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Last Updated: Thursday, 1 April, 2004, 10:24 GMT 11:24 UK
S Africans fight for Aids drugs
By Justin Pearce
BBC News Online, South Africa

Cynthia Nkuna feels she has been given another lease of life.

Cynthia Nkuna
Nkuna's husband does not believe she is infected with the virus
Mrs Nkuna, 38, is HIV positive, and last year started receiving the anti-retroviral (ARV) drugs that suppress the effects of the virus.

She lives with her husband and six children in Orange Farm, a poor community of shacks and self-built houses, south of Johannesburg.

Mrs Nkuna obtains the ARVs from an organisation called the Treatment Action Campaign (TAC).


Up to now, these drugs have not been supplied at government health clinics in this province.

She said she was diagnosed with HIV after developing skin rashes and tuberculosis.

Those who are sick can be strong
Matsidiso Madondo
"The clinic just gave me a cream for the rash, and advised me to eat healthy foods," Mrs Nkuna says.

"I did not know about ARV. I was worried, knowing my youngest children were so young - I felt I would leave them and die, and who would look after them then?" she said.

Mrs Nkuna says her husband still refuses to accept that she is infected with HIV.

Denial and misinformation continue to hamper the fight against the virus.

'Ancestors curse'

Just around the corner, Matsidiso Madondo, 30, proudly wears a T-shirt that declares "HIV positive".

Women at a government clinic
The government says ARV drugs will now be supplied to state hospitals
Ms Madondo says she is strong and well after starting the course of ARV treatment.

She has a home business selling beer and supports her two children and other relatives.

But her younger sister, she says, is also HIV positive and refuses to face reality.

"She is very sick, but she believes the ancestors have brought this on her. The sangoma (traditional healer) told her this, and said she must keep a chicken in the house to cure it," says Ms Madondo.

Tough choices

At least five million South Africans - one in eight people - are estimated to be infected with HIV.

Cynthia Nkuna and Matsidiso Madondo are, in a sense, the lucky ones.

Limited funds mean that TAC, can at present supply drugs to only 10 people in the whole of Gauteng province, which includes the cities of Johannesburg and Pretoria.

Dudu Dlamini, who co-ordinates TAC's treatment programme for the province, says it is "depressing" having to decide who qualifies for treatment.

Ms Dlamini looks forward to the day when people with HIV can get ARV drugs through the state health care system.

Infected mothers

For several years, TAC has been putting pressure on the government to make ARVs available.

Ms Dlamini, who is herself taking ARV drugs, became involved in TAC after her own child died of HIV-related illness.

We will be watching very carefully, and if [the health minister] doesn't follow through on this commitment, we will reassess our position
Jonathan Berger, Aids Law Project

"I didn't want anyone else to suffer the way I did," she says.

TAC at the time was bringing a court case against the government, demanding that clinics supply the drug Nevarapine to pregnant mothers, to prevent their babies from becoming infected.

Her face lights up as Ms Dlamini remembers: "To see women giving birth to HIV-negative babies..."

Government retreat

Following a further court case last year, and after two provincial governments rebelled against national policy and started distributing ARVs, the national government started to reconsider its position on the drugs.

Last week, Health Minister Manto Tshabalala-Msimang announced that her department would give the option of ARV treatment to people whose CD4 count (a measure of the spread of the virus in the body) had dropped below 200.

Matsidiso Madondo and her children
Matsidiso is able to run a business after getting Aids drugs
Activists are relieved, but wary.

"The minister has agreed to implement what we wanted, and the government will be procuring drugs in the interim," said Jonathan Berger of the Aids Law Project - a group which was considering further legal action against the government, but put its plans on hold when the minister announced the policy change.

"We will be watching very carefully, and if she doesn't follow through on this commitment, we will reassess our position," said Mr Berger.

Clinics in Gauteng are due to start distributing ARVs in early April, but this will be more complicated than simply handing out bottles of pills.

Drugs have to be taken at specific times each day, and even a slight irregularity can cause a serious setback in a patient's condition.

Ms Dlamini says TAC intends to work with the provincial government, using the experience it has built up through working with carriers of HIV, and monitoring treatment.

Back in Orange Farm, Matsidiso Madondo looks forward to the day when all carriers of HIV can be as active as she is.

"The government should give ARVs to everyone. Those who are sick can be strong," says Ms Matsidiso.

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