Jaspreet Kindra
KwaZulu-Natal Premier Lionel Mtshali said on Thursday that the province will press ahead with plans to provide nevirapine to HIV-positive pregnant women in the next two months despite the reluctance of his MEC for Health, Dr Zweli Mkhize.
Mtshali said Mkhize should have raised with him his concerns about dispensing the drug. Mkhize expressed his reservations about Mtshali’s plans at a press conference in Durban on Wednesday, two days after Mtshali’s announcement. Sources said Mtshali was likely to raise the issue with Mkhize in their weekly cabinet meeting next Wednesday. Mkhize was not available for comment.
Observers have described the clash between Mtshali, who is national chairperson of the Inkatha Freedom Party, and Mkhize, who is deputy chairperson of the African National Congress in KwaZulu-Natal, as arising out of their respective parties’ opposing opinions about how to deal with HIV/Aids.
Mtshali’s spokesperson, Mahlathi Tembe, said earlier this week that KwaZulu-Natal was going to act on the instructions of the Pretoria High Court judgement last month, which ordered the government to provide a comprehensive national mother-to-child-transmission prevention roll-out plan by March 31.
But then followed the press conference called by Mkhize who is a medical doctor where he said he did not have a problem with nevirapine but there were several problems in relation to support services, including the costs of providing counselling and staff to run the programme.
Tembe said Mtshali had already received offers from several companies and non-governmental bodies willing to help out with the counselling and other costs. He also said Mkhize had been provided with the details of the offers in October last year.
Pharmaceutical concern Boehringer Ingelheim has agreed to provide nevirapine to the province for the next five years free of cost. Mtshali announced in November that the province had received a proposal from a pharmaceutical company through the offices of IFP leader Mangosuthu Buthelezi to provide the drug free of charge.
The national government has filed papers in the Constitutional Court to overturn the Pretoria High Court judgement ordering nevirapine be dispensed. The government has argued that it lacks the capacity to dispense the drug and has reservations about the efficacy of nevirapine.
The stand-off between Mkhize and Mtshali on the issue is not new. Mtshali spoke in favour of dispensing the drug in November. The Mail & Guardian at the time reported that Mtshali had briefed Mkhize and his director general, Ronald Green-Thompson, about his stand. In the same M&G report Mkhize cited costs of distribution as the inhibiting factor. This week Mkhize shifted his ground saying that distribution was not a problem and, in fact, the costs lay in counselling.
Mtshali has denied that he is politicising the issue by going against the government saying he was acting out of a humanitarian need to respond to the human tragedy unfolding in his province. KwaZulu-Natal has the highest prevalence of HIV/Aids in the country. Previously one in every three women who visited antenatal clinics were identified as infected by the virus but doctors say the figure has increased to one in two. While acknowledging that nevirapine ”does cause complications”, Mtshali said it is the pregnant woman’s ”prerogative to save her child” from contracting HIV.
King Edward VIII Hospital in Durban is one of 18 national sites running a trial plan to provide nevirapine. Mkhize indicated in November that he was awaiting the outcome of these trials. This week he said the trials had identified problems related to counselling and capacity. This has been confirmed by sources close to the pilot project. The sources, however, said they expect the problems to be resolved and have been told that the programme will be extended to all hospitals in April.