Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
South African Press Association (Johannesburg) - April 4, 2002
The partnership between the two countries in the fight against HIV-Aids remained solid, visiting US Health Secretary Tommy Thompson said in Pretoria.
"There are going to be some differences ... but the positives of our partnership are so much more than the few things that we disagree (on)," he told reporters in Pretoria.
"You have to look on the positive side."
Thompson said his South African counterpart Manto Tshabalala-Msimang was "extremely open" about the nevirapine issue.
The two were briefing reporters on talks they had been conducting since Thompson's arrival on Wednesday.
His visit has been described as a White House mission to strengthen co-operation in the field of public health between the two countries.
Reiterating that the US was using nevirapine, Thompson said: "We have tested the efficacy of it and we feel that it is safe. We feel there is a need for using it in the United States."
South African health authorities are resisting the general use of nevirapine to reduce the transmission of HIV from pregnant women to their babies.
Extending the distribution of nevirapine beyond 18 official pilot sites, the Health Department contends, would jump the gun on studies about available resources and the efficacy and effect of the drug.
It has cited, among others, concerns that the positive effects of nevirapine could be nullified by breastfeeding.
Thompson said he and his delegation had discussed this particular issue with Tshabalala-Msimang.
"I want you to know that the minister has been extremely open and positive about doing everything she can in this regard. We want to work with her," he said.
"But in regard to any health care issue, the health department of a particular state has to make certain decisions (and has) certain responsibilities. That is a decision that is being discussed with the minister of health."
Tshabalala-Msimang said South Africa and the US shared a common concern on the need for effective and sustainable infant feeding practices.
Once South Africa had gathered sufficient information from its research sites on this, "we wish to consider collaborative exercises on our experiences with other partners, especially on our continent".
Thompson said the US did not know everything about HIV-Aids, and could also learn from South Africa.
"This is a process of evolution, of learning and of exchanging (information).
People are going to change as we learn more about this disease," he said. "I want you to know that we are partners. We are going to work together to improve the quality of health of the people of South Africa and the US."
In response to a question on the link between HIV and Aids, Tshabalala-Msimang sharply rejected assertions that the government was questioning conventional views on the matter.
"He (President Thabo Mbeki) has never questioned the causality between HIV and Aids. All he has done was to locate HIV within the circumstances of South Africa."
South Africa's approach was to seek a comprehensive response to all factors that fuelled HIV-Aids, including poverty and malnourishment.
Senior African National Congress MP Peter Mokaba this week told the New York Times newspaper: "HIV? It doesn't exist. The kind of stories that they tell that people are dying in droves? It's not true."
Tshabalala-Msimang reiterated the government's programme against the disease was based on the assumption that HIV causes Aids.
But it would be wrong to think that all deaths in South Africa were caused by HIV-Aids, she said.
"Causes of death in this country are related to issues of poverty. You talk about tuberculosis. You talk about cholera and you talk about malaria. We have to address those issues."
Other causes of death related to the fact that South Africa was in a period of transition from apartheid to democracy, Tshabalala-Msimang said.
They included violence against women and road accidents. Affluent lifestyles were another factor -- "the food that we eat, alcohol consumption, tobacco consumption, hypertension, (and) diabetes".
"As a Department of Health, we cannot ignore all of these causes of death in our country and straitjacket ourselves to only HIV-Aids," she said.
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