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TAC calls for comprehensive treatment and prevention plan
Zackie Achmat, Treatment Action Campaign, 26 Sept 2002 Reposted courtesy of AF-AIDS ([email protected])
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New research demonstrates the enormous social and economic costs our country will face if government does not lead civil society and the private sector in the use of anti-retroviral therapy. The Treatment Action Campaign's call for a national treatment plan by government with clear budgets and time-frames is the only chance this government has to avoid a social catastrophe.
Research conducted by the UCT Centre for Actuarial Research (CARE) demonstrates that a comprehensive treatment and prevention plan that incorporates anti-retroviral therapy will prevent millions of AIDS deaths and new HIV infections. By implementing voluntary counselling and testing (VCT), prevention of mother-to-child transmission (PMTCT), improved management of sexually transmitted infections (STIs) and highly active anti-retroviral therapy (HAART), nearly three million AIDS deaths can be averted and over 2.5 million HIV infections can be prevented by 2015. Furthermore, a treatment programme that includes HAART can prevent approximately one million "double-orphans" (children under the age of 18, both of whose parents have died).
The TAC has used the results of the CARE research to estimate the costs of implementing these programmes. The cost of HAART for adults gradually increases from R224 million in 2002 to R6.8 billion in 2007 to a peak of R18.1 billion in 2015. These amounts include personnel and monitoring costs and assume that generic medicines that have been proven equivalent to patented brand-name drugs are available for use. With a realistic price reduction in anti-retroviral medicines to R300 per month for a first-line regimen and R450 per month for a second-line regimen, the cost of Adult HAART can be reduced to R14.1 billion in 2015. Adult HAART is the most expensive of the health interventions that CARE has modelled, but has the most significant effect on life-expectancy and AIDS deaths.
Central to our work is the right to life and dignity of all people. However, a clear human rights approach is not the only gain for society. Treatment will not only save lives, it will reduce hospitalisation costs to the public health sector and the cost of orphan grants and caring for orphans.
Furthermore, through treatment we can avoid: the collapse of the public health system; loss of human capital (e.g. teachers, nurses, students); and immense social dysfunction. In addition, the economy will benefit from investment in health-care, stability in productivity and retention of skills.
While modelling the future is not an exact science, this is the most comprehensively researched work of this kind that has yet been done with regard to the South African HIV epidemic. It is therefore the best information available and there is an imperative to act upon it, given the challenges the HIV epidemic poses for South Africa's development.
Government must now meet its Constitutional duty to ensure the rights to life, dignity and health-care. It must develop and implement a plan which at a minimum incorporates voluntary counselling and testing, prevention of mother-to-child HIV transmission, improved management of sexually transmitted infections and highly active antiretroviral therapy. By working together, all sectors of South African society can alleviate the worst effects of the HIV epidemic. We must act now!
(The CARE research was commissioned by the TAC. We wish to thank Leigh Johnson, Professor Rob Dorrington, the Centre for Actuarial Research, Alex Van Den Heever, Chris Raubenheimer and all the health care professionals and researchers who provided information for this work. This research will be submitted to NEDLAC, the Health Ministry, SANAC and provincial health departments.)
The full CARE report is available from: www.commerce.uct.ac.za/care
A fact sheet explaining this research in more detail is available upon request from: [email protected]
It is available for download from the TAC website: www.tac.org.za
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