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Last Updated: Monday, 4 August, 2003, 11:47 GMT 12:47 UK
Q&A: South Africa and Aids
At the first national Aids conference in Durban, South Africa, the government is coming in for heavy criticism over its approach to Aids.

BBC News Online looks at the reasons for the row.

What is the scale of the problem?

Aids is the biggest health crisis ever to hit South Africa, affecting almost everyone in some way.

South Africa has the single biggest HIV-positive population in the world, estimated at somewhere between four and five million, roughly 10% of its population.

Click below to see statistics on Aids in South Africa

Researchers say Aids is the leading cause of death in the country, accounting for one in four deaths.

Activists say some 600 South Africans die from Aids-related diseases each day.

What is the government doing about it?

The goals of the government's Aids Action Plan are preventing HIV transmission, reducing the impact of HIV/Aids and enhancing the ability of communities to cope.

They have worked hard to ensure safe sex messages reach young people and making condoms widely available.

But campaigning groups accuse the South African Government of not doing enough to treat those with the virus.

In particular they argue that the government should be doing more to provide anti-Aids drugs, known as anti-retrovirals (ARV), which when used have drastically reduced the number of deaths.

In July an unpublished government study was leaked saying the lives of 1.7 million South Africans could be saved in the next seven years if the government made anti-Aids drugs universally available immediately.

So why hasn't the government made these drugs universally available?

The government says it prefers to emphasise prevention and the importance of nutrition and poverty reduction.

Health Minister Manto Tshabalala-Msimang told the BBC recently: "We have never said we don't need anti-retroviral drugs. It is a matter of cost."

It's tragic that the leadership in South Africa have not looked at this epidemic as an incredible threat to really their economic and human survival in that country
Dr Mervyn Silverman
Aids campaigner

The government has maintained this position for some time, despite financial help being offered to provide free and very cheap drugs.

Many campaigners feel that cost is not the only issue and that the government is deliberately dragging its feet by delaying the publication of reports and questioning the safety of ARVs.

They blame President Thabo Mbeki and his handling of the crisis. He controversially queried the link between HIV and Aids, and dubbed anti-retroviral drugs "dangerous".

The row is best illustrated by the long running difficulties over the introduction of the only anti-retroviral drug approved by the government - Nevirapine.

Research has shown it can cut mother-to-baby infection rates by nearly a half.

But it was only approved last year, after the Treatment Action Campaign (TAC) pressure group won a court victory forcing the state to provide it to pregnant HIV-positive mothers.

Currently, only about 10% of HIV-positive pregnant women in South Africa have access to the medication.

But even this could now be under threat.

Recently the country's Medicines Control Council (MCC) threatened to ban the UN-recommended drug.

The MCC has given the drug's German manufacturer 90 days to prove the drug is safe, after it rejected a Ugandan study.

The TAC has now voted to resume its campaign of civil disobedience in its pursuit of ARVs for all.

The government has looked into the costs of providing them but is delaying any decisions.

Meanwhile, hundreds of people die every day because they are not being provided with the anti-retrovirals that could treat them.




SEE ALSO:
SA anti-Aids drug shock
31 Jul 03  |  Africa
SA media alarm at Aids drug move
01 Aug 03  |  Africa
SA Aids deaths report leaked
14 Jul 03  |  Africa
S Africa grows despite Aids
09 Jul 03  |  Africa
Africa forum tackles Aids
04 Jul 03  |  Africa


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