Chronology of HIV/AIDS treatment access debate
Wednesday 8 October 2003


East Africa
Great Lakes
Horn of Africa
Southern Africa
·South Africa
West Africa


Country Profiles
Conferences / Research
Job opportunities

News Briefs

AFRICA: Generic AIDS drug plan supported
SOUTH AFRICA: Mining company leads in AIDS treatment
AFRICA: Stronger support urged for adolescent AIDS
PlusNews E-mail Subscription

SOUTH AFRICA: Chronology of HIV/AIDS treatment access debate

JOHANNESBURG, 19 August (IRIN) - The South African cabinet finally approved the provision of AIDS drugs to HIV-positive citizens through the public health system on 8 August. It instructed the health ministry to act "with urgency".

This announcement came after months of a bitter row between South Africa's AIDS activists and the department of health, over the delay in implementing a treatment policy. The following is a chronology of events in the treatment access debate, from December 2001 through to the government's decision this month to introduce a treatment plan.

2001: December - The Pretoria High Court orders the South African government to provide antiretrovirals (ARVs) to all HIV-positive pregnant women after a court case brought against the government by AIDS lobby group, the Treatment Action Campaign (TAC). In their application TAC argued that the government had a duty to offer nevirapine under the constitutional right to health care.

In handing down his judgement, Justice Chris Botha said the government should provide a programme on how they will extend their mother-to-child transmission (MTCT) prevention scheme by the end of March 2002. The government's MTCT programme was initially restricted to 18 national pilot sites. Doctors at state hospitals which were not part of the pilot sites were not allowed to prescribe nevirapine.

2002: 21 January - The KwaZulu-Natal provincial government announces that HIV-positive pregnant women in state hospitals will receive nevirapine. KwaZulu-Natal becomes the second province, after the Western Cape, to defy government policy by making the drug available.

February - Finance Minister Trevor Manuel announces that in addition to an estimated R4 billion (US $348 million) spent by provincial health departments on AIDS-related illnesses, funding for "prevention programmes, hospital treatment and community-care programmes will amount to R1 billion (US $87 million), rising to R1.8 billion (US $156 million) in 2004/5."

This amount includes a "progressive rollout of a programme to prevent mother-to-child transmission at the conclusion of the current trials."

1 February - International humanitarian organisation, Medecins Sans Frontieres (MSF) and TAC announce they are importing generic drugs from Brazil for their pilot ARV programmes.

March - When asked during an interview on national television if government would be prepared to follow the court order to roll out its nevirapine programme, minister of health Tshabalala-Msimang was quoted as saying: "No, I think the courts and the judiciary must also listen to the authorities — regulatory authorities — both from this country and the United States."

28 March - The government announces it will appeal the Pretoria High Court judgement, ordering them to provide nevirapine to HIV-positive pregnant women, in the Constitutional Court.

5 April - The 2001 High Court decision ordering the state to roll out nevirapine is upheld by the Constitutional Court, which points out that by restricting nevirapine to 18 pilot sites, government is violating the constitutional rights of women and their babies.

17 April - In a cabinet briefing, government announces that survivors of sexual assault and rape can finally receive ARVs. A hospital superintendent had earlier been discharged for insubordination because he accommodated the Greater Nelspruit Rape Intervention Project (GRIP) in his facility. GRIP was the first NGO to provide antiretroviral prophylaxis for rape survivors in cooperation with doctors.

26 April - The Global Fund to Fight AIDS, TB and Malaria awards the country a US $165.2 million grant. But Tshabalala-Msimang blocks the US $72-million grant awarded to KwaZulu-Natal, saying the province should not have approached the Fund directly.

June - The release of the 2001 antenatal survey showed a minimal increase of 0.3 percent in the national HIV prevalence rate, taking the overall figure for people aged between 15 to 49 to 20.4 percent.

July - Findings from the 14th international AIDS conference in Barcelona, Spain, demonstrate that AIDS treatment campaigns are possible in poor communities. Tshabalala-Msimang, attending the international conference, is quoted as saying ARVs are "poisons" killing "our people".

August - Mining giant Anglo American says it will pay for ARVs for its workers, as part of its expanded HIV/AIDS strategy.

October - During the launch of its "Campaign of Hope" for AIDS, cabinet issues a statement acknowledging that ARVs could "improve the condition of people living with HIV/AIDS" and says government is addressing challenges such as drug prices "to make it feasible and effective to use antiretrovirals in the public health sector".

14 October - Deputy-President Jacob Zuma meets with representatives from TAC for the first time, indicating a thaw in relations between the groups.

17 December - In an interview with the Guardian newspaper, Tshabalala-Msimang is reported as saying budgetary priorities meant her department could not provide ARVs to HIV-positive South Africans. "South Africa cannot afford drugs to fight HIV and AIDS, partly because it needs submarines to deter attacks from nations such as the US," the newspaper quotes her as saying.

25 December - The National Association of People Living with HIV/AIDS launch a fasting protest outside the offices of GlaxoSmithKline as part of its 'Black Christmas' campaign to demand free ARVs.

14 February 2003 - AIDS activists march to the opening of parliament to call for a national treatment plan to provide free ARVs to all those who need them. AIDS advocacy groups say they have been left with no choice but protest action, after the government failed to sign a National Economic Development and Labour Council (NEDLAC) agreement for a treatment and prevention plan last year.

21 February - The government will not elevate HIV/AIDS above other diseases by giving it priority attention, Tshabalala-Msimang is reported as saying. She had seen the draft treatment plan drawn up by NEDLAC, but no one would compel her to sign as the state had many pressing issues to deal with.

27 February - Finance minister Manuel announces plans to almost double the amount spent on HIV/AIDS. Over the next three years, R3.3 billion (US $400 million) will go towards extending preventative programmes and finance "medically appropriate" treatment for HIV/AIDS.

28 February - Government misses the TAC deadline for signing the NEDLAC framework agreement for a national HIV/AIDS treatment and prevention plan.

March - The health minister again comes under fire for appointing AIDS dissident Roberto Giraldo as her nutritional adviser.

18 March - Tshabalala-Msimang denies undermining the importance of ARVs but maintains the need for adequate infrastructure before rolling out a treatment plan. "I want to put the infrastructure in place before freely distributing it. However, it appears the Constitutional Court is forcing me to do it. In my heart I believe it is not right to hand them [ARVs] out to my people."

19 March - In an update on the national HIV/AIDS plan, government says the work of a joint technical team tasked to look into the resource implications of an expanded response to HIV/AIDS, including antiretroviral treatment, is nearing completion and cabinet will be considering the findings. But Manuel slams calls for ARVs, saying claims about the effectiveness of the drugs in the treatment of HIV/AIDS are "a lot of voodoo" and spending government money on them is "a waste of very limited resources".

20 March - TAC launches its civil disobedience "Dying for Treatment" campaign. Activists lay charges of culpable homicide against Tshabalala-Msimang, and Minister for Trade and Industry Alec Erwin, for failing to prevent an estimated 600 AIDS-related deaths every day.

April - Global Fund executive director Richard Feachem flies into the country expecting to sign an agreement allowing the grant money to be released. The government blames last minute hitches and there is no signing. "This is very disappointing. The work is urgent and the money needs to flow - the delay in money means a loss of human lives. These are life and death issues," Feacham is quoted as saying.

23 April - South Africa's AIDS policies are failing and the government urgently needs to make drugs freely available, a report by the South African Human Rights Commission (SAHRC) says. Despite the creation of one of the most comprehensive policies and enabling legislation in the world, the country had not succeeded in implementing these plans sufficiently to make an impact on reducing the prevalence of HIV/AIDS, the SAHRC report warns.

1 May - Following a meeting with Deputy-President Zuma, TAC announces it will suspend its civil disobedience action aimed at forcing the government to introduce a national HIV/AIDS treatment programme. TAC says they will meet with the government in June to try to iron out disagreements over the treatment plan.

28 July - The use of nevirapine to prevent mother-to-child transmission (MTCT) of HIV in South Africa comes under threat after drug regulatory body, the Medicines Control Council (MCC), gives pharmaceutical company Boehringer-Ingelheim 90 days to provide new data on the safety of the drug. If Boehringer-Ingelheim fails to come up with new evidence supporting the use of the drug, nevirapine's registration for use in MTCT will be withdrawn.

August - TAC holds its annual congress and decides to resume the civil disobedience campaign it suspended earlier this year following talks with Zuma.

3 August - Department of health director-general Dr Ayanda Ntsaluba tells delegates attending the country's first national AIDS conference that the state's provision of ARVs is no longer a matter of "if, but when and how ... and at what pace".

7 August - The agreement between the government and the Global Fund is finally signed, with the Fund committing US $41 million to the country over two years.

8 August - Cabinet issues a statement instructing the health department to develop a "detailed operational plan" for the ARV rollout.

See also

SOUTH AFRICA: Special Report on AIDS treatment programme

Fact Box on antiretroviral therapy



Recent SOUTH AFRICA Reports

Govt clarifies Mbeki's statement on HIV/AIDS,  30/Sep/03
MCC softens stance on Nevirapine,  15/Sep/03
Government releases long awaited AIDS figures,  11/Sep/03
Second vaccine trial given go-ahead,  26/Aug/03
Special Report on AIDS treatment programme,  19/Aug/03


Inter Press Service (IPS)
The Global Fund to fight AIDS, Tuberculosis & Malaria
The NGO community in Botswana
UN System for Mozambique
The Body: A Multimedia AIDS and HIV Resource

PlusNews does not take responsibility for info in links supplied.


PlusNews is produced under the banner of RHAIN, the Southern African Regional HIV/AIDS Information Network. RHAIN's members currently include:


  • IRIN

  • Inter Press Service (IPS)



  • Health Systems Trust

  • Health & Development

  • GTZ/Afronets

[Back] [Home Page]

Click to send any feedback, comments or questions you have about IRIN's Website or if you prefer you can send an Email to

The material contained on this Web site comes to you via IRIN, a UN humanitarian information unit, but may not necessarily reflect the views of the United Nations or its agencies. If you re-print, copy, archive or re-post any item on this site, please retain this credit and disclaimer. Quotations or extracts should include attribution to the original sources. All graphics and Images on this site may not be re-produced without the express permission of the original owner. All materials copyright © UN Office for the Coordination of Humanitarian Affairs 2003