Letter to the South African President, Minister of Health and all Members of Parliament,
concerning the development of a treatment plan and the declaration of a health emergency

President Thabo Mbeki
Minister Manto Tshabalala-Msimang
Members of Parliament
14th March 2001

Dear President Mbeki


The Treatment Action Campaign (TAC) believes that the current debate and discussion on whether to declare an emergency in relation to HIV/AIDS is important for all people in South Africa. For us the HIV/AIDS epidemic has always been a matter of great urgency. TAC supports COSATUís view that HIV/AIDS presents a serious threat to the future of South Africa and that it requires urgent, emergency measures. However, the government needs to complete a few steps before declaring a public health emergency.


Cosatu states correctly that the unnecessary loss of lives due to profiteering has reached crisis proportions in our country. This is an emergency. In addition, says Cosatu, there is no sign that the governmentís ABC message is working. TAC agrees. Treatment of people living with HIV/AIDS is the critical element that has been left out of the equation. Prevention and treatment are inextricably bound together. Most people will come forward to be tested only if there is a benefit to it, that benefit is treatment. Such an approach will encourage openness and allow social mobilisation. It also dispels the myth that HIV/AIDS is a "death sentence". Access to medicines, especially anti-retrovirals, remain beyond the reach of the majority of people and the government because of high prices and patent abuse. This is an issue of great urgency to all of us.

There are different ways of addressing the critical obstacle of patent abuse by drug companies - declaring a public health emergency is one of them. TRIPS, the World Trade Organisationís agreement on intellectual property rights allows exceptions in cases of "national emergency" or in "circumstances of extreme urgency". There are other routes such as applying for voluntary and compulsory licences in terms of the Patents Act as well. However, government should have a clear treatment plan before declaring a public health emergency.


The drug companies are on the defensive and they are lowering their prices. World opinion supports action by the government but undue haste will not automatically lead to solutions. TAC urges the government to immediately develop a treatment plan that includes a list of all the medicines needed to treat HIV/AIDS. This includes drugs for opportunistic infections and the prohibitively priced anti-retroviral medicines. A clear plan on training all health workers and a public campaign on voluntary counselling and testing is essential. Additional investment in clinics, laboratory facilities, hospitals and staff are essential components of a treatment plan. Sources of funding must be identified to ensure that a treatment plan is sustainable.

A public health emergency will suspend the property rights of drug companies on all essential HIV/AIDS medicines including anti-retrovirals. Governmentís first step to ascertain whether a public health emergency will be necessary will be to request, in writing from every drug company voluntary licences for opportunistic infection and anti-retroviral medicines. Such licences will allow local generic manufacture and competition on patented medicines. If they agree to voluntary licences such an emergency may not be necessary. But, government must ask them for licences now.

Another alternative is to use the Patents Act and to apply for compulsory licences through the Courts. Such a procedure might be more onerous because the drug companies will drag matters on forever in a Court of Law. Therefore, TAC calls on government to draft a Treatment Plan by 16th June 2001 and to make it an Act of Parliament. TAC also asks government to report to Parliament on drug company responses to requests for voluntary licences before 27th April 2001.

For people with HIV/AIDS, faced with imminent death and little prospect of treatment the matter is of great urgency as reflected in the Cosatu statement. TAC appeals to all politicians to practice restraint and to place the lives of people before petty politicking. The Democratic Alliance opposes the Medicines Act. Yet, the Medicines Act will prevent a situation that allows drug company profiteering at the expense of life. This is necessary for all medicines not only drugs needed for the treatment of HIV/AIDS. TAC asks all parties to initiate and support a motion in Parliament asking all drug companies to drop the court action against the government.

TAC once again draws your attention to the Memorandum delivered to Parliament on 12th February 2001 and urges government to respond to that Memorandum.

Yours faithfully

Zackie Achmat
(TAC Chairperson)

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