Aids Bulletin - March 2005 Vol. 14, No. 1

By the end of 2004, about 11 000 of the approximately half a million people urgently needing ARVs in South Africa had access to them. The Operational Plan for comprehensive HIV/ AIDS care, management and treatment for South Africa envisaged that 153 000 people would be on ARV treatment by March 2005. This enormous shortfall is not a matter of numbers, it is a matter of lives. One of the main reasons for delays in the roll-out has been limited drug supply; such that accredited sites must continually delay treatment initiation because they cannot guarantee a steady supply of drugs to patients. This is the result of endless delays in the formal tender process at national level. Before the roll-out began, great concern was expressed about the capacity of an under-resourced public health care system to implement ARV treatment. Yet despite under-staffing and limited training opportunities, South African health care workers in ARV provision sites have proved themselves equal to the task of ARV treatment provision. And South African HIV/ AIDS patients have begun to show en mass that pessimism regarding their capacity to adhere to complicated drug regimes is unfounded. The people of South Africa, those who are affected by this epidemic and who are at the forefront of fighting it, have once again shown their mettle. And it is due to their efforts - in making the roll-out thus far a success - that any excuses as to why ARV treatment remains unavailable to the vast majority have indeed now run out. In this special issue of the AIDS Bulletin, we look at the enormous potential of the ARV roll-out for strengthening the public health sector as a whole - if the challenges involved are firstly, acknowledged and secondly, met - by all. In this regard, academics and researchers have an important role to play, not just in evaluating and monitoring the roll-out, but in contributing their skills and expertise to the development of an efficient, integrated and equitable public health care system. We are confident that this edition of the Bulletin reflects this contribution and would therefore like to thank all the authors who have contributed. We also thank Research Matters for funding this edition of the AIDS Bulletin