Important note: Information in this article was accurate in 2001. The state of the art may have changed since the publication date.

Reuters NewMedia - Monday November 26, 2001
Wambui Chege

Activists say South Africa, which has more people living with HIV-AIDS than any other country, is in the grip of a catastrophic epidemic and they want the government to provide the antiretroviral nevirapine to pregnant women nationwide.

About 300 activists marched to the Ministry of Health, where they presented a memorandum demanding the government drop its objections to antiretroviral drugs. They then marched to the High Court in Pretoria to launch their case.

"This case is about life and death. It raises concerns about whether the newly born child will live or die," said Gilbert Marcus, lawyer for the Treatment Action Campaign (TAC), which launched the case.

"It is also about what seems to be a state-sanctioned program which irrationally and arbitrarily ... results in the predictable but avoidable deaths of thousands of children," Marcus told the court.

Marchers waved placards which read "Give Women a Choice Give Women a Chance" and "Let's Make Life Worth Living."

South Africa has balked at the use of nevirapine and other antiretrovirals such as AZT at public hospitals, saying they are too expensive and casting doubt on the efficacy of some.

But the activists say President Thabo Mbeki's government should stop spending billions of dollars on a new arms package and divert some of the money to badly needed AIDS drugs.

"Mbeki must stop giving money for weapons. We want the drugs for our kids," said Clarina Segolodi, a 33-year-old activist who has lost a brother and sister to AIDS.

Mbeki, who has yet to acknowledge a causal link between HIV and AIDS, has branded antiretrovirals as dangerous as the disease they treat.

BREASTFEEDING COUNTERS NEVIRAPINE

The TAC and other groups lobbying on behalf of people living with HIV-AIDS have taken the National Department of Health and health ministers from eight of the country's nine provinces to court saying they are violating people's constitutional right to life and to health care.

Between 70,000-100,000 babies are born HIV-positive annually. A dose of nevirapine -- a tablet given to the mother during labor and a teaspoon to the baby in the first 72 hours after birth -- could cut infection by up to 50 percent, the activists say.

They want the government to provide a timeframe for the roll-out of a full treatment program including counseling and the provision of powdered baby milk for a minimum nine months. Babies can still develop HIV-AIDS after birth through breastfeeding, which experts say increases the risk of infection by 16-30 percent.

The government has set up pilot projects at 18 sites across the country to assess the value of nevirapine, but the AIDS groups said this was insufficient as the program only reached 10 percent of HIV-positive women.

In the light of an offer by German pharmaceutical Boehringer Ingelheim last year to provide nevirapine free to the government for five years, Marcus said its reluctance over the drug was "not just irrational but nothing short of insanity."

But the government says there are other costs apart from the drug itself. "We don't dispute that nevirapine is beneficial but our main concern is that we don't have a good grasp of what a total package of support would entail," Ayanda Ntsaluba, director-general of the Health Department, told reporters. Ntsaluba added nevirapine's effectiveness was countered by the fact mothers breastfed their babies.

"Eighty percent of the women on nevirapine continue to breastfeed because they don't want to suffer the stigma associated with being HIV-positive. That is one of our biggest problems," Ntsaluba said.
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