Hopes that South Africa's victory in court would lead to quick access to treatment for AIDS sufferers were dashed yesterday.
Minutes after leaving the Pretoria High Court in joyous celebration at the decision by 39 drugs companies to abandon their case against the South African government over patent protection, Dr Manto Tshabalala-Msimang, Health Minister, said the government still had doubts about using anti-retrovirals and had no plans to make them available in the public sector.
"It is erroneous to suggest we do not give treatment to AIDS sufferers just because we do not provide anti-retroviral therapy," the minister emphasised. "We do treat pneumonia or thrush or skin diseases. By providing adequate nutrition and by curing opportunistic infections, AIDS sufferers can function adequately.
"We are concerned with resistance to anti-retrovirals. We also need to build up the capacity to administer the drugs adequately and effectively. The infrastructure must first be in place," she said.
For AIDS activists who have fought the court battle on the government's side, the court victory quickly turned sour. "If the government does not grasp this opportunity, this victory will be lost," said Mr Kevin Watkins of Oxfam yesterday.
"Anti-retrovirals work," Mr Zackie Achmat, leader of the Treatment Action Campaign, said yesterday. "There is resistance if you misuse them and side-effects if you use them for too long. But South Africa has the best infrastructure of all developing countries and the majority of the population lives in urban areas, where there are nurses and doctors to administer the drugs."
The drugs companies' unconditional withdrawal of their case against the South African government yesterday would allow the government to seek cheap drugs on the international market. But the government gave no indication yesterday that it intended to obtain anti-retrovirals for the estimated 500,000 HIV-positive South Africans.
Doctors who have to deal with AIDS sufferers expressed frustration at their inability to treat them effectively. "I am sick and tired of giving multivitamins to manage a terminal illness," said Dr Glenda Gray, HIV physician at Johannesburg's Baragwanath hospital. "When you see people getting better with anti-retrovirals, you just cannot go back to vitamins."
The government's record on the issue of AIDS treatment is at best chequered. Last year, Dr Tshabalala-Msimang said anti-retrovirals were highly toxic and counterproductive, while President Thabo Mbeki openly doubted the link between HIV and AIDS.
These controversies have paralysed government action, limiting it to little more than the treatment of infections and to information campaigns.