Education/government/antiretroviral/TAC
Business Day, 14 October 2002, State antiretrovirals move significant'

AIDS activists have reacted cautiously to cabinet's announcement that government is investigating the feasibility of providing antiretroviral medicines to AIDS patients attending public clinics and hospitals.

In April government took a dramatic step away from its stance on the harmful effects of antiretroviral medicines, when for the first time it acknowledged the drugs could help prolong the lives of people infected with HIV.

Since then, the only people with access to antiretrovirals in the public sector have been victims of sexual assault and occupational injury such as accidental syringe-needle pricks.

Treatment Action Campaign secretary Mark Heywood said Wednesday's cabinet statement, which outlined the steps government planned to provide antiretrovirals in the public sector was significant, as it was the first time government had made "concrete commitments" on widening access to the drugs since April's cabinet statement.

However, Heywood expressed reservations about the cabinet's intention to make technical changes to the law to enable the import and manufacture of generic AIDS drugs, which are considerably cheaper than their brand name equivalents.

The existing legal framework did not require amendments, he said, and changes to the law would result in unnecessary delays in providing the drugs.

"We have the patents act which allows compulsory licensing in the public interest, and we have the Doha declaration saying that countries can (declare) a public health emergency and override patent laws."

The World Trade Organisation meeting in Doha last November resulted in an agreement that relaxed aspects of international trade laws on medicinal patent rights, enabling governments to issue compulsory licences for the production of generic medicines without the consent of the drugs' patent holders.

Heywood estimated there are 1-million people in SA who need antiretrovirals. So far, only brand name antiretrovirals are available in SA and then only to patients in the private sector.

Heywood also voiced concern over the composition of the task team set up to investigate the cost implications of providing antiretroviral medicines. It is made up of treasury and health department officials.

Heywood said it should also include experts in actuarial research, and representatives from nongovernmental bodies which had experience in antiretrovirals, such as Médicins sans Frontières.