Inter Press Service - July 14, 2000
Anthony Stoppard

At the Aids 2000 conference, this week the President of the South African Medical Research Council, Malegapuru Makgoba, pointed out that: "Enough scientific evidence is in existence to prove that we need to intervene with drugs to prevent mother-to- child transmission. And, people suffering in the late stages of AIDS benefit from anti-retroviral drugs (used in the treatment of Aids)."

He was speaking at a discussion hosted by Medecins Sans Frontieres (MSF) -- an international humanitarian organisation of doctors -- and the Treatment Action Campaign (TAC) at the Aids 2000 conference.

"We are carrying out programmes to reduce HIV transmission from mothers to newborns and we know it is working, but we are also seeing a dramatic impact on people's willingness to get tested and their attitude toward HIV during the existence of these programmes," said South African MSF head Eric Goemaere.

"We have never claimed that one can control the epidemic by one treatment alone, but MSF is now convinced that prevention without any possibility of care is not working. Treatment programmes will reinvigorate prevention efforts," he added.

A representative of South Africa's Western Cape Provincial Administration, which runs a successful mother to child transmission prevention programme -- Farid Abdullah, insisted: "we can't deal with this epidemic without anti-retroviral therapy".

Abdullah pointed out that the programme created the opportunity for many unplanned spin-offs, including a dramatic impact on general awareness and knowledge of AIDS and improved staff knowledge.

The provincial administration is making anti-retroviral drugs available to mothers in Khayelitsha, South Africa's second largest township, despite South Africa's national government's refusal to do the same.

At a press conference Thursday, the South African TAC gave the country's national government an ultimatum to provide pregnant women with nevirapine -- an anti-retroviral -- drug, or be taken to court.

TAC said it was acting on behalf of a group of women with HIV who are between two and three months pregnant. They are demanding nevirapine to prevent the transmission of the disease to their unborn children.

More than 5000 HIV-positive babies are born in South Africa every month, according to figures reported at the conference. The government's decision not to provide them with anti-retrovirals is mainly based on cost and safety concerns.

While addressing the conference earlier in the day, Makgoba, said the development of a HIV/Aids vaccine and the supply of anti- retrovirals to pregnant mothers posed some of the greatest moral dilemmas in society. He pointed out that the affordability of treatments in a society that prided itself on human rights and promoted equity and development created great ethical problems.

Later, he joined African scientists in condemning the "scientific exploitation" of Africa by international agencies. Makgoba said it seemed that Africa provided the manual labour to collect samples while international organisations take the credit for the resulting discoveries.

"Africa is used as an experimental laboratory," he observed, "Great discoveries in the fight against HIV/Aids have come out of Africa without us ever being credited for it."

Meanwhile, it was reported that the Aids Coalition to Unleash Power (Act-UP) -- an activist group that has been virulently demanding governments make Aids treatments available to people with the disease, at the conference -- has been receiving money from a pharmaceutical company that produces an anti-Aids drug.

Representatives of pharmaceutical company Merck Sharpe and Dome reportedly admitted funding the group that has been demanding the South African government provide Aids treatment drugs free to pregnant women.

In another session of the conference, violence against women was identified as one of the most overlooked factors driving the spread of the HIV virus, which is sexually transmitted.

"Violence against women is an important contributor to HIV's spread," said Dr Gro Harlem Brundtland, director-general of the World Health Organisation (WHO). "We will not achieve progress against HIV until women gain control of their sexuality," she said.

Results of a Zimbabwe study revealed that more than three- quarters of HIV-infected women had been forced to have sex with their partner. In Kenya, 20 percent of women living with HIV were subjected to violence after they told their partners their test results, according to figures released at the conference.

"Some women do not want to reveal their HIV status because of fear of violence, emotional abuse, or abandonment," explained the acting director of WHO's department of violence and injury prevention, Dr Pamela Hartigan.

"First, women are at particular risk from AIDS because of cultural norms that reinforce inequality between the sexes and put women in subservient positions. Then, others are at risk because women who become HIV-infected feel powerless to discuss their test results with their partner," she added

The conference also heard a call for a proper look into whether or not decriminalisation of sex work would bring about a reduction in the spread of HIV. John Davies, who helps sex workers in Romania, described the suggestion that decriminalisation led to a decrease in HIV transmission as "an idea that has become part of the mythology of pro sex work activism".

He was supported by Shane Hart-Petzer of the Network of Sex- Worker Projects (NSWP) -- an international coalition of people and organisations providing support and information to sex workers.

The main ways suggested to control the spread of HIV among sex workers, included: regulating the business and insisting on mandatory testing for -- and treatment of -- the virus, providing accessible and appropriate services for the industry; and increasing the ability of sex workers to protect their health and the health of their clients.

Hart-Petzer said: "What it means is to remove the control of prostitution from the criminal code and locate it within a framework of industrial regulation.

That is a better option for sex workers."

The conference end on Friday. (END/IPS/as/sm/00)
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