South Africa: President Mbeki still refuses anti-AIDS drugs to pregnant women - Reports From Around the World: Africa - Brief Article

WIN News, Spring, 2002

THE NEW YORK TIMES, Feb. 5, 2002

DURBAN, South Africa:

"With a simple, two-page statement, Mr. Llionel Mtshali, who runs the provincial government in Durban, quickly became the most prominent figure in a widening campaign to challenge the national government's policy of restricting the distribution of AIDS drugs in public clinics and hospitals.

Mtshali sent out a press release that he was going to defy the national government and distribute lifesaving drugs to every pregnant woman infected with the AIDS virus in this province in an effort to save newborn babies.

This week, a group of advocates for AIDS patients held a news conference in which they displayed generic AIDS drugs they had purchased in Brazil in open defiance of South Africa's patent laws.

Meanwhile, a small number of doctors and nurses have begun quietly distributing the AIDS drug - Nevirapine - to pregnant women without government permission. National health officials have limited the drug to a handful of sites in each province, even though research has shown that it significantly reduces a pregnant woman's risk of transmitting HIV to her newborn.

Every year, 70,000 babies are born HIV positive in South Africa, which has more people infected with the AIDS virus than any other nation. One tablet of nevirapine taken during labor - along with a single dose for the newborn - can reduce the risk of transmission by as much as 50 percent.

The national government's program to distribute the drug reaches about 90,000 women a year, about 10 percent of those who give birth annually. In December, a High Court judge ordered the government to expand the program after advocates for AIDS patients sued. . .

The government's position reflects President Thabo Mbeki's concerns about the side effects and toxicity of AIDS drugs and his widely publicized musings about whether HIV really causes AIDS.

In this instance, the cost of the drug itself may not be a factor, as the pharmaceutical company, Boehringer Ingelheim, has offered nevirapine free. But even government officials acknowledge that the public outcry is mounting as doctors, ministers and politicians demand a rapid expansion of the nevirapine program. These advocates say government officials are keeping a desperately needed program out of hospitals that could provide testing, counseling and support. As for safety, they point out that nevirapine has already been approved by the United Nations and the World Health Organization. With 36 percent of adults infected with HIV in this province, more than anywhere else in the country, Mr. Mtshali said he could wait no longer.

'Let's face it: it's a desperate situation,' Mr. Mtshali said in an interview in his offices here this week. 'None of us in this province hasn't lost a relation to this pandemic. We can't fold our arms when people are dying around us'.

Mr Mtshali grew up in KwaZulu-Natal, the province that extends from the palm trees and the sea of South Africa's eastern coast to the hills of rural Zululand. He says he is weary of visiting villages and hearing constituents beg for help he cannot give and feeling desperate. . .

In October, Mr. Mtshali approached his provincial health minister and asked him to expand the nevirapine program, which is only available in two large sites here. His health minister explained that the national government would only consider expanding the program in a year. Mr. Mtshali said he pondered that for a few months.

Then, he decided that he had no choice but to forge ahead whesther the national government liked it or not . . .'I live in this province,' Mr. Mtshali said. 'I have a responsibility in this province. I travel all over this province and I talk to poor people. They appeal to me in desperation. . Many clinics lack adequate space and staffing to handle the surge of women coming in for testing and counseling. . .

Here in KwaZulu Natal, the provincial government now plans to rapidly roll out the nevirapine program in the coming months...Other provinces, including the Western Cape and Gauteng have also forged ahead.

Meanwhile, Mr. Mtshali, a retired school teacher and a member of former President Nelson Mandela's cabinet, has become a hero for many. He has been interviewed on national radio and television and been applauded by AIDS advocates and opposition politicians. . ."

Barbara Kenyon, who runs the nonprofit group that distributes AIDS drugs to rape victims said she hoped that other provincial leaders will follow.'I hope this starts a whole tidal wave of people standing up for what's right'"