AIDS Treatment and Human Rights in Context by Peris S. Jones (auth.)

By Peris S. Jones (auth.)

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He said he was getting worse. It was in his mind that they are going to kill him. So they could n’t do much in his body because he did n’t believe in them. After a week, he said: “No more anti-retrovirals. Say anti-retrovirals and I’m going to scream”. He never took them again. ” What followed was an odyssey of alternative treatments, such as consultations with sangomas, spiritualism, an herbal remedy put into pill form by someone medically unqualified to do so, and a nurse, apparently sent by the Minister of Health to administer a concoction of lemon juice and olive oil to be used with pills (Africa’s Solution), with extracts from the African potato.

The Struggle to Access Treatment and Other Services in South Africa O 27 And those cultural understandings have been inescapably influenced by the racist context of apartheid South Africa. In particular, the chemical warfare program of the late apartheid era provided fertile ground for conspiracy theories to flourish. Evidence emerged in the 1990s that this program had been used to kill and maim black opposition figures. AIDS itself became associated with similar racial motivations, allegedly to reduce the black population.

These, it is argued, should be carefully scrutinized so that they provide inclusion rather than exclusion of patients. A fundamental issue in access concerns the prevailing public health emphasis upon adherence or likelihood of adherence as the key determinant in initiating someone into treatment. This is inherently about medical efficacy rather than other ethical principles discussed. The chapter therefore looks in detail at South Africa’s guidelines in order to illustrate some of these trade-offs and dilemmas.

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