South African government forced to give mothers antiretroviral drug
Pat Sidley, Johannesburg
South Africa's Constitutional Court has ruled against the South African
government in its fight with hundreds of state employeddoctors and
nurses and the Treatment Action Campaign over theprovision of an
antiretroviral drug to HIV positive pregnantwomen.
The government has resisted making nevirapine available to thousands of poor
women reliant on public health facilities. Thedrug helps reduce the
transmission of HIV to the unborn infant.It is also cheap and easilyadministered.
The court decided that the state's policy of providing a very limited number
of women with the drug in 18 pilot sites wasunconstitutional, as it
failed to guarantee women their rightsin terms of the constitution.
Hospitals with adequate facilitieswill now have to give the drug to
women who wantit.
The fight has raged for close to a year in different courts, with the
government losing at every stagebut
fighting on. Thegovernment has contested that the drug's safety has
not been proved,although it provided no evidence to back up its
claim and maintainedthat the courts should have no role in the
creation of healthpolicy. The Constitutional Court ruling, which was
unanimous,has shown clearly that the court will hold the
government's policyup against the constitution and rule
accordingly.
For AIDS activists this has been a huge victorybut
the next major battle may be a little late for Zackie Achmat, the mostprominent leader in the Treatment Action Campaign. This battle
will be for the provision of antiretroviral drugs to poor peoplewith
HIV/AIDS who cannot afford to buy the life prolongingdrugs.
Battling with a drug resistant infection of the chest, Mr Achmat has AIDS and
a low CD4 count and will not take antiretroviralsuntil the
government shows that it will provide antiretroviraltreatment to itscitizens.
At present in South Africa the only people able to receive the drugs are
those with access to private healthcare.
However, South Africa has an estimated five million people who are HIV
positiveand most of
them arepoor.
Mr Achmat was not able to address a plenary session at last week's Barcelona
AIDS conference in person because of his illhealth, but he addressed
the session through a video link, callingon drug companies to
provide licences to generic drug manufacturersso that poor people
can have more access to cheaperdrugs.
Several studies have shown that the government could begin to provide
antiretroviral drugs to patients who most need it inhospitals that
can provide the required monitoring and testingas well as thedrugs.
The government has repeatedly refused to address the issuelargely,
it seems, because of the lead given by President ThaboMbeki's
eccentric views on AIDS. He has several times expresseddoubts about
the link between HIV andAIDS.
Health minister Dr Manto Tshabalala-Msimang has for a second time been quoted
as saying that nevirapine would "poison" SouthAfrica's womena
view she has apparently repeated since the courtfinding.
Several government spokespeople have expressed the view that antiretroviral
drugs arepoisonous.
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