/ 5 February 2002

Hard luck for E-Cape babies: no nevirapine

Port Alfred | Tuesday

THE Eastern Cape will not expand its nevirapine programme because only 30% of babies born to HIV-positive mothers contracted the virus, health MEC Max Mamase said on Monday.

Speaking at the launch of the district health and provincial health authorities, held at the Fish River Sun near Port Alfred, he dismissed the perception that HIV-positive pregnant women transmitted the virus to their unborn babies as a myth.

He said the virus could only be transmitted to the baby during the birth process if there was an exchange of fluids, which would require both mother and child to suffer ”membrane” damage.

However, a doctor, who cannot be named for professional reasons, said there were three stages during which the virus could be transmitted to a baby.

”It can happen in utero (before birth), during birth or through breast feeding,” he said.

”It does not require ‘damage’ to either mother or child for it to occur during birth.”

The doctor confirmed that an estimated 30% of HIV-infected mothers were likely to transmit the virus to their babies.

”But that is still a lot of babies.”

In the Eastern Cape alone an estimated 10 500 babies are born HIV-positive every year.

Mamase said anyone caught distributing nevirapine would be in ”hot water”.

Premier Makhenkesi Stofile supported Mamase’s view and said that only if the results from the province’s two nevirapine pilot sites showed that the drug was successful, would the province go ahead with expansion.

He said officials were awaiting the results of the pilot programmes, which were due to be ”submitted” to Mamase this week but might be done at a later stage because the MEC was currently attending the conference at the Fish River Sun.

”We await those results and if indeed the results indicate that we must go ahead with nevirapine, we will go ahead with nevirapine.”

The premier repeated Mamase’s assertion that the government would not be ”pressurised” by lobby groups into ”willy-nilly” expanding its existing nevirapine programme.

”We will not fall into that trap. We are not going to be rushed into doing anything unreasonable.”

Stofile said many drugs had been lobbied internationally and were later found to be toxic and subsequently withdrawn.

Earlier he indicated that the anti-retroviral AZT had ”disappeared” for exactly this reason, something many health workers at the conference denied.

Stofile said many people wondered why the government was not giving nevirapine to pregnant mothers if it really protected babies against infection.

He said Mamase’s explanation that an HIV-positive pregnant woman would not ”automatically” pass the virus on to child during a normal birth had ”dispelled many myths” for him.

He made a plea to people who ”know nothing about it” to be more responsible about speaking out on the issue of HIV/Aids.

Meanwhile, the Colleges of Medicine of South Africa (CMSA) said on Tuesday it was ‘unethical and against medical principles’ to withhold preventive treatment for mother-to-child transmission of HIV.

The CMSA, reacting to the current controversy about the preventive treatment of HIV infection and Aids, said it was also against medical principles to penalise doctors in the public sector who obtained and administered nevirapine to their patients in a proper manner.

The CMSA, which represents 7 000 specialists and 2 000 family practitioners, believes it is unethical to create in the minds of the public the belief that proven effective treatment is useless or even harmful.

In a statement on Tuesday, the CMSA said there was indisputable evidence that nevirapine administered as a single dose to the mother and a single dose to the newborn dramatically reduced transmission of HIV for the baby.

Unwanted or toxic effects were extremely rare after a single dose of nevirapine and long-term use of currently favoured anti-retrivoral drugs will significantly prolong the life of people with HIV/Aids; reduce the costly complications of Aids, and improve the quality of life. – Sapa

From Business Day:

A good plan will iron out the problems with nevirapine February 5, 2002