Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
Mail & Guardian (Johannesburg) - Wednesday, April 17, 2002
Mariette Le Roux
A circular giving public hospitals and clinics the go-ahead to prescribe the drug was being sent out by provincial health authorities to all medical superintendents.
This was in compliance with a Constitutional Court order that nevirapine be provisionally provided by all public health facilities with the capacity to do so.
In terms of the court order, "capacity" should be understood to mean that before providing the drug, hospitals and clinics should at least be able to counsel and test their patients.
In Gauteng, it appeared that all state hospitals and most of the larger clinics would be able to issue prescriptions for the drug, representative Popo Maja said.
The circular should have reached hospitals and clinics in the province by the end of the week.
Women who needed nevirapine could start approaching public hospitals and clinics immediately, but the process of giving them the drug could take several weeks.
The women would first have to be counselled, after which their doctors had to order the drug from the province, Maja said.
He added the province had a central store of nevirapine, and there should be no delays in the process of delivering the drug to hospitals.
In Mpumalanga, a task team had been set up to evaluate which hospitals had the capacity to provide nevirapine, and how much of the drug had to be ordered for the provincial depot.
This process would be conducted in liaison with hospital superintendents, and should be completed by Friday, provincial representative Dumisani Mlangeni said.
The province expected to make an announcement on Monday as to which facilities could distribute the drug.
Mpumalanga had 27 hospitals and about 350 clinics.
The Free State said it was busy issuing the circular to hospitals and clinics, and a process was underway to evaluate the "practical implications" of the court order.
Northern Province health authorities were on Wednesday engaged in a meeting to determine the province's readiness to comply with the judgment, while the North-West said it was busy ascertaining which facilities could issue the drug.
The Eastern Cape health department said it would issue a statement on the matter on Thursday. The Northern Cape could not be reached for comment.
The circular being distributed to hospitals and clinics outlines the circumstances in which nevirapine can be prescribed, the required doses, and topics for patient counselling.
The Constitutional Court on April 4 refused the government leave to appeal against a Pretoria High Court execution order demanding that it provide nevirapine at State institutions with the capacity to do so.
The high court order was made pending the outcome of a further Constitutional Court hearing in May of the government's main appeal against a ruling that it put in place a plan to make nevirapine freely available.
Prior to the court orders, the government distributed nevirapine exclusively at 18 pilot sites countrywide.
The judgment did not apply to the Western Cape and KwaZulu-Natal, which had their own nevirapine programmes in place.
The United Democratic Movement and the Congress of SA Trade Unions on Wednesday welcomed government's adherence to the court order.
It was, however, long overdue, UDM president Bantu Holomisa said in a statement.
"That it takes government court case after court case and another two weeks to draft a circular is a perfect illustration of their unwillingness and intransigence when it comes to treating HIV/Aids."
The party urged doctors to demonstrate that they had the capacity and the commitment to save lives.
"This will once and for all prove that government's arguments about a lack of capacity to treat HIV/Aids is a convenient lie to dodge responsibility and protect the president from embarrassment. His ego must no longer weigh heavier than the lives of thousands of babies."
Cosatu described the move as a victory for logic.
"It will save the lives of hundreds of babies who would otherwise have been born HIV-positive."
The labour federation urged the government to continue with the programme regardless of the outcome of its Constitutional Court appeal in May. - Sapa
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