Providing antiretroviral treatment for all who need it in South Africa

In August 2003, the South African government announced its support for the provision of highly active antiretroviral therapy (HAART) in the public sector. This was a major break-through (antiretrovirals are now explicitly recognised as beneficial) but the Cabinet statement was very cautiously worded about actual implementation. The Ministry of Health has been instructed to develop a 'detailed operational plan' but it is increasingly clear that one of the major constraints on the scale and pace of the roll-out will be the amount of resources allocated to it. Given the discourse of 'unaffordability' which has dogged South African AIDS policy making over the past five years (Nattrass, 2004 forthcoming) it is likely that South Africa will opt for a limited intervention on the grounds that resources are best spent elsewhere