http://bmj.com/cgi/content/full/324/7344/997

BMJ 2002;324:997 ( 27 April )
 

News roundup

Mbeki forced to do a U turn over AIDS drugs

Pat Sidley Johannesburg

The South African government has, under pressure, relented on its HIV/AIDS policy and will supply certain antiretroviral drugs under specific and limited circumstances.

The policy shift follows a resurgence in the eccentric policies inspired by President Thabo Mbeki’s doubts about the link between HIV and AIDS.

After a cabinet meeting a week ago, the government decided that it will put in place a national plan to supply nevirapine to HIV positive pregnant women and their babies to reduce the risk of transmission of the virus to the babies. Women who have been raped will also benefit from the shift in policy as all state hospitals will be able to offer them zidovudine as post-exposure prophylaxis. Women will be fully informed of the side effects. The cabinet seems also to have conceded that antiretroviral treatment can at times prolong the life of people living with AIDS.

The government has also discussed trying to stop Mr Mbeki’s supporters among the AIDS denialists in the United States from writing to South African and other newspapers, using their status as advisers on "President Thabo Mbeki’s Advisory Panel on AIDS." This was a group of scientists and non-scientists set up two years ago by Mr Mbeki to discuss, among other things, whether HIV infection leads to AIDS.

The moves probably have symbolic relevance more than anything else, and they come too late to save the job of one hospital superintendent, who was effectively fired for sanctioning the giving of zidovudine to women who had been raped. The country’s courts had already ruled that the government should supply nevirapine, and zidovudine is not licensed for use after rape. However, zidovudine has been seen to be effective and is in widespread use, although largely in the private sector.

The shift comes after pressure was placed on the ruling African National Congress (ANC) party from several important quarters. Discontent among party supporters and from within the ranks of senior members of the health department, who have reportedly threatened to resign over the issue, helped tilt the issue. In addition, a group of prominent black businessmen—led by one-time presidential contender Cyril Ramaphosa, who is highly respected and has the support of many grassroots party supporters—put its weight behind a change in policy.

Mr Ramaphosa was also a part of an initiative led by former president Nelson Mandela who has repeatedly criticised Mr Mbeki’s policies in public and then took them up with a national executive committee meeting of the ANC.

The ANC’s coalition party, the Inkatha Freedom party, led by Mangosotho Buthelezi, has also played a crucial role, with pressure within the cabinet, as well as at provincial level. Mr Mbeki’s diplomats have also reported on the difficulties of spreading South African policy abroad, particularly trying to raise money for its initiatives in Africa in the wake of seemingly ineffective policies to combat the disease.

The Constitutional Court is due to rule next month on a case brought initially by the Treatment Action Campaign, which lobbies for AIDS treatment, and doctors to force the issue on nevirapine.

The battle is far from over. A propaganda campaign is still being waged from within the ANC and has found its way with lavish, paid inserts, into local newspapers disavowing the links between HIV and AIDS. But most are welcoming the changes so far.
 
 

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Collections under which this article appears: HIV Infection/AIDS Governments - non UK

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Journalism or propaganda?

David Rasnick

bmj.com, 26 Apr 2002 [Full text]

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