57%. Most of those who died were babies and young adults.
- Over 5 million people are HIV-positive in South Africa.
- Over 300,000 people died of HIV in 2004. Even more are expected
to die in 2005.
- About 500,000 of the 5 million people living with HIV are sick
enough that they need to start antiretroviral treatment now.
But without antiretroviral treatment most people who develop AIDS will
die within two years after experiencing many avoidable illnesses and
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
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
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:
- Mobilise in our communities by handing out pamphlets and running
educational workshops encouraging people to get tested.
- We need to make sure our local clinics and hospitals offer HIV
testing to people who are ill or who are being treated for TB.
- We have to campaign for the swifter rollout of treatment,
improvement of clinic services and, critically, improved conditions of
service for health-care workers so that they are attracted back to the
public health service.
- Organise community action days. TAC is organising one for 7 June
2005. Join us in handing out pamphlets on HIV, cleaning up clinics and
conducting workshops on HIV treatment, prevention and nutrition.
Contact your nearest TAC office for more details
Why TAC is calling for government to Treat 200 000 by 2006
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
"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:
- The TAC does not receive funds from the pharmaceutical industry
or from entities that front for the pharmaceutical industry;
- The TAC does not promote drugs that kill people, particularly
- The TAC does not pay people and provide them with free T-shirts
to demonstrate on behalf of the pharmaceutical industry against the
South African government;
- The TAC does not force the government to spread disease and death
among the people of South Africa;
- The TAC is not ruining the South African economy; and
- The TAC is not destabilizing South African democracy."
Regaining my health after testing positive
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
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]