Monday, November 26, 2001

JOHANNESBURG South Africa’s leading anti-AIDS group takes its former ally, the government, to court today to demand treatment for HIV-positive pregnant women in order to reduce HIV transmission to some 70,000 babies infected every year.
The Treatment Action Campaign (TAC) an ally of government in its legal clash with drug companies over affordable medicines declared that the state had a constitutional duty to reduce mother-to-child transmission (MTCT) of HIV through the anti-retroviral drug Nevirapine.
In April, 39 major pharmaceutical manufacturers withdrew a court bid to stop South Africa from importing and producing cheap versions of patented AIDS drugs, in what was hailed as a landmark victory for generic drugs in the developing world.
“They must save lives,” TAC legal spokesman Mark Heywood said yesterday, preparing for a night vigil in Pretoria.
“Wasted little infants, struggling to breathe refusing to feed as swallowing is too painful,” fill hospital wards, states an affidavit supporting the TAC by pediatricians from three hospitals.
The TAC, Haroon Saloojee, who is the doctor in charge of community pediatrics at Wits University, and the Children’s Rights Center developed the application, to be heard today and tomorrow in the Pretoria High Court.
More than 150 health professionals, trade unions, religious and human rights groups support their campaign, which confronts President Thabo Mbeki’s skepticism about the efficacy of anti-retrovirals and the impact of HIV/AIDS.
In October, Mr. Mbeki questioned the Medical Research Council’s findings that HIV/AIDS was the leading cause of death, and he warned of the toxicity of anti-retrovirals.
Now the TAC demands the government make Nevirapine, costing about 10 rand, or $1, a treatment, available at all state hospitals and clinics to HIV-positive pregnant women.
The second order is for the government to plan and implement a national program to prevent or reduce MTCT.
This should include voluntary HIV/AIDS counseling and testing, Nevirapine where appropriate and a supply of formula milk to prevent transmission through breast-feeding.
The TAC calls on the government to produce this program within three months, estimating it would cost about $16 million and save the public health sector the expense of caring for HIV-positive infants.
The government’s ante-natal survey for 2000 found 24.5 percent of pregnant women were infected. In the same year, former President Nelson Mandela called for “large-scale actions” to prevent MTCT.
The government now provides Nevirapine to HIV-positive pregnant women at only two research and training sites in each of the nine provinces, with the Western Cape and Gauteng provinces making it more widely available.
The minister of health and eight provincial health ministers, excluding the Western Cape with whom TAC settled, were the respondents in the case.
Health director-general Ayanda Ntsaluba has submitted the main affidavit defending the goverment’s approach on medical safety, operational and infrastructural grounds.
“This year an amount of about 25 million rands was set aside for this work [on MTCT research] at a national level,” he said in a statement.
“It is a more cautious approach, with a strong monitoring component and one that takes a rigorous view of safety issues and effectiveness.”
The TAC argues that this policy benefits only about 10 percent of pregnant women and effectively “discriminates against poor people.”

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