/ 16 October 1998

Babies too poor to live

Loose cannon: Robert Kirby Sometimes journalists actually do get that whopping Sisyphean boulder to the top of the hill. It takes a great deal of heaving and huffing, but eventually down it tumbles, taking the Emmanuel Shaws, the Jesse Duartes with it.

It needed literally dozens of press, radio and television boulders to coax, motivate, induce, stimulate, provoke, impel, embarrass and generally bulldoze Messrs Mufamadi, Fivaz and their glorified barmen to do anything about Richmond. The same has gone for much else in the way of bureaucratic tardiness.

As the Sunday Times has now identified, it seems yet another concerted shove is urgently needed. It’s no great surprise that once again the compressed mass of the latest giant boulder is needed to flatten another bewildering decision by the redoubtable Dr Nkosazana Zuma. What follow are a few flanking support thrusts.

What Dr Zuma is now doing is putting a quick stop to the implementation of a medical regimen which would inhibit – by about half its frequency – the transmission of the HIV (human immunodeficiency virus) from pregnant mothers to their unborn babies.

Current findings are that something like 60% of babies of HIV-positive mothers receive the virus from their mothers. However, Dr Zuma says that saving half of these vulnerable babies from contracting the HIV during the latter part of their intrauterine life is too expensive.

No one knows into exactly which price- bracket Dr Zuma places a infant’s right to a full and healthy life; but it appears to be about R500.

What the Perinatal HIV Research Unit at the Chris Hani Baragwanath hospital has found is that treatment during late pregnancy with the drug AZT reduces the chance of the virus crossing the placental barrier between maternal and foetal circulations, cutting the transmission rate by more than 50%.

Dr Zuma says that at R500 per mother treated, this is too much. By way of justification she adds the curious argument that far too many mothers would have to be treated to save far too few babies. Oh Nuremberg, where is thy sting?

Here also arises a revealing way of evaluating Dr Zuma’s adequacy as a minister of health. A comparison might be made with the figure of R14-million Zuma was prepared to pay for the disastrous musical extravaganza she commissioned to enhance what she called “Aids Awareness”. At R500 per baby saved from an awful choking Aids death after a year or three of pitiful life, the Sarafina II budget could have saved 280 000.

Today the total national cost per annum of the AZT treatment for public hospitals is around R80-million – a crippling 0,5% of the total health budget – or slightly more than the amount already earmarked to fund next year’s international public wank-and- gormandise festival, the 1999 Non- Aligned Summit.

If R80-million is, according to Dr Zuma, quite beyond her health department’s means, what about the cost of treating and mitigating the distress of the brief lives of the babies who otherwise might not be infected? That will be far more expensive than the paltry R500 which would save them from acquiring the disease in the first place.

What about the consolation of parents witnessing the wasting and death of their children denied the treatment which could have saved them? Immeasurable? Unless, like Dr Zuma, you can blandly impose a price-limit on human loss.

Instead of practical handling of the HIV problem, what is preferred by the government is what Dr Glenda Grey, director of the Baragwanath Perinatal Research Unit, so aptly describes as “incoherent” campaigns. We need no reminder of these simply because, apart from Sarafina II, the public Aids education campaigns have been all but imperceptible, never mind intelligible. In many other countries – unblessed by Dr Zuma’s vision – the HIV infection rate has been reversed and is in decline. In South Africa it is soaring with 1 500 new infections a day.

Instead our country is served up – at the ridiculously inappropriate hour of twelve noon – with Mr Thabo Mbeki’s avuncular “Address to the Nation”. His earth-shattering counsel turned out to be: “If you feel your randiness running away from you, for heaven’s sake use a condom.” The rest of the show was a collection of vague promises from predictable sources.

I’m sure that Dr Zuma’s abject failure in the matter of managing the South African Aids crisis will ultimately be blamed on trusty old apartheid.

I also have this feeling that if Dr Zuma would occasionally listen to counsel other than her own, a lot more could be achieved.