January 22, 2002

South Africa still has concerns on AIDS drug

South Africa has strong reservations about the use of an antiretroviral AIDS drug that cuts the risk of mothers passing the deadly disease to their newborns, the country's health minister said on Tuesday, January 22. Health Minister Manto Tshabalala-Msimang reiterated Pretoria's controversial opposition to the use of the drug nevirapine after a provincial leader said he would allow its use in state hospitals despite government policy. Nevirapine is at the centre of a heated court case between South African AIDS activists demanding that Pretoria offer the drug to the public, citing the constitution's clauses on the rights to health care and dignity.

Lionel Mtshali, premier of the largely rural KwaZulu-Natal province, where as many as one out of three pregnant women are HIV-positive, said his decision was based on the principle that emergency health care was a constitutional right. South Africa is believed to have more people with HIV-AIDS than any other country, with some five million sufferers. Some 70,000-100,000 babies are born HIV-positive each year, a number that experts say could be reduced with the use of nevirapine and other drugs.

Tshabalala-Msimang rebuked Mtshali for ignoring government policy on antiretrovirals. "His (Mtshali) announcement has taken us by surprise. We'd have expected him to consult us, to cooperate with the government," she told reporters. "Taking nevirapine is not like swallowing an aspirin. We want to understand the other issues - of resistance and reversal of gains," the minister said, adding that it would be irresponsible to dispense the drug without the proper health infrastructure. Mtshali planned to roll out a five-year programme for the drug's use within three months using supplies from German pharmaceutical firm Boehringer Ingelheim, which had offered it for free, Mtshali's spokesman Mahlati Tembe said.

Mtshali is a member of the opposition Inkatha Freedom Party. President Thabo Mbeki, of the African National Congress, has expressed scepticism about the causal link between HIV and AIDS and called antiretrovirals as toxic as the condition they treat. He has also provoked controversy by appointing so-called "AIDS dissidents", some arguing that AIDS is caused by recreational drug use, to his advisory panel on the condition. AIDS drugs are extremely limited in the public health sector despite Pretoria's legal success last year in beating off attempts by 39 of the world's biggest drug firms to keep it from importing cheaper generic versions of their medicines. KwaZulu-Natal would become the second of South Africa's nine provinces to make nevirapine available at state hospitals, following the lead of the wealthier Western Cape province. (The Namibian)

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