San Francisco - Knowing that it will take strong medicine to stem the AIDS avalanche, some doctors in South Africa are doing what the government still won't do - provide anti-retroviral (ARV) drugs to AIDS sufferers. In Khayelitsha, a sprawling shantytown near Cape Town, the Nobel Peace Prize winning group Doctors Without Borders is treating 300 patients, all of whom are in the advanced stages of the disease.
The goal is to counter the government's claim that treatment is impossible - and even dangerous, because of the possibility of developing resistance to ARV drugs - without the sophisticated medical infrastructure and extensive blood testing common in the West. Patients are treated by nurses, not doctors, and their infection levels and immune response are tested only twice a year. The results so far provide hope for a nation in need: 90 percent of the first group of patients had undetectable levels of HIV after three months of treatment.
A similar program is being carried out at Chris Hani Baragwanath Hospital in Soweto, where doctors are providing ARVs with the help of a $22 million grant from the National Institutes of Health. When the project is in full swing, it will be giving the drugs to 1,800 people in Soweto and the Cape Town area. In collaboration with Pangaea, an affiliate of the San Francisco AIDS Foundation, the doctors in Soweto have applied for a $15 million Secure the Future grant from Bristol Myers Squibb to offer ARVs to another 2,100 patients.
Earlier this month, Nelson Mandela, who has served as a sort of conscience of the nation on the AIDS issue, raised the stakes even higher. The Nelson Mandela Foundation and the South African Medical Association joined forces to announce the nation's largest program ever to provide anti- retroviral drugs. It is seeking $8 million in donations to provide free medicines to 9,000 patients at 18 sites across the country. "Talk is necessary but it is not sufficient," Mandela said in introducing the program. "The test is what you are doing on the ground."