Your daily Selection of IRIN Africa PlusNews reports, 3/29/2004

[Guest guest]

U N I T E D N A T I O N S

Office for the Coordination of Humanitarian Affairs

Integrated Regional Information Network

CONTENT:

1 - AFRICA: ARVs - too little, too late

1 - AFRICA: ARVs - too little, too late

MAPUTO, 29 March (PLUSNEWS) - The long-awaited rollout of antiretroviral

(ARV) drugs through public health systems is at last becoming a reality in

a growing number of African countries. But the initial excitement greeting

the announcement of each new AIDS treatment programme is often tempered by

a closer examination of the figures, and the realisation that only a

fraction of those in need will initially be able to access therapy.

In the case of Mozambique, the government aims to have just 8,000 people

on ARVs by the end of 2004, out of an estimated 173,000 people eligible

for treatment. By 2005 that target climbs to 21,000 out of 197,000 in need

of ARVs – a shade over 10 percent.

" The fact that a country like Mozambique, with the leadership, the

commitment, the partnership and support of the donors, will have just

21,000 on treatment in 2005 - that, to me, is shocking, " said KY Amoako,

head of the Economic Commission for Africa, at a three-day meeting of AIDS

experts last week in Maputo, Mozambique.

[http://www.uneca.org/chga/maputo/index.htm ]

Amoako, chairman of the Commission on HIV/AIDS and Governance in Africa

(CHGA), set up by UN Secretary-General Kofi n in 2003, led their

latest gathering. The goal of the 20 commissioners is to analyse the

impact of HIV/AIDS over two years, and promote effective policy responses

among political, civil society and business leaders.

" What I've found really interesting is that even the most optimistic

projections of treatment by governments are minute, " said Alan Whiteside,

a CHGA commissioner and University of KwaZulu-Natal professor. " If we talk

about Mozambique, that by 2005 they will have 21,000 people on treatment,

and you look at that in terms of WHO's [World Health Organisation] '3 by

5', I don't know where they are going to get three million [on treatment

by 2005] from. " [see separate interview:

http://www.plusnews.org/AIDSreport.asp?ReportID=3194 ]

" I think the health systems cannot do more, " he told PlusNews. " The answer

isn't necessarily money - although that's crucial - it's to find ways of

capacitating health systems to provide the treatment. "

Fellow commissioner Milly Katana, an HIV-positive member of the board of

the Global Fund, stressed a more activist role governments should play on

a continent with the world's largest number of HIV-positive people.

" Our African governments have completely failed the people; they have

failed to set the right priorities. Somebody said that in Africa we spend

billions each year on weapons, but we cannot buy ARVs, which are now

costing 50 US cents, " she noted.

" The different priorities between us, as Africans, and donors also has a

hand in it, " she added. " We need large-scale programmes - we are no longer

trying things at this point in time; we know what works; we know what

doesn't work. When you talk about treatment, we know that generic drugs

work - cheap and simple regimens - just give them to the people. "

Whiteside said even for governments that were sincere in improving

conditions of their people, difficult choices remained.

" I think African leaderships would love treatment to be there, but they

are very well aware of their creaking health systems and the fact that, in

Africa, you have to make choices between where you spend your money. Do

you spend it on education or on health? And then, if you spend it on

health, what do you spend it on - the disease that is killing most

children, which is malaria - on immunisations which would provide

long-term protection, or on antiretroviral therapy? "

An additional problem is Africa's powerlessness in negotiating agreements

with pharmaceutical companies and donors.

In the 14-member Southern African Development Community there is no

coordinated framework for an AIDS response, Mozambican health minister

Francisco Songane told the meeting. There is no common approach to ARV

treatment programmes in the region, whether in terms of deciding between

generics or brand-name drugs, or the duration of funding secured from

donors. He described the response of individual countries as " going with

the opportunities that appear " .

" I think we've heard very clearly in this commission a couple of comments

on the funding that is coming, " said Whiteside. " The first is that we

don't know how sustainable it will be; secondly, that every source of

funds comes with strings and reporting requirements, which are putting an

additional burden on our resources in Africa. "

[ENDS]

[This Item is Delivered to the English Service of the UN's IRIN

humanitarian information unit, but may not necessarily reflect the views

of the United Nations. For further information, free subscriptions, or

to change your keywords, contact e-mail: Irin@... or Web:

http://www.irinnews.org . If you re-print, copy, archive or re-post

this item, please retain this credit and disclaimer. Reposting by

commercial sites requires written IRIN permission.]

Copyright © UN Office for the Coordination of Humanitarian Affairs 2004

IRIN Contacts:

IRIN-Asia

Tel: +92-51-2211451

Fax: +92-51-2292918

Email: IrinAsia@...

To make changes to or cancel your subscription visit:

http://www.irinnews.org/subscriptions

Subscriber: AIDS treatments