The pharmaceutical company Pfizer has offered to supply its antifungal preparation fluconazole (Diflucan) free to all those in South Africa with crypto-coccal meningitis caused by AIDS and who are too poor to buy the drug.
The move follows the start of a campaign by a group of non-governmental organisations known as the Treatment Action Campaign, whose work concerns issues of accessibility to treatment for those with HIV or AIDS.
The campaign and the charity Médecins Sans Frontiàres had asked Pfizer to provide the drug for about 10% of its usual price in South Africa or to allow the campaign to manufacture a generic equivalent for much less or import it from other countries where it costs less.
The drug is available in South Africa at about 38 rands (£3.80; $6) a tablet but is available in Thailand for around4 rands because of differences in patent protection. Médecins Sans Frontiàres's campaign was not confined to South Africa, but was launched in several other countries as well.
It was doubted initially whether the health ministry would place the resources needed at the disposal of public health facilities to ensure that patients with meningitis would be treated with the drug for no cost. The scepticism was caused by the government's uncertain approach to HIV and AIDS.
However, the health minister, Dr Manto Thsabalala-Msimang, together with other government representatives, various non-governmental organisations, and representatives of the National AIDS Council, met during the past week to discuss how to make the most of the Pfizer donation. A group of representatives was due to meet Pfizer this week to discuss how bestto use the donation and toclarify several outstanding issues.
Among these issues is the fact that the offer is extended only to those with cryptococcal meningitis and not to those with thrush, although this is the drug most useful for treating thrush in those with AIDS.
Around 10% of people with AIDS get cryptococcal meningitis, which comes fairly late in the progression of AIDS. Up to 40% however, are liable to contract thrush, which can also be treated successfully with fluconazole. This opportunistic infection hits earlier in the development of AIDS.