Johannesburg | Monday
AS the Treatment Action Campaign drags the government to court for refusing to supply anti-retrovirals to HIV-positive pregnant women, the state suggested on Friday it may introduce pilot projects to supply the drugs to public-sector patients infected with the virus.
The drug helps prevents transmission of the virus from HIV-positive women to their babies.
Government’s latest stance on the issue emerged during a briefing with health-director Ayanda Ntsaluba on Friday, Business Day said.
The paper quoted Ntsaluba as saying that the government may “initiate antiretroviral pilots in the public sector and see what comes out”.
“There is some validity in saying let’s not wait that long’,” he said.
The TAC has, for its part, declared the state has a constitutional duty to reduce mother-to-child-transmissions (MTCT) of HIV through the anti-retroviral drug Nevirapine.
Last April, 39 major pharmaceutical manufacturers withdrew a court bid to stop South Africa from importing and producing cheap versions of patented Aids drugs, in what was hailed as a landmark victory for generic drugs in the developing world.
“They must save lives,” TAC legal representative Mark Heywood said on Sunday, preparing for a night vigil in Pretoria.
“Wasted little infants, struggling to breathe … refusing to feed as swallowing is too painful,” fill hospital wards, paediatricians from three hospitals stated in an affidavit, supporting the TAC.
Ntsaluba was quoted as saying it was a very difficult situation. “It would have been preferable that an issue like this should not find its way into the courts.”
He told Business Day that he believed the TAC should have tried to deal with the issue differently but said he understood the professional and ethical difficulties doctors faced over the issue.
The TAC demands the government make Nevirapine, costing about R10 (about one dollar) a treatment, available at all state hospitals and clinics to HIV-positive pregnant women.
The second order is for the government to plan and implement a national programme to prevent or reduce MTCT.
This should include voluntary HIV/Aids counselling and testing, Nevirapine where appropriate, and a supply of formula milk to prevent transmission through breast-feeding.
TAC calls on the government to produce this programme within three months, estimating it would cost about R160-million and save the public health sector the expense of caring for HIV-positive infants.
The government’s ante-natal survey for 2000 found 24,5% of pregnant women were infected and in the same year former president Nelson Mandela called for “large-scale actions” to prevent MTCT.
But presently the government only provides Nevirapine to HIV-positive pregnant women at two research and training sites in each of the nine provinces, with the Western Cape and Gauteng provinces making it more widely available.
The minister of health and eight provincial health ministers, excluding the Western Cape with whom TAC settled, are the respondents in the case.
Health director-general Ayanda Ntsaluba has submitted the main affidavit defending the government’s approach on medical safety, operational and infrastructural grounds.
“This year an amount of about R25-million was set aside for this work (on MTCT research) at a national level,” he said in a statement at the weekend.
“It is a more cautious approach, with a strong monitoring component and one that takes a rigorous view of safety issues and effectiveness.”
TAC argues this policy benefits only about ten percent of pregnant women and effectively “discriminates against poor people” as Nevirapine, registered by the Medicines Control Council, is available to private patients.
The TAC emphasises the lack of access has dire consequences for poor women, infants and the medical staff caring for them.
One doctor at a rural hospital stated, in an affidavit, that withholding Nevirapine from women was “morally and ethically wrong” and therefore “doctors at this hospital have bought Nevirapine with their own money and are administering it”.
Nevirapine is an urgent and critical public health care measure, TAC argues in its founding affidavit by Siphokazi Mthathi, advocating its use as “safe, cheap and consistent with the recommendations of international health authorities” Meanwhile TAC has organised demonstrations in various parts of the country which would coincide with the court hearing.
A night vigil was held at Pretoria’s Church Square overnight on Sunday, where crosses bearing names of babies who died from the disease will be displayed.
This will be followed by a march to the Health Ministry’s Offices on Monday where a memorandum will be handed over.
Other marches will be held on Monday in Cape Town (to Parliament), at the Durban City Hall and at the Elim Hospital in the former Venda area of the Northern Province.
The TAC’s intended court action has received widespread support, with a number of non-governmental organisations either attending the briefing in a show of moral support or sending letters of support.
Among these were the British-based Oxfam Great Britain which called for the quick completion of the trials currently underway in South Africa, and the introduction of a national programme of treatment to new-borns, based on the lessons learned.
Other organisations represented included Jubilee 2000, the Community Aids Response, the Reproductive Rights Alliance and the Aids Consortium. – CLAIRE KEETON, DMG reporter
FEATURES:
State faces new HIV battle August 28, 2001
Dissident supports ‘plot against Mbeki’ theory May 11, 2001
Aids: TAC vs state November 26, 2001