Jan 18, 2002

SOUTH AFRICA: Doctors Defy Ban on Anti-retroviral Drugs

The South African Medical Association (SAMA) has come to the defence of doctors who are defying the government's ban on administering anti-retrovirals - drugs designed to reduce the spread of HIV and AIDS - in the public health system. SAMA represents around 70 percent of South African doctors, both in the private and public sectors.

Doctors at Kimberley Hospital, in South Africa's Northern Cape province, were reportedly reprimanded for treating a nine-month-old girl with anti-retrovirals, after she was raped and sodomised. They received the reprimand from Elizabeth Dipou Peters, who is a Member of the Executive Council (MEC) for Health, according to media reports.

The South African government has refused to make anti-retrovirals available in state hospitals on the grounds that it is not known how effective the drugs are - and that they may in fact be toxic. While the use of the drugs to reduce the spread of HIV and AIDS is accepted practice internationally, South Africa President, Thabo Mbeki, has repeatedly warned that they are dangerous and has questioned the link between HIV and AIDS.

Despite this official government stance, doctors in public hospitals have reportedly been quietly providing the drugs to survivors of rape and pregnant women, in an attempt to protect them from the disease. However, it now looks like they may be headed for a clash with the South African health department.

In a statement, SAMA says: ''The Human Rights, Law and Ethics Committee of SAMA affirms its strong support for the rights of medical practitioners to clinical independence and autonomy... This includes the right to treat patients without undue influence, pressure or victimisation from employers or government institutions,'' it says. ''SAMA also supports the rights of patients to receive necessary treatment, always with their informed consent. This includes the rights of all pregnant women who are HIV positive to receive the best available treatment that has been proven to reduce mother to child transmission. This principle should apply to rape survivors.“

SAMA points out that its members and affiliated groups were part of a recent court case in which the South African government was taken to court in an attempt to force it to make anti-retrovirals available in the public health system, to pregnant women and survivors of rape. While the court ruled in favour of the Treatment Action Campaign (TAC), which led the case against the government, the health department has decided to appeal against the finding.

The minister of health has indicated that the department's main reason for appealing the decision to South Africa's Constitutional Court is to get certainty over just how much influence the courts should have in setting government policy. It may take as long as a year before the appeal is heard.

Ironically, at the end of last year, the ruling African National Congress (ANC) became part of a coalition that won control of the Western Cape provincial government. While under the control of the opposition Democratic Alliance, state hospitals and clinics in the Western Cape treated rape survivors with anti-retroviral drugs to minimise the risk of HIV infection. The new coalition government, which is dominated by the ANC, has promised to continue with the policy of providing anti-retrovirals in the provincial public health system. (IPS)


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