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Cape Town, South Africa, Clinic Launches Nevirapine Distribution Program
kaiser Daily HIV report
2001-02-23

A Cape Town clinic last month became the first among a national network of 18 public clinics to offer nevirapine free of charge to pregnant women.

A Cape Town clinic last month became the first among a national network of 18 public clinics to offer nevirapine free of charge to pregnant women. The Guguletu clinic has already provided the drug to more than 80 HIV-positive pregnant women in an effort to prevent vertical HIV transmission and reduce the flood of sickly, HIV-positive babies, who have put an "overwhelming" strain on South African hospitals. The programme provides women who test positive for HIV with one nevirapine pill, which they are instructed to keep in a safe place and take during labor; their newborns are also given a single dose of nevirapine -- a regimen that is estimated to reduce vertical HIV transmission by 50%. The program also provides women a six-month supply of free baby formula, as HIV can be transmitted through breastfeeding. Officials hope that by April, all 18 clinics in the network will provide HIV testing, counselling and drugs to pregnant women, and that the programme will reach between 36 000 and 60 000 women in its first year. According to the New York Times, however, the programme will reach probably no more than 20% of the estimated 250 000 women infected with HIV who become pregnant each year in South Africa. In addition, the program does not offer women any other treatment. About 600 000 babies are born with HIV worldwide every year; 90% of these are born in Africa.

In deciding to launch the nevirapine program, South Africa ends its bitter, public feud with the medical establishment, and joins eight other African countries -- including Botswana, Zimbabwe, Uganda and Ivory Coast -- in offering nevirapine through similar programs. However, health officials in those African nation that operate nevirapine distribution programmes have encountered several roadblocks. Some pregnant women resist taking HIV tests, and nurses and counselors are overwhelmed by the new burden of testing and counseling. Women also have resisted accepting the free infant formula, as African women who do not breastfeed are often shunned in society. Moreover, health officials have not been able to guarantee reliable supplies of the formula or clean water. Peggy Henderson, a specialist in mother-to-child programs for UNICEF, said, Giving out the drugs is the easy part. The whole intervention is much more difficult than we predicted 
(Source: Kaiser Daily HIV report, 18/02/01)

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