Access to anti-retroviral drugs is at the centre of legal battles between NGOsand the government
Belinda Beresford
In Mpumalanga the fight between provincial Minister of Health Sibongile Manana and an NGO that helps rape survivors is heading for the courts.
The MEC is seeking to evict the Greater Nelspruit Rape Intervention Project (Grip) from rooms in the Rob Ferreira and Themba state hospitals, where the organisation provides care to women and children who have been raped.
Grip’s services include helping survivors gain access to anti-retroviral drugs, which are thought to reduce the chance of a rape survivor contracting HIV from her attacker(s). According to the latest antenatal survey on HIV infections, Mpumalanga has the second-highest prevalence rate among pregnant women at just less than 30%.
In her founding affidavit Manana asked for a punitive cost order against Grip for failing to vacate the rooms, which she says are needed by the Department of Health. Grip had been given permission by the hospitals’ superintendents to use the rooms.
The organisation’s services include providing morning-after pills to prevent pregnancy, underwear, antibiotics to prevent sexually transmitted diseases, assistance with reporting the crime, counselling and the provision of financial aid to buy anti-retroviral drugs if prescribed by a doctor.
In her affidavit Manana makes it clear that the supply of anti-retroviral drugs was an issue when Grip was asked to leave the rooms. “The question of the supplying of certain anti-retroviral medicines at the hospital causes problems for the department in the sense that people are getting discontent in other sections after having taken notice or heard of the anti-retroviral medicines supplied by [Grip] at the two hospitals and insist on receiving the medicine at other hospitals under my authority.
“It is at this stage not the policy of the government to supply those medicines and it causes problems for the department to try and explain to ordinary people … the reason why it is not supplied, while the Rob Ferreira and Themba hospitals do supply these medicines.”
In a responding affidavit the head of Grip, Barbara Kenyon, said the organisation did not supply anti-retroviral drugs. “At all times, doctors employed at the hospital prescribed the drugs to rape survivors. The prescription was filled at a local pharmacy and [Grip] was merely responsible for payment of the account.”
Many medical aids including the government’s provide some anti-retroviral drugs after rape. Its efficacy has not been proven scientifically because trials on rape survivors are ethically and practically difficult. However, such treatment is supported by circumstantial evidence and some doctors consider it unethical not to prescribe antiretroviral drugs if possible in such circumstances.
The acrimonious dispute between Manana and Grip has led to the NGO’s lawyers filing a complaint to the Human Rights Commission (HRC), claiming that the MEC had been indulging in hate speech.
The Aids Law Project (ALP) has alleged that Manana was involved in drafting a petition that was signed by some of Grip’s volunteer counsellors, accusing the NGO of “intending to drug our people to death”. The petition says: “We cannot defy our President Thabo Mbeki in his call against the use of AZT”, and accuses leading members of Grip of being “another Wouter Basson intending to drug our people to death. With you comes the promotion of drug usage.”
The complaint to the HRC says Manana had told Grip volunteer workers that the NGO was “poisoning black rape survivors”.
The ALP has also complained about the deputy director of parliamentary liaison for the Government Communication and Information System (GCIS) in the Western Cape.
Al-Ameen Kafaar wrote a letter to a Cape Town newspaper accusing an aid agency based in Khayelitsha of treating blacks as guinea pigs by providing anti-retroviral drugs to prevent transmission of HIV from mother to child. The GCIS dissociated itself from Kafaar’s letter, saying he had written it in his personal capacity.
The complaint to the HRC claimed that such statements “amount to hate speak. They risk inciting people to violence and we are extremely concerned about the safety of the health care workers and members of NGOs concerned.”
The complaint also cites a report in a Cape Town newspaper in October last year that African National Congress representative Smuts Ngonyama had criticised the Khayelitsha initiative as being “reminiscent of the biological warfare of the apartheid era”.
The ALP and the Treatment Action Campaign (TAC) are involved in multiple legal activities around the issue of anti-retroviral drugs. Use of such drugs is seen as politically sensitive by many in the wake of Mbeki’s public questioning of their use and of the link between HIV and Aids.
The two organisations are poised to launch legal action against the government for delays in providing anti-retroviral therapy to prevent mother-to-child transmission of HIV. The Medicines Control Council authorised nevirapine for use in prevention of mother-to-child transmission of the virus some time ago. The ALP and the TAC are also considering bringing a case to the Constitutional Court on the grounds that the flat refusal to provide anti-retroviral drugs to people with HIV and rape survivors breaches South Africans’ constitutional right to health.
A meeting of the health department, trade union representatives and the ALP and the TAC this week was described as “interesting” by one attendee who said national Minister of Health Manto Tshabalala-Msimang had accused ALP director Mark Heywood and TAC chairperson Zackie Achmat of being “sell-outs”.
The TAC acknowledged that the meeting was “painful, difficult and acrimonious”.