IsiXhosa - Treatment Action Campaign

Magazine of the Treatment Action Campaign 

treatment 

UMzabalazo wonyango 

usaqhubekeka 

Ufikelelo kunyango: Bona ukuba 

amanye amazwe agcina njani 

Kutheni ipilisi enye kuphela, kanye 

ngemini sele iza kuba yinyani 

Into ekufuneka uyazile nge-tenofovir 

kunye nezikhokelo ezintsha zonyango 

June 2010 

1

Umhleli: Marcus Low 

Usekela Mhleli: Mara Kardas-Nelson 

Umhleli Wekopi: Cathy Goudie 

Abafake isandla: Lihle Dlamini, Catherine Tomlinson, 

Mary-Jane Matsolo, Ntombizonke Ndlovu, Andrea 

Zeelie, Adam Malapa, Catherine Karlsson, Malusi 

Mbatha, Lamya Moosa, Nathan Geffen 

Uqweqwe lwangaphambili: Photo by Brendan 

Bannon/International Federation of the Red Cross. 

Iifoto: Brendan Bannon/International Federation of 

the Red Cross, Mara Kardas-Nelson, Zethu Mlobeli, 

Damien Schumann, Roulé le Roux, Eric Miller, Oupa 

Nkosi/Mail & Guardian, David Harrison, Delwyn 

Verasamy/Mail & Guardian, Ntombizonke Ndlovu, 

David Chancellor/International Federation of the Red 

Cross, Adam Malapa, Malusi Mbatha, Gallo Images/ 

Getty Images, Roger Segelken/Cornell University 

News Service, Mike Blyth, Paul Bettings, Suraj 

Mishra, Mary-Jane Matsolo, Talia Frenkel/American 

Red Cross, International Federation of the Red Cross, 

Emily Chastain, blog.dragonballyee.com, Paymon 

Ebrahimzedah. Illustration on page 12 by Brice Reignier 

Imibulelo ekhethekileyo ku-Simon Collins of 

HIV i-Base, Professor Mark Cotton, director of the 

Children’s Infectious Disease Clinical Research Unit 

at the University of Stellenbosch, and to the Médicins 

Sans Frontières – Campaign for Access to Essential 

Medicines and MSF South Africa office 

Usasazo: Kagiso Seleka 

Uyilo: Designs4development, www.d4d.co.za 

Ushicilelo: CTP Book Printers 

Iguqulwe yi-Bohle Conference and Language Services 

I-TAC izibophelele ekuboneleleni abantu abane- 

HIV, iintsapho zabo kunye nabakhathaleli ulwazi 

oluchanekileyo olumalunga namayeza asindisa 

ubomi kunye nonyango. I-TAC kunye neenkokheli 

zayo bazimele kwishishini loxubo-mayeza ngokunjalo 

nakumashini amayeza endalo kunye namayeza 

angamanye kwaye ayinamdla wezemali kuwo. 

Olu hlelo lwe-Equal Treatment luxhaswe Global Fund 

to Fight AIDS, Tuburculosis and Malaria and by Oxfam 

Australia. 

Le magazini ifumaneka ngeXitsonga, isiXhosa 

nesiZulu. 

Ungalufumana olu hlelo kunye nezinye iintlelo 

ze-Equal Treatment ku- www.tac.org.za/community/ 

equaltreatment/ 

Equal Treatment is 

published by the Treatment 

Action Campaign 

Idilesi yePosi: PO Box 2069, Cape Town 8001 

Idilesiye Sitalato: Westminster House, 

122 Longmarket Street, 3rd Floor, Cape Town 8000 

Inombolo yomNxeba: 0861 END HIV 

Ifeksi: +27 21 422 1720 

I-Website: www.tac.org.za 

II-Ofisi zesSithili ze-TAC 

ISithili sesa-Khayelitsha: 021 364 5489 

ISithili sase-Ekurhuleni: 011 873 4130 

ISithili saseLusikisiki: 039 253 1951 

ISithili saseMgungundlovu: 033 394 0845 

ISithili i-Gert Sibande: 017 811 5085 

2 

ISithili saseMopani: 015 307 3381 

IzIqulatho 

amaphepha 

2 –15 

amaphepha 

16–21 

amaphepha 

6 –7 kunye 

namaphepha 

14–15 

uhlelo 33 – Juni 2010 

IsiXhosa 

Izikhokelo ezintsha nethenda ye-ARV 

Emva kokulinda ixesha elide izikhokelo 

zonyango lwe-antiretroviral zoMzantsi 

Afrika zide zahlaziywa ekugqibeleni. 

Make sijongeni olunye lolu tshintsho 

lubalulekileyo kwizikhokelo, 

siphonononge ukuba kungenzeka 

umntu athathe ipilisi enye kanye 

ngemini, kunye nokumisela okufunwayo 

kwithenda ye-antiretroviral ka-2010. 

Imfuno yamachiza angcono 

Unyango lwabantwana abane-HIV 

lunokwenziwa ukuba lube lula kakhulu 

ngeendibaniselwano zamachiza. 

Siphonononga ukuba yintoni engenziwa 

ukuqinisekisa amayeza alungele 

abantwana ayafumaneka. Sikwaxoxa 

noxhathiso kumachiza kunye nokuba 

kungenzeka ukuba abantu abaninzi 

kungafuneka ukuba batshintshele 

kunyango lwesibini olubizayo 

nolukuluhlu olulandelayo. 

Ufikelelo: Ngoko nangoku, apha 

naphaya 

Ngexa wonke umntu ethetha ngokuba 

iza kuba njani iNdebe yeHlabathi, sikala 

ukuba athelekisa njani na amazwe xa 

kuza ekujonganeni ne-HIV – kwaye 

abase-Brazil baqhuba kakuhle. 

Sikwakuzisa la nexesha lokwenzeka 

kweziganeko elibonisa ukuba ufikelelo 

kunyango lutshintshe njani na 

ngokuhamba kweminyaka.

Ifoto ngu-Mara Kardas-Nelson 

Ndaba ngomnye wabantu bokuqala owaba nethamsanqa 

ukuba afumane unyango lwe-I antiretroviral (ART) oko 

kusenzeka ngeProjekithi yoNyango le-Treatment Action 

Campaign (Iphulo eliZabalazela uNyango) ngo-2003, 

xa isibalo sam se-CD4 sasingama- 91. Ngelo xesha 

urhulumente wethu waye wathandabuza ukunika abantu 

abane-HIV ii-antiretrovirals (ARVs) ngenxa yezimvo 

zokungafuni ukukholwa koosopolitiki abaphezulu. 

Abantu abaninzi baya basweleka, kodwa ngaphandle 

koko saye salulwela ufikelo kwi-ART. 

Wathi urhulumente akubhengeza ukukhutshwa 

kwe-antiretroviral ngasekupheleni kuka- 2003, aye 

akhula amathemba ethu. Emva kwetyala le-PMTCT 

(usulelo olusuka kumama lusiya emntwaneni), saye 

sanemvakalelo yokuba siphumelele elinye idabi 

kwakhona. Saye sakhankasela ama-200,000 abantu 

ukuba bafumane ii-ARVs ngo-2006. saye safuna inkxaso. 

Saye salwela ukwehliswa kwamaxabiso amachiza, 

kwaye ngamanye amaxesha sasityholwa kakubi 

kusithiwa sisebenzela iinkampani zoXubo-mayeza. 

Sicela umngeni kwibala elinxulunyaniswa ne-HIV, saye 

saqhuba iphulo lokungena umnyango nomnyango 

sifundisa abantu ngokusazi isimo sabo se-HIV, ukuthatha 

ii-ARVs nokubambelela kunyango. 

Abantu baye baqala ukutyelela izibhedlele zabo 

beyokufumana i-ART. Kodwa sisajongene nemiqobo 

emininzi. Nangoko, zange silahle ithemba. Endaweni 

yoko, saye salwa ngamandla saqhuba nomsebenzi 

wethu kwinqanaba lasekuhlaleni. Kwathi kwakusebenza 

ukukhutshwa kwe-ARV, kwakho imiceli mngeni emisha: 

ukungabikho kwamachiza, kunye nemfuno yokuzisa 

amachiza asebenza ngamandla. 

Ndisakhumbula siqhankqalaza sisiya kwii-ofisi ze- 

ASPEN ekumNtla waseThekwini ngexesha lephulo lethu 

le-tenofovir. Yayiyimini eyayishushu kakhulu, kodwa 

kwakungekho namnye owayebonisa ukulikhathalela 

elo langa laligqatse ubhobhoyi okanye indlela ende 

eyayinyuka endulini. Ndisakhumbula xa sasiqhankqalaza 

ngaphandle kwesibhedlele i-Mahatma Gandhi, sibuza 

sifuna ukwazi ukuba kutheni kukho i-1,300 yabantu 

Inqaku loMhleli 

abasekuluhlu lokulindela lwesibhedlele. Enye indoda 

yasibuza ukuba ibizakuba isaphila na ngeKrisimesi 

ukuba ibingafakwanga kwi-ARVs. Ndisakhumbula xa 

endisebenza nabo u-Promise, Ralph no-Sindi baye 

baleqiswa ngezinja kwintolongo yase-Westville, kuba 

babexhasa amabanjwa ukuba afumane unyango, nawo. 

Yayingamaxesha anzima lawo. Kodwa okungenani 

sinokujonga emva sithi iinzame zethu azihambanga nje. 

Ubunkokheli bezopolitiko bangoku luzibophelele 

ekuthembiseni ekulweni iHIV/AIDS- kwinkqubo yempilo 

karhulumente. SinoYilo lweSicwangciso seSizwe 

olujoliswe kuwo wonke umntu Izigulane zinofikelelo 

kunyango kwiikliniki zazo zengingqi, kwaye iPhulo 

lukuCetyiswa nokuVavanyelwa i-HIV lizakusebenza 

ngokubhekisele kuzo zonke ikliniki ezinika unyango 

olusisiseko ukuba zibe ziindawo ze-ART. Kwakuthi 

kusakwenzeka oku, ibe ngabantu abambalwa 

abazakuhamba imigama emide beyokuvavanywa 

beyokufuna nonyango. 

Eskugqibeleni sinezikhokelo ezitsha neziphuculiweyo 

ze-HIV kwaye kuqikelelwe ukuba ngoJuni 2011 malunga 

nesigidi esinye sabantu siyakuba nofikelelo kwii-ARVs. 

Le yenye yempumelelo ekufuneka siyibhiyozele! 

Koko imiceli mngeni emininzi isasele. Abantu 

basajikiswa ezikliniki kuba abekho oogqirha 

okanye oosokhemisti bokukhupha amayeza. Abanye 

bayivavanyelwa emva kwexesha kakhulu i-HIV, usulelo 

oluhamba ne-TB/HIV isulelo olubanga ukusweleka 

kwabantu abaninzi eMzantsi Afrika. 

Ibala elinxulunyaniswa ne-HIV lisekhona, kodwa 

abantu abaninzi basaqhuba bezithatha ii-ARVs zabo 

ngaphandle kobunzima obubehlelayo. Aba bantu baphila 

ubomi obunempilo – kwaye ndingomnye wabo mna. 

Sibubungqina bokuba ii-ARVs ziyasebenza. Isende 

indlela ekusafuneka siyihambe, kodwa ke yindlela 

esingayihamba sonke. Njengabantu abane-HIV, kufuneka 

siqhube sixhasana kwaye sibambelele kunyango ukuze 

siphile ubomi obude, nobugqibeleleyo. 

Lihle Dlamini, Usekela Sosiba Jikelele we-TAC 

1

IZIKHOKELO EZINTSHA 

NETHENDA 

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Ichiza elitsha 

ekliniki 

Ifoto ngu-Mara Kardas-Nelson 

Ngu-Catherine Tomlinson no-Marcus Low 

Ukuba ngaba ukwirejimeni equlethe 

i-d4T kwaye uphethwe yi-lactic acidosis, 

lipodystrophy, peripheral neuropathy okanye 

i-pancreatitis, kufuneka ubuze ugqirha wakho 

ngoko nangoko malunga ngokutshintshela 

kwi-tenofovir. Ukutshintshela kwi- tenofovir 

kunokususa iziphumo ebezingalindelekanga 

ezininzi ezinxulunyaniswa ne- d4T. 

Ekugqibeleni iSebe lezeMpilo sele liqalile 

ukutshintsha i-stavudine (d4T) nge-tenofovir (TDF). 

Eli linyathelo elikhulu eliya phambili kunyango 

lwe-HIV eMzantsi Afrika. Nantsi into ekufuneka 

siyazi. 

Kutheni i-tenofovir ingcono kuned4T 

I-Stavudine (d4T) ibiyinxenye yerejimeni yamachiza 

okuqala eNkqubo yeMpilo kaRhulumente eMzantsi 

Afrika iminyaka emininzi. Ukuba ngaba ubufumana 

ii- antiretrovirals (ARVs) kwiikliniki zikarhulumenete, 

amathuba ngawokuba enye kwezintathu ii-ARVs oye 

wayifumana yi-d4T. I-D4T iye yanceda ukusindisa 

amawaka obomi kummandla. Koko, yiyo ebangele 

iziphumo ebezingalindelekanga ezimandundu 

eziye zehlela abanye abantu abakunyango lweantiretroviral 

(ART). 

Iminyaka emininzi i-Treatment Action Campaign 

(TAC) ibikhankasela ukuba endaweni ye-d4T 

kufakwe i-tenofovir (TDF). Isizathu esingundoqo soku 

kukuba i-tenofovir ineziphumo ebezingalindelekanga 

ezimbalwa kune-d4T. Kumazwe atyebileyo amaninzi

kwaye kwangena i-tenofovir endaeni ye-d4T 

kwiminyaka emininzi eyadlulayo. 

Amalingo ezonyango abonise okuhle nge-tenofovir 

ukodlula i-d4T. Uphononongo obeluthiwe thaca 

kwiNkonfa yoMbutho wamaZwe ngamaZwe we- 

AIDSA (International AIDS Society Conference) 

ngo-2009 eKapa lwabonisa ukuba iirejimeni 

eziqulethe i-d4T zineziphumo ebezingalindelekanga 

ezimandundu ezininzi kwaye zifune utshintsho 

lwamachiza rhoqo kuneerejimeni eziqulethe 

i-tenofovir. Uphononongo lwaluthelekisa izigulane 

ezili-1000 ezazikwirejimeni equlethe i-tenofovir 

kwi-1000 yezigulane ngenye indlela ezazikwirejimeni 

efanayo kodwa yona equlethe i-d4T. I-50.5% 

oyezigulane ezithatha i-d4T yehlelwa ziziphumo 

ebezingalindelekanga ezinxulumene ne-d4T yaze 

i-16.2% yathsintshelwa kwichiza elitsha ekupheleni 

kweminyaka emibini. Kwiqela le-tenofovir 

yi-2.5% kuphela yezigulane eyehlelwa sisiphumo 

esinxulumene ne- tenofovir. 

Ezinye zeziphumo ebezingalindelekanga 

ezinxulunyaniswa ne-d4T ziquka i-lactic acidosis 

(imelo apho i-lactic acid yakheka ngokukhawuleza 

egazini kunokuba umzimba uyisuse), i-lipodystrophy 

(utshintsho kumafutha omzimba kunye nemilo 

yomzimba), i-peripheral neuropathy (umonakalo 

kumxokomezelo wemithambo-luvo ye-peripheral) 

kunye ne-pancreatitis (ukukrala kwe-pancreas, 

ilungu elikhupha iihomoni eziyimfuneko). 

Ngokuchaseneyo, izigulane ezikwi-tenofovir 

zehlelwa ziziphumo ebezingalindelekanga 

ezimandundu ezimbalwa kakhulu. Koko i-tenofovir 

iye yanxulunyaniswa nomonakalo wezintso kwaye 

izigulane ezithatha ichiza kufuneka zihlolelwe 

iingxaki zezintso. 

Izikhokelo ezitsha 

Iindaba ezimnandi kukuba ukusukela ngomhla 

woku-1 Aprili 2010 iSebe lezeMpilo liqalile 

ukutshintsha i-d4T nge-tenofovir njengenxenye 

yonyango lomgca wokuqala kwiNkqubo yezeMpilo 

yoMzntsi Afrika. 

Oku akuthethi ukuba wonke umntu okwi-d4T 

uyakutshintshela kwi-tenofovir ngoko nangoko. 

Kuphela ngabantu abaqala unyango okokuqala 

emva komhla we-1 Aprili kunye nabantu abehlelwa 

ziziphumo ebezingalindelekanga ezimandundu 

kwi- d4T abaza kufumana i-tenofovir. Ukuba 

ngaba ukwirejimeni yonyango oluqulethe i-d4T 

kwaye awehlelwa zizo naziphi na iziphumo 

ebezingalindelekaga, akuyi kubakho mfuneko 

yokutshintshela kwi-tenofovir. 

Esinye isizathu sokungatshintsheli zonke izigulane 

kwi-tenofovir ngexesha elinye, kukuba urhulumente 

usenokungakwazi ukufumana i-tenofovir eyoneleyo 

yomntu wonke. Kwakhona, ukuba ngaba abantu 

baqhuba kakuhle kwi-d4T, asikho isizathu sokuba 

bayitshintshe irejimeni yabo. 

Imithombo: S. Rosen et al., 

‘Net cost of switching from 

stavudine to tenofovir in first 

line antiretroviral therapy in 

Zambia’, IAS 2009. Available at 

http://www.ias2009.org/abstract. 

aspx?elementId=200721757. 

I-TAC imele ukukhutshwa kwe-tenofovir njengenxenye yeMithombo yephulo leMpilo. Ifoto ngu-Zethu 

Mlobeli, courtesy MSF. 

I-Tenofovir nethenda ka-2010 

ISebe lezeMpilo liwathenga amachiza e-antiretroviral (ARV) ngethenda ye-ARV 

ekhethekileyo. Ithenda ye-ARV eyanikwayo ngo-2008 iyaphela kulo nyaka 

kwaye urhulumente uzakunika ithenda entsha msinyane nje. 

Ukufumana ilungelo lethenda kubalulekile ekuhlangabezaneni nokujoliswe 

kuko kwe- NSP, ekuphumezeni izikhokelo ezintsha zonyango kunye nokwehlisa 

amaxabiso amachiza. Ngexesha lonke lethenda yonyaka ophelileyo kuphela 

yinguqulelo enye kuphela kasinga chiza (generic) tenofovir eyabhaliswayo yaze 

yathengiswa. Oku kwathetha ukuba i-tenofovir yahlala ibiza imali eninzi. 

Iinguqulelo zoosinga tenofovir ezisalindele ukuba zibhaliswe kwiBhunga 

eliLawula amaYeza loMzantsi Afrika (Medicines Control Council) (MCC) 

kufuneka zibhaliswe ukonyusa ukhuphiswano kunye nokwehlisa amaxabiso. 

Ukuphucula kunye nowenza lula iirejimeni zamachiza i-MCC kufuneka 

ikhawulezise ubhaliso lwazo zonke iindibaniselwano ze-tenofovir ezisekelwe 

kwidosi esisigxiba. 

Jonga kwiphepha le-12 ngokuthe vetshe ngethenda ka-2010 ye-ARV kunye 

nemiqobo kwi-MCC. 


NETHENDA 

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NETHENDA 

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Ibali lika- 

Eunice 

U-Mary-Jane Matsolo 

wenza udliwano-ndlebe 

no-Eunice Lindiso 

malunga namava akhe 

ngokutshintsha kwistavudine 

(d4T) waya 

kwi-tenofovir (TDF). 

U-Eunice Lindiso ngowasetyhini oneminyaka engama-33 ohlala eKhayelitsha unonyana 

one-14 leminyaka. U-Eunice kwafunyaniswa ngovavanyo ngo-2007 ukuba une-HIV, 

emva kokufumanisa ukuba isithandwa sakhe awayethandana naso iminyaka emininzi 

sasinganyanisekanga kuye sithandana nowasetyhini owayesaziwa ekuhlaleni ukuba une- 

HIV. Ukufunyaniswa kwakhe ngoxilongo u-Eunice isibalo sakhe se-CD4 sasingama-192, 

kodwa ke ngelo xesha wayengabonisi mpawu ezimandundu zosulelo lwe-HIV. 

Ngo-2007 waqalisa unyango lwe-antiretroviral (ART) esebenzisa i-stavudine (d4T), 

lamivudine (3TC) ne-nevirapine (NVP). Emalunga neenyanga ezine kolu nyango u- 

Eunice waqalisa ukuphawula iziphumo ebezingalindelekanga. Waba nobucaphu-caphu 

obukhulu wagabha rhoqo ngenxa yesiphimo ebesingalindelekanga esixhaphakileyo 

se- d4t esaziwa ngokuba yi-lactic acidosis (imeko apho i-lactic acid yakheka egazini 

ngokukhawuleza kunokuba unokukwazi ukuyisusa umzimba). Oku kwenza kwanzima 

kakhulu kuye ukuba akhathalele unyana wakhe kuba ixesha elininzi wayengaphilanga 

ngokwaneleyo ukuba akwenze oko. 

Wathi akukhalaza malunga noku, ugqirha wakhe watshintshela u-Eunice kwirejimeni 

ene-Zidovudine (AZT), 3TC ne-nevirapine. Kule rejimeni waye waqala ukwehlelwa 

bubunzima kodwa kwangaxesha nye amabele akhe akhula ukusuka kwisayizi 32B ukuya 

ku-36D. Le yindibaniselwano yokwehlelwa ngamafutha kunye nokufumana amafutha 

sesinye isiphumo ebesingalindelekanga se- d4t esaziwa angokuba yi-lipodystrophy. 

Nge-3 ka Febuwari 2010 unyango luka-Eunice lwaye lwatshintshwa kwakhona. Kweli 

tyeli waye waqala irejimeni ye-tenofovir (TDF), 3TC ne-nevirapine. Ugqirha wakhe 

wamcacisela ukuba olu unyango luneziphumo ebezingalindelekanga ezimbalwa kunye 

nokuba angaphathwa yintloko kunye nobucaphucaphu. Koko, akukhange kwenzeke oku. 

Endaweni yoko, u-Eunice ufumanise ukuba unyango olutsha luye lwaziguqula ezinye 

iziphumo ebezingalindelekanga ezimbalwa ezamehlela kwi-d4t. Isayizi yakhe yebhodi 

yabuyela ku-32B kwaye uphila ubomi obunempilo. Enkosi kwi-tenofovir akasaziva egula 

ngalo lonke ixesha ngoku kwaye unobudlelwane obuhle nonyana wakhe.

Izikhokelo ezintsha zonyango lwe-antiretroviral 

NgoMatshi ka-2010 izikhokelo zonyango zoMzantsi Afrika – ezazigqityelwe ukuhlaziywa ngo- 2004 – 

ekugqibeleni zaye zahlaziywa emva kweminyaka emininzi yolibaziseko olungeyomfuneko. Itheyibhule 

engasezantsi ibonisa ukuba ngubani oyakufanela awaphi na amachiza, phantsi kwezikhokelo ezitsha eziqale 

ukusebenza ngowo-1 Aprili 2010. 

Abantu abadala kunye nabantwana abafikisayo 

Umgca wokuqala 

Zonke izigulane ezintsha ezifuna unyango TDF + 3TC/FTC +EFV/NVP 

Abo bakwi-d4T ngoku bengenazo iziphumo ebezingalindelekanga Hlala kwi-d4T 

Uphawu lokungaqhubi ngeyeza kwi-TDF: isifo sezintso AZT+ 3TC +EFV/NVP 

Umgca wesibini 

Ukungaphathwa kakuhle yirejimeni ye-first line esekelwe kwi-AZT TDF + 3TC/FTC + LPV/r 

Ukungaphathwa kakuhle yirejimeni yomgca wokuqala esekekwe kwi-TDF AZT + 3TC + LPV/r 

Ukungaphathwa kakuhle yirejimeni yomgca wesibini – thumela kwingcali 

Iimveku nabantwana 

Umgca wokuqala 

Zonke iimveku ezingaphantsi kweminyaka emi-3 ABC + 3TC + LPV/r 

Abantwana abaneminyaka em i-3 nangaphezulu ABC + 3TC + EFV 

Abo okwangoku bakwi-d4T bengenazo iziphumo ebezingalindelekanga Remain on d4T 

Umngca wesibini 

Ifoto ngu-Damien Schumann 

Abantwana abangaphezulu kweminyaka emi-3 abangaphathwanga kakuhle yi-ABC ABC + ddl +LPV/r 

+ 3TC + EFV 

Abangaphathwanga kakuhle yirejimeni ye-AZT okanye ye-d4T ABC + 3TC + LPV/r 

Irejimeni engaphathanga kakuhle ye-LPV/, iimveku ezingaphantsi kweminyaka emi-3 ezingaphathwanga 

kakuhle ngumgca wokuqala okanye umgca wesibini – thumela kwingcali 

Undoqo: abacavir (ABC), zidovudine (AZT), didanosine (ddI), stavudine (d4T), efavirenz (EFV), emtricitabine (FTC), 

lopinavir/ritonavir (LPV/r), nevirapine (NVP), tenofovir (TDF), lamivudine (3TC) 


NETHENDA 

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NETHENDA 

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Ipilisi enye, kanye ngemini 

Ngu-Catherine Tomlinson no-Marcus Low 

Iindibaniselwano zedosi emiselweyo 

kwenziwa isincomo sayo ngabasebenzi 

bezempilo kunye nombutho wezoNyango 

lwe-HIV kumaZantsi e-Afrika. Umthwalo 

wepilisi osezantsi unxulunyaniswa 

nobambelelo oluphucukileyo. 

Ifoto ngu-Roulé le Roux

I-TAC iyakuqhuba ikhankasela ukuba kwenziwe iindibaniselwano zedosi emiselweyo eziqulethe i-tenofovir into 

enokufezekiswa kwinkqubo yempilo karhulumente. Ipilisi enye kanye ngemini iyafikeleleka, inokwenzeka, kunye 

nasemdleni womntu ngamnye. 

Uninzi lwabantu eMzantsi Afrika abathatha unyango 

lwe-antiretroviral (ART) kufuneka bathathe amachiza 

amathathu awohlukeneyo yonke imihla. Amanye 

kufuneka athathwe ngamaxesha athile amanye 

kufuneka athathwe ngaphambi okanye emva kokutya. 

Ukuthatha iipilisi ezininzi kangako kunye nokuzithatha 

ngokwemiyalelo kunganzima kwaye kufuna 

ukuziqeqesha okukhulu. Esi sesinye isizathu sokuba 

kutheni ukubambelela kakuhle kunyango kunokuba 

nzima. 

Kwiminyaka yakutsha nje oosonzululwazi baye 

bakwazi ukudibanisa ii-antiretrovirals (ARVs) ezintathu 

ezohlukeneyo zaba yipilisi enye ekufuneka uyithathe 

kanye kuphela okanye kabini yonke imihla. Olu hlobo 

lwendibaniselwano ‘lweepilisi ezintathu kwenye’ 

kuthiwa yindibaniselwano yedosi emiselweyo (fixed-dose 

combinations) equka i-tenofovir. 

Iindaba ezimnandi zezokuba iindibaniselwano zedosi 

emiselweyo eziqulethe i-tenofovir ziyafikeleleka 

kwaye azibanjwa yimida ebekwa kwilungelo lomenzi. 

Kukho imiqobo ngokuphathelene nokubhaliswa 

kwezi ndibaniselwano zedosi emiselweyo kwiBhunga 

eliLawula amaYeza (jonga kwiphepha le-12), kodwa 

ukuba urhulumente uyafuna, unokunika i-FDCs 

equlethe i-tenofovir kwinkqubo yempilo karhulumente 

ngasekupheleni kuka-2010. 

Ubambelelo kunyango oluphuculiweyo 

olunxulunyaniswa nokuba kufuneke uthathe 

iipilisi ezimbalwa lusekiwe ngokwenziwa kwenani 

lamaphononongo. Uhlalutyo lwamaphononongo 

alithoba luye lwalandelela ubambelelo kunyango 

kwizigulane ezingama-20,242 – i-11,925 yezigulane 

ezikwiindibaniselwano zedosi emiselweyo nama- 8,317 

ezigulane ezikwiirejimeni zendibaniselwano enechiza 

– ngaphezulu kwe-avareji yeenyanga ezi-8.6. Uhlalutyo 

lufumanise ukuba ingozi yobambelelo kunyango 

olulambathayo yehliswa ngama-26% kwizigulane ezikwi- 

FDCs. 

Ubambelo kunyango olulambathayo lukhokelela 

kuxhathiso kwichiza olunyukayo. Ngenye indlela, 

uxhathiso olukhulu luthetha ukuba abantu 

abaninzi kufuneka batshintshele kumgca wesibini 

nowesithathu wonyango olubiza kakhulu. Ngoko ke, 

ukwazisa iindibaniselwano zedosi emiselweyo kunye 

nokwehlisa imfuno yamachiza abizayo omgca wesibini 

nowesithathu. 

Ukuthatha ipilisi enye kuphela ngosuku nako kwenza 

lula ukuba uthathe amayeza akho bucala. Oku 

kunokufaka isandla ngokungaphaya kubambelelo 

olulungileyo kunyango kwizimo apho kunzima kuzo 

ukuxela isimo sakho ngenxa yebala okanye uloyiko 

lwebala. 

De zibe iindibaniselwano zedosi emiselelweyo zilungela ukufumaneka, ukusebenzisa 

iblista yamayeza ukulungisa amayeza akho kuyakunceda ukuqinisekisa ukuba 

uthatha umthamo owaneleyo suku ngalunye. Ifoto ngu-Eric Miller, courtesy MSF. 

Ii-FDCs kunye nethenda ye-ARV ka-2010 

Ithenda ye-ARV ka-2010 lithiuba elichanekileyo lokuba urhulumenteaveze 

iindidaniselwanozedosi emiselweyo (fixed-dose combinations) (FDCs). 

Njengomthengi wamazwe ngamazwe omkhulu wonyango lwe-antiretroviral, 

uMzantsi Afrika kufuneka usebenzise amandla awo okuthenga ngokufuna ukuba 

iirejimeni zenziwe zifumaneke ngee-FDCs apho kwenzekayo, okanye ngenye 

indlela zifakwe kwipakethe zeeblista ekulula ukuziseebznisa. 

Ukufaka kunye kudibanisa onke amachiza kwirejimeni kwipakethe yeblista 

enye. Iirejimeni kufuneka zipakishwe kwiipakethe zekhalenda eziphakamisa 

ubambelelo, ezifanayo nezo zisetyenziswa kwizicwangcisi ezithathwa ngomlomo. 

Oku kunokufuna ukuba iinkampani zoosinga machiza zisebenzisane ekupakisheni 

amachiza azo. 

Indibaniselwano yedosi emiselweyo neerejimeni ezifakiweyo ziyakwehlsia 

umthwalo kubasebenzi bokhathalelo lwempilo. Ziyakwenza lula ulawulo lonikezo 

kunye namakhonco okufumana kwiSebe lezeMpilo, ngokunjalo. Ukufaka kunye 

kwakhona kunokwehlisa imiqobo, ingakumbi kwizibonelelo zasemaphandleni, 

okubangwa kukunqongophala kweekhemisti. UmThetho neMimiselo yeeKhemisti 

uvumela ukuba umncedisi kaSokhemisti odlulileyo kwisiseko kwisibonelo sempilo 

esisiseko sikarhulumente okanye nasiphi na isibonelelo esivunywe liBhunga 

leeKhemisti, akhuphe amayeza phantsi kokonganyelwa okungangqalanga. Oku 

kunokwenzeka ngaphandle kokuba amayeza akwiipakete zesigulane esele zilungile 

apakishiwe kwakhona kulungiselelwa le njongo esibhedlele okanye kwindawo 

yephondo ehlala amayeza. 

Jonga kwiphepha le-10 ngokungaphaya ngethenda ye-ARV ka-2010. 

Umthombo: SANAC Technical Task Team on Treatment, Care and Support, ‘Building the Capacity of 

the Primary Health Care System for HIV/AIDS Diagnosis, Care and Treatment in EMzantsi Afrika’, 

May 2009; S. Bangalore et al., ‘Fixed-Dose Combinations Improve Medication Compliance: A Meta- 

Analysis’, The American Journal of Medicine (2007) 120, 713-719 


NETHENDA 

7

UFIKELELO 

8 

Sithelekiswa njani 

kwihlabathi xa lilonke? 

E-Brazil 

Abemi: 198,739,269 (2009) 

I-avareji yeminyaka ekulindeleke 

ukuba umntu ayiphile ukusukela 

ekuzalweni: Amadoda 68, 

AbaseTyhini 76 (2009) 

Inani labantu abaphila ne- HIV/AIDS: 

730 000 (2007) 

Qaphela: Ixabiso lolu thelekiso 

lunyiniwe ngenxa yokuba 

ayololonyaka omnye lonke 

kunye nakumthombo omnye. 

Kuzo zonke izehlo sisebenzise 

iingqikelelo zakutsha nje 

esizifumene kwimithombo 

ethembekileyo. 

Brazil 

Botswana 

EBotswana 

Abemi: 1,990,876 (2009) 





Inani labantu abaphila ne-HIV/AIDS: 

300,000 (2007) 

Ingqikelelo yobukho jikelele be-HIV kubantu abadala: 

South Africa 

India 

Russia 

EMzantsi Afrika 

Abemi: 49,052,489 (2009) 






5.2 Million (2008) 

E-Russia 

Abemi: 140,041,247 (2009) 



ekuzalweni: Amadoda 59, AbaseTyhini 

73 (2009) 


940,000 (2009) 

E-Indiya 

Abemi: 1,156,897,766 (2009) 

I-avareji yeminyaka ekulindeleke ukuba 

umntu ayiphile ukusukela ekuzalweni: 

Amadoda 65, AbaseTyhini 67 (2009) 

Inani labantu abaphila ne-HIV/AIDS: 2.4 

Million (2007) 

0.6% (2007) 

23.9% (2007) 

18.1% (2009) 

0.3% (2007) 

1.1% (2009)

Ufikelelo kwi-ART (ipesenti yabo bafuna i-ART kwaye beyifumana): 

Brazil 

Botswana 

South Africa 

India 

Russia 

Inani labantu abafuna i-ART: 

80% (2007) 

79% (2007) 

28% (2007) 

Insufficient data 

16% (2007) 

Ufikelelo kwi-PMTCT (uthintelo losulelo olusuka kumama lusiya emntwaneni): 

Brazil 

Botswana 

South Africa 

India 

Russia 

Brazil 

Siphi ngoku 

Botswana 

South Africa 

India 

Russia 

230,000 (2007) 

120,000 (2007) 

1.7 million (2007) 

Insufficient data 

190,000 (2007) 

UMzantsi Afrika uneyona nkqubo yecandelo likarhulumente ye-ART enkulu ehlabathini 

kodwa okwangoku unceda kuphela isiqingatha sabantu abafuna unyango. Okwangoku 

bamalunga nama-900,000 abantu abakwi-ART leyo urhulumente aneenjongo zokuyonysa 

iye kwisigidi esi-1 ngasekupheleni kukaJuni. Kuqikelelwa ukuba ngabantu abazizigidi ezi-2 

okwangoku abafuna unyango. Urhulumente ujolise ekubeni aliphinde kabini inani labantu 

abafumana unyango kulo nyaka uzayo oko kusenziwa ngokuphunyezwa kwezikhokelo 

zonyango ezihlaziyiweyo kunye nephulu lokuCetyiswa nokuVavanyelwa i- HIV. 

Inani labantu abanofikelelo kwi-ART: 

Brazil 

Botswana 

South Africa 

India 

Russia 

181,000 (2007) 

93,000 (2007) 

460,000 (2007) 

158,000 (2007) 

31,000 (2007) 

72% (2007) 

95% (2008) 

76% (2007) 

10% (2006) 

87% (2006) 

Imithombo: UNAIDS/WHO Global 

HIV/AIDS online database – Country 

Epidemiological Fact Sheets on HIV/ 

AIDS and Sexually Transmitted 

Infections; World Health Statistics 2009 

report; avert.org; World Bank. Statistics 

compiled by Catherine Karlsson. 

UFIKELELO 

9


NETHENDA 

10 

Ingaba siyakuwafumana amayeza esiwafunayo? 

ITHENDA: 

Imiqobo ephakathi kwakho nonyango olungcono 

UMzantsi Afrika unangaphezulu kwezigidi ezihlanu zabantu 

abaphila ne-HIV kwaye kuqikelelwa ukuba izigidi ezibinoi 

zabantu okwangoku zifuna unyango. 

Ilizwe lineyona nkqubo inkulu ye-antiretroviral (ARV) 

ehlabathini - malunga nama-900 000 abantu abafumana 

unyango kwicandelo likarhulumente. Eli nani kufuneka 

liphindeke kabini uke lihlangabezane nama-80% ekujolise 

Ifoto ngu-Oupa Nkosi/Mail & Guardian 

Ngu-Catherine Tomlinson 

kuwo onyango lwe-HIV & AIDS kunye noYkilo 

weSizcwangciso loMzantsi Afrika (2007-2011). 

Xa kunikwa isikeyile senkqubo yonyango, ngokunjalo 

nemfuno engxamisekileyo yokonyusa inani labantu abafumana 

unyango, uMzantsi Afrika kufuneka wenze konke onako 

ukuyenza ukukhusela ufikelelo kumachiza afikelelekayo. 

Kufuneka kwakhona siphucule ubulunga bamachiza ethu 

ukuze kwehle iziphumo ebezingalindelekanga kunye nemfuno 

yokutshintsha unyango. Njengomthengi omkhulu kumazwe 

ngamazwe wonyango lwe-antiretroviral (ART), uMzantsi

Afrika kufuneka usebenzise amandla awo okuthenga ukuba 

ufumane amaxabiso asezantsi ngokunjalo nokuphucula 

iirejimeni nokufuma iindibaniselwano ekulula ukuzisebenzisa 

kunye neerejimeni ezifakwe kunye. 

Ithenda yangoku yonyango lwe-HIV yayikhutshwe ngo-2008 

kwaye izakuphelelwa ngoMeyi 2010. Inkqubo yethenda 

yangaphambili yaye yagxekwa ngenxa yokuswela kwayo 

ukuvuleleka yaziwe kunye nothabatho nxaxheba. Imibutho 

yasekuhlaleni izibandakanya nethenda ezayo oko ikwenza 

ngeQumrhu eliHlola uHlahlo lwaBiwo-Mali neNkcitho 

(Budget and Expenditure Monitoring Forum) (BEMF) 

ohlangansia kunye abo basebenzisanayo kuqukwa neengcali 

zomthetho, abezonyango, abezoqoqosho, abo baphanda 

ngeziso kunye nemanyano yabasebenzi namatsha-ntliziyo 

asekuhlaleni. Amaxwebhu avela kwi-BEMF ayafumaneka kuhttp://www.tac.org.za/community/BEMF 

ISebe lezeMpilo leSizwe liphuhlisa ithenda ye-antiretroviral 

ezayo lidibene ne-Clinton Foundation HIV/AIDS 

Initiative (CHAI). I-CHAI isebenza noorhulumente kunye 

neenkampani zoxubo-mayeza nezoosinga machiza zamazwe 

ngamazwe zisenza uthethathethwano lokuba kwehliswe 

amaxabiso ee-ART. 

I-CHAI yenze inani lezindululo kwiSebe lezeMpilo leSizwe 

ngeendlela zokuphucula iirejimeni zonyango kunye neendleko 

zolawulo kwithenda ezayo. Ithenda ye-antiretroviral kufuneka 

ingeniswe kwaye ivunywe nguNondyebo weSizwe phambi 

kokuba yaziswe uwonke-wonke ukuba abhide. 

Inqaku ekungavisiswana ngalo lelokuba ingaba ubhido 

kufuneka luvulelwe iinkampani zoMzantsi Afrika 

kuphela na ukuba ubhido lwazo luyafikeleleka. Kujongwa 

impucuko yezityalo eziveliswa ekhaya kunye nesabelo sazo 

esinokuthelekelelwa kwimarike, ezi nkampani kufuneka 

zikwazi ukukhuphisana kumazwe ngamazwe. 

Ngexa uninzi lwamachiza e-antiretroviral ithengwa ngethenda 

karhulumente eyenziwa apha ekhaya, ixabiso loosinga machiza 

kakhulu lingenxa yexabiso lawo lezithako zoxubo mayeza 

ezisebenzayo (APIs), jikelele ezivela phesheya. Ukuqinisekisa 

ukuba uMzantsi Afrika ungazisebenzisela ithuba lamaxabiso 

amazwe ngamazwe elinokufikeleleka ngexesha lonke lethenda, 

ithenda kufuneka ifune iinkampani ezithengisa imveliso 

egqityiweyo ukuba zehlise amaxabiso azo zokwenza oko 

zisabela kutshintsho lwemarike olwehlisa iindleko zee-APIs. 

Kulandela izibhengezo zikaMongameli Jacob Zuma zoSuku 

lwe-AIDS lweHlabathi luka – 2009, iSebe lezeMpilo leSizwe 

liye lahlaziya izikhokelo zalo zonyango lwe-HIV/AIDS. Oku 

bekuyimfuneko ekufumaneni iirejimeni ezintsha nezingcono 

oko kusenziwa ngethenda ezayo. Imiqobo emininzi yokufuma 

ezi rejimeni koko isahleli (jonga kwibhokisi esekunene). 

Imiba engundoqo yethenda 

Iindibaniselwano zedosi emiselweyo (Fixed-dose 

combinations) (FDCs) kunye nokufakwe kuzo 

Urhulumente kufuneka asebenzise ithenda ezayo ukuphucula kunye 

nokwenza lula iirejimeni zonyango. Ukwenza oku kubalulekile ukuba 

urhulumente athenge ii-FDCs nanini na xa ziofumaneka. Xa zingafumaneki 

ii-FDCs urhulumente makathenge iipakethe ezidibanisa onke amachiza 

erejimeni zibe yiblista enye ekulula ukuyisebenzisa (Jonga kwiphepha 

lesi-7 ngokungaphaya.) 

Tenofovir (TDF) 

Inani leenguqulelo zoosinga tenofovir, kuquka neendibaniselwano zedosi 

emiselweyo esekelwe kwi-tenofovir zisalindele ukubhaliswa liBhunga 

eliLawula amaYeza (Medicines Control Council) (MCC). I-MCC kufuneka 

ikhawulezise ukubhaliswa kwala machiza. (Jonga kwiphepha lesi-2 

ngokungaphaya.) 

Abacavir (ABC) 

Iinguqulelo ezingosinga abacavir, kuqukwa neendibaniselwano 

zabantwana ze-ABC/lamivudine, zisalindele ukubhaliswa yi-MCC. I-MCC 

kufuneka ikhawulezise ukubhaliswa kwala machiza. 

Lopinovir/Ritonavir (LPV/r) 

Iipilisi ze-heat stable paediatric LPV/r zisalindele ukubhaliswa yi-MCC. 

Ubukho bechiza buyimfuneko ekuphunyezweni kwezikhokelo zonyango 

ezihlaziyiweyo. I-MCC kufuneka ikhawulezise ukubhaliswa kweli chiza. 

(Jonga kwiphepha lama-20 ngokuthe vetshe kwi-ABC ne-LPV/r.) 

Kule minyaka idlulileyo sibone ukuzibophelela 

ngokwezopolitiko okunyukayo ekuphuculweni 

konyango olusekelwe kubungqina, uthintelo 

nokhathalelo lwe-HIV. Urhulumente uphinde 

wazibophelela kwakhona ekuhlangabezaneni nojoliso 

loYilo weSicwangciso seSizwe (National Strategic 

Plan) (NSP), wolula uhlahlo lwabiwo-mali lwe-HIV 

kwaye uhlaziya ekwaphucula izizikhokelo zonyango. 

Ukufumana ilungelo lethenda ye-ARV kuyimfuneko 

ukuba olu tshintsho kufuneka luphunyezwe 

ngokufanelekileyo. Urhulumente makasebenzise 

eli thuba aphucule izibonelelo enze lula unyango 

nokhathalelo lwezigulane kunye nabasebenzi 

bokhathalelo lwempilo. 

Ifoto ngu-David Harrison 

Ifoto ngu-Delwyn Verasamy/ 

Mail & Guardian 

Umntu osayina amaxwebhu ambalwa angenza 

umahluko wokuba ingaba kufanele uhlale 

uhlutshwa sisiphumo ebesingalindelekanga 

na okanye hayi, okanye mhlawumbi uthatha 

iipilisi ezintathu ngemini okanye enye. 

11

12 

Umqobo we-MCC 

UMzantsi Afrika ujongene nomqobo ongundoqo 

ekuphuculeni iirejimeni zonyango – ubhaliso olusezantsi 

lwamachiza olwenziwa liBhunga eliLawula amaYeza 

(Medicines Control Council) (MCC). Amachiza 

amaninzi ayimfuneko kwizikhokelo esitsha zonyango 

awakavunywa yi-MCC, ingakumbi indibaniselwano 

yedosi emiselweyo ( fixed-dose combinations) (FDCs) 

kunye nemixube yabantwana. 

UMbutho wabezoNyango we-HIV wamaZantsi 

e-Afrika (HIV Clinicians Society of Southern Africa) 

uye wacela i-MCC ukuba ikhawulezise ukubhaliswa 

kwenani lamachiza e-antiretroviral phambi kokuba ibe 

iyagqitywa ithenda, ingakumbi iindibaniselwano zedosi 

ezimiselweyo ezisekelwe kwi-tenofovir (TDF) (-based 

fixed-dose combinations) ngokunjalo neendibaniselwano 

ze-abacavir/lamivudine (ABC/3TC) kunye ne-lopinavir/ 

ritonavir (LPV/r) engumxube wabantwana. 

Ukuba ngaba imiqobo ye-MCC ayisonjululwa 

kwangexesha, ithenda kufuneka ivumele ukuthengwa 

kwamayeza angekabhaliswa yi-MCC okwangoku. La 

machiza kufanele ukuba sele ebhalisiweyo yimibutho 

elawulayo yamazwe ngamazwe efana noLawulo lokuTya 

namaChiza (Food and Drug Administration) (FDA) 

eMelila. La machiza kufuneka ubhaliso lwawo kwanoba 

lukhawuleziswe eMzantsi Afrika. 

Umfanekiso ngu- 

Brice Reignier

Intlekele yase-Edendale 

NgoMeyi 2009 isibhedlele sase-Edendale eMgungundlovu saye 

sayeka ukuqalisa izigulane ezitsha ezine-HIV kunyango lweantiretroviral. 

NgoJulayi kwakusele kukhona abantu abaninzi 

abamalunga nama-2,000 ababesekuluhlu lokulindela unyango. 

Oogqirha nabongikazi baxelela abeendaba ukuba kusweleka 

izigulane veki nganye. 

Esinye isizathu sokungaqalisi ezinye izigulane kunyango 

yayiyikukunqongophala koogqirha kunye noosokhemisti 

esibhedlele. Oogqirha baxelela abeendaba ukuba bazise 

amagosa empilo esithili ngeengxaki ezo ukusukela 

ngoNovemba 2008. 

Ngowe-16 Julayi 2009 i-TAC eMgungundlovu kunye 

nemibutho ebambisene nayo baye balungiselela uqhankqalazo 

ekwakuze kulo ngaphezulu kwama-700 abantu. Isiqulo 

soqhankqalazo sasi sesi ‘ULUHLU LOKULINDELA = 

UKUFA’. Ujoliso yayisisimo sesiBhedlele sase-Edendale, 

ukunqongophala kwendawo yokuqhubela inkqubo ye-ARV 

ngokusebenzayo kunye nokunqongophala kwabasebenzi 

kwizibonelelo zikarhulumente. Uqhankqalazo lwenzeka 

emva kosuku ekwakubanjwe ngawo umthandazo ubanjelwa 

abo baswelekileyo ngenxa yokunqongophala konyango. 

Asazi ukuba ngabantu abangaphi ngqo 

abasweleka ngenxa yonqongophalo 

e-Edendale. 

Ngu-Ntombizonke Ndlovu 

Ekugqibeleni, ngenxa yemisebenzi 

ye-TAC, eminye imibutho eyahlukeneyo 

kunye nabeendaba, saye sasonjululwa 

isimo. NgoJulayo ka-2009 i-MEC 

yezeMpilo yaKwazulu-Natal, uGqirha 

Sibongiseni Dhlomo,waye wasusa 

uMphathi wezeMpilo weSithili , u-May 

Zuma-Mkhonza owayesohluleka 

kukulawula ukukhutshwa kwee-ARV 

kwisibhedlele sase-Edendale. Kwaye 

kwavakala kwakhona ukuba uZuma- 

Ifoto ngu-Ntombizonke Ndlovu 

Mkhonza waye wala isithembiso esivela 

kubanikeli bamazwe ngamazwe sokuncedisa ekuhlawuleni 

oogqirha kunye noosokhemisti abangaphaya esibhedlele. 

“Ingaba kwakufanele ukuba ide iyokufikelela apho? Ngubani 

ekufuneka athathe uxanduva lwako konke oko kusweleka 

koobhuthi noosisi bethu, oomama nootata bethu kunye 

nabantwana bethu abaswelekayo?” – incwadana yamalungu 

ye-TAC eMgungundlovu ka-2009. 

Ifoto ngu-Ntombizonke Ndlovu 

UFIKELELO 

13

UFIKELELO 

14 

Ifoto ngu-Eric Miller, courtesy MSF 

ufikelelo kumayeza ayim 

1959 

Kwi- 

Democratic 

Republic of 

Congo 

Isehlo sokuqala 

esaziwa njenge- 

HIV siyehla. 

2002 


i-TAC ne-MSF babhengeza 

ukuba bangenisa elizweni 

oosinga machiza abavela e-Brazil 

kwinkqubo yabo ye-ARV. Oku 

kungathobeli 

kuvumela 

iprojekithi 

elingwayo 

ye-ARV 

eKhayelitsha. 

2002 


Amatsha-ntliziyo abeka ityala 

uMphathiswa wezeMpilo uManto 

Tshabalala-Msimang kunye 

noMphathiswa wezoRhwebo 

noShishino u-Alec Erwin ngokubulala 

ngaphandle kokufuna ukwenza njalo 

ngama-600 abeMi boMzantsi Afrika 

abasweleka yonke imihla ngnxa 

yokunqongophala kufikelo 

lonyango. Oku kwenza 

inxenye yephulo le-TAC’s 

‘lokuSwelekela 

unyango. 

1986 

Kwihlabathi 

Jikelele 

I-retrovirus 

ngaphambili 

ebisaziwa 

njengonobangela 

we-AIDS 

ngokusemthethweni 

ibizwa njenge-HIV. 

2002 

EBotswana 

Inkqubo 

yokuqala 

yonyango 

lwe-HIV 

e-Afrika 

iyaziswa. 

1987 

EMelika 

I-Zidovudine (AZT) 

iba lichiza lokuqala 

elivunywayo 

kunyengo lwe-HIV 

ngexabiso lama- 

R30,000 ngomntu 

ngonyaka. I-AZT 

ayiyi kufumaneka 

eMzantsi Afrika de 

ibe ngu- 1999. 

1987 

EMelika 

I-AIDS Coalition to 

Unleash Power (ACT UP) 

iyasekwa ukuba ixhase 

unyango olungcono kunye 

nemigaqo-nkqubo yabantu 

abaphila ne-HIV. 

Photo from blog.dragonballyee.com 

2001 

E-Qatar 

IsiBhengezo sase-Doha (Doha 

Declaration is) siyaziswa. Esi 

sivumelwano sitsha kwi- TRIPS 

sicacisa ukuba oorhulumente 

bayakungawathathi njani nanini 

amalungelo omenzi. Ukungenisa 

elizweni okunxuseneyo (ukungenisa 

oosinga machiza abavela kwamanye 

amazwe elizweni) kunika amazwe 

anengeniso encinane ulawulo 

olukhulu lwemiqathango yonyango 

kubemi balo. UMphathiswa 

wezeMpilo waseMzantsi Afrika u 

Manto Tshabalala- Msimang, uyala 

ukusebenzisa i-Doha ukuze afumane 

unyango olufikelelakayo olungaphaya. 

2002 


Ngenxa yoxinzelelo 

loluntu kunye 

nolwamazwe 

ngamazwe, 

urhulumente uveza 

inkqubo yakhe 

yonyango lwe-ARV 

phantsi koYilo 

lokuSebenza loNyango 

oluBanzi kunye 

noKhathalelo lwe-HIV/ 

AIDS. 

1989 

KwiHlabathi Jikelele 

Ixabiso le-AZT lehla 

ngama-20%, kulandela 

iminyaka emibini 

yoqhankqalazo lwe- ACT 

UP. Unyango luxabisa 

ama-R24,000 ngomntu 

ngamnye ngonyaka — 

lusabiza kakhulu kuninzi 

lwabo baphila ne-HIV. 

2001 


Inkundla igweba 

ngecala le-Treatment 

Action Campaign 

kwi-TAC vs 

uRhulumente, iyalela 

urhulumente ukuba 

enze kufumaneke 

i-nevirapine 

kwabasetyhini 

abakhulelweyo abane- 

HIV njengenxenye 

yenkqqubo yosulelo 

olusuka kumama lusiya 

emntwaneni (prevention 

of mother-to-child 

transmission) (PMTCT). 

Ifoto ngu-Eric M 

2004 

e-Indiya 

Umbutho woLawulo lwe-AIDS 

weSizwe (National AIDS Control 

Organization) (NACO), ebambisene 

norhulumente, uyaqala ukubonelela 

ngee-ARVs simahla. 

Ifoto yi-International Federation of the Red Cross

funeko kwixesha le-hIV 

1994 

E-Uruguay 

Isivumelwano samazwe ngamazwe ekuthiwa yi-Trade 

Related Aspects of Intellectual Property Rights 

(TRIPS) siyayilwa, esichaphazela onke amazwe 

angamalungu oMbutho woRhwebo weHlabathi. 

Esi sivumelwano sifuna ukuba amazwe athobele 

umthetho welungelo lomenzi – oko kumisela umda 

kwinani lamachiza akhuphisanayo emarikeni, loo nto 

ke igcine amaxabiso wephezulu. Ukusukela ekubeni 

unyango lomgca wokuqala nolomgca wesibini 

lusabonelelwa ngamalungelo abenzi, luhlala lubiza 

kakhulu kwaye lufumaneka kakhulu kumazwe 

anengeniso ephezulu. Amazwe anengeniso 

ephakathi kunye nesezantsi aye anyanzeleke ukuba 

alinde kude kuphelelwe imihla yamalungelo abenzi, 

okanye ade amachiza anebrendi ehlise amaxabiso 

ngokuhamba kwexesha. 

iller, courtesy MSF 

1998 


I-Treatment Action 

Campaign (TAC) 

iyasekwa ukuze ifune 

inkxaso yofikelelo 

olukhulu kunyango 

lwe-HIV lwabo bonke 

abantu baseMzantsi 

Afrika. 

2005 

Kwihlabathi jikelele 

Ilungelo lomenzi 

le-AZT’liyaphelelwa, 

okokuvunyelwa 

iinguqulelo ezininzi 

zoosinga machiza. 

Ichiza liyafumaneka 

ngama-R670 ngomntu 

ngamnye ngonyaka, 

libiza ngaphantsi ngama- 

20% kunenguqulelo 

enelungelo lomenzi 

kunye nasezantsi 

ngama-87% kunexabiso 

lakuqala. 

2006 

EMelika (United 

States) 

I-Atripla, ipilisi 

yokuqala enye, 

indibaniselwano 

yedosi emiselweyo 

yakanye ngemini 

kusetyenziswa 

unyango 

lwendibaniselwano 

yamachiza 

amathathu, 

ivunyiwe. 

1997 

E-Brazil 

I-Brazil iphumeza ukunikwa 

kwemvume yamachiza 

okunyanzelekileyo, oko 

okuvumela abenzi ukuba 

bavelise iinguqulelo 

ezingoosinga machiza 

zamachiza anamalungelo 

abenzi. Ngokungawahoyi 

amalungelo omenzi, 

amaxabiso ehla kakhulu 

kwaye ufikelelo kunyango 

lwenyuke. UMzantsi Afrika 

zange uke unyanzelise 

imvume enyanzelekileyo. 

1994 

EMelika 

I-AZT esetyenziswa ngabasetyhini 

abakhulelwe kufumaniseka 

ukuba ilwehlisa ngama-70% 

usulelo olusuka kumama lusiya 

emntwaneni. 

Ifoto ngu-Talia Frenkel/American Red Cross 1994 

EMelika 

Unyango oluSebenza ngamandla 

kaKhulu lwe-Antiretroviral (Highly 

Active Antiretroviral Therapy) 

(HAART), olunendibaniselwano 

yee-ARVs ezininzi luyayilwa. Le 

indlela yonyango olunamandla ibiza 

ama-R36,000-R55,000 ngomntu 

ngamnye ngonyaka. I-HAART 

ayiyikufumaneka eMzantsi Afrika de 

ibe ngu-2004. 

2007 

E-Thailand 

Urthulumente 

wase-Thai 

ukhupha iimvume 

ezinqumamisa 

amalungelo abenzi 

kumayeza abizayo 

nayimfuneko, 

evumela 

ukungeniswa 

elizweni koosinga 

machiza be-ARVs. 

1996 

EMelika 

I-Post-exposure prophylaxis 

(PEP), ikhosi emfutshane 

yamachiza e-ARV, kwenziwa 

isincomo sayo ekwehliseni 

ingozi yosulelo lweHIV emva 

kokungakhuseleki okunengozi 

kakhulu kwizibonelelo 

zokhathalelo lwempilo, oko 

kusehlisa usulelo ngama-79%. 

I-PEP ayiyikufumaneka eMzantsi 

Afrika de ibe ngu-2002. 

Ifoto nguMalusi Mbatha 

2007 


Uyilo lweSicwangciso 

seSizwe se-HIV/AIDS and 

STIs (NSP) iyaziswa, lujolise 

ukubeka ama-80% abantu 

abafuna unyango kwii-ARVs 

ngo-2011. 

1996 

E-Brazil 

Inkqubo yokuqala 

yesizwe esimahla ye-ARV 

iyaziswa ngurhulumente 

onengeniso esezantsi. 

2010 


Ngaphandle kwenkqubela 

enkulu eyenziwe 

kwiminyaka engama-20 

edlulileyo, ngaphantsi 

kwesiqingatha sabo baphila 

ne-HIV bafuna unyango 

abanofikelelo kulo. 

15

IMFUNO YAMACHIZA 

AMATSHA 

uxhathiso 

kwichiza 

16 

Ngu-Marcus Low 

kunye nawe 

Ifoto ngu-David Chancellor/International Federation of the Red Cross 

Yintoni uxhathiso? 

Uxhathiso kwichiza kwenzeka xa iyeza elithile,okanye 

indibaniselwano yamayeza, engasenako ukucinezela 

okanye ukuphilisa isifo. Kuthetha ukuba isifo 

sitshintshile emzimbeni wakho ngendlela yokuba lide 

liyeke ukusebenza iyeza. Le yinto eyenzekayo xa abantu 

bane-HIV betshintsha kunyango lwe- antiretroviral 

therapy (ART) lomgca wokuqala besiya kunyango 

lwe-ART lomgca wesibini kuba unyango lwe-ART 

yomgca wokuqala lungasasebenzi. 

Njegokuba i-HIV isosulela iiseli ezintsha iphinde iziveze 

kwakhona emizimbeni yethu, iyaguquka (iyatshintsha). 

I-HIV iguquka ngokukhawuleza kuba inezinga eliphezulu 

lokuziphinda (yenza iikopi zayo ngokukhawuleza) kwaye 

ayinayo indlela ‘yokujonga kwakhona’ – oku kuthetha 

ukuba xa iikopi ezintsha ze-HIV zisenziwa emzimbeni 

wakho, akukho ukukhangela ukuba ingaba i-HIV entsha 

ifana ngqo neyangaphambili. Ngenxa yoku ukuziguqula 

kwenzeka ngokupheleleyo ngethuba – okunye kuhle, 

okunye kubi, kwaye okunye akwenzi mahluko. 

Ukuba, ngethuba okunye ukuziguqula kuyaxhathisa 

kumayeza akho, uhlobo loxhathiso lwe-HIV 

luyakuphindaphindeka kuba lungcono ekulweni 

unyango kunezinye iintlobo ze-HIV emzimbeni wakho 

olungenako oko kuziguqula. Njengoko oku kuziguqula 

kuvela ngobuninzi, amayeza ngqo owathathayo aye 

angasasebenza kakhulu. 

Yiloo nto ke kufuneka sithathe indibaniselwano 

yee-antiretrovirals ezintathu ezohlukeneyo ukugcina 

intsholongwane iphantsi kolawulo. Ukuba ngaba 

iyaziguqula intsholongwane ukuze icinezele elinye 

lamachiza, amanye amabini asenokuyithintela ukuba 

izitshintshe kwaye iphindaphindeke.

Igrafu A:Amanqanaba echiza 

noxhathiso 

Inqanaba ekujoliswe kulo lechiza kufuneka 

libengaphezulu kwe-MEC ukuphepha uxhathiso 

kwaye lingabi phezulu kakhulu ukude libange 

iziphumo ebezingalindelekanga. 

MEC 

Idosi 

Ingozi enyukileyo yeziphumo ebezingalindelekanga 

Idosi 

Idosi 

MEC = Minimum Effective Concentration 

(UbuNcinane beNgxinano eSebenzayo) 

Idosi 

Igrafu B: Amanqanaba echiza 

noxhathiso 

Ukuba ngaba uphosa idosi okanye ushiywe lixesha 

amanqanaba echiza anokwehla aye kwinqanaba 

apho kungenzeka khona uxhathiso 

MEC 

Ingozi enyukileyo yoxhathiso Ingozi enyukileyo yoxhathiso 

luvela njani uxhathiso 

Ukuze ucinezele i-HIV, umthamo wee-antiretrovirals 

emzimbeni wakho kufuneka ugcinwe kwinqanaba 

elichanekileyo. Ukuba ngaba amanqanaba aphezulu 

kakhulu, kuvulwa iingcango zokuba kuvele uxhathiso. 

Igrafu A ibonisa amanqanaba echiza emzimbeni 

wakho ukuba ngaba uthtaha iyeza ngqo qho kwiiyure 

ezingama-24. Qaphela ukuba lihala lisendaweni 

echanekileyo njani inqanaba lechiza. 

Igrafu B ibonisa ukuba ukuba kwenzeka ntoni ukuba 

ngaba uphosa idosi enye yechiza ebekufanele ukuba 

uyithathe qho kwiiyure ezingama-24. Qaphela ukuba 

inqanaba lexchiza lehla kanjani kwindawo apho 

usengozini yokuvela uxhathiso. 

oonobangela basekuhaleni boxhathiso 

Xa iikliniki ziphelelwa ngamayeza kwaye abantu 

abane-HIV- bejikiswa, bonke abo bantu basengozini 

yokuvela uxhathiso. Ngoko ke, unikezo lwamayeza 

oluthembekileyo lubaluleke kakhulu ekugcineni 

uxhathiso luphantsi kuluntu lwethu. 

Koko, ukulawula uxhathiso akukho malunga nokuba 

kufumaneke amachiza kwiikliniki kuphela. Kumalunga 

nokuba abantu abane-HIV bathathe ii-ART xa kufuneka 

bekwenzile oko. Xa kuziwa kwiinkqubo zonyango 

ezinempumelelo, ufikelelo kunyango kuphela 

sisiqingatha sebali – ubambelelo oluchanekileyo 

kunyango sesinye. 

Idosi Idosi Idosi Idosi Idosi 

ephosiweyo ethathwe 

emva 

kwexesha 

Imifanekiso isekelwe kwiigrafu ezivela kwi-iBase 

Ivela njani i-TB exhathisayo kumachiza 

Uxhathisa kumachiza yingxaki enzima kakhulu ingakumbi xa kuziwa kwi-TB. 

Iintlobo ezigqithisileyo ze-TB exhathisayo kumachiza kunzima ukuzinyanga. 

Njengonyango lwe-HIV, uxhathiso kunyango lwe-TB kuye kuvele ngenxa 

yokuphazamiseka konyango. Ngamachiza e-TB oku kuhlala kusenzeka ngenxa 

yokuba abantu bayayeka ukuthatha amayeza abo xa beziva bengcono. Nangona 

beziva bengcono, i-TB mycobacterium kusenokwenzeka ukuba isasebenza 

emizimbeni yabo ize iziguqule ibe luhlobo oluxhathisayo. 

Zimbini iindlela zokufumana i-TB exhathisayo kumachiza: 1.Ukuba ngaba 

uyifumana komnye umntu kunye nokuba 2.Ukuba ngaba ivela emzimbeni 

wakho. Uhlobo lokuqala singazama ukululawula sisebenzisa amanyathelo 

okulawula usulelo njengokuqinisekisa ukuba sinendawo engena umoya 

kakuhle nokuba siphi na. Olwesibini uhlobo sinokuluphepha ngokuthatha 

amayeza ethu e- TB njengoko emiselwe, nokuba sele siziva ngcono. 

Ungacinga nge-HIV njengenyoka. Kufuneka 

ube namatye anzima amathathu okuyicinezela 

phantsi le nyoka. Uxhathiso luyavela kufana 

nokube ingathi unamatye amabini lilitye 

elinye nenyoka ke ezinokuphuncuka. Ukuba 

ngaba uthatha ii- antiretrovirals zakho emva 

kwexesah kufana nokungathi uwaphakamisa 

kancinane la matye. Uxhathiso lufana nenyoka 

efunda ukuba ingazikhulula njani na. 


AMATSHA 

17


AMATSHA 

18 

Ingxaki ngonyango lomgca 

wesibini nomgca wesithathu 

Njengoko abantu abaninzi bechitha ixesha elininzi kunyango 

lwe-antiretroviral, sinokulindela ukuba unyango lomgca 

wesibini nomgca wesithathu luyakunyuka kwiminyaka ezayo. 

Kuba unyango lomgca wesibini nomgca wesithathu lubiza 

kakhulu kunonyango lomgca wokuqala, oku kungenzeka 

ukuba kukhokelele kwiingxaki ezinzima zenkxaso. 

Kubalulekile ke ngoko ukuba sikhankase kwangaphambili 

siqinisekise ukuba unyango olunobulunga lomgca wesibini, 

nomgca wesithathu nolulandelayo luyafikeleleka kwaye 

luyafumaneka kwinkqubo yempilo karhulumente. 

Alpha Mlondobozi 

Ifoto ngu-Adam Malapa 

Ukuhlala ngoloyiko 

U-Adam Malapa uye wadlana indlebe no-Alpha 

Mlondobozi oxhathisayo kunyango lwe-antiretroviral 

yomgca wokuqala kwaye okwangoku ekwirejimeni 

omgca wesibini. 

U-Alpha Mlondobozi uneminyaka engama-43 

yobudala. Uhlala e-Bridgeway, ngaphandle nje 

kwedolophu yase-Tzaneen kwiPhondo laseLimpopo. 

Unonyana oneminyaka engama-24 kwaye ube ne-HIV 

ukusukela ngo-2000. 

Wathi akufumanisa isimo sakhe se-HIV u-Alpha 

woya kakhulu. Awayekwazi nje yayikukuba i-HIV 

ayinayngeki kwaye wayecinga ukuba umntu 

uyafa msinyane nje awukwazi ngesimo sakhe. 

Ngecandelo labucala waye waqala ngoko nangoko 

unyango lwe-antiretroviral (ART). U-Alpha 

zange afumane kucetyiswa ngendela ezisebezna 

ngayo ii-antiretrovirals (ARVs), okanye nakuphi 

na ukucetyiselwa ukubambelela kumachiza. 

Ngamanye amaxesha unyango lwakhe wayeluthatha 

emva kwexesha ngeeyure ezimbalwa kuze okuke 

kumtatazelise kuba ugqirha wamxelela ukuba 

kufuneka awathathe ngexesha amayeza akhe. 

U-Alpha swaqala ngerejimeni ye-stavudine (d4t), 

lamivudine (3TC) ne-efivarenz (EFV). Wayephathwa 

lurhudo olungamandla rhoqo kwaye egabha. 

Indlela ekukuphela kwayo yokulawula ezi ziphumo 

bezingalindelekanga yaba kukuba angeniswe 

esibhedlele iintsuku ezimbalwa. Wayehlala ephethwe 

bubucaphucaphu kwaye eziva ebuthathaka. 

Emva kokungaboni bungcono kolu nyango waye 

watshintsela kwirejimeni yomgca wesibini. Kweli 

tyeli u-Alpha waye wabhalisa kwisibonelelo sempilo 

sikarhulumente. Waya kwizifundo zonyango 

kunye nakwiiseshoni zokubamabelela kunyango 

kwiSibhedlele iLetaba apho waye wazuza ulwazi 

oluninzi malunga ne-HIV kunye nokuba kubaluleke 

kanjani na ukuthatha unyango lwakho. Emva 

kweenyanga ezimbalwa ekunyango lomgca wesibini 

kwaye kwabakhona utshintsho olungundoqo 

empilweni yakhe. Waye waqala ukufumana amandla 

akhe kwakhona waze wazimanya namaqela enkxaso 

esibhedlele, apho waye wabelana namava akhe 

kunye nezinye izigulane ezine-HIV. 

Ku-Alpha, unyango lomgca wesibini lelona 

themba lakhe lokugqibela kwicandelo lempilo 

likarhulumente. Nangona unyango lunceda, 

akakwazi ukukuqhela ukukrakra kwamanye 

amachiza, umzekelo i-didanosine (ddI), ethathwa 

kanye ngemini ungekatyi. Iyipilisi enzima ukuba 

uyiginye kuba inkulu kakhulu. Mhlawumbi 

ungayinyibilikisa okanye uyihlafune ukuze ukwazi 

ukuyiginya. “Andikwazi ukuyichaza ukuba 

ingcamleka njani kodwa imbi,” utshilo u-Alpha. 

“Omnye umceli mngeni kum yi-lopinavir/ritonavir 

(LPV/r). Kufuneka ndithathe ama-100mg amane 

[iipilisi] ukwenza ama- 400mg [engumthamo 

olungileyo] obunzima bam. Kum [ezo] ziipilisi 

ezininzi kakhulu ngexesha elinye,” uphawule. 

“Ngaphambili kwakungcono kuba ndandizithatha 

njengeekhapsule, kodwa ngoku ndizithatha 

njengeepilisi ekufuneka ndizingcamle, eyinto embi 

kakhulu ke leyo kum.” 

U-Alpha woyika kwakhona into enokwenzeka kwixa 

elizayo ukuba ngaba uvela uxhathiso kwirejimeni 

ayesebenzisa ngoku. “Andazi ngenene ukuba yintoni 

eza kwenzeka. Ndicinga ukuba umntu uyakuvela 

alindele ukusweleka.”

Abantwana 

Nee-antiretrovirals 

Ngu-Catherine Karlsson 

Eyona ndlela isebenzayo yokuthintela usulelo lwe-HIV 

ebantwaneni lunyango lwe-PMTCT (prevention of mother- 

to-child transmission) (uthintelo losulelo olusuka kumama 

luye emntwaneni), kodwa ke kwiimeko apho umntwana 

aye wosuleleka ngaphandel kwale mizamo kukho imfuno 

emandla yokumnika i-ART. Njengoko iimveki ezine-HIV ziye 

zibonakalise iimpawu zezonyango kunyaka wokuqala wobomi 

babo uMbutho wezeMpilo weHlabathi wenze isindululo 

sokubekwa kunyango kwee-mveku ezinjalo ngoko nangoko 

emva kokuzalwa. NgoSuku lwe-AIDS leHlabathi kunyaka 

ophelileyo, umongameli Jacob Zuma waye wabhengeza ukuba 

uMzantsi Afrika uyakuzilandela ezi zindululo uqala ngo-Aprili 

2010. 

U-Mark Cotton, umlawuli weYunithi yoPhando 

lwezoNyango ngeziFo zabaNtwana ezoSulelayo ( Children’s 

Infectious Disease Clinical Research Unit) kwiYunivesiti 

yase- Stellenbosch, uthi zimvuyisa kakhulu izikhokelo ezitsha 

kuba yinto iingcali zoMzantsi Afrika ebeziyixhasa kule 

minyaka mithathu idlulileyo. Isibhengezo sikamongameli 

yaba linyathelo eliya kwicala elichanekileyo, kodwa ke imiceli 

mngeni isasele xa kuziwa ekinikeni usana kunye nabantwana 

i-ART. 

U-Cotton uthi ukunqongophala kweendibaniselwano 

zamachiza akhethekileyo abantwana kusahleli kungumqobo 

ongundoqo. 

Ifoto ngu-David Chancellor/International Federation of the Red Cross 

Ngaphandle konyango lwe-antiretroviral (ART), ngaphezulu 

kwama-30% abantwana abosulelwe yi-HIV abaya kusweleka 

phambikokuab bafike kunyaka wabo wokuzalwa wokuqala 

kunye namalunga nama-50% phambi kokuba badibanise 

iminyaka emibini. Ngonayngo ke, malunga nama-75% ezi 

ntsana anokusindiswa. 

Njengabantu abadala, intsana nabantwana kufuneka 

banyangwe okungenani ngamachiza amathathu awohlukeneyo 

ukunyina ingozi yokuvela koxhathiso. Koko, amachiza 

kufuneka anikwe ngeedosi ezincinane. Ngaphaya koko, 

iinxenye kunye neendibaniselwano zezi dosi kufuneka 

zitshintshwe rhoqo njengoko umntwana ekhula. Ukuze 

ulinganise iidosi ngokuchanekileyo, ubalo olunononophelo 

kufuneka lwenziwe, usebenzisa indlela enzima esekelwe kubude 

nakubunzima bomntwana. 

Ezi zibalo akulula ukuba zenziwe kwiikliniki zempilo 

kwimimandla esemaphandleni kuba zisoloko zingenazo 

izixhobo eziyimfuneko, njengezibali, Endaweni yoko 

abasebenzi ngezempilo kufuneka bazenze lula izibalo baze 

bohluke ii-antiretrovirals (ARVs) zabantu abadala bezohlulela 

abantwana. Le ndlela inyusa ingozi yokudosa ngaphezulu 

okanye ngaphantsi (Jonga kwiphepha le-17 ngokungaphaya 

ngokuba ukudosa ngokungaphantsi kungakhokelela njani 

kuxhathiso.) Ukwenza lula ukudosa kunokuba neziphumo 


AMATSHA 

19


AMATSHA 

Sources: Newell, M. et al, 

‘Mortality of infected and 

uninfected infants born to HIVinfected 

mothers in Africa: a 

pooled analysis’, The Lancet 

364:9441 (2004). 

20 

ezibi emntwaneni. 

Ukudosa ngokungaphezulu 

kunokunyusa iziphumo 

ebezingalindelekanga 

emntwaneni, ngexa ukudosa 

ngaphantsi kunokukhokelela 

kuxhathiso kwichiza. 

Ukudosa kwenziwa nzima 

Ifoto ngu-Emily Chastain nangakumbi yinto yokuba 

iintsana azikwazi ukuginya 

iipilisi. Kuye kufuneka ke ngoko ukuba zilithathe ichiza 

ngokohlobo lwesiraphu okanye imigubo. Oku kubanga 

iingxaki kuba akwenzeki ukuba bonke abazali bayigcine 

efrijini isiraphu okanye ukufumana amanzi okusela okuxuba 

umgubo ngawo. Kwakhona, ungcamlo olubi lunokwenza 

ukuba umntwana angafuni ukuginya.. 

Oko kuthiwa yindibaniselwano yedosi emiselweyo ( fixeddose 

combinations) (FDCs) oko kuhlanganisa ii-ARVs 

eziphindiweyo zibe yipilisi enye kubantwana isanda 

Ithenda ye-ARV ka-2010 ARV neeRejimeni 

zabaNtwana 

Nanjeko uMzantsi Afrika ulungisa i-ART yentsana kunye 

nabantwana, kufuneka uqinisekise ufikelelo kunikezo 

lwarhoqo lwamachiza abantwana akhuselekileyo, anobulunga 

obuphezulu. 

Abacavir (ABC) 

Umbutho weMpilo weHlabathi unduluile ukusetyenzisa 

kwe-ABC kweerejimeni zabantwana zomgca wokuqala. 

Amaphononongo abonise ukuba inokusetyenziswa 

ngokusebenzayo kwiindawo ezinemithombo enyiniweyo. 

Kulandela isikhalazo sokhuphiswano lwekomishini i-TAC 

kunye namaqabane, kunye nenani labavelsii boosinga 

machiza ngoku banokuthengsia i-ABC. Ufikelo kwi-ABC 

onokukwazi ukuyithenga lulityaziswa lubhaliso oluhamba 

kancinane lwemveliso ezintsha ze-ABC liBhunga eliLawula 

amaYea loMzantsi Afrika (Medicines Control Council) (MCC). 

Umbutho wabezamaYeza e- HIV umeme i-MCC ukuba 

ikhawulezise ukubhalisa zonke iimveliso ze- ABC kwaye 

ingakumbi iindibaniselwano zabantwana ze-ABC/lamivudine. 

kuphuhliswa kutsha nje. Kumazwe apho zifumaneka khona ezi 

pilisi kulula ke ukuwagcina, ukuwathutha kunye nokuwafaka 

amayeza ngoku. Iingozi ezinxulumene nabezonyango zokuba 

kohlulwe iipilisi zabantu abadala zisohlulelwa abantwana sele 

ziphelisiwe kwezi ndawo. Koko, imixube yabantwana ibiza 

kakhulu kunonyango lwabantu abadala. Kaninzi azifikeleleki 

kwimimandla efuneka kakhulu kuzo. 

Ekuqaleni kulo nyaka, kwinqaku le- Plus News, uGqirha Eric 

Goemaere, umlungelelanisi wezonyango waseMzantsi Afrika 

kumbutho woogqirha abangamavolontiye i-Médicins Sans 

Frontières, waye wavakalisa ukukhathazeka kwakhe ngabantu 

abangabanyangiyo abantwana kuba besoyika ukubala iidosi 

ngokungachanekanga baze babenze bagule kakhulu. Waye 

wamemela unyango lwabantwana ukube lwenziwe lube lula 

kubongikazi kwinqanaba lokhathalelo lwempilo elisisiseko 

ukuze ukunyanga abantwana kube lula njengokunyanga 

abantu abadala. 

Kucacile ukuba uphuhliso olungaphaya lweendibaniselwano 

zedosi emiselweyo ezingabiziyo kubantwana zifuneka kakhulu. 

Lopinovir/Ritonavir (LPV/r) 

Phantsi kwezikhokelo ezitsha i-LPV/r isetyenziswa kunyango 

lomgca wokuqala kuzo zonke iintsana ezingaphantsi 

kweminyaka emi-3. I-LPV/r iyasetyenziswa kwakhona 

kwiirejimeni yomgca wesibini kubantwana abangaphezulu 

kweminyaka emithathu, kubantwana abafikisayo kunye 

nakubantu abadala abangaphathwa kakuhle lunyango lomgca 

wokuqala. 

I-LPV/r iphansti kwelungelo lomenzi eMzantsi Afrika kwaye 

ithengiswa yi-Abbott Laboratories kuphela. Ukuba ngaba 

amaxabiso asezantsi kasinga chiza le-LPV/r ayafumaneka 

uMphathiswa ugunyaziswa ngumThetho wamaLungelo 

abeNzi ukuba acele i-Abbott ikhuphele iimvume abenzi 

boosinga machiza ngemiqathango efanelekileyo. 

Iipilisi ezizinzileyo zabantwana i-lopinovir 100mg/ritonavor 

25mg zisalindele ukubhaliswa yi-MCC. Ezi pilisi ziyimfuneko 

ekuphumezeni izikhokelo ezitsha kwaye i- MCC kufuneka 

ikhawulezise ubhaliso zazo. 

Imithombo: www.who.org; www.avert.org; www.newsplus.org; P. Nahirya-Ntege et al, ‘Successful management of suspected abacavir hypersensitivity reactions among 

African children in the ARROW’, IAS (2009); Violari, A. et al, ‘Early antiretroviral therapy and mortality among HIV-infected infants’, N Engl J Med. 359, 2233-44, 20 

November 2008 (http://www.ncbi.nlm.nih.gov/ pubmed/19020325).

USphelele Yende uneminyaka emine 

ukwi-ART sukusukela ngoSeptemba 

2007. Ifoto ngu-Mbatha 

USphelele Yende uyinkwenkwe eneminyaka emine 

evela kwilali Iswepe e-Gert Sibande, kwiPhondo 

laseMpumalanga. Ngumntwana odlamkileyo 

ophila ngokonwaba ne-HIV. USphelelewaba 

kunyango lwe-antiretroviral (ART) ukusukela 

ngoSeptemba 2007 x umama wakhe wafumanisa 

okokuqal ukuba une-HIV. UMalusi Mbatha uthethe 

nomama kaSphelele uNomsa Nhlengethwa, 

ilungu le-Treatment Action Campaign (TAC) kunye 

nevolontiye kwikliniki yase-Iswepe. U Nomsa uye 

wanika amagqabantshintshi ngamava omntwana 

wakhe ukusukela ekufunyanisweni kwakhe ukuba 

une-HIV. 

NgoSeptemab ka-2007, xa uSphelele wayeneminyaka 

emibini yobudala, waye wagula waze umama wakhe 

wamsa ukuba ayokwenziwa uvavanyo lwe-HIV. 

Wayefumansie ngesakhe isimo se-HIV kunyaka 

onagphambili. 

Emva kokuba efunyaniswe ene-HIV, uSphelele 

iwaye waqala ngoko nangoko unayngolwerejimeni 

1a kwiSibhedlele sase-Piet Retief. UNomsa kwaye 

kwafuneka ukuba aziqhelanise ngokukhawuleza 

nesimo se-HI sonyana wakhe, kwaye amncede 

ukuba athathe i-ART ukuze akwazi ukuphila ubomi 

obuqhelekileyo. Irejimeni yokuqala yonyango 

awaqala wayizama uSphelele zange imsebenzele 

kakuhle. Waye waqhuba egula – egabha, 

ephathwa yintloko ebuhlungu rhoqo, kunzima 

ukuba atye kwaye esehlelwa bubunzima obuninzi. 

Ngeli xesha uSphelele waye wavela neempawu 

zokurhoza zentlalo-ngqondo. Wayengasakonwabeli 

ukuba phakathi kwabanye abantwana, kaninzi 

Ibali 

likaSphelele 

ekhetha ukuhlala ekhaya nomama wakhe. Emva 

kweenyanga ezintandathu, wayokukhangelwa 

impilo. Ugqirha wafumanisa ukuba umthamo wakhe 

wentsholongwnae egazini ungama-45,000, waze 

wamtshintshela kwi-zidovudine, didanosine and 

lopinovir/ritonavir ngoko nangoko. 

USphelele wasabela kakuhle, kwaye akasaguli 

ngoku okanye kwehle ubunzima bakhe.UNomsa 

uxel ukuba ngumntwana odlamjke kakhulu 

odlalayo. Uthanda yonke imidlalo edlalwa 

ngamanye amakhwenkwe engqingqini, njengebhola 

ekhatywayo, imidlalo yokulwa, ukudlala ngeemoto 

njalo njalo. Sele elungele ukuya esikolweni sabo 

bangekangeni esikolweni kulo nyaka uzayo, kwaye 

ufuna ukuba lipolisa xa emdala ukuze abambe bonke 

abantu abangalunganga. 

Xa kubuzwa ukuba umntwana wakhe uziva njani 

ngokuthatha amayeza yonke imihla, uNomsa 

kuqala ubengafuni uSphelele. Ehleka, uchaza ukuba 

ubeqhele ukubaleka kanjani na, kodwa ebemxelela 

ukuba kufuneka athathe amayeza akhe ukuze 

angaguli kwakhona. Unyango ngoku sele luyinxenye 

yesiqhelo yobomi bakhe bemihla ngemihla ude 

abuze nomama wakhe ukuba ingaba ulithathile na 

iyeza olakhe. Xa uSphelele ebona uNomsa ethatha iiantiretrovirals 

zakhe, uyakulangazelela nangakumbi 

ukuthatha ezakhe. Into yokuba akazange ehlelwe 

kuko nakuphio na ukuphazamiseka kunyzngo 

lwakhe nayo imncede kakhulu. 

UNomsa unemvakalelo yokuba kubalulekile 

kubazali kunye nakubagcini babantwana abane-HIV 

ukusamkela isimo somntwana kwaye bazibophelele 

ekumncedeni ukuthatha unyango lwakhe-. 

Umceli mngeni ngowokuba abanye 

abazali baye bangakholwa okanye 

boyike ukuyokuthatha iziphumo, 

oko kube neziphumo ezibi kwimpilo 

yomntwana. 

21

ULAWULO KUNYE NOKUFUMANEKA 

KWAMACHIZA/ AMAYEZA 

22 

Imithombo: http:// 

www.msfaccess.org/ 

main/access-patents/ 

make-it-happencampaign/ 

campaign-updates/ 

february-9-2010/; 

http://www.unitaid. 

eu/en/20091215237/ 

News/UNITAID- 

APPROVES- 

PATENT-POOL. 

html 

Yintoni ekufuneka uyazi 

Yintoni ilungelo lomenzi? 

Ilungelo lomenzi lilungelo elikhethekileyo elinikwa umenzi 

ngumthetho. Lithatha ukuba umenzi eyedwa wenza isigqibo 

sokuba oko akwenzileyo kufuneka kusetyenziswe njani na. 

Umzekelo, ukuba ngaba wenza uhlobo olutsha lwe-oveni 

olwahlukileyo kwaye olusebenzisa iindlela ezikrelekrele 

zokufudumeza ukutya, ungafaka isicelo ke sokuba ufumane 

ilungelo lakho lokuba ngumenzi nge-oveni leyo. Ukuba ngaba 

ulinikiwe ilungelo lomenzi, abanye abantu ke bayathintelwa 

ukba bathengise ii-oveni ezisebenzisa le ndlela yakho 

ikrelekrele yokufudumeza ukutya – ngaphandle kokuba 

bafumana imvume yakho. Indlela yelungelo lomenzi ekwanye 

yiyo le isebenza kumachiza amatsha kunye nezinye izinto 

ezenziwayo ezininzi. 

Amalungelo omenzi ahlala inani elithile leminyaka kuphela 

– emayezeni ngokuqhelekileyo iba yiminyaka eqala kweli- 

10 ukuya kwengama-20. Uluvo apha kukuba, kwixesha 

elinyiniweyo, ilungelo lomenzi livuza umenzi ngomsebenzi 

wakhe wokwenza i-oveni entsha okanye iyeza. Ukuba ngaba 

uwedwa unelungelo lokuthengisa loo mveliso yakho intsha 

imangalisayo, unokuniza ixabiso eliphezulu kakhulu kwaye 

wenze imali eninzi ngokukhawuleza kwinto leyo oyenzileyo. 

Kumayeza ayimfuneko afana nee-antiretrovirals kuye 

kubenzima kakhulu kunee-oveni. Iinkampani zinikwa 

amalungelo abenzi kwaye la malungelo abenzi abavumela 

ukuba bawagcine ephezulu amaxabiso. Ukwenza oku ngexa 

abantu besweleka ngenxa yokuba bengakwazi ukufikelela 

kumayeza athile oko akunazo iinqobo ezisesikweni. 

Ngesi sizathu, sinolungiselelo olufana nee-patent pools, 

iimvume ezinyanzelekileyo kunye nokungenisa elizweni 

okunxuseneyo(okucaciswe kwenye indawo kweli nqaku). 

Ukhuselo lelungelo lomenzi kwilizwe elithile alinabeli 

kwamanye amazwe. 

Ii-Patent pools 

I-Patent pool yechiza le-HIV ivumela ukuba iinkampani 

zamachiza zingenise ngokuzithandela amalungelo azo abenzi 

kumbutho ozimeleyo ofana ne- UNITAID, ekuMbutho 

weMpilo weHlabathi kwaye enjongo yawo ingundoqo 

ikukunyusa ufikelelo kumachiza kwizifo ezikhoyo kwihlabathi 

jikelele. I-UNITAID iye ke isasaze la malungelo abenzi 

bamachzia e-HIV ukuba ziye kwiinkampani ezenza oosinga 

machiza kunye nakubaphandi baze ke bona bafumane 

intlawulo efunyanwa xa kuthengiswe umsebenzi wakho wena 

menzi wokuqala okanye wena mnini welungelo lokwenza. 

I-patent pool ke ngoko ifana nevenkile enesikhululo 

esinye apho iinkampani zinokuya khona ziyokufumana 

iimvume zokuba zenze amachiza athile. Kunokuba zenze 

uthethathethwano nezinye iinkampani, abenzi kuphela 

zisebzna ne-patent pool. 

Ekujikeleziseni la malungelo abenzi, ukhuphiswano olukhulu 

lwe-patent pool kukuba ivumela ukwenziwa kwamachiza 

angoosinga machiza ziinkampani. Ezi nkampani zinokuvelisa 

iikopi ngqo zamachiza anokufikeleleka ngakumbi kwabo 

bawafunayo.. 

I-patent pool ye-HIV kwakhona ivumela uphuhliso olulula 

lweendibaniselwano zedosi emiselweyo, kuba onke amalungelo 

abenzi ayakufumaneka kubaphandi abafuna ukudibanisa iiantiretrovirals 

ezithile zibe yipilisi enye. 

Eyona ndlela isebenzayo yokunyusa ukusasazwa kwamachzia 

e-HIV kunge-patent pool ehlolwayo nesebenzayo. Oku kuyakuvunela 

usasazo olubanzi lwamachiza asindisa ubomi e-HIV 

ngokuphelisa iimonopoli kunye nokwehlisa umiso olungeyomfuneko. 

Iinkampani zoxubo-mayeza ngokwe-avareji zichitha ngokuphindwe kabini kwintengiso 

kunye nakulawulo kunokuba besenza inkcitho kuphando nakuphuhliso. Oku kucebisa 

ukuba izigidi ngezigidi ezenziwe ngenxa yokhuselo lelungelo lomenzi ziseteynziswa 

kakhulu kwintengiso kunokuba zisetyenziswe kuphando. 

Ngu-Lamya Moosa 

no- Catherine Karlsson

Yintoni i-TRIPS? 

U-TRIPS umele i-Trade-Related Aspects of Intellectual Property 

Rights, isivumelwano samazwe ngamazwe esisetyenziswa nguMbutho 

weMpilo weHlabathi (World Trade Organization) (WTO). I-TRIPS 

yaveza imithetho yelungelo lomenzi kwinkqubo yorhwebo yamazwe 

ngamazwe kwaye yabeka imida ethile kumazwe angamalungu 

e- WTO ngokunxulumene namalungelo abaseki okanye abaqambi. 

Abaninzi bathi i-TRIPS yakhokelela kufikelelo olunyiniweyo 

kumayeza ayimfuneko kumazwe asaphuhlayo. ISibhengezo sase- 

Doha yayingumzamo wokubuyisela kwisimo sangaphambili 

i- TRIPS ukuze ipahakamsie ufikekelelo kumayeza kwilizwe 

elisaphuhlayo. 

Yintoni imvume enyanzelekileyo? 

Ukuba ngaba amachiza anelungelo lomenzi abiza kakhulu kwaye 

kukho intlekele kawonke-wonke yempilo, iimvume ezinyanzelekileyo 

zinokunikwa. Ezi zinika abenzi boosinga machiza basekhaya 

ilungelo lokuvelisa eli chiza linelungelo lomenzi nokuba umnini 

lungelo uyavuma okanye akavumi. Xa abenzi boosinga machiza 

beqala ukuvelisa ichiza, ixabiso layo liye lehle ke kakhulu ngenxa 

yokhuphiswano. Ngaphandle kokuba namandla omthetho 

okukwenza oko uMphathiswa wezeMpilo waseMzantsi Afrika zange 

ake alisebenzise eli lungelo. 

Yintoni iSibhengezo sase-Doha? 

ISibhengezo sase-Doha kwi-TRIPS wsaye saphunyezwa 

nguMbutho weMpilo weHlabathi ngo- 2001 e-Doha, e-Qatar. 

Siqiniseksia kwaye sicacisa ilungelo lamazwe aphuhluyo lokwenza 

oosinga machiza, ngamaxesha entlelekele yesizwe kwezempilo, 

ukungawananzi amalungelo omenzi agcinwe ziinkampani 

zamachiza ezingundoqo. Ngenxa yokuba i-HIV iyingxakeko 

eMzantsi Afrika, uMphathiswa wezeMpilo unokusebenzisa 

iSibhengezo sase-Doha ukunika iimvume ezinyanzelekileyo 

(jonga ngasezantsi) ngamachiza abiza kakhulu ngenxa yonyino 

lwamalungelo abenzi. Akekho umphathiswa wezempilo 

waseMzantsi Afrika owake wawasebenzisa la magunya. 

Yintoni ukungenisa elizweni 

okunxuseneyo? 

Ukungenisa elizweni okunxuseneyo kuxa ilizwe lingenisa kwilizwe 

alo oosinga machiza avela kwelinye ilizwe ngaphandle komnini 

welungelo lomenzi. Oku kaninzi kwenzeka ngohlobo lokuba 

amazwe aphuhlileyo angenise izinto kwilizwe lawo (njenge-Indiya) 

elinabenzi boosinga machiza abanamandla. Ukungenisa elizweni 

okunxuseneyo kungongela oorhulumente imali eninzi kuba kukho 

umahluko omkhulu wexabiso phakathi kweemveliso zoxubo 

mayeza ezithengisqa kumazwe awohlukeneyo. 

INGABA INOKUSEBENZA NJANI I-PATENT POOL... 

1. 

Iinkampani zinikeza ngamalungelo 

abenzi e-HIV abazivelisileyo 

kumbutho ozimeleyo, ekuthiwa 

yi-patent pool. 

PATENT 

PATENT 

PATENT 

POOL 

2. 

PATENT 

Iinkampani zamachiza kunye 

nabaphandi bangafikelela ngoku kwaye 

bathenge amalungelo abenzi kwi-patent 

pool. Umenzi ufumani imali efunyanwa 

ngumezi kwiintengiso. 

3. 

Inkampani 

zamachiza ezininzi 

zinokwenza kwaye 

zithengise kwa leli 

chiza linye. Oku 

kwenza ukuba 

ixabiso lechiza 

lehle. 

Le mifanekiso isekelwe kwividiyo ye-MSF patent pool, efumaneka ku-www.youtube.com. Funda 

ngokungaphaya ngephulo loFikelelo le-MSF Access campaign ku- MSFAccess.org. 

PATENT 

4. 

20 10 

25 25 

Abaphandi 

banokusebenzisa 

amalungelo abenzi 

ukuphuhlisa 

amachiza ekulula 

ukuba asetyenziswe 

ebantwaneni kunye 

neendibaniselwano 

zeepilisi ezintsha 

eziyimfuneko. 



23

Ifoto yi-courtesy of Gallo Images/Getty Images 



24 

2. 

Uninzi lwezinto ezidityanisiweyo 

zokwenza amayeza zizinto ezivela 

kwizityalo, kodwa ke ezinokusebenza 

kakhulu kwaye zibe netyhefu esezantsi. 

Iilebhu ezininzi zikhetha ukuvavanya izinto 

ezidityanisiweyo kuba okuvela kwizityalo 

akulula ukwenza amalungelo omenzi kuzo. 

3. 

Ipilisi inomxube wemichiza esebenzayo nengasebenziyo, 

ngokuqhelekileyo ngokohlobo lomgubo, ecinezelwe 

okanye efakwe kwisiqulatho yaba yinto eqinileyo. 

Umatshini wokwenza iipilisi unokwenza 

amakhulu amawaka eepilisi ngeyure. 

4. 

Umzi mveliso oonomatshini 

abazisebenzelayo abaphucukileyo 

uyakufaka kwiibhotile phakathi 

kwama-120 nama-240 eepilisi 

ngomzuzu, kwaye uyakuvelisa 

phakathi kwama-2000 nama-5000 

eepakethe zeblista ngomzuzu. 

5. Nangona ezinye iipilisi ziveliswa eMzantsi Afrika, 

izithako ezisebenzayo zoxubo-mayeza, oaknye ii-APIs, 

kaninzi kuye kufuneke ukuba zingeniswe elizweni 

zivela phesheya. Oku kuthetha ukuba, naphambi kokuba ilori 

ithathe iipilisi kwiindawo ezigcinwa kuyo 

kwiidolophu ezinkulu zizise kwikliniki yakho 

yengingqi, ezinye izithako kwiipilisi zihambe 

amawaka eekhilomitha zivela phesheya ukuba 

zifike kwimizi mveliso yoMzantsi Afrika apho 

zenziwa khona. 

Ifoto ngu-Paul Bettings 

ApHO AvELA KHONA 

1. 

AMAYEZA 

Amahlathi eemvula zetropiki njengalalwo afumaneka kummandla we- 

Amazon wamaZantsi eMelika alikhaya kuma-50% azo zonke iindidi 

zezityalo, ngoko ke abalulekile kuphando ngamachiza. Koko, amayeza 

amaninzi, kuqukwa nee- antiretrovirals, awaqulathanga mveliso 

yezityalo. 

Ifoto ngu-Roger Segelken, Cornell University News Service, copyright © 1997 Cornell University. 

Ifoto ngu-amien Schumann 

Ifoto yi-courtesy of Gallo 

Images/Getty Images 

6. 

ISebe lezeMpilo lithenga 

amayeza e-antiretroviral 

ngethenda ekhethekileyo yeantiretroviral. 

Ithenda ka-2008 yayixabisa 

ngaphezulu kwe-R3.6 yesigidi sezigidi. 

Ithenda ka-2010 ye-ARV iyakunikwa 

ngasekupheleni kwalo nyanka. 

Ifoto ngu-Flickr user Mike Blyth 

7. 

Imigca emide kunye 

nokungabikho kwamayeza 

kunokubangela kukungabikho 

kwabasenzi aboneleyo aezikliniki 

kunye nokungabikho kofikelelo 

kumayeza ayimfuneko. 

Ifoto ngu-Oupa Nkosi/Mail & Guardian 

8. 

Nasemva kohambo olude lwepilisi ukuba ifikelele kwabo 

bayifunayo, abantu abaninzi abazithathi njengoko kumiselwe 

iipilisi zabo. Ukuba nofikelelo kunyango sisiqingatha nje 

kumceli mngeni xa kuza ekuphileni ne-HIV – ubambelelo olululo 

kunyango ngomnye. 

Ifoto ngu-by Oupa Nkosi/Mail & Guardian

umsebenzi ombi 

Ngeenyanga nje, ngaphezulu kwesigidi sabantu abane- 

HIV eMzantsi Afrika baza kube befumana unyango 

lwe-antiretroviral (ARV). Esinye sezizathu ezingundoqo 

sokuba kutehniukuze kwenzeke oku, kukuba amaxabiso 

ee-ARVs awe kakhulu kule minyaka ilishumi idlulileyo. 

Ngoo-1990s, unyango lwe-ARV lwalubiza ama-R3,000 

ngenyanga. Ngoku urhulumente uthenga irejimeni 

eqhelekileyo nge-R150 ngenyanga. 

Amaxabiso aphantsi enze ukuba inkqubo yonyango 

lwe-HIV ifikeleleke kurhulumente. Ngaphandle koku 

kwehla kakhulu kumaxabiso, phantse ibe sisigidi 

sabantu esongezelelekileyo engaba besiswelekile 

okanye siza kusweleka eMzantsi Afrika. 

ziye zifikeleleke njani ii-aRVs 

Ekuqaleni koo-2000s, kuba la machiza ayenamalungelo 

abenzi, kuphela yinkampani eyayinalo ilungelo lomenzi 

eyayisenza isigqibo sokuba ngubani omakawathengise. 

Oku kwathetha ukuba akukho lukhuphiswano kwii-ARVs 

kwaye ke ngoko iinkampani zinokubiza amaxabiso 

aphezulu kakhulu. 

Koko zintathu izinto ezaye zenzeka ukuze kwehle 

amaxabiso: 

1. Abenzi kakhulu abazinze e-Indiya (kodwa kwakhona 

nase-Brazil kunye nakwezinye iidawo)baye benza 

iinguqulelo zoosinga machiza ezingabizi kakhulu 

zee- ARVs. Babenokukwenza oko kuba amayeza 

ayengenawo amalungelo abenzi e-Indiya. Koko, 

ekuqaleni la machiza ayengafumaneki eMzantsi 

Afrika kuba ayenamalungelo abenzi apha. 

2. Amatsha ntliziyo eMzantsi Afrika, kwi-Afrika kunye 

nakwihlabathi jikelele aye akwazi ukukhankasela 

iimvume zabenzi booosinga machiza ukuba 

bawathengise e-Afrika amayeza abo. 

3. Kulandela olu xinzelelo zonke iinkampani ezenza 

ii-ARVs phantsi kwelungelo lomenzi zaye zawehlisa 

amaxabiso azo (umzekelo, i-fluconazole, efavirenz 

ne-tenofovir) okanye zavumela ukhuphiswano 

loosinga machiza (umzekelo, i-ddI, d4T, AZT, 

lamivudine and nevirapine). 

Ii-ARVs ezininzi ezenziwa e-Indiya ziyathengiswa ngoku 

eMzantsi Afrika ngamaxabiso afikelelekayo. 

umthetho wase-Indiya welungelo 

lomenzi 

Ngo-2005, urhulumente wase-Indiya waye wawisa 

umThetho ovumela ukuba amayeza abe namalungelo 

abenzi. Ngenxa yoko, amayeza enziwe ukusukela ngo- 

2005 awunako ukuphinde enziwe kwakhona ziinkampani 

ezenza oosinga machiza ezisebenza e-Indiya. 

Okukuthetha inyathelo elinye ngaphezulu alisenzeki 

kumachiza amatsha. Kunzima ke ngoko ukukhankasa 

ngempumelelo ukuze kwehle amaxabiso amayeza. 

Umzekelo, i-raltegravir yi-ARV entsha ebalulekileyo 

ingakumbi kubantu abaxhathisayo kwezinye iirejimeni 

ze-ARV. Okwangoku ibiza ama-R2,396 kuqukwa ne-VAT. 

Oku kubiza kakhulu kwinkqubo yezempilo karhulumente 

yoMzantsi Afrika. Ayikho inguqulelo yoosinga machiza 

yayo e-Indiya okanye naphi na . 

Okungenani ngamachiza esifo sephepha amabini 

amatsha ekungenzeka ukuba afumaneke kule minyaka 

imbalwa izayo. Afuneka ngokukhawuleza la mayeza 

ngenxa yokhulua kukabhubhani we-TB exhathisayo 

kumachiza. Iyahlupha into yokuba kusenokwenzeka 

ukuba angafikeleleki apho afuneka khona kakhulu: 

kumazwe ahluphekayo. 

uthethathethwano lwe- Eu/Indiya 

Ngoku, umbono wokwenza kufumaneke amachiza 

ii-ARVs ezintsha eMzantsi Afrika ngamaxabiso 

afikelelekayo uphantsi kwentsongelo ngenxa yezehlo 

ezenzeka e-Indiya. Ingakumbi kuba, iManyano 

yaseYurophu (European Union) (EU)ibeka uxinzelelo 

kurhulumente wase-Indiya ukuba asayine isivumelwano 

sorhwebo esiyakwenza ukhuphiswano lube yimfuneko 

kumayeza ayimfuneko asengaphantsi kwelungelo 

lomenzi lube nzima nangakumbi.. 

Uqulunqo olwathubelezayo lwemibhalo 

yothethathethwano lubonisa ukuba i-EU ityhalela 

unyino lweminyaka emihlanu ukuya kwelithoba kulwazi 

olunokusetyenziswa ziinkampani zoosinga machiza xa 

befaka isicelo sokubhalisa amayeza abo kwiqumrhu 

lolawulo lwamayeza lase-Indiya. Oku kuyakwenza kube 

nzima nangakumbi ukubhalisa oosinga machiza. 

I- EU ikwatyhalela ubukho belungelo lomenzi 

(ngokuqhelekileyo iminyaka engama-20) ukuba lihlale 

ixesha elide. I-EU kwakhona ifuna ukba ikwazi ukuthatha 

amayeza ophula aamlungelo abenzi be-EU pkwimida 

ye-EU, nokuba la mayeza asendleleni eya kumazwe 

angaphandle kwelizwe le-EU, elifana nelase-Afrika. 

Ukuba ngaba ayamkelwa la manyathelo, ukhuphiswano 

loosinga machiza kumalungelo abenzi bee-ARVs 

kwi-sub-Saharan Africa wluyakuba nzima kakhulu. 

Ngaphandle kokuba kubekho into esiyenzayo, amachiza 

amatsha ayakuhlala engafikeleleki. Oku kuyakubanga 

ukuhluphela nokusweleka okungeke kuphetshwe. 

Ifoto ngu-Suraj 

Mishra, courtesy MSF 

Amaxabiso 

asezantsi eeantiretroviral 

asindise ubomi 

obuninzi. Kodwa 

ke ngoku iManyano 

yeseYurophu izama 

ukunyanzela 

isivumelwano 

sorhwebo 

esiyakwenza 

kubenzima 

ukunyanzela 

amaxabiso 

asezantsi amachiza 

kwixa elizayo. 



25

I-TB Ifunyaniswa njani ngoxilongo i-TB ekhoyo 

26 

Kulula ukuba ikliniki ikuvavanye ukuba unayo na i-HIV. 

Umthamo omncinane wegazi uthathwa kwiintupha zakho, 

igazi ke lize lisetyenziswe kwiimvavanyo ezilula. 

Kwimizuzu engama-20 ukuya kwengama-30, ungasazi 

isimo sakho se- HIV. Iimvavanyo ziyakhawuleza, azibizi 

kwaye zichaneke kakhulu. Ukuba ngaba inkqubo 

yovavanyo lwe- HIV iqhutywa ngokufanelekileyo, ithauba 

lokufunyaniswa okungachanekanga lincinane kakhulu. 

Ngelishwa, akunjalo kwi-TB. Okungenani sisiqingatha 

sabo bonke abantu baseMzantsi Afrika abosulele yi-TB. 

Kodwa abantu abaninzi abosulelwe yi-TB ngeke baguliswe 

sisifo. I-TB yabo ayisebenzi kwimiphunga yabo. Ayizivelisi 

kwaye ihleli phantsi kolawulo lwezixokelelwano zabo 

Ngu-Nathan Geffen 

Isifo sephepha esikhoyo (Active tuberculosis) (TB) kunzima ukusifumanisa. Kuthatha ixesha elide 

ukufumana iziphumo ezichanekileyo kwaye izigulane ziye zifune unyango ngokungxamisekileyo. 

Yimali eninzi kakhulu ekuye kufuneke ukuba kwezinwe ngayo utyalo-mali kuphando ngovavanyo 

olukhawulezayo, oluchanekileyo nolufikelelekayo lwe-TB ekhoyo. 

zokugonyeka. Ngenxa yokuba abanyu abaninzi bene-TB 

engabonakaliyo (engasebenziyo) kwaye kunqabile 

ukuba oko kuthethe ukuba baza kugula, kaninzi 

akubalulekanga kangako ukufumanisa ngoxilongo i-TB 

engabonakaliyo TB. Endaweni yoko, into ekufuneka 

sibe nako ukuyifumanisa ngoxilongo ngabantu abo 

i-TB yabo izivelisayo. Kaninzi bayakugula okanye babe 

bazakuphathwa yi-TB. Le kuthiwa yi-TB esebenzayo. 

I-TB esebenzayo kusezantsi kwaye kuyabiza 

ukuyifumanisa. Le yingxaki, kuba abantu abaninzi abane- 

TB esebenzayo kaninzi kuye kufuneke ukuba banyangwe 

ngoko nangoko. Ukuba ngaba oogqirha abanakuqiniseka 

ukuba isigulane siphethwe sesiphi isifo, kuye kube nzima 

ukwenza izigqibo zonyango ezichanekileyo. 

Ifoto ngu-Damien Schumann

Iindlela zokufumanisa i-TB 

esebenzayo 

I-X-reyi 

Kaninzi izigulane ezineempawu ze-TB (umzekelo, 

ukukhohlela iiveki ezimbini, ukwehla kobunzima, 

ukubula ebusuku) ziyakuthathwa i-x-reyi esifuba. I-x-reyi 

engasekunene ibonsia isigulane esine-TB. 

Oogqirha kufuneka babe namava ukuze bayifumanise 

i-TB besebenzisa i-x-reyi. Kodwa nangoko ii-x-reyi kaninzi 

aziniki lwazi lwaneleyo lokufumanisa i-TB. Kwakhona, 

ii-x-reyi ngeke ziyibone i-TB esebenzayo engaphandle 

kwemiphunga (eyaziwa ngokuba yi- extra-pulmonary TB). 

Imakroskowupu yesikhohlela 

Indlela engcono yokuzama ukufumanisa i-TB kukucela 

isigulane ukuba sikhohlele isikhohlela (okanye sikhuphe). 

Isikhohlela ke sinokuthunyelwa kwilebhu eqhelekileyo. 

Apho, ichaphaza elikhethekileyo eliye liqatywe 

kwisikhohlela liyakuyibonisa phantsi kwemakroskowupu 

i-TB. Ngasekunene ezantsi yifoto ebonsia ukuba ibonakala 

njani na i-TB phantsi kwemakroskowupu.. 

Kodwa ke imakroskowupu yesikhohlela nayo ineengxaki. 

Ukuchaneka kwayo kuxhomekeka kwinkqubo eqhutywa 

ngumsebenzi waselebhu oqeqeshiweyo kwisakhono eso. 

Kwakhona, izigulane ezininzi, ingakumbi ezo zine-HIV, 

azinasifo sephepha soneleyo kwizikhohlela zazo ukuba 

kungade kubonakale phantsi kwemakroskowupu. 

Njengee-x-reyi, imakroskowupu yesikhohlela ayinako 

ukufuamnisa i-TB ngaphandle kwemiphunga. 

Ukukhuliswa kweentsholongwane 

(Culture) 

Eyona ndlela ichanekileyo yokufumanisa i-TB 

okwangoku kukuthumela isampuli yesikhohlela kwilebhu 

ephucukileyo eyakuthi ibeke isikhohlela kwindawo 

ekukhuliswa kuyo intsholongwane ekhethekileyo apho 

iintsholongwane (microbes) (germs) ezifana neze-TB 

zinokukhula khona. Ukuba akukho TB ikhulayo apho 

kuloo ndawo ikhuliswa khona, isigulane ke ngoko 

mhlawumbi asinayo i-TB, okungenani hayi emiphungeni. 

Ukuba ngaba ngenene iyakhula i-TB, isigulane sinayo 

i-TB. 

Iimvavanyo zokukhuliswa kweentsholongwane 

zinokusetyenziswa ukufumanisa i-TB ngaphandle 

kwemiphunga. Okukwenziwa ngokuba kuthathwe 

umcu kwilungu lomzimba ekukrokrelwa ukuba line-TB. 

Umzekelo, ukuba ngaba kubonakala ngathi umntu 

une-TB yomqolo, ulwelolomqolo lunokuthunyelwa 

elebhu ukuba kuyokukhuliswa iintsolongwane. 

Kodwa iimvavanyo zokukhuliswa kweentsholongwane 

zineengxaki nazo. Ziyacotha kaninzi kuthatha iiveki 

ezimbalwa phambi kokuba kufumaneke iziphumo. 

Ziyabiza kananjalo, kwaye kufuneka zenziwe kwilebhu 

ephucukileyo. Ngaphaya koko, isikhohlela okanye omnye 

umcu womzimba kufuneka zithunyelwe ngononophelo xa 

zisuka ekliniki ziziya elebhu. 

I-PCR 

Njenge-HIV, i-TB ekhoyo inokufunyaniswa kusetyenziswa 

uvavanyo lwe-PCR (polymerase chain reaction). 

Kodwa luyabiza, lufuna ilebhu ephucukileyo kwaye 

aluchanekanga njengokukhuliswa kweentsholongwane 

(culture). 

Iindlela ezintsha 

Iindlela ezintsha zokufumanisa i-TB ngoxilongo 

kuyaphandwa ngazo. Olunye ufumaniso lwesifo 

ngoxilongo olutsha olunika umdla luyaphandwa 

eKhayelitsha, kodwa kusekwangoko kakhulu ukuxela 

ukuba luyakusebenza kwaye lufikeleleke njani. 

Kodwa yimali encinane kakhulu ekwenziwe ngayo utyalomali 

kuxilongo olutsha lokufumanisa i-TB. Ekugqibeleni 

kuyakufuneka uvavanyo lwe-TB ekhoyo olusebenza 

njengovavanyo lwe-HIV. Kufuneka lungabizi, luchane, 

kube lula ukuluqhuba kwaye lunike iziphumo ngemzuzu. 

Isende indlela ekusafuneka ihanjwe phambi kokuba sifike 

apho. Okwangoku, i-Treatment Action Campaign (TAC) 

kufuneka ifake uxinzelelo kurhulumente waseMzantsi 

Afrika, kumaZiko eMpilo eSizwe asekelwe eMelika 

kunye noMbutho weMpilo weHlabathi ukuba bancede 

ekuqinisekiseni ukuba imali eninzi kwenziwa ngayo 

utyalo-mali kuphando lwe-TB. 

Iintolo zibonisa ukungaqheleki 

kule x-reyi yemiphunga oko 

okubonisa i-TB. Ifoto ivela kwi- 

Wikipedia. 

Iityhubu ezibomvu yibhaktiriya 

yesifo sephepha. Ifoto ivela kwi- 

Wikipedia. 

Izixhobo zokuhlola 

intsolongwane ka 

Gawulayo zikwenza oko 

ngokukhawuleza,ziyafikeleleka 

ngokwexabiso kwaye 

ziyawuchana umhlola ngokuthe 

ngqo. Akunjalongo ke kodwa 

kwizixhobo zokuhlola i sifo 

sephepha(TB). Zona zithatha 

ixesha elide, kunezinto ezininzi 

ezenziwayo. 

Inxaso mali iyadingeka ke ukuze 

sifumane izixhobo zokuhlola 

isifo sephepha ezikhawulezayo 

nezithe ngqo". iPhoto ithathwe 

ngu Paymon Ebrahimzedah 

Mabini amanyathelo okuchaneka kovavanyo lwezonyango: ubuntununtunu 

nokuchana. 

Uvavanyo kufuneka lube nobuNTUNUNTUNU: 

Ukuba ngaba isigulane sine-TB, kufuneka uvavanyo lukhombise i-TB. 

Uvavanyo olunobuntununtunu bama- 90% lukhombisa i-TB amaxesha 

alithoba kwalishumi xa ikhona, kodwa lixesha elinye kwalishumi apho liye 

lusilele ekukhombiseni i-TB xa ikhona. 

Uvavanyo kufuneka LUCHANE: 

Xa isigulane singenayo i-TB, uvavanyo kufuneka lungafumanisi i-TB. 

Ukuba ngaba uvavanyo luchane ngama- 90% , oku kuthetha ukuba 

ngamaxesha alithoba kwalishumi lokuba uxilongo ngokuchanekileyo 

alukhombisi i-TB xa ingekho, kodwa kwixesha elinye kwalishumi 

iyayikhombisa i-TB ibe ingekho. 

I-TB 

27

INDABA 

28 

IiNdaba zeSebe le-taC 

IKhayelitsha condoms inika ama - 500,000 eekhondom ngenyanga 

Ngu-Mary-Jane Matsolo 

I-Treatment Action Campaign (TAC) eKhayelitsha yaye yawongwa ngoMatshi 

liSebe lezeMpilo laseNtshona Koloni ngokuba yi-NGO esasaza iikhondom 

ezininzi eNtshona Koloni. I-TAC yaye yawongwa ngesitifiketi sokugqwesa 

liSebe. Iwonga laye lamkelwa ngumlungelelanisi wosasazo lweekhondo 

ozinikeleyo we-TAC eKhayelitsha, uThobela Vika. 

Iphulo lekhondom elaziwa ngokuba yi-‘Super Saturday’ lenzeka apho 

amaqabane e- TAC afikelela kwiindawo ezininzi kangangoko anako. 

Banikezela ngeekhondom ezikolweni, kwiishibhini, kwiindawo zokulungisa 

iinwele nasezirenkini zeeteksi kwaye benza konke okusemandleni abo 

ukuqinisekisa ukuba iikhondom zifikelela kubantu abaninzi kangangoko 

kunokwenzeka. 

I-TAC Khayelitsha iyodwa isasaza ama-500 000 eekhondom ngenyanga 

kwiKhayelitsha xa iyonke.Oku bekungeke kuphunyezwe ukuba 

bekungengokwamaqabane ethu asebenza nzima kwisithili. 

I-taC ikhumbula u-andrew 

Warlick 

U-Andrew Warlick ngosizi usweleke ngeCawa ka-11 Aprili 2008. 

Ukusweleka kwakhe kuye kwasothusa kakhulu ingakumbi kwa-TAC 

apho waye wachukumisa iintliziyo zoluninzi. 

U-Andrew waye wajongana nomsebenzi woLawulo nokuHlola 

(Monitoring and Evaluation) (ME) ngodlamko noyilo, edibanisa kunye 

inkqubo yethu ye-M&E kwaye ebeka isiseko sophuhliso olunomdla 

lwexesha elizayo. Ngempumelelo nganye, wayengakwazi ukuzimba 

ngomdla awayenawo – kwaye ulangazelelo lwakhe lwalusesulela. 

Wayengasinguye umcinezeli wamanani nje kuphela, kodwa wayefuna 

ukubona impumelelo yamaphulo awayewahlola. 

I-Equal Treatment yayiyiprojekithi eyayisentliziyweni yakhe, kwaye 

wayenothando lokuqinisekisa iimpembelelo zayo ezifikelela phezulu. 

U-Andrew wayezikhathaza ngokumangalisayo ngokuphila kwabanye – 

abaninzi bayakuwukhumbula umdla wakhe kubomi babo. 

Hamba kahle, qabane nomhlobo. 

Ifoto ngu-Mary-Jane Matsolo

4 

6 

0 

 

 

x 

2 

 

7nt 

f Hlth b 

dn thrh 

l . across 

bn nbr f 

nt n pll 

d . 

tt fr 

r tht 

t phttd 

fr dn r 

nd nttd patent ___. b 

tttn, t lld 

frt dr pprvd 

nt 

l f ntrtrvrl 

rp t l, 

f dvlpn . 

uphold patent rights. 

hldrn r lld 

ntrntnl 

8 

1. The Department of Health buys antiretroviral 

medicines through an antiretroviral ___. 

4. A pill that combines a number of different pills into 

one pill is called a fixed dose ___. 

5. To do a culture test for tuberculosis requires that a 

___ sample is sent to a sophisticated laboratory. 

6. When patents for medicines are administered and 

negotiated by one central institution, it is called a 

7. What was the first drug approved for HIV treatment? 

9. When the levels of antiretrovirals in your body drop 

too low, you are in danger of developing ___. 

10. Medicines for children are called ___ medicines. 

11. An important international agreement that bound 

World Trade Organization member countries to 

 

 

We will give a R200 

Pick n Pay gift 

voucher for the first 

crossword drawn 

from a hat with all the 

correct answers. The 

answers can be found 

in this issue of Equal 

Treatment. 

Last month’s winner 

will be announced in 

a future issue. 

Fax or post your 

completed crossword, 

with your name, 

address and contact 

number. 

Address: Equal 

Treatment, PO Box 

2069, Cape Town 8001 

Fax: 021 422 1720 

Dn 

ht dr trtn t rpl d4T 

n frt ln trtnt 

2 Th Down t rt t dn 

tbrl t th nt 

1. What drug is starting to replace d4T in first-line 

lld treatment? tt. 

hn pn frd t rnt 

2. The most accurate way to diagnose tuberculosis at the 

ln moment is lln called a ___ test. nr 

nftrr t prd 

3. When a company is forced to grant licenses allowing 

ptntd dr, t lld 

generic manufacturers to produce a patented drug, it 

lnn. is called ___ licensing. 

8 ht ntr plntd 

8. What country implemented compulsory licensing in 

plr 1997 to ensure that lnn its citizens have access n to HIV t 

nr treatment? t tzn hv t 

HV trtnt. 

Equal treatment’s Crossword Puzzle 

29

30 

Lulama James will turn 40 

in April. In addition to being 

HIV-positive, she has had TB 

since 2005, progressing to drugresistant 

TB and recently to 

extensively drug-resistant TB. 

In February of this year, she 

stopped responding to treatment. 

Lulama needs 

more treatment 

options NOW. 

Campaign for Access to 

Essential Medicines 

Médecins Sans Frontières 

Rue de Lausanne 78, 

CP 116 CH-1211 Geneva 21, 

Switzerland 

Tel: +41 (0) 22 849 84 05 

www.msfaccess.org 

New drugs and treatment options are desperately needed. 

The reason? Without it, people’s options for life-saving drugs will run out.

IsiXhosa - Treatment Action Campaign

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