iClinic - October 20, 2000
Marjolein Harvey
While there is evidence that the incubation period of AIDS is lengthening in industrialised countries and people living with the virus can live longer - probably as a result of better patient care and medical advances in new antibiotic treatment and antiretroviral therapies - HIV/AIDS remains a death sentence for the poor.
While the ANC and the Democratic Alliance are conducting slinging matches at each other over their stance to providing antiretrovirals in the public healthcare system, and the Treatment Action Campaign will meet with police on Friday to hand over a sample of an illegally imported generic drug used to treat HIV/AIDS-related diseases, people continue to die.
Millions of South Africans do not have access to even the most basic essential treatments for AIDS-related opportunistic diseases. In many cases, this is because the cost of the treatments is too high.
Pharmaceutical companies use their exclusive patents to charge exorbitantly high prices for medication that is available at much lower prices in other countries.
An excellent example of profiteering is provided by the drug company Pfizer, a multinational which has remained strangely silent since it first made an offer of free Fluconazole, an offer which soon appeared false.
Fluconazole is an essential drug for treating two opportunistic infections associated with HIV, Cryptococcal Meningitis and Systemic Thrush. In the private sector, Fluconazole costs approximately R50 per tablet. Government buys Fluconazole from Pfizer at approximately R29 per tablet. However, it is sold by many generic manufacturers at less than R2 per tablet.
"Pfizer uses its patent to prevent the South African government from importing Fluconazole from generic drug manufacturers," says the TAC on its website.
In 1990 the Department of Health (DOH) instituted a mechanism to monitor the HIV epidemic in South Africa and nine years later launched a five-year plan to tackle the pandemic in this country.
Unfortunately, it is President Thabo Mbeki's criticism of the HIV/AIDS link and government's refusal to provide medicinal care to people living with HIV/AIDS that stand out in my mind.
The tenth annual national HIV survey of women attending antenatal clinics of the public health services, October 1999 showed that the HIV prevalence rate is estimated at 22.4%.
"In order to optimise the health and well-being of the mother and child, ideally the management of HIV-positive pregnant women should include routine care and lab monitoring; administration of antiretroviral therapy during pregnancy and postpartum for the infant; and prophylactic therapy to protect against opportunistic infections," according to the report by a SA health expert.
AIDS drugs have come a long way since the 1980s. Then there was just one product, AZT, to fight the HIV virus which causes the disease.
Three recent studies from Thailand, C|te d'Ivoire, and Burkina Faso - all resource-poor countries - showed that short-term administration of zidovudine during late pregnancy and delivery reduced the risk of perinatal HIV transmission.
In the Thailand study, for example, vertical transmission was reduced from 18.6 percent to 9.2 percent.
Utilised singularly or in combination, the administration of zidovudine during pregnancy, the use of elective Caesarian sections instead of vaginal childbirth, and bottle feeding instead of breast feeding have been shown to reduce the likelihood of an infant contracting HIV from an infected mother.
Additional research suggests that less costly alternatives such as a single dose of nevirapine may be useful in resource-limited regions.
Why then is the department of health not providing these drugs? There is no clear answer to this pertinent question. The TAC's response is action, while the response of politicians seems to be the scoring of political points.
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