http://bmj.com/cgi/content/full/324/7331/191/b
BMJ 2002;324:191 ( 26 January )
News
Doctor reprimanded for giving antiretroviral drug to baby who was raped
Pat Sidley
A second senior public hospital doctor has been reprimanded for supplying
the antiretroviral drug zidovudine to a rape victim. When given
within two days of the rape, this drug can stop the virus replicating.
What scandalised commentators was that the much publicised rape, in
Kimberley in the Northern Cape province, was of a 9 month old
baby. She was given the drug as part of extensive treatment after
being gang raped by several men.
Dozens of babies in South Africa have been raped, and the crime is on the
increase. People speculate that the increase is due to a myth
believed by some men that sex with a young virgin will cure AIDS.
The doctor concerned was reprimanded by health department officials, who
pointed out that giving antiretroviral drugs in cases of rape is not
department policy.
Zidovudine is on the essential drugs list, but only for use by hospital
staff who are injured while dealing with contaminated blood.
This incident, together with the government's confusing policy on the supply
of antiretrovirals to prevent transmission of the virus in
pregnancy, has prompted doctors to act. The South African government
remains locked in a legal battle with a group that lobbies for AIDS
treatment, the Treatment Action Campaign. It fought and lost a court
battle with the campaign over the provision of antiretroviral drugs
for HIV positive pregnant women.
The government is to appeal the decision of the High Court, which ordered
the government to set up a service offering treatment to all women
who test positive and are pregnant and who wish to avoid passing the
virus to their unborn babies. Its appeal is based on fears that the
finding could unleash claims for all manner of treatment not
available from the state and that the court's perceived interference
in policy matters was inappropriate.
But pending the appeal, which could take several months or longer, the
campaign is to ask the court to enforce the order.
The case arose from the fact that the health department is running a limited
experimental programme that provides a few women with nevirapine to
prevent transmission of HIV to babies. At present, there are only
18 official test sites, two per province, which are allowed to
provide it.
The drug has been offered free by its manufacturer, Boehringer Ingelheim. If
the drug was widely available, up to 20000 babies' lives a year
could be saved. The Treatment Action Campaign's court case is in the
name of a paediatrician employed by the state and hundreds of his
colleagues.
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one of dozens who have been raped in
South Africa
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