Sunday Times, South Africa - October 8, 2000
Carol Paton and Laurice Taitz

Yet taxpayers must cough up so MPs can get the SAME drug

Members of Parliament have access to the AIDS drug AZT, which the government has decreed should not be given to rape victims or HIV infected at public hospitals.

The parliamentary medical aid scheme, which serves 2 000 MPs, judges and President Thabo Mbeki, pays R35 000 for anti-HIV therapy and provides AZT to pregnant women and rape victims.

But the government this week ordered a health organisation to stop providing the drug to poor people in Mpumalanga. And Mbeki said in letters about the drug written to the Democratic Alliance leader, Tony Leon, that providing AZT to rape victims would violate the law as the drug was not registered for that purpose. He said Leon's advocating of the administration of AZT to rape victims was a "blatant defiance of the law".

Parliament's medical scheme, Parmed through Aid for Aids, sanctions the use of antiHIV drugs to prevent the transmission of the virus pregnant women, rape survivors and victims of needlestick injuries.

The drugs are subsidised by the taxpayer as the state pays twothirds of Parmed's monthly premium of R970.

Membership of the scheme is compulsory for all members of Parliament and the provincial legislatures, the President, all members of the Cabinet and judges of the Constitutional and High Courts.

The medical scheme's "Aid for AIDS" programme has been adopted by all medical aids managed by the umbrella company Medscheme. The drugs range from R25 000 to R40 000. The programme provides cover for several AIDS drugs, including AZT, 3TC and nevirapine.

So far 68 members out of 2 000 have signed up for the new benefit, which came into effect on July 1. It replaces a previous benefit that covered members for a certain amount of anti-HIV drugs but did not actively help members manage their condition.

This week the Mpumalanga Health Department ordered the Greater Nelspruit Rape Intervention Project, a nonprofit organisation, to stop providing AZT and 3TC to rape as this "was not in accordance with health policy".

Donor funding had paid for the drugs, which were administered at public clinics and hospitals.

On Monday the provincial Deputy Director-General of Health, Dr Gulam Karim, called the rape project's co-ordinator, Barbara Kenyon, to a meeting and told her that if the project was to continue providing the drugs, the programme would have to be endorsed by the provincial legislature.

But after submitting a motivation for the project to continue, Kenyon was told that the Health MEC, Sibongile Manana, had said that giving the drugs to rape victims "was not in accordance with government policy" and would be stopped.

The rape project sees about 50 women and children every month.

Kenyon said the number of children had "skyrocketed" since the beginning of the year because of the spread of the myth that men can be cured of AIDS by raping a child.

Kenyon said: "It's an outrage. If you are rich and sitting in government you can get lifesaving medication, but if you are poor and living in rural Mpumalanga then you are denied it."

George Mohlamonyane, a spokesman for Manana, said: "We cannot say that the project has been chased away. What we can say is that they did not follow correct channels. They are operating without authorisation."

Although AZT and 3TC are registered drugs in South Africa, they have not been registered for use in preventing HIV transmission in cases of rape.

However, the head of the Medicines Control Council, Dr Helen Rees, said this was because of the difficulty of designing ethical trials to test the drugs in that role.

"Using them in this way is called off-label use," said Rees. "It is a common occurrence in countries around the world."
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