Aids problem overshadows Mbeki's prideBy Nicol degli Innocenti and John Reed South Africa is slipping backwards into underdevelopment, largely due toHIV/Aids, according to the United Nation's Development Programme's humandevelopment report, released on Tuesday.This is likely to embarrass Thabo Mbeki, South Africa's president, when he meetsUS President George W. Bush in Pretoria on Wednesday, as he would like to pointwith pride to his country's status as Africa's economic powerhouse and a driver ofpolitical integration.The report, which uses indicators such as life expectancy, educational attainmentand income, shows South Africa falling to 111th place out of 175 countries rankedworldwide, from 107th the previous year. It has dropped 28 places since 1990, theUN said, "primarily because more people were dying younger from Aids-relatedillnesses."John Ohiorhenuan, the UNDP's resident representative in the country, said: "SouthAfrica has slipped mainly because of lower life expectancy, due to Aids, and thedrop in enrolment rates, again due to HIV/Aids. A critical look is needed at theeffectiveness of some of the government's policies."The country has more than 4.7m infected people, the highest number in the world.The government insists its Aids strategy, which focuses on awareness, prevention,and nutrition rather than treatment is successful.But Aids activists, doctors and medical experts have criticised the government forfailing to agree a national treatment plan to provide anti-retroviral drugs to statehospitals and clinics.Life-prolonging anti-retroviral therapy is available to private patients, but most HIV-positive South Africans cannot afford it. An estimated 1m people wouldbenefit from ART.Manto Tshabalala-Msimang, the health minister and a staunch ally of Mr Mbeki,has said that anti-retrovirals are not effective, toxic, difficult to administer, and tooexpensive. Under pressure last year, she appointed a government team toinvestigate the cost of providing ART on the public health system.The long-awaited and unpublished report, completed in April, concludes that inspite of some infrastructure problems, a nationwide ART programme is feasible,affordable and necessary. The report says ART is the cheapest way to fight thepandemic, and estimates that even a 50 per cent roll-out would prevent 700,000deaths by 2008.The health ministry has not yet presented the report to cabinet. Critics accuse DrTshabalala-Msimang of delay tactics, when about 600 South Africans die everyday of Aids-related illnesses. The Treatment Action Campaign, South Africa'slargest Aids activist group, is threatening its second civil disobedience campaignthis year and court action against the government if a decision is not announcedsoon."There is no justification for further withholding the report from the public andfrom cabinet," said Mark Heywood, the group's national secretary. "The evidenceis overwhelming: the government is betraying its people by not taking Aidsseriously." Earlier this year the Bureau of Market Research at the University ofSouth Africa confirmed that 40 per cent of adult deaths in 2000 and 2001 wereAids-related. The report predicted that by 2015 the country's population of 44.8mwould reach 49m, 12m lower than without Aids.
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