Call for more action on mother-to-child Aids

Activists and doctors on Wednesday accused the government of backsliding on promises to provide more effective treatment to prevent mothers passing on Aids to unborn children.

The Treatment Action Campaign (TAC) said that more than 60 000 babies are infected with HIV yearly in South Africa, most of them in the womb.

Many of these could be avoided by improving testing and counselling services for pregnant women and providing HIV-positive women with up-to-date therapy.

At the moment, many clinics in South Africa use just one anti-Aids drug — nevirapine — for HIV-positive pregnant women, even though the World Health Organisation recommends a drug cocktail.

”Pediatric HIV has almost been eradicated in many countries in the world,” said Francois Venter, head of the Southern African HIV Clinicians Society.

”Poorer countries with far worse infrastructure than South Africa have made significant progress in decreasing transmission. In South Africa, a middle-income country, the fact that HIV-infected women have access to a substandard regimen for protection of their children is a sad reflection on our health system,” he said.

HIV is now the most common cause of death among pregnant women and almost one in three pregnant women are HIV positive, according to the clinicians society. Because of the stigma associated with Aids, some pregnant women refuse to take an Aids test. Many don’t get the chance.

An estimated 5,4-million South Africans have Aids. Nearly 1 000 people die each day of the disease and the same number become newly infected.

Medical workers say they are particularly frustrated because preventing mother-to-child transmission of the disease is relatively straightforward.

”HIV in children is a preventable disease and we’ve known it is a preventable disease for more than 10 years,” said Tammy Meyers, a pediatrician at South Africa’s biggest hospital, Chris Hani-Baragwanath. The Soweto hospital sees about 90 HIV infected children a month — and many die before they get treatment, Meyers told a news conference organised by the TAC.

The government promised last November to overhaul its mother-to-child transmission programmes by the end of the year to bring them into line with international standards. But the TAC accused Health Minister Manto Tshabalala-Msimang of stalling.

Her department had no immediate comment on Wednesday.

Tshabalala-Msimang has long been accused of frustrating provision of antiretroviral drugs. Her department last December said it had finished new guidelines on so-called dual therapy and this was waiting approval by regional health bosses. She said its implementation would depend on training health professionals to use the additional drugs and getting extra money for the new drugs.

The TAC said that even poor hospitals in rural areas were ready to implement the new therapy but could not do this without government approval. It said that health professionals should bypass government if need be.

In the Western Cape province, the local health department started implementing dual therapy in 2004, without waiting for central government to act. As a result, infant HIV infection in the sprawling suburb of Khayelitsha — one of the hardest hit areas in the country — is now under 4%. Infant mortality, or deaths for children under one, in Khayelitsha has dropped from 43 per 1 000 lives births in 2001 to 31 per 1 000 live births in 2006, according to Cape Town authorities. — Sapa-AP

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