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The personal views of Mr Loefler (October 2002 JRSM1) are at odds with those of the WHO and inter alia the last two International AIDS Conferences where the rolling out of treatment for HIV/AIDS in developing countries was high on the agenda. The issue is not only one of a basic human right for the recipient, whether they be in developed or developing countries, but also of helping prevent the spread of HIV/AIDS. His experiences in Nairobi, Kenya, do not necessarily speak for the rest of Africa or possibly elsewhere outside his domain in Kenya.
Here in South Africa, the Government has now accepted that a coordinated countrywide response is necessary to confront the spread of HIV/AIDS. Its National Strategic Plan 2000-2005 embraces the five thrusts of the WHO—treatment, care and attention; research, evaluation and monitoring; prevention; ethical and human rights considerations; and communication and education. The treatment component includes the use of antiretrovirals. Several successful interventions with antiretrovirals as part of holistic thrusts within and outside reproductive health have been reported, not only here in South Africa but throughout developing countries in Africa and other parts of the world.
The spread of HIV/AIDS is reaching epidemic proportions in South-east Asia, India, China and some areas of Central and Eastern Europe, fuelled by prejudices of the kind expressed by Mr Loefler. Notably two developing countries, which had embarked on coordinated responses, have managed to contain their countries' epidemics—i.e. Brazil and Thailand. Now here in South Africa as well as in Brazil it was the ground-swell from rural and urban communities, labour and other grass-roots levels that positively influenced the national response.