By Donwald Pressly

Business Day (South Africa) 5 June 2001

The Health Ministry was emphatic on Tuesday that the government would not provide triple therapy of anti-retrovirals for the long-term management of AIDS.

Speaking in her Budget vote at Parliament, Health Minister Manto Tshabalala-Msimang said: "Our position remains the same. We have no plans to introduce the wholesale administration of these drugs in the public sector".

ARVs were not a cure for HIV/AIDS, she said.

"In addition, we remain concerned about aspects of toxicity, the availability of laboratory services, and infrastructural and educational constraints, particularly in the rural areas.

"This position is not ideological ... Obviously we will continue to explore all the options available to us, including the provision of our legislation and the Who (World Health Organisation) and UNAIDS-sponsored negotiations with pharmaceutical companies."

The government and opposition are at loggerheads over the issue with the Democratic Alliance's Western Cape government backing the Medicine sans Fronteires (Doctors without Borders) campaign to provide ARVs to pregnant women with HIV.

About 30 women in the Western Cape have already received the treatment with this number expected to rise to 180 over a 10-month period.

The Minister said there was "tremendous public interest" in her national department's Nevirapine programme to prevent mother-to child transmission of HIV and 18 research sites had been set up to determine such matters as toxicity and drug resistance.

She said in terms of prevention, she believed there were "signs the safe sex messages are beginning to bear fruit among the youth". A range of youth surveys showed high awareness of HIV/AIDS, good knowledge of prevention methods and increased use of condom use, she said.

In addition, for the last two years, Tshabalala-Msimang said the department's ante-natal survey had shown a drop in HIV rates among teenage mothers, a much less dramatic increase in the prevalence of HIV and a sharp drop - of 50% over three years - in the syphilis rate.

With regard to treatment and care of AIDS, she said health facilities around the country for voluntary counseling and testing were using rapid test kits for the first time.

In addition, the Department of Health was providing fluconazole to patients with fungal infections that were associated with HIV/AIDS.

"Fluconazole was previously beyond our budget limits, but we negotiated a partnership agreement with Pfizer Inc. In terms of this, the company has donated a two-year supply worth R375m to public sector hospitals."

Her Department's management, she said, of "opportunistic infections is gradually improving as health workers are trained to use relevant guidelines".