Government will not tolerate what amounts to blackmail in the provision of antiretrovirals (ARVs) by local companies and will look further afield for cheaper suppliers if necessary, Health Minister Aaron Motsoaledi warned on Tuesday.

Speaking during debate on his budget vote in the National Assembly, Motsoaledi said the prices that South Africa paid for ARVs were significantly higher than any other country.

"This has been confirmed by our international development partners and has been said publicly by the executive director of UNAids during his speech at World Aids Day last year when he shared a platform with President [Jacob] Zuma."

These high prices were despite the fact that South Africa had the largest ARV programme in the world.

"And to us, it does not make sense, because we must be able to purchase ARVs at the lowest prices as we are the largest consumer of ARVs in the whole world, and so we must benefit from economies of scale," Motsoaledi said.

"If we continue doing things the way we are doing them, the fiscus will be overburdened.

"So... let me put it once and for all. There is no choice. We must purchase ARVs at the lowest possible cost from whatever source that can guarantee us the lowest prices, whether it's inside the country or outside the country. We are going to have to do so."

He said this position had already generated some opposition from some local pharmaceutical manufacturers.

"They have claimed that this approach will result in job losses.

"I believe this is a sort of a blackmail. But I'll never bow down to it," he said.

"We need to understand that unless we take decisive action we will not overcome the challenges that HIV and Aids present.

"This is why the new ARV tender specifications will be prepared in a way that opens the way for us to purchase ARVs at the lowest possible price.

"I will not compromise on this one."

However, Motsoaledi emphasised that this policy applied only to ARVs and not to other pharmaceutical products.

In a speech dedicated to the late Deputy Health Minister Molefi Sefularo - who died in a car crash last week - he said that an additional 519 public heath facilities had been prepared to provide ARVs from April 1.

This meant that more than 1 000 public health facilities now provided eligible patients with ARVs.

Over time, all public heathcare facilities would provide ARVs.

Motsoaledi also recommitted government to the new HIV/Aids treatment guidelines as announced on World Aids Day in December last year, saying some people seemed to be sceptical "about our resolve to implement the new treatment guidelines".

"I wish to assure this House we are very determined. This, however, does not mean we are not experiencing a few teething problems in the implementation of this new treatment policy and strategies.

"We do have our own problems, such as our human resource capacity, our low human resource capacity, and supply and logistical problems in some facilities."

However, these were not insurmountable problems and they were currently being addressed, Motsoaledi said.