By Brendan Boyle

Reuters 12 Feb. 2002

Cape Town -- Opposition leaders hurled ridicule and defiance at President Thabo Mbeki on Tuesday over his government's continued refusal to expand the use of drugs to prevent mother-to-child transmission of the AIDS virus.

Mangosuthu Buthelezi, leader of the mainly Zulu Inkatha Freedom Party (IFP), said he had instructed the IFP premier of KwaZulu-Natal province to dispense with testing and counseling if necessary and offer nevirapine to all pregnant women.

"Our nation is dying of HIV/AIDS. We can no longer hesitate or falter," he said, adding that 40,000 babies were born HIV positive in that province alone last year because the government would not accept international research on the use of nevirapine.

South Africa has the largest number of people living with HIV and AIDS in the world. United Nations and local agencies estimate that one in nine South Africans is infected, though only 10% of them know they carry the virus.

Earlier on Tuesday, Health Minister Manto Tshabalala-Msimang told reporters and diplomats the government was not yet ready to move from testing of the nevirapine programme at 18 sites around the country to a national rollout, saying more research was needed.

"We need to have policy that is informed," she said.

Tshabalala-Msimang did not confirm or deny reports by political and party sources that the government would allow provinces to extend nevirapine programmes from the test sites to other hospitals if it was done without fanfare or public reversal of existing policy.

"We're not really saying that the provinces must do as they wish," Tshabalala-Msimang said, adding that the national and provincial departments would meet again soon to review the research and decide a way forward.

Life and Death

Opposition Democratic Alliance leader Tony Leon demanded an unequivocal statement on the government's plans, telling parliament: "Why, on this life and death matter, this war which is devouring our nation, do we have between the lines or study the tea leaves.

"Why on earth, if he is changing his policy, can the president not say so himself in a manner that is intelligible and straightforward," he asked.

Leon demanded that Mbeki, who has questioned the link between HIV and AIDS and has not linked the two terms in recent speeches, should acknowledge that HIV causes AIDS.

Buthelezi said KwaZulu-Natal, the most populous province with the highest incidence of HIV and AIDS, would offer nevirapine in defiance of the government's hesitant policy.

"Henceforth, health facilities in KwaZulu-Natal will ensure that children are not born with a death sentence. Nevirapine will be made available to all mothers, whether or not they are HIV positive," he said, adding that 40% of pregnant women in the province were HIV positive.

The state-funded Medical Research Council estimates the disease will kill up to seven million of South Africa's 44 million people by 2010.

Every year, around 100,000 babies are born with the virus, which, according to international research, can be blocked in at least 50% of cases by the use of nevirapine during and immediately after childbirth.

HIV Carriers Ostracised

Former US ambassador to the United Nations Richard Holbrooke, now a global AIDS campaigner, said in Cape Town last week that AIDS and the Mbeki government's reluctance to tackle it had overtaken crime as the major obstacle to investment in South Africa.

Tshabala-Msimang said results of the nevirapine tests presented to a meeting of national and provincial ministers 10 days ago had shown a range of problems around the country and needed to be fully studied before reaching a conclusion.

Amongst the problems were hostility from nurses towards HIV-positive mothers in rural areas and a lack of private counseling facilities.

Many South African communities ostracise women known to be infected. Tshabalala-Msimang said this meant women using baby formula to restrict HIV transmission often were forced to breastfeed when their families were present to hide their condition from their relatives.