/ 19 December 2004

‘No one forced govt to use nevirapine’

The government is trying to blame everyone else for its decision to use nevirapine in its mother-to-child HIV prevention programme, the Treatment Action Campaign (TAC) said on Saturday.

It was responding to biting commentary in the African National Congress’s weekly newsletter, which said United States health officials had used African’s as guinea pigs for the anti-retroviral drug nevirapine.

The article, which was not signed, also claimed that NGOs under the control of the pharmaceutical companies had (with the collusion of the Constitutional Court) forced the government to roll out nevirapine before it felt satisfied of its safety.

”The Constitutional Court order did not bind the Health Department to the use of nevirapine, and also paved the way for them to change their regimen as they saw fit,” Mark Heywood, a TAC spokesperson, said on Saturday.

”We always maintained that there were better regimens. At the time, our drug of choice was AZT. It was the South African government that decided to use nevirapine, largely on the basis of the Uganda trial,” Heywood said.

It is this very Uganda trial for nevirapine — conducted by the US’s National Institute of Health — that has come under the spotlight this week because of flaws and irregularities in the research.

The ANC’s letter was particularly scathing about the TAC, which has always been a thorn in the side of the Department of Health.

The anonymous author suggested that TAC is more interested in serving the interests of the pharmaceutical companies than the health and lives of Africans.

This is nonsense, Heywood said.

”You won’t find one cent of drug-company money in the bank accounts of the TAC. We are not in the pockets of any pharmaceutical company. Our interests are in health.”

The safety and efficacy of nevirapine has been proved by the World Health Organisation, although the organisation does recommend alternative regimes where possible. This is because when used as a single dose it can cause resistance, and inhibit later treatment.

The letter in the ANC’s newsletter, however, implied that there had been numerous deaths due to nevirapine, which were covered up by the US authorities to promote their own ends.

Many doctors and NGOs have expressed concern that these sorts of statements will undermine people’s faith in the drug, which the Department of Health has stated it will still be using in its mother-to-child prevention programmes ”until a new approach has been decided upon”.

TAC chairperson Zackie Achmat accused Mbeki of hiding behind the anonymous article, saying: ”President Mbeki does not have the courage to publicly declare his views on HIV.”

ANC spokesperson Smuts Ngonyama denied the letter is the view of President Thabo Mbeki, but said it is an ”opinion piece” from an unidentified member of the party.

”Since it was carried in the ANC’s weekly newsletter, it certainly has his endorsement, so we hold him responsible unless another author comes forward,” Heywood said.

”The TAC doesn’t mind taking knocks here and there, but it is very inappropriate for the president of the country to speak a language that threatens a major public health programme.”

He admitted that there were people who died during the Uganda trial, but added: ”In two years of extensive use of this medicine in South Africa, the worse that’s been reported is a skin rash.” — Sapa

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