Independent On-line, 01 December 2002, Drugs for all brings hope on World Aids Day

It's taken court battles, public protest and one person's refusal to take medication which could save his life. But, finally, an agreement has been reached which could lead to the provision of anti-retrovirals for Aids patients by next year.

Dramatic, last minute negotiations have culminated in a deal between the government, unions, religious leaders, community organisations and Aids activists at the National Economic, Development and Labour Council (Nedlac) on the eve of World Aids Day, which is being commemorated on Sunday.

Only negotiators from the business sector still have to give their final approval of the deal. "It looks like we have an agreement," Nedlac executive director Phillip Dexter confirmed late on Saturday. "It's subject to some modification, such as the detailed wording, but the principles are all agreed."

This means that, for the first World Aids Day in many years, there is good news for South Africans living with the virus. The agreement marks a fundamental shift from last year's World Aids Day, when the government was facing a court battle over the anti Aids drug, Nevirapine.

The Nedlac document is an all-encompassing agreement which deals with everything from prevention programmes to medication to goals for the reduction of South Africa's HIV prevalence rate.

The agreement is binding on government because Nedlac is a statutory body.

The agreement includes an understanding that "no person should be sent away from hospital or a health care institution or not treated because of their HIV status".

Provision is also made for: reducing by one fifth the number of babies infected with HIV by 2005.

The document says this would be possible if 80 percent of pregnant women had access to Nevirapine, which halves the transmission from mother to child; extending access to Nevirapine to the whole country; providing antiretrovirals to all rape survivors to prevent them contracting HIV; recognition of "the importance of the provision of antiretrovirals treatment as an important component of a national prevention and treatment plan"; the setting of national targets by next year to try to reduce HIV prevalence by 25 percent among 15 to 24 year olds; and launching a series of national days to promote HIV testing. The first of these will be on March 1 next year.

But one of the biggest breakthroughs is an understanding that could see anti-retrovirals triple therapy being made available in the public sector some time next year. No deadlines have been set for the provision of anti-retrovirals to people living with the virus. However, there is an agreement that the parties who brokered the Nedlac deal will return to negotiations after February next year, once a report by the departments of health and finance about the affordability of antiretrovirals has been completed.

Then new discussions will be held about the logistical aspects of providing triple therapy to the estimated 4,7 million South Africans living with HIV.

Aids activist Zackie Achmat, who can afford to buy antiretrovirals but has refused to take them until the government agrees to make them freely available, said he "really welcomed" the news that an agreement had been reached at last. But he added: "We will only be really happy once that agreement has been signed by all parties."

Asked if the Nedlac deal meant he would start triple therapy, he said: "It is certainly one of the things that will make me consider taking anti-retrovirals."

Officials from the department of health were unavailable for comment.