Zuma’s sweeping new Aids plan

2009-12-02 11:38

South Africa announced ambitious new plans yesterday for earlier

and expanded treatment for HIV-positive babies and pregnant women, a change that

could save hundreds of thousands of lives in the nation hardest hit by the virus

that causes Aids.

President Jacob Zuma – once ridiculed for saying a shower could

prevent Aids – was cheered as he outlined the measures on World Aids Day.

The new policy marks a dramatic shift from former President Thabo

Mbeki, whose health minister distrusted drugs developed to keep Aids patients

alive and instead promoted garlic and beet treatments. Those policies led to

more than 300?000 premature deaths, a Harvard study concluded.

The changes are in line with new guidelines issued a day earlier by

the World Health Organization that call for HIV-infected pregnant women to be

given drugs earlier and while breast-feeding.

By treating all HIV-infected babies, survival rates should also

improve for the youngest citizens in South Africa, one of only 12 countries

where child mortality has worsened since 1990, in part due to Aids.

Zuma compared the fight against HIV, which infects one in 10 South

Africans, to the decades-long struggle his party led against the apartheid

government, which ended in 1994 with the election of Nelson Mandela in the

country’s first multiracial vote.

“At another moment in our history, in another context, the

liberation movement observed that the time comes in the life of any nation when

there remain only two choices: submit or fight,” Zuma said. “That time has now

come in our struggle to overcome Aids.

Let us declare now, as we declared then,

that we shall not submit.”

Zuma was greeted with a standing ovation when he entered a Pretoria

exhibition hall filled with several thousand people.

In some ways, Zuma is an unlikely Aids hero. As his Zulu tradition

allows, he has three wives – experts say having multiple, concurrent partners

heightens the risk of Aids. And in 2006, while being tried on charges of raping

an HIV-positive family friend, he testified he took a shower after extramarital

sex to lower the risk of Aids. He was acquitted of rape.

The one-time chairperson of the country’s national Aids council may

never live down the shower comment. But Zuma has won praise for appointing Dr

Aaron Motsoaledi as his health minister. Aids activists say Motsoaledi trusts

science and is willing to learn from past mistakes.

South Africa, a nation of about 50 million, has an estimated

5.7?million people infected with HIV, more than any other country.

UNAIDS executive director Michel Sidibe, who took the podium

shortly before Zuma, told the president: “What you do from this day forward will

write, or rewrite, the story of Aids across Africa.”

Zuma said in his speech that the policy changes would take effect

in April. They include treatment for all children under 1 year old, regardless

of their level of CD4 cells, a measure of immune system health.

Patients with both tuberculosis and HIV will get treatment if their

CD4 count is 350 or less, compared to 200 now, which means treatment would start

earlier. Pregnant women who are HIV-positive also would start treatment earlier.

That is in line with the new WHO recommendations that doctors start HIV patients

on drugs when their level of CD4 cells is about 350.

The expanded treatment was expected to be free, as it is now,

although Zuma did not confirm that. He said all health institutions, not just

specialist centres, would provide counselling, testing and treatment.

He also called on South Africans to get tested for HIV. But,

contrary to speculation in recent days, he did not take an HIV test

Tuesday.

“I have taken HIV tests before and I know my status,” he said. “I

will do another test soon as part of this new campaign. I urge you to start

planning for your own tests.”

Kurt Firnhaber, who runs Right to Care, one of the largest private

providers of Aids treatment, counselling and testing in South Africa, said Zuma

outlined “steps that aren’t rhetoric - if they’re implemented.”

He said the burden would now be on the government and foreign

donors to find the money to meet Zuma’s ambitious goals.

Yesterday, in response to a plea from Zuma, the United States

announced it was giving South Africa $120 million (R876?million) over the next

two years for AidS treatment drugs. That is in addition to $560 million the US

has already pledged to give South Africa in 2010 for fighting Aids.

Mark Heywood, executive member of the Treatment Action Campaign

said the Zuma speech marked a departure in thinking that would have a global

impact. Heywood shared the stage with Zuma on Tuesday.

“It was a very good speech in all its aspects - the empathy he

showed, what he said about prevention and the need to test for HIV was all very

positive,” Heywood said.

Zuma’s government had earlier set a target of getting 80% of those

who need Aids drugs on them by 2011.

Setjhaba Ranthako brought his 4-year-old daughter Tshegofatso to

hear Zuma’s speech, saying education should start early.

“I’ve seen in President Zuma a person who’s willing to listen, and

say, ‘Here I am, come with your views, and let’s turn your views into an

effective campaign to combat the spread” of Aids, said Ranthako, who works with

a group that raises awareness about Aids among men.

The crowd rose to their feet when Zuma finished his speech. Then he

danced along with a choir that sang: “Zuma, you are blessed.”


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