The government, having beaten the all-powerful pharmaceutical companies, held a press conference in Pretoria on Thursday at which it promptly shot itself in the foot.
Aids activists and commentators have reacted with dismay to statements by Manto Tshabalala-Msimang, the health minister, who made it clear that providing Aids drugs was not a government priority.
She made her statements at a press conference less than an hour after the Pharmaceutical Manufacturers' Association (PMA) and 39 manufacturers dropped their challenge to the government's Medicines and Related Substances Control Amendment Act of 1997.
Asked about plans for treating the nation's five million people infected with HIV, Tshabalala-Msimang insisted that the government was already offering adequate care without Aids drugs.
The courtroom exploded into jubilation The pharmaceutical companies had agreed out of court that the act be implemented without amendments. The act allows the government to import or allow the production of cheaper, generic medicines where medicines are no longer under patent. It will also allow transparent pricing mechanisms to be set by a pricing committee, and parallel importation.
On Thursday Pretoria's High Court exploded into jubilation as the withdrawal was made official by Judge President Bernard Ngoepe - and the pharmaceutical companies were ordered to pay costs.
The outcome of the case was welcomed by the World Health Organisation and Medicines Sans Frontieres as well as the International Aids Society.
But at the press conference, Tshabalala-Msimang said that "it's not correct to say just because we don't provide anti-retrovirals and other Aids medicines that we don't take care of HIV and Aids patients".
She added that, as far as mother-to-child transmission of HIV was concerned, the ministry was "looking at women holistically".
The government needs to redirect money from defence She said that if the "opportunistic diseases" that afflict people with HIV were dealt with, people with Aids would be able to manage their lives successfully. Tshabalala-Msimang also said that anti-retroviral drugs remained too expensive.
"They are not affordable as far as we are concerned," she said, repeating that the government was worried about the safety of the anti-retroviral drugs.
Ayanda Ntsaluba, the director-general of the department of health, said: "We are not yet persuaded that AZT is good for people who have been raped".
Jo-Anne Collinge, a spokesperson for the health department, confirmed on Friday that although Nevirapine was registered early this week by the Medicines Control Council for use in mother-to-child transmission, its use had not yet started at the sites set up at 18 clinics throughout the country.
In any case, the use of Nevirapine "had still to be okayed" by the cabinet this week, she said.
Mark Heywood, the head of the Aids Law Project, said the press conference had "indeed been a bit disappointing.
"On the one hand, of course, the withdrawal by the pharmaceutical companies was a significant victory, and also the government and the pharmaceutical companies are talking again, which is also important.
"But the problem is that we urgently need a national treatment plan for dealing with HIV and Aids. Notwithstanding what the minister says, we don't have one. And when you have five million people to deal with, you need a detailed one: a financial one and a treatment plan with clear protocols.
"The country needs to compile a list of medicines that we need here, proper infrastructure, the recruitment of more nurses and incentives to staff to work in rural areas, and greater emphasis on treatment literacy.
"In the long term government needs to redirect money from defence and the repayment of debt."
In terms of government claims that it cannot afford anti-retrovirals for all, Heywood said that no one had made a proper cost-benefit analysis.
"To claim that dealing with the opportunistic diseases is a solution is absurd. All that happens if you deal with opportunistic diseases only is that people get sick again and come back to hospital."
He said it was now up to activists to try to "break down the wall" set up by government regarding the use of anti-retrovirals.
Zackie Achmat, of the Treatment Action Campaign, said that "as in any marriage, we will be the government's strongest critics. This country does have good infrastructure and 52 percent of the population lives in urban areas. So there is no reason why anti-retroviral treatment cannot be arranged."
Asked why he thought the government had put a dampener on the joy immediately after the court case, one activist, who asked not to be named, said that as best he knew there was still a view in government circles that HIV did not cause Aids - as well as a suspicion that anti-retrovirals were "poison".
A spokesperson for the drug companies confirmed that someone in government had changed a phrase in the final letter of agreement between the PMA and government from "HIV and Aids, malaria and tuberculosis" to "communicable diseases", thus avoiding mention of HIV and Aids.
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