Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
South African Press Association (Johannesburg) - August 4, 2003
Dr Ashraf Coovadia of the SA Paediatric Association was responding to an Inkatha Freedom Party call for doctors to do more to protest against the Medical Control Council threat to delist Nevirapine for the prevention of mother-to-child transmission (PMTC).
The MCC has given manufacturer, Boehringer Ingleheim, 90 days to present more safety and efficacy data.
The MCC stance has been widely criticised.
IFP health spokeswoman, Dr Ruth Rabinowitz said: "It is not enough for the Medical Association South Africa (MASA) to compare South Africa's Aids policy to euthanasia.
"Doctors are in the front-line of implementation of policies that are clearly unethical, dangerous, unscientific and damaging to public health. It is high time they began to implement their commitment to serving patients by boycotting the current policies."
Coovadia said he was not sure what more doctors could do. "We make a noise whenever and however we can," he said.
Coovadia, who is a paediatrician at Johannesburg's Coronation hospital, said Nevirapine had reduced the rate of transmission to babies from HIV positive mothers to nine percent at that hospital.
"Around a quarter of new paediatric admissions are HIV-infected and around 40 percent to 50 percent of the children lying in our wards are HIV infected.
"They stay in hospital longer and have more complications. It costs R300 a month for medications to care for an HIV infected child, and R600 a month if one includes the costs of medical monitoring and care," Coovadia said.
A single dose of Nevirapine to mother and child to prevent HIV transmission, however, costs R30, although at present government receives the medications from Boeringer Ingleheim for free for the next three years.
It is estimated that around 8,000 babies are born to HIV infected mothers each month in South Africa. Few live beyond the age of four and they need repeated hospital admissions during their short lifespan.
Rabinowitz called for "a revolt on behalf of the entire medical fraternity so that we are not found guilty of complicity with genocide".
"Anonymous testing of women for HIV, the refusal to acknowledge the value of Nevirapine in preventing mother to child transmission, the refusal to accept US73 million (R548-million) for HIV programmes in KwaZulu-Natal and the refusal to provide anti-retrovirals top the list of human rights abuses by government," Rabinowitz said.
"The South African government is determined to have its way.
Doctors of conscience should not assist them.
"Life, it appears, has become disposable in the rainbow nation."
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