SAPA 14 Dec. 2001

An estimated 50 000 lives could be saved next year due to Friday's court order that the state should provide the anti-retroviral drug Nevirapine to all medically suited HIV-positive pregnant women, Dr Haroun Salojee of the Save Our Babies campaign said.

He was reacting to Judge Chris Botha's judgment in the Pretoria High Court ordering the government to expand its present programme for the prevention of mother-to-child transmission of the virus by the administration of Nevirapine.

Botha ordered the respondents in the case, the Health Minister and nine provincial health MECs, to provide Nevirapine to pregnant women in public health facilities where, in the judgement of the doctor in consultation with the medical superintendent, this was medically indicated.

"(This) shall at least include that the woman concerned has been appropriately tested and counselled," he said.

"The respondents are ordered to forthwith plan an effective comprehensive national programme to prevent or reduce the mother-to-child transmission of HIV, including the provision of voluntary counselling and testing, and where appropriate, Nevirapine or other appropriate medicine, and formula milk for feeding."

This programme must provide for progressive implementation in the whole country and for implementation in a reasonable manner, the judge said.

By March 31, each of the respondents must deliver a report outlining under oath what they have done to implement the order about the programme and what further steps they intended taking.

The applicants had the right to reply to that within a month, whereby the respondents could once again reply within two weeks.

Botha postponed the application to a date yet to be fixed for the consideration and determination of the reports, replies and answers.

Reacting to the orders, Mark Heywood of the Treatment Action Campaign said: "This effectively means that if there is a sense of urgency on the part of the government, that any facility in the country were testing and counselling can be done properly, can provide the medication, and thereby potentially tens of thousands can benefit immediately.

"We have seen children dying when we knew they could be saved," he said.

"We've been shackled too long by our policy makers," said Saloojee, who is a paediatrician at Johannesburg's Coronation Hospital.

"Now we are free to do what we are best trained to do - saving our babies."

Catie Vawda of the Children's Rights Centre said it was a victory for democracy.

"We've had a kind of medical apartheid, but we now have the tools to fight it."

She said it did not solve the AIDS problem though.

"It is certainly going an enormous way to addressing it and taking it under control. I think we have learnt from Brazil that it can be rolled back. This is a first step and an important step in that direction."

Heywood said: "The problem of AIDS is a deep and multi-dimensional one. This judgment is very, very significant but it doesn't solve the problem of AIDS by any means. All it does, is it gives us hope and confidence to address other aspects of the problem of AIDS in South Africa."

He said TAC's campaigns for next year could include ones to pressurise the government to change its attitude on treatment for adults.

"We don't want to save the lives of children only to create a generation of orphans. We fight for all aspects of the interests of the child."