Mail & Guardian (Johannesburg) - January 26, 2001
Charlene Smith
PRESIDENT Thabo Mbeki has given the go-ahead for South Africa to begin implementing a massive programme to provide free anti-retrovirals and milk powder to HIV-positive pregnant women to retard the transmission of the virus to babies.
In a dramatic move, the government, while not officially changing its policy stance on the treatment of HIV/Aids, is swiftly rolling out a comprehensive approach to prevent babies from being infected with HIV. This will save the lives of tens of thousands of babies each year.
It follows approval - unannounced - by the Medicines Control Council of Nevirapine for the prevention of mother-to-child transmission of HIV/Aids.
This makes South Africa the second Southern African country to implement such a programme after Botswana, which is providing universal access to anti-retrovirals for pregnant HIV-positive women and rape survivors.
The responsibility for funding the programme is shared by the government and nine provinces. All pregnant women presenting at public hospitals and clinics covered by the programme will be tested for HIV/Aids. This will greatly improve South African statistics on the prevalence of the virus.
The Department of Health has been moving toward this approach for two years. Provinces approached milk formula companies to slash costs in 1999. Since then the companies have bid against each other in tenders and, along with pharmaceutical companies, are likely to come under pressure from international Aids activists this year to slash profits on milk formula.
Late last year each province had to present data to the government detailing the numbers of babies born each year with HIV; how they could give access to free anti-retrovirals for mothers and babies; how they could provide free milk formula to mothers; and what funding sources were available.
The rapid HIV test the government plans to use in the programme costs less than R3 a time. The government will, for the present, take up the Boehrringer Ingelheim offer of free Nevirapine delivered to clinics by the drug manufacturer for the next five years.
The governmentÆs stance comes at a time when conflict has erupted between Unicef, doctors and mothers about HIV-positive mothers breastfeeding. Unicef has been lambasted in some quarters for endangering babies by sticking to what its opponents say is a long-held antipathy to the makers of milk formula and for telling HIV-positive mothers to breastfeed.
A third of HIV-positive mothers will pass the virus on to their babies through breastfeeding. But things are not that clear cut. In many areas, a lack of clean water imperils the lives of babies who receive formula milk.
A report last week by the World Health Organisation showed a community of 800 000 in KwaZulu-Natal had no access to clean water.
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