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'HIV drugs gave me back my life'

At that time, life-saving Aids medicines, widely available in the West, were too expensive for poor people in countries such as South Africa. The brand-name medicines, which cost R1 400 a month even with big discounts offered by drug companies, are still too expensive. But Damane, 25, from Khayelitsha, Cape Town, has now gained access to even lower-cost generic versions of the same drugs, imported from Brazil, and he credits them with restoring his health.

"I am now well," he told a packed news conference in Johannesburg on Tuesday as he held up a plastic pill box - with one pill compartment for each day of the week - that helps him to take his anti-Aids medicines on schedule.

Damane, a nervous smile showing under his blue baseball cap, was exhibit No 1 as a coalition of South African Aids activist groups announced they had imported the Aids medicines from Brazil in violation of drug-company patent rights but with the full blessing of the Medicines Control Council (MCC).

Citing preliminary results from a pilot project in Khayelitsha, the activists said the anti-Aids medicines had driven the amount of virus in people's bloodstreams to undetectable levels after less than one year of treatment and that Aids patients were getting up off what could have been their death beds and returning to productive work and family life.

"We literally resuscitated people," said Dr Eric Goemaere, who heads the Aids clinic run by Medecins Sans Frontieres (MSF) in Khayelitsha. The preliminary results from the Khayelitsha pilot study, which reported findings from among 85 patients taking the Aids medicines, represent the first evidence from a township clinic setting in South Africa that the anti-Aids drugs can be taken on a long-term basis and can have the same dramatic impact in improving health as they have had in industrialised countries.

The activists - drawn from the ranks of MSF, the Treatment Action Campaign (TAC), Oxfam and Cosatu - pointed to the findings on Tuesday in order to urge the South African government to set up pilot projects providing the medicines to symptomatic Aids patients in each province. They argued that the government should follow Brazil's lead and begin making its own low-cost generic versions of the drugs. "It is difficult but it is feasible in developing-country conditions," said Mark Heywood of the TAC.

The government did not respond to the activists' calls, and said the MCC would check whether the Brazilian imports were legal. The companies which own the patent rights for the drugs do not have plans to sue the activists. Dr Peter Moore, medical director at GlaxoSmithKline, said they would wait for the MCC to act. Kevin McKenna, spokesperson for pharmaceutical company Boehringer-Ingelheim, said he was not surprised at the developments. "I don't think we're falling off our chairs at the moment.

This situation has been threatening for some time," he said. The Khayelitsha study, begun in May, enrolled patients in the final stages of Aids who were given a combination of three drugs - AZT, 3TC and Nevirapine.

Now 24 of the 26 patients who have been followed since the beginning have no detectable HIV in their blood. One of them is Damane. He said he takes two pills in the morning and two in the evening. The government has warned that such drugs may be too toxic and too difficult to take. Damane did report initial side-effects - dizziness, nausea, diarrhoea and a skin rash. But those abated. He said he had no problem sticking to the regimen.

"It is my life," he said. The activists called on the government to apply for compulsory licences that would allow local companies to make generic drugs. The brand-name drugs cost $5 (about R57) a day, while the generics cost $1,55 (R18). For Damane, the drugs can't come soon enough. He said it was hard to live knowing that his HIV-positive friends did not have access to the same life-saving medicines. "I am not happy that I am on anti-retroviral therapy and others are not."