South Africa gets ready for AIDS conference

JOHANNESBURG: AIDS researchers from around the world gather in South Africa on Tuesday amid tentative signs the nation is finally embracing mainstream approaches to fighting the epidemic.   

Hopes of a shift in South Africa's attitude to a disease affecting nearly 12 percent of its 47 million people have been building since the government in March unveiled a revamped AIDS strategy, including an expanded rollout of life-saving drugs.

Anti-retroviral (ARV) medications are credited with drastically reducing AIDS deaths and are now widely accepted as the frontline treatment for HIVAIDS.    But the South African government was a late and reluctant convert to the ARV camp -- experts say it wasted years and lives questioning the drugs efficacy and safety, and soliciting the views of dissident scientists who opposed their use.  

President Thabo Mbeki's administration has now changed course, making ARVs a pillar of its new National Strategic Plan to fight HIVAIDS. It envisions a five-fold increase in the number of HIV-positive people accessing the drugs by 2011.

The result is a slightly more upbeat mood in South Africa, where 5.5 million people are infected with HIV and 1,000 die each day from AIDS, as activists and scientists convene for the South African AIDS Conference in Durban from June 5-8.  

It is the third such conference to be held in the nation. "We are definitely more positive about what is going on," said Nathan Geffen, policy coordinator for the Treatment Action Campaign, a South African-based group that campaigns for the rights of people with HIVAIDS.  

"The adoption of the National Strategic Plan by cabinet is a watershed, and most of what is needed to deal with the HIV epidemic is in that plan," said Geffen.

CHALLENGES, SOLUTIONS

But South Africa's effort to cut new HIV infections and halt the spread of the virus is threatened by a critical shortage of healthcare workers, especially in rural areas where nurses often are the only trained clinicians to treat the sick.   

A report released last month by French medical charity Medecins Sans Frontieres  concluded the epidemic could not be stemmed in South Africa and neighbouring countries without a surge in the number of doctors, nurses and medical assistants. 

It added that restrictions on who was allowed to prescribe drugs -- only doctors are typically licensed in South Africa to do so -- could cripple the country's efforts to get AIDS medication to some 700,000 people in need of treatment. 

South African health officials have responded to the crisis by, among other things, enlisting traditional healers or sangomas as they are called, to spot the signs of HIV infection and persuade patients to get tested and take ARVs.

Many South Africans consult traditional healers for routine problems. Educating these practitioners about HIV/AIDS could help dispel the myths surrounding the disease and stop its spread.

"Traditional healers are so important in these communities. People trust them more than they trust us nurses," said Ivy Mdletshe, a nurse who is part of a project linking traditional healers with standard healthcare in KwaZulu-Natal province.  

The programme, however, is seen as a stopgap by members of the medical profession who question whether healers will be able to diagnose HIV, which is sometimes accompanied and mistaken as pneumonia or tuberculosis, both rampant in South Africa.

Also looming over the conference is the future of South African Health Minister Manto Tshabalala-Msimang, who has been recuperating following a liver transplant operation in March.

Tshabalala-Msimang has been a pivotal figure in South Africa's HIVAIDS crisis since becoming health minister in 1999, engaging in bitter debates with AIDS activists and at times appearing to question accepted HIV science.

Tshabalala-Msimang, who some consider an obstacle, indicated recently that she would resume her duties at some point.