AIDS and the scientific governance of medicine in post-apartheid South Africa
AIDS and the scientific governance of medicine in post-apartheid South Africa
复制标题
DOI：
10.1093/afraf/adm087
复制
发表时间：
2008-04-01
期刊：
影响因子：
2.8
通讯作者：
Nattrass, Nicoli
中科院分区：
文献类型：
--
作者：
Nattrass, Nicoli
种族隔离后南非的艾滋病政策一直受到对抗逆转录病毒药物（ARVs）的持续反感的影响。这种敌意最初是由姆贝基总统对艾滋病科学的质疑造成的，随后是对使用抗逆转录病毒药物实施预防和治疗方案的直接抵制。这场战斗在法庭和政治舞台上失败后，卫生部长Tshabalala-Msimang继续将抗逆转录病毒药物描述为“毒药”，并支持未经检验的替代疗法。人口模型显示，如果南非政府以与西开普省相同的比率使用抗逆转录病毒药物进行预防和治疗（西开普省无视抗逆转录病毒药物的国家政策），那么在1999年至2007年间，大约171,000例艾滋病毒感染和343,000例死亡可以避免。药品管制委员会（MCC）和医学研究委员会（MRC）这两个重要的科学机构属于国家卫生部的职权范围。虽然名义上是独立的，但由于它们对艾滋病采取的科学方法，它们都经历了政治干预。2006年，副总统负责协调艾滋病政策后，艾滋病政策有所改善。然而，对医学科学治理的破坏仍然是一个需要解决的遗留问题。
AIDS policy in post-apartheid South Africa has been shaped by persistent antipathy towards antiretroviral drugs (ARVs). This hostility was framed initially by President Mbeki's questioning of AIDS science and subsequently by direct resistance to implementing prevention and treatment programmes using ARVs. Once that battle was lost in the courts and in the political arena, the Health Minister, Tshabalala-Msimang, continued to portray ARVs as 'poison' and to support alternative untested therapies. Demographic modelling suggests that if the national government had used ARVs for prevention and treatment at the same rate as the Western Cape (which defied national policy on ARVs), then about 171,000 HIV infections and 343,000 deaths could have been prevented between 1999 and 2007. Two key scientific bodies, the Medicines Control Council (MCC) and the Medical Research Council (MRC) fall under the ambit of the national Department of Health. Although notionally independent, both have experienced political interference as a consequence of their scientific approach towards AIDS. AIDS policy improved after the Deputy President was given responsibility for coordinating AIDS policy in 2006. However, the undermining of the scientific governance of medicine is a legacy that still needs to be addressed.