ARV rollout in Gauteng brings hope

Melita Sekhotho has vowed to be first in line when anti-AIDS drugs are finally dished out on April 1. The long-awaited rollout of anti-retroviral drugs (ARVs) in Gauteng, which was announced on Tuesday by Health MEC Gwen Ramokgopa, was welcomed by all - especially those whose lives hang in the balance.

For Sekhotho, the rollout means a chance for a longer and better-quality life. Three weeks ago, HIV-positive Sekhotho said she could not afford to buy anti-AIDS drugs and demanded that Ramokgopa make them available to her.

"I am HIV-positive, but I also deserve a bright future. We've been waiting too long, people are dying every day," the 35-year-old said at the time.

Sekhotho could hardly conceal her excitement at Tuesday's announcement.

"The people of Gauteng will be celebrating tonight. I'll be the first in the queue on April 1."

"We're still going to die, but ARVs prolong life and make us healthier," she said.

Dr Glenda Gray, director of the perinatal HIV research unit, affiliated to Wits University, said the positive ripple effects in providing anti-AIDS drugs were overwhelming.

"Firstly, it sustains life, meaning people can work and send their children to school, and it prevents increasing numbers of orphaned children," Gray said.

Mbulelo Mangqu, whose CD4 count is below 200 and has been HIV-positive for the past seven years, said he had been waiting to die - until he heard about the rollout.

"On April 1, I will be given a second chance to live," said 29-year-old Mangqu. "Maybe I'll stop having ailments like thrush and diarrhoea and I'll be able to lead a normal life."

"Before this announcement, I was waiting to die - because there was no way I could afford the drugs. But now there's hope."

The Treatment Action Campaign (TAC) said the rollout was a "great step forward".

"The five major hospitals where the ARVs will be rolled out will offer the potential to reach significant numbers," TAC spokesperson Mark Heywood said. "Gauteng has also set up a timeframe for the rest of the rollout and this will provide clarity for HIV-positive people about when this service will begin and where."

"We are aware that a number of other provinces are ready to roll out, and they should start as soon as possible."

However, Heywood added that the TAC was still considering legal action against Minister of Health Manto Tshabalala-Msimang.

"We are unhappy with the drug-procurement process and the fact that it's creating a delay. ARV sites across the country have been ready for the rollout for some months, but the drugs will only be available from July."

"We are asking for the department to take urgent steps to make sure the drugs are available in the interim."

At the beginning of next month, five government treatment sites around Gauteng will begin administering the drugs.

Ramokgopa said this would extend to include 18 other sites in the province by next year. The hospital sites - Johannesburg, Chris Hani Baragwanath, Helen Joseph, Coronation and Kalafong - which will cater for new and existing patients who are ready to start ARV treatment, have all met the requirements needed to begin rolling out the drugs. The requirements include having a sufficient number of trained staff, laboratory facilities and pharmacy controls.

The next six sites - George Mukhari, Pretoria Academic, Natalspruit, Leratong, Far East Rand and Kopanong hospitals - will be ready in August.

Matshidiso Madondo, 30, who has been living with HIV since 2001, started taking ARVs in November last year.

"Now I won't have to watch my friends die," she said. "I had been very sick. I was bed-ridden, I had diarrhoea, my mouth was full of thrush and I couldn't chew. But since taking ARVs, I have been able to eat and I feel stronger."

"It has given me a chance to lead a productive life. I was lucky because I was able to find a sponsor, but many of my friends couldn't afford to get the drugs - and they died."

Sister Sue Roberts, co-ordinator of Helen Joseph's HIV clinic, said: "I have seen people who were virtually dying, but some hospitals didn't want to treat their opportunistic illnesses - and were just ignoring them.

"Once the ARVs are here, there will be fewer excuses."

Ramokgopa said the aim was to treat 10 000 people by the end of March next year.

"The number of people to be treated will initially amount to about 100 new cases a week per site for the first two to three months, whereafter there will be rapid expansion."

An amount of R95-million has been allocated for the implementation of the treatment programme over the next year.

While the national tender process for suppliers of the anti-AIDS drugs is still under way, the Gauteng Health Department will buy the drugs from various "reliable" sources.

While the plan was being rolled out, Ramokgopa said, the department's primary challenge "is to ensure that the 40-million South Africans who are not infected with HIV stay that way", and they would continue with prevention programmes.