Government is to take a decision on the use of antiretroviral (ARV) drugs for the treatment of HIV and Aids in the "very near future", Health Minister Dr Manto Tshabalala-Msimang announced yesterday.

Speaking during debate in the National Assembly on her budget vote, she also outlined details of the free health care policy for people with disabilities, announced by President Thabo Mbeki earlier this year.

Tshabalala-Msimang said the report of the joint health and Treasury task team into the cost of various treatment options, including ARVs, would be presented to Cabinet soon.

A decision "on this issue that has come to dominate the public debate on HIV and Aids" would then be taken, she said.

The programme to prevent mother-to-child transmission of HIV infection through the provision of Nevirapine had also expanded.

There were now more than 650 service points participating in this programme.

The latest HIV prevalence survey - the 13th undertaken at antenatal clinics - confirmed that the rate of infection had stabilised, but not yet declined overall.

"However, for the fourth year in a row we are seeing a small drop in the levels of infection among our teenagers," she said.

"When it comes to treatment, three absolutely critical factors are good health infrastructure, adequate numbers of knowledgeable health workers and the availability of affordable medicines.

"This remains true, to varying degrees, whether or not the element of antiretroviral drug therapy becomes part of the treatment programme".

Tshabalala-Msimang said the free health care policy for people with disabilities would come into operation on July 1.

It would cover out-patient visits to hospitals as well as admissions, and include disability aids such as wheelchairs and hearing aids.

The benefit would include people who had permanent disabilities that resulted in moderate to severe difficulty in living a normal life.

It would include older persons who were considered to be frail, and long-term patients in institutions for mental health care.

However, it would not be available to people who had medical aid cover, who had a temporary disability, or who had a chronic illness that did not cause substantial loss of functional ability, she said.

Speaking during the debate, the Democratic Alliance's Sandy Kalyan launched a strong attack against Tshabalala-Msimang, labelling her incompetent and appealing to President Thabo Mbeki to remove her from Cabinet.

"The honourable Minister of Health has failed in her task to provide health for all".

"She is a liability to the health of South Africa, and the DA urges President Mbeki to appoint someone who is more up to the task of keeping South Africa healthy," Kalyan said.

Replying at the end of the debate, Tshabalala-Msimang said Kalyan's words were "just hot air", and not worth responding to.

Dr Ruth Rabinowitz of the Inkatha Freedom Party said that if the war against Aids had been confronted unflinchingly at the outset, the current quagmire could have been avoided.

The ethics that informed the Aids strategy also left much to be desired.

"The IFP's view on Aids therapy is to treat where there is capacity, beginning somewhere and expanding our care. Do away with anonymous testing, broaden pre-test counselling; let every pregnant women know if she has HIV.

"Knowledge protects both the affected and the uninfected," Rabinowitz said.

Deputy Health Minister Renier Schoeman warned South Africans of the dangers involved in buying medicines via the Internet.

He said medicines control legislation went a long way towards making medicines more affordable without sacrificing any of the safeguards presently in place to ensure medicine safety and quality.

However, technology had introduced new risks and new challenges in the area of medicines control.

"The illegal marketing of medicines across national borders by means of the Internet is a threat to the sound control system that we have developed under the Medicines Control Council and of which we are justifiably proud".

People had various reasons to turn to the Internet to purchase medicines. These included costs, access to medicines not registered in South Africa, and fulfilling needs created by addiction.

"The point is that medicines purchased through the Internet are an unknown quantity. There is a tendency for medicines to move illegally from uncontrolled markets into markets where quality is more strictly controlled.

"The growth of the Internet has provided opportunities for unscrupulous individuals to advertise and distribute controlled substances, counterfeit medicines and unproven quack remedies," Schoeman said. – Sapa.