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About 100 paediatricians in the Treatment Action Campaign, which campaigns for access to treatment for HIV and AIDS, are to take legal action against the South African health ministry over its continuing refusal to supply antiretroviral drugs for the prevention of transmission of the virus from HIV positive pregnant mothers to their babies.
The government announced last year that it would set up limited sites to test the effects of nevirapine, an antiretroviral drug registered for use in adult and paediatric HIV infection but not then registered in South Africa for use in prevention of transmission from mother to child.
However, previous trials, including one in Uganda, have found nevirapine to be effective, safe, and inexpensive in reducing the incidence of babies contracting the virus from their mothers.
It was subsequently registered by South Africa's Medicines Control Council and is being widely used, as well as the GlaxoSmithKline drug AZT, in the private sector.
The government has, however, stubbornly refused to make it widely available in the public sector, where women need it most. This has been widely attributed to President Thabo Mbeki's eccentric views on AIDS and a resulting paralysis of action in his cabinet.
The 18 sites countrywide at which the government was prepared to make the drug available were also very slow in getting off the ground, and it has become apparent that politicians, health department officials, and healthcare professionals are divided on how to take the issue forward. Many doctors and nurses and senior officials of the health department, as well as some of the provincial politicians, believe that lives of babies are being needlessly lost.
Mark Heywood of the Treatment Action Campaign said a lawyers' letter had been sent to the health minister, Dr Manto Tshabalala-Msimang, asking her to immediately supply the drug to all doctors in the public health system who wanted to provide it for their patients or to give good reasons why this should not happen.
He said about 75000 babies were born HIV positive in South Africa every year. If the drug was supplied immediately at least 20000 of those babies' lives could be saved, given the fact that not all women would gain access to it straightaway. It is understood that several officials in the health department would like to be able to reply to the letter by making the drug available.
Health minister Tshabalala-Msimang replied without addressing the specific questions asked. Instead, her five page letter recounted the history of research and attempts by the department of health to establish guidelines to minimise the transmission of HIV/AIDS from mother to child. The letter raised several potential problems with the drug, all of which have been raised in the past.
Mr Heywood said he found the letter disappointing and that the matter seemed certain to have to be resolved in court.
A statement given last week by the South African Catholic bishops' conference condemning “widespread and indiscriminate promotion of condoms as an immoral and misguided weapon in our battle against HIV/AIDS” has angered AIDS activists. “Condoms dramatically reduce the risk of HIV infection, and every infection averted is a life saved,” said David Harrison, director of loveLife, a South African non-governmental organisation.