Reuters 21 Feb. 2002

Cape Town -- South Africa will expand research into the use of Nevirapine to limit mother-to-child transmission of the virus that causes AIDS, but will not make the drug universally available, the government said.

"Universal access will be decided upon when important questions have been answered by the research," the government said in an advertisement prepared for publication on Friday.

The advert was drafted amid an escalating ruling party row over the use of the drug, which has been offered to South Africa free for the next five years by makers Boehringer-Ingelheim.

President Thabo Mbeki and Health Minister Manto Tshabalala-Msimang have so far insisted that Nevirapine, shown in international research to block infection in more than 50 percent of births, can be provided only in 18 pilot sites involving 215 hospitals and satellite clinics.

They have cited safety, cost and capacity issues as obstacles to universal access.

The advert reaffirmed that the government would go ahead with its appeal against a court order granted to AIDS activists demanding universal access to Nevirapine at all state hospitals.

It said the appeal was not against the AIDS program but to determine finally "whether the courts or the elected government decides on the detail of providing health services."

Premiers of the two provinces not controlled by Mbeki's African National Congress(ANC) -- the Western Cape and KwaZulu-Natal -- have announced plans to extend the Nevirapine program to all hospitals under their jurisdiction.

On Monday Mbhazima Shilowa, the ANC premier of Gauteng province, which includes Johannesburg and Pretoria, broke ranks with the government and said he would make the drug available to all HIV-infected women during delivery.

His position was supported by the ANC-aligned Congress of South African Trade Unions (COSATU) and by health activists, but Shilowa was repudiated by the health minister and the ANC, whose spokesman accused him of political point-scoring.

Increased Funding

In an apparent signal of a government change of heart, Finance Minister Trevor Manuel on Wednesday increased funding for AIDS prevention, including the Nevirapine program, three-fold in his budget for fiscal 2002/03.

The government appeared to close the debate with the advertisement, which was approved by Mbeki's cabinet on Wednesday and distributed to reporters ahead of publication.

"Preventing mother-to-child transmission of HIV forms part of the government's program of HIV-AIDS prevention.

"It is also part of a broader strategy to combat HIV-AIDS that depends critically on building partnerships across society," the advert said.

South Africa has the highest number of people living with HIV-AIDS in the world. With one in nine of the country's people believed to be infected, medical researchers fear that up to seven million people could die of AIDS-related illnesses by 2010.

Health authorities say more than 100,000 babies are born HIV-positive each year.