/ 23 July 1999

Ban on AZT to pregnant women under review

Howard Barrell

New Minister of Health Dr Manto Tshabalala- Msimang is reviewing the ban on the use of the antiretroviral drug AZT by HIV-positive pregnant women to prevent infection of their unborn children.

She is also leading a group of South African HIV/Aids experts to Uganda early next month to investigate the Central African country’s remarkable success in curbing the rate of new infections. While there, the group will be assessing the claims made on behalf of another antiretroviral drug, nevirapine.

The United States National Institute of Health has reported that test results in Uganda show that the new drug, which is considerably cheaper than AZT and easier to administer to patients, halved the spread of HIV from infected mothers to their infants.

In Uganda, the group will also be studying community-based HIV-awareness programmes, which are credited with helping to reduce the rate of new infections.

Tshabalala-Msimang said HIV/Aids was her major concern. Curbing the rate of new HIV infections was her “number one priority for this year”. In taking forward this effort, she said she believed “the time has arrived to review the decision” not to supply AZT to HIV-positive pregnant women.

The decision was taken by her predecessor, Dr Nkosazana Dlamini-Zuma, on the grounds that AZT was too expensive and its benefits to the unborn children of HIV-positive women were not clear enough.

There are 3,6-million HIV-positive South Africans and current estimates are that there are 1 500 new infections each day.

One of Tshabalala-Msimang’s first acts after her appointment as health minister was to call a meeting of people and groups working to curb the HIV/Aids pandemic. Activists spoke of a new sense of purpose after the meeting.

One HIV/Aids worker praised the “sense of urgency she brought to the meeting, the questions she asked and her willingness to listen”. “It was a breath of fresh air,” he said.

Next week, said Tshabalala-Msimang, the Ministry of Health is hosting a three-day workshop for various youth and student bodies aimed at developing a programme to address the issue of young people’s sexual behaviour. The meeting is designed to “produce output, not merely to be a talking shop”, she said.

The workshop ties in with revived plans, first mooted by her predecessor, to introduce “life skills” courses at all schools. The courses will include discussion on responsible sexual behaviour, HIV/Aids and other sexually transmitted diseases.

Tshabalala-Msimang said she met new Minister of Education Professor Kader Asmal last week and they were both “committed to rolling out the programme” as soon as possible. In the immediate future this would involve training teachers to run the life skills courses and exploring the use of the Internet and other resources for the purpose.

On Thursday she met provincial health MECs and departmental heads to ensure proper co- ordination of the range of anti-HIV/Aids measures being developed and to get a more accurate understanding of the needs in the provinces.

Next week, the interministerial committee on HIV/Aids, usually chaired by President Thabo Mbeki, is due to meet, and her suggestion for a review of her predecessor’s ban on AZT treatment for HIV- positive pregnant women is likely to come under discussion.

She said the Medical Research Council (MRC), headed by Professor Malegapuru Makgoba, is pressing ahead with a project to develop an anti-HIV/Aids vaccine appropriate to the strain of the virus found in Southern Africa.

The project is the brainchild of the former head of the MRC, Dr Wally Prozesky. The Department of Health is co-sponsoring the project with the Department of Arts, Culture, Science and Technology.

Tshabalala-Msimang said the government had not yet reached a decision whether HIV and/or Aids should be made a notifiable disease. She would maintain an open mind during public representations which are due to be made on the proposal.

But, she said, notifiability could help in the planning counter-measures and providing assistance to sufferers and carers as the pandemic developed.