S. AFRICA TO FIGHT AIDS LOBBY ON NEVIRAPINE DEMAND
By Brendan Boyle
Reuters 14 Sept. 2001
Cape town -- The South African government will oppose a
court bid by AIDS campaigners to force it to
provide drugs that cut mother-to-child HIV transmission at birth,
Health Minister Manto Tshabalala-Msimang said on Thursday.
"Yesterday was the deadline for us to respond. We have indicated
that we intend to oppose their case,'' she told reporters at a
The Treatment Action Campaign (TAC) is demanding that the
government start a national programme to distribute a key
antiretroviral drug called nevirapine to help cut the number of
children born with the human immunodeficiency virus (HIV) that causes
Earlier this year, the TAC fought alongside the government in a
successful court battle for the right to manufacture copies of
patented drugs in South Africa and to buy branded drugs at the best
prices available anywhere in the world.
Now the TAC says the government is dragging its heels on a key
intervention to cut the HIV infection rate, which already is
estimated at one in nine with close to 5 million people already
carrying the virus. Experience in other countries indicates that
nevirapine given to an HIV-positive mother during delivery
significantly cuts the rate of infection amongst babies.
South Africa has more people living with HIV and AIDS than any other
country in the world.
Tshabalala-Msimang said the government would continue a pilot study
at 18 clinics around the country, monitoring the success of the single-
dose nevirapine intervention at childbirth and its influence on
resistance for 2 years before deciding whether to extend the
She said cultural and other issues also had to be managed,
citing community reaction to women who, in line with the non-
transmission strategy, do not breast-feed their babies.
"In our culture, a woman who gives birth and does not breast-feed
raises eyebrows,'' she said. "If you don't have support systems on
the ground, this programme will just fall flat on its face.''
South Africans rarely admit publicly to being HIV-positive because it
usually leads to social isolation and sometimes even to physical
attacks or murder. President Thabo Mbeki has stirred international
controversy by questioning the link between HIV and AIDS and by
saying that violence and not AIDS was the biggest single cause of
Tshabalala-Msimang said the government was not considering any
other use of antiretroviral drugs in the public health system because
their use remained too expensive.
She said drug treatment of adult AIDS cases required expensive drug
cocktails and regular clinical monitoring and blood sampling for life
to prevent the development of drug-resistant strains.
"We just cannot afford the medicine. If I want to buy
antiretrovirals, I would have to forget everything else, even at the
reduced costs that are being talked about,'' she said.
Several major pharmaceutical companies have offered South Africa AIDS
drugs at cut prices, but the government has not yet accepted, saying
the health system cannot afford the monitoring that goes with their