Mandela joins MSF to scale up AIDS treatment in South Africa

ALT Eric Miller/MSF

Cape Town - Today in South Africa, Nelson Mandela and Médecins Sans Frontières (MSF) announced that they will join forces to create a new AIDS treatment project near Umtata - Mandela's birthplace.

During a visit to one of the AIDS clinics in Khayelitsha, Mandela expressed support for the treatment initiative, coupled with prevention programmes, to protect the lives of people infected with HIV and to curb the impact of the virus. 

"We have created the impression that we don't care about the young people who are sick and dying...This is a war.  It means that all of us should stand on our feet and mobilise the community," Mandela said, after hearing from beneficiaries of the programme. 

"Give me a statement of how I can help financially," he continued, after donning an 'HIV Positive' t-shirt which was offered to him by Matthew Damane, one of the first clients to receive antiretrovirals in Khayelitsha.  

Recalling Mandela's own struggle during the apartheid era, Dr. Fareed Abdullah, director of HIV/AIDS programmes in the Western Cape province said, "We are as determined as you were when you made a statement in 1961 that you would not surrender.  There is no greater inspiration than that you have visited us today." 

Abdullah later said:  "The AIDS programme in Khayelitsha has been demonstrating for over a year that it is not only possible to effectively treat people with AIDS in poor settings, but that bringing antiretroviral treatment into the battle against HIV/AIDS radically changes a community's perspective about the disease.  The challenge is now to scale up treatment in order to reach the estimated 600,000 people who desperately need it in South Africa." 

An estimated six million South Africans are HIV-positive. Only one in every thousand people who currently need antiretroviral treatment (ART) in South Africa, receive it through public services - half of them through the AIDS clinics in Khayelitsha.

The Nelson Mandela Foundation hosted a recent gathering of 26 initiatives throughout the country ready to start ART. It was clear from discussions that there is a commitment for treatment, but a lack of political support and funding.

The AIDS programme in Khayelitsha, a township outside of Cape Town with a 20% rate of HIV infection, provides care for more than 3,000 people. Three hundred clients receive ART with generic versions of antiretroviral drugs. 

"Antiretroviral therapy saved my life.  I used to get sick but now I am healthy and very active educating others about this disease," said Babalwa Tembani, 20, a beneficiary of the MSF programme who explained that she became HIV-positive after being raped by an uncle at the age of 14.  "But I shouldn't just be one of the lucky ones.  There are too many people dying even though we know that there is medicine that can help people."

The Khayelitsha clinics are the result of a partnership between MSF, the Provincial Administration of the Western Cape and the Treatment Action Campaign. Established in 2000, this is the first program in the country to provide ART in public primary health-care services.  Already clients have shown dramatic improvements.

Success in poverty settings

Ninety percent of clients on ART had undetectable viral loads after three months, a figure that remained constant over the following three months, indicating high levels of compliance.  Patients on treatment for six months have shown an average weight gain of 8.8 kilos. Since the introduction of ARVs, voluntary counselling and testing in the community has also risen dramatically from 1,000 per year in 1998 to more than 12,000 in 2002.

By using generic versions of antiretroviral drugs, MSF has been able to provide triple therapy at about R10 ($1) per patient per day, a fourth of the price of the same medication purchased at a South African private pharmacy. Nevertheless, the cost of ART could still be substantially reduced, at least up to R2 per day.

"The AIDS crisis in Africa is desperate," said Dr. Eric Goemaere, Head of Mission for MSF in South Africa.  "People with HIV/AIDS are fed up with the international community's broken promises and of hearing only about pilot projects.  

"The time to scale up is long overdue and this will only be possible with political action at the national and international level. With the Nelson Mandela Foundation we hope to create another project in South Africa that prolongs people's lives and serves as a road map for scaling up treatment here and in other countries."