Sunday Times (Johannesburg) - December 2, 2002
Bobby Jordan

KGOTSO Hlalele was born 50km too far south. As a result, there's a good chance he is HIV-positive.

A premature baby, he arrived at Sebokeng Hospital near Vereeniging because his mother was away from her home at the time.

If he had arrived on schedule at Soweto's Chris Hani Baragwanath Hospital - figuratively, just up the road from Sebokeng - he would have received a drop of nevirapine syrup that could have meant he did not contract the virus from his mother.

The little boy - now four months old - is at the centre of a historic legal tussle over access to Aids drugs that began this week in the Pretoria High Court. His mother, Sarah Hlalele, has submitted a key affidavit denouncing the fact that her child might die because he was born in the wrong place.

She has become a voice for thousands of mothers whose children are born HIV-positive because the government dispenses nevirapine at only a handful of hospitals.

"I put the blame on the government because if there had been nevirapine at Sebokeng Hospital, then my baby would have received it," said Hlalele.

The mix-up was even more tragic because Hlalele knew all about nevirapine and had kept a single dose at her home, ready for the birth of her son.

"When I arrived at the hospital I told them I was [HIV] positive and that I needed nevirapine. They said, there's no nevirapine here," said Hlalele, who must now wait until her son is 18 months old to know whether he has the virus.

This week she sat nervously at the back of court 4D in the Pretoria High Court while Judge Chris Botha was told her story by a legal team seeking to force the government to make nevirapine more available in the public health sector.

At present the drug is dispensed mostly in the Western Cape and Gauteng and at a handful of hospital "test sites" elsewhere.

Aids activists and doctors spearheading this week's court action say they are being prevented from dispensing nevirapine or other anti-Aids drugs. Research shows that a single dose of nevirapine - available in the private sector for R13 a tablet - reduces the risk of an HIV-positive mother transmitting the virus to her baby by up to 50%.

"Our argument is that not only is nevirapine affordable, it's cost-effective," said Nathan Geffen of the Treatment Action Campaign. "We're asking the court to force the government to come up with a nevirapine implementation plan."

In court this week, a government legal representative, Marumo Moerane, said the health d epartment lacked the manpower for such a programme.

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