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) - May 3, 2002
"Death is different," the TAC's senior counsel Gilbert Marcus said, arguing that there was not enough urgency in the state's approach to South Africa's "terrible" Aids epidemic.
"This is a case in which thousands of babies who are born, die in misery. A single dose (of nevirapine) can ensure them a life of health and well-being," said Wim Trengove, senior counsel for the University of the Western Cape's Community Law Centre and the Institute for Democracy in SA (Idasa).
The court is hearing the appeal of Health Minister Manto Tshabalala-Msimang and seven health MECs against a Pretoria High Court judgment ordering them to make the drug available to all HIV-positive pregnant women where medically indicated and where the women have been tested and counselled.
Marcus said that, by May 2000, the Department of Health had ascertained that 25 to 35 percent of babies born to HIV-positive women became HIV-positive during pregnancy, at birth or during breast feeding.
In sub-Saharan Africa 75 percent of these would die by their fifth birthday. Most of the HIV-positive babies would die in the first two years. "This must have called for the most dramatic and most urgent intervention," Marcus said.
Instead South African citizens were repeatedly faced with changes in government policy.
On Thursday, senior counsel for the government Marumo Moerane said the government was not prepared to provide nevirapine in the public sector unless it could provide "the full package" of services, including testing, counselling, monitoring and breast milk formula. The formula is necessary because breast feeding can cause the transmission of the HI-virus. The state was not able to extend its perinatal anti-HIV programme to provide anti-retrovirals because it could not yet provide this full package, he argued.
Arguing on Friday, Trengove said this approach was flawed because testing, monitoring, counselling and breast milk formula should already be in place. "They are the A B C of any (anti-)mother to child transmission programme... These should have been in place long before nevirapine appeared on the horizon," he said.
Trengove argued that the fact that "the package" referred to by Moerane was not in place when nevirapine was registered in April 2001 constituted a pre-existing flaw in the government's programme.
He said the state had a constitutional duty to ensure that everyone had physical and economic access to basic health care.
Probed about the practicalities of this suggestion, he answered that there were obvious cost constraints, but that the government had to work towards a situation where this was true for all South Africans.
"Why shouldn't the constitution be taken literally?" he asked.
"Not providing (anti-retroviral treatment) is a violation of the right to dignity. It says that the mother and baby are not worthy citizens," Trengove said.
The court is to continue to hear argument on Monday.
The Community Law Centre, Idasa and Cotlands Baby Sanctuary have joined the TAC in support of the Pretoria High Court judgment ordering a roll out of the government nevirapine programme as "friends of the court".
020503
SA020502
Copyright © 2002 - South African Press Association. Reproduction of this article (other than one copy for personal reference) must be cleared through the South African Press Association, Cotswold House, Greenacres Office Park, Cnr. Victory & Rustenburg Roads, VICTORY PARK, PO BOX 7766, JOHANNESBURG, 2000; Fax No: +27 11 782-1587/8, Tel No: +27 11 782-1600.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.
Always watch for outdated information. This article first appeared in 2002. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 2002. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .