KZN doctor cleared on treatment charge

The KwaZulu-Natal health department has dropped a misconduct charge against rural doctor Colin Pfaff, following a storm of protest, the doctor confirmed on Thursday.

Pfaff faced the charge for administering dual therapy—two antiretroviral drugs—to prevent the infection of babies born to HIV-positive mothers.

At the time he was charged, official policy was that only a single drug, nevirapine, be administered.

The department’s decision to act against him elicited angry reaction from members of the medical profession throughout the country.

Pfaff was on Wednesday handed a letter from the manager of Manguzi Hospital, where he works, saying: “Withdrawal of charge of misconduct. My letter dated 31 January 2008 with regards to the above matter is hereby withdrawn.”

Pfaff confirmed on Thursday that he had received the letter, but declined to say anything other than: “I’m relieved.”

KwaZulu-Natal health spokesperson Chris Maxon confirmed that the charges had been withdrawn, but would not comment on the reasons for their withdrawal. “We are not happy with the media fanfare that has gone with this issue.
We would rather resolve it with our employee directly,” he said.

Since the row over Pfaff broke out, the national Department of Health has revised its guidelines on prevention of mother-to-child transmission of HIV (PMTCT), and now advocates dual therapy, with nevirapine and AZT.

Dual therapy is more effective in preventing transmission and less likely to lead to development of drug resistance.

Announcing the guidelines last week, Health Minister Manto Tshabalala-Msimang implied that the provincial health department was correct in its decision to act against Pfaff. “We have particular protocols and guidelines on dual therapy. Anything done outside these guidelines is incorrect,” she said.

The South African HIV Clinicians’ Society on Thursday welcomed the withdrawal of the charge. “This is a good day for all South Africans with HIV, and for the healthcare workers who will be treating them,” it said.

It said the protests had been “one of the largest healthcare worker campaigns ever seen in South Africa”.

“This was a spontaneous outpouring of anger at the news that Colin was being disciplined for doing his ethical duty, implementing improved PMTCT regimens in a rural area. The petty bureaucracy and lack of support of senior department of health officials towards coalface staff struck a deep chord with many of us.”

A petition and meetings “at multiple levels” seemed to have paid off, it said.

“We hope we see support, rather than interference, by managers in implementing the national strategic plan goals, especially as Trevor Manuel’s budget gives us money to double the number of people on antiretroviral therapy in the next three years. To do this, we will need an army of people like Colin,” the society said.

The extra antiretrovirals Pfaff had been supplying were funded by a foreign donor, not the KwaZulu-Natal provincial government.—Sapa

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