Hungering for HAART

“I was not born with a hunger to be free. I was born free—free in every way that I could know … It was only when I began to learn that my boyhood freedom was an illusion, when I discovered as a young man that my freedom had already been taken from me, that I began to hunger for it.”

—Nelson Mandela (1)

Of any country in the world, South Africa is experiencing one of the most severe HIV epidemics. According to Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates, by the end of 2005, South Africa had 5.5 million people living with HIV and approximately 1000 AIDS-related deaths per day (2). A recent survey found that people in South Africa spend more time at funerals than while shopping, having their hair cut, or having barbecues (3). Clearly, urgent action is needed to reduce the impact of the pandemic in South Africa.

In this context, although the international community has widely commended South Africa's implementation of a government-funded antiretroviral program, the slow pace of implementing this program is causing growing concern. In 2003, South Africa stated an official plan to have more than 380 000 people enrolled in government-funded highly active antiretroviral therapy (HAART) programs between 2005 and 2006 (4). However, by September 2005, only 85 000 people in these programs …