In issuing its request to the Department of Health, the Cabinet endorsed the recently released report of the Joint Health and Treasury Task Team Charged with Examining Treatment Options that estimated that a national program employing ARVs to treat the most seriously compromised individuals could save 500,000 to 1.7 million lives over the course of 5 years, depending on the eventual scope and successful implementation of such a program. South Africa has been hit hard by the AIDS epidemic, with approximately 5.3 million of its 45 million people infected with HIV. According to Task Team Report estimates, 400,000 to 500,000 of these people have already developed AIDS.

On August 20, in response to the Cabinet's request, Minister of Health Manto Tshabalala-Msimary appointed a National HIV and AIDS Treatment Task Team to coordinate the drafting of the countrywide plan for the universal rollout of ARVs. Dr. Anthony MBewu, Executive Director for Research at the Medical Research Council of South Africa chairs the Task Team. Dr. Nono Simelela, Cluster Manager for HIV & AIDS, Tuberculosis and Sexually Transmitted Infections in the Department of Health was named coordinator for implementation of the plan. The Team also includes other experts in the health sector and senior officials from the Department of Health. The Team has been assisted by senior representatives and experts assembled by the William Jefferson Clinton Foundation, including Pangaea and others who have advised on similar countrywide planning efforts in countries such as The Bahamas, Rwanda, and Tanzania.

At Pangaea, we believe that conditions are right for the mobilization of such an ambitious planning effort. The price of ARVs continues to come down and progress is being made at the WTO-level with regard to a worldwide agreement on the licensing and production of generic drugs for utilization in the developing world. Earlier this year, the United States, with a personal pledge from President Bush, stepped forward to offer increased funding to develop HIV/AIDS care and treatment programs and challenged other countries in the developing world to do the same. Countries like Brazil have shown that it is possible fight HIV/AIDS on a national level. In Africa, smaller countries like Rwanda and Tanzania, with fewer resources and less-developed medical infrastructures than South Africa, have completed the countrywide planning process and will begin phasing in long-term HIV/AIDS care and treatment plans later this year.

We have learned a great deal in just a few years about how to build and replicate sustainable HIV/AIDS care and treatment programs in the developing world and these lessons can now be utilized in South Africa as local, provincial and national agencies gear up for the planning and implementation effort. Necessary components of a comprehensive program include HIV testing and counseling, services coordination, medical treatment including ARV drug therapy, clinical monitoring and adherence support, psychosocial care, community and home-based care, ancillary support services, and prevention education and counseling. All these elements must be woven together to build successful local programs; with the proper planning, funding, and government support, we are confident that South Africans will be successful in this ambitious initiative.

South Africa has great challenges in dealing with HIV/AIDS, but it has great resources as well. The economy is strong and diverse. The medical infrastructure in South Africa, while obviously in need of further enhancement to deal effectively with the proposed HIV-AIDS treatment program, is among the strongest on the continent. The government is strong and stable. Numerous grass roots organizations are active in the fight against the disease.

As we have seen in Rwanda and other countries, the first step in building a countrywide care and treatment program is to have support from the highest levels of government. It's clear from the strong statement by the Cabinet and the prompt follow-up by the Department of Health, that President Mbeki and his senior advisors have given the new initiative their full support. The South African government should be supported in their historic effort to create a comprehensive approach to HIV prevention, care and treatment across the nation.