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South Africa launches world's biggest anti-AIDS drive

Jacob Zuma's government rolls out massive plan to test and provide treatment.

Fanelwa Glwasshu, 39, wears a T-shirt indicating that she is HIV-positive, in Cape Town's Khayelitsha township, Feb. 22, 2010. Some 5.5 million people live with HIV/AIDS in South Africa — more than in any other country — while 33 million people live with the disease worldwide. Brightly colored T-shirts with the HIV-positive logo are distributed by the Treatment Action Campaign to reduce the stigma surrounding the disease. (Finbarr O'Reilly/Reuters)

JOHANNESBURG, South Africa — As South Africa ramps up a high-profile campaign to test 15 million people for HIV in the next year, experts are questioning whether the country’s struggling health care system can support this massive new undertaking.

The world’s most ambitious HIV testing campaign is appropriate for South Africa as it has more people with the AIDS virus than any other country. But until recently South Africa's fight against the disease was held back by the denialist policies of the government of former president Thabo Mbeki.

To help staff the new campaign, some 2,500 retired health care workers, including doctors, nurses, pharmacists and counselors, have been recruited to return to work. In addition to widespread testing and counseling, the government aims to provide antiretroviral treatment to 80 percent of the more than 5 million HIV-positive South Africans.

Mark Heywood, deputy chairperson of the South African National Aids Council, which is leading the effort, admits that “the capacity of the system to manage the numbers” is one of the main challenges ahead. “We’re already breaking the bank,” he said.

While South Africa’s government currently might not have all the resources to meet the demands of the campaign, Heywood is confident that “we will manage to meet them as we go along.”

Treatment Action Campaign, an activist group, says it will be monitoring the implementation of the testing as well as updating of the treatment regime. Revised guidelines for antiretroviral treatment came into effect early in March and will see earlier treatment for pregnant women, people with HIV and tuberculosis, and HIV-positive babies.

“We want this campaign to be properly implemented and we are facing a health care shortage,” said Catherine Tomlinson, a senior researcher with TAC. “We don’t want this to be a short-term campaign.”

An estimated 5.7 million South Africans are HIV-positive. The new campaign, which receives support from international agencies including UNAIDS and the U.K.’s Department for International Development, will see free testing available at the health department’s 4,300 clinics and hospitals, as well as at hundreds of retail pharmacies around the country. At least 1 million more people will begin treatment in the next few years as a result of the increased testing and access to AIDS medicines, according to the government. As part of prevention efforts, 1.5 billion condoms will be distributed this year.

Jonny Steinberg, author of "Three-Letter Plague: A Young Man’s Journey Through a Great Epidemic," described the campaign’s planned expansion of antiretroviral treatment to as many as 2 million people as “the greatest challenge the country’s rickety health care system has faced” since the end of apartheid.