What is the South African Gov. role in fight AIDS/Hiv ? Mbeki questions Aids stats
08/02/2004 21:57 - (SA)
Jan-Jan Joubert and Willem Jordaan
Cape Town - President Thabo Mbeki on Sunday questioned the extent of HIV/Aids deaths, because of the absence of statistics on the causes of death in South Africa.
After Mbeki did not focus on HIV/Aids and Zimbabwe in his State of the Nation address on Friday, he was bombarded with questions on these issues in an interview with the SABC on Sunday.
In his reaction, Mbeki said he would address the two issues in a second State address after the election.
Reacting to a question on his personal roll in government's fight against the pandemic, Mbeki indicated that deputy president Jacob Zuma was handling the matter on government's behalf.
He said that the allocation to HIV/Aids in the budget showed that "few countries were doing as much as South Africa".
When asked whether it wouldn't help if he personally showed more empathy with sufferers of the disease, Mbeki retorted that he had said a lot about the issue and that government's stance on the matter remained unchanged.
"Tuberculosis is also a big problem. My doctors say there is a diabetes epidemic. Why does nobody talk about it? There are many health issues."
When it was put to him that these diseases were treatable while HIV/Aids was not, he said: "No, that is not the reason". Interviewer Redi Diareko quoted statistics of the World Health Organisation and exclaimed: "This is our country about which these findings were made. You are our leader ..." Mbeki responded that the WHO could speak for itself, but that South Africa did not have reliable statistics on causes of deaths. He said he wanted something more than mathematical calculations - information on death certificates.
More at... news24.com/News24/South_Africa/Politics/...
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Every epidemic disease is now renamed 'AIDS' under the Bangui Definition.
Mortalities (non natural) in S.A. remain at the same 2.2% P.A. that they were BEFORE AIDS. Either every other disease in the region vanished overnight or 'AIDS' is simply the old diseases with a new name. You decide.
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In Africa, the continent supposedly being decimated by
HIV, HIV tests are rarely ever done, so there the idea
that all patients with AIDS are infected with HIV is
based entirely on supposition.
At a WHO conference in the Central African Republic in 1985, U.S. Centers for Disease Control (CDC) introduced the "Bangui Definition" of AIDS in Africa.
The CDC officials later explained, "The definition was reached by consensus, based mostly on the delegates' experience in treating AIDS patients. It has proven a useful tool in determining the extent of the AIDS epidemic in Africa, especially in areas where no testing is available.
It's major components were prolonged fevers (for a month or more), weight loss of 10% or greater, and prolonged diarrhea..."(McCormick, 1996). Where AIDS is diagnosed clinically, large numbers of AIDS patients test negative for HIV. As no HIV testing is required in Africa we have no idea how many AIDS cases there are HIV positive (De ####, 1991; Gilks, 1991; Widy-Wirski, 1988).
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Other conditions common in underprivileged and
impoverished communities that are known to cause false
positive results are tuberculosis, malaria, hepatitis and leprosy (Burke, 1993; Challakeree, 1993; Johnson, 1998; Kashala, 1994; MacKenzie,1992; Meyer, 1987). In fact, these are the primary health threats in Africa; several million cases of tuberculosis and malaria are reported in Africa each year - more than all the AIDS cases reported in Africa since 1982 (WHO, 1998)*. This just came out in the scientific journal Nature:
Editorial
Nature 447, 1 (3 May 2007)
Published online 2 May 2007
South Africa's AIDS plan
A strategic plan has been developed to tackle the nation's HIV crisis 鈥?at last.
After years of prevarication, the government of South Africa has finally adopted a sound and comprehensive strategy for managing the country's AIDS epidemic. The 160-page plan, which was endorsed by the South African National AIDS Council on 30 April, lays out proposals to cut infection rates, improve diagnosis of the disease, and treat the estimated 5.5 million South Africans already infected with HIV.
The plan has been welcomed by physicians, AIDS researchers and activists in South Africa, who have long been frustrated by the reluctance of President Thabo Mbeki's government to confront the world's worst national AIDS problem head-on.
It sets two main objectives: by the end of 2011, the rate of infection should be halved; and antiretroviral treatment should be readily accessible to 80% of the people who require it. The estimated cost of all this is US$6 billion over the next five years, with drug costs accounting for 40% of the total. The plan expresses the hope that the private sector and foreign donors will provide half of the cash, with the South African government paying the rest.
According to a report released in November by the Actuarial Society of South Africa (ASSA), 1.8 million people have died of AIDS in South Africa so far. Current estimates of the number of people requiring antiretroviral treatment range between 800,000 and 1 million. But only about 300,000 are receiving it, with two-thirds of them being treated by the Department of Health and the rest by private healthcare schemes and non-governmental organizations. Many more of those already infected with HIV will need drug treatment within five years.
The absence of an effective AIDS strategy for South Africa until now has particularly affected the availability of treatment for children born with the disease. Only one-tenth of the estimated 200,000 children who might benefit from antiretroviral treatment are receiving it, according to the International Treatment Preparedness Coalition. That is partly because the treatment of children carries extra bureaucracy. Just to be tested for HIV (a prerequisite for access to antiretroviral treatment), they require identity numbers, which in many cases they don't have, as well as consent from a biological parent 鈥?a problem because many are cared for by other members of the extended family. There is no other medical condition where such criteria have to be met before starting treatment.
Slowing the infection rate may be even more challenging than administering therapy. The rate is already falling in urban areas: ASSA estimates that 530,000 people were infected in South Africa last year, down from the peak annual infection of 650,000 in 1998. But in rural areas such as the Umkhanyakude area of KwaZulu-Natal province, for example (see page 26), infection rates remain high and public understanding of AIDS is threadbare.
Additionally, a lack of trained doctors and nurses is likely to act as a serious constraint on the full implementation of the strategic plan. Many have grown frustrated over the government's AIDS policies, sometimes to the point of leaving the country, or at least the public sector.
A lack of trained doctors and nurses is likely to constrain the full implementation of the plan.
Although admirably broad in its scope, the plan falls short of addressing some of the technical and bureaucratic obstacles that stand in the way of AIDS prevention and treatment. Another problem is Mbeki's failure, so far, to publicly acknowledge the AIDS crisis.
Indeed, reluctance on the part of some of South Africa's leaders to face up to the extent of the problem remains an issue. But deputy president Phumzile Mlambo-Ngcuka, whom many see as a possible successor to Mbeki when his term expires in 2009, has rewritten the government's AIDS agenda by helping to draw up the strategic plan. The health minister Manto Tshabalala-Msimang, who embarrassed South Africa with her remarks at the World AIDS Congress in Toronto last August (see Nature 444: 663; doi:10.1038/444663a 2006), is currently on sick leave. If Mbeki is serious about confronting AIDS, he should appoint someone with the necessary aptitude and enthusiasm, such as deputy health minister Nozizwe Madlala-Routledge, to succeed her. Africa - Origin and large HIV carryiong population counry... |
