THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE                                                          WINTER  2008

m e s s a g e  f r o m  
t h e  e x e c u t i v e

You will, I hope, be reading this at or immediately after the 
Durban AIDS Conference, an extravaganza held every two 
years and hosted this year by the Journal editor, Professor 
Linda-Gail Bekker. A huge amount of work goes into these 
conferences, and we hope this one is a massive success. The 
Society, funded by a generous grant from MTN, is support-
ing the skills-building workshops.

The Free State antiretroviral crisis is still not over, but ap-
pears to be a microcosm for the rest of South Africa. Un-
der-funding of the health system, appalling oversight by 
the previous Minister of Health and the South African cabi-
net, loss of health care staff and increasing costs of medical 
care have created multiple crises at various levels. Com-
bined with a cholera outbreak that paradoxically has noth-
ing to do with the Health Department and everything to do 
with crumbling municipal water infrastructure, things look 
grim for South Africa, especially when compared with some 
of its neighbours. Botswana boasts an antiretroviral pro-
gramme that would be the envy of some developed world 
countries. 

The Society asked its members to filter through any reports 
of rationing or drug stock-outs, triggering a deluge of e-
mails, faxes and phone calls, not just from the Free State 
but from across the country. Reports of other stock-outs, as 
well as staff shortages, have been fed to the Department.

In late February our new Minister of Health, Barbara Hogan, 
met with members of the Society, the AIDS Law Project, the 
Treatment Action Campaign and the South African National 
AIDS Council (SANAC) after we raised issues regarding the 
Free State problems. We were deeply impressed with her 
frankness and commitment, as well as the extent of her 
grasp of the problem. She has requested help in the form of 
reporting problems, and we are hoping to institute a more 
formal ‘problem helpline’ in the future.

The Minister needs help to fix the South African health care 
system. The Society is determined to give her whatever help 
we can.

FRANCOIS VENTER
President

SUMMER  2009                                                            THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE                                                  

Dr Francois Venter (HIV Clinicians Society), Jonathan Berger 
(AIDS Law Project), Mark Heywood (ALP, South African 
National AIDS Council), Minister Barbara Hogan (Department 
of Health), Adila Hassan (ALP), and Professor Helen Rees 
(SANAC, Reproductive Health and HIV Research Unit).

F R O M  T H E  E DI TOR

What an exciting time we are having in terms of HIV 
meetings in South Africa this year! I can't wait to finally get 
to the 4th SA HIV Conference in Durban, and in July we will 
be back here in the Fairest Cape at the HIV Pathogenesis 
Conference – always very worth while in terms of the new 
findings and new thinking it attracts. Both conferences 
have had an excellent number of abstracts, so peer reviewed 
input at both is going to be great.

This edition of the journal is the usual smorgasbord of 
HIV issues from guidelines to clinical, ethics and debate. 
It will be available at the Durban Conference. Honermann 
and colleagues explore the ethicolegal aspects of labour 
practices related to HIV-infected employees, and in 
particular the stance that the military took on HIV-infected 
recruits. Firnhaber and colleagues re-look at hepatitis B and 
HIV co-infection and review diagnosis, management and 
outlook. Osih and Venter give us a rapid-fire tour de force 
of the recent Conference on Retroviruses and Opportunistic 
Infections held in Montreal in February. Polly Clayden, 
a favourite author, brings us a clear review on the state 
of ART in relation to pregnancy. The Clinician's Society 
and a number of other groups present their consensus 
statement of timing for initiation of ART and who in our 

patient load should receive expedited ART commencement 
– an important reminder that despite the pervasive notion 
of ‘there is no emergency in HIV’, unnecessary delays 
in treatment can result in a great deal of morbidity and 
mortality. Practitioners need to be sure that perfection 
(taking many weeks to get a patient to the point of perfect 
‘readiness’) does NOT become the enemy of the good. We 
have two excellent pulmonary clinical case studies, one 
adult and one paediatric, and on the prevention front 
Kenyon and Badri explore the role of concurrency in STI 
and HIV prevalence – watch this space: I think we will be 
hearing much more about multiple concurrent partnerships 
in Durban and beyond. Soul City is currently also launching 
their ‘one love’ campaign. Finally, a cheerful project report 
from Hofmeyr and colleagues on the Keiskamma AIDS 
Treatment programme in the Eastern Cape is a lesson on 
what can be done at primary community level to save lives 
and turn bad statistics around. Wishing you good reading 
and great conferencing!

LINDA-GAIL BEKKER
Editor

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Message from the executive.indd   5 3/16/09   2:17:56 PM