Fear of delay in Nevirapine access

by Lynne Altenroxel

Less than a week after South Africa's highest court ordered the government to make Nevirapine immediately available to HIV-positive pregnant women, politics appears to be getting in the way.

A key provision of the ruling by the Constitutional Court was that public clinics and hospitals must have the capacity to provide the medicine. Doctors disagree sharply with the government about which hospitals have capacity and which do not.

In Limpopo, Health MEC Sello Moloto said in a speech before the court made its decision that the province's health infrastructure may not necessarily be capable of handling the assignment on a widescale basis, but a draft survey by his health department found every hospital in the province set up to do so.

Every respondent felt ready and willing to implement a prevention of mother-to-child transmission programme with the use of Nevirapine ... these overwhelmingly positive responses suggest rollout could begin with making Nevirapine available to all hospitals, the survey reads.

Moloto said he had never seen the document, which was compiled at the end of March.

The differences may simply reflect confusion in the government bureaucracy. On the other hand, AIDS activists believe they may signal deliberate delaying tactics.

Nathan Geffen, spokesperson for the Treatment Action Campaign, said provincial claims of a lack of capacity were yet another attempt to obfuscate and confuse.

The judges' decision is clear, he said. It's not up to any province to determine who has capacity. It's up to the doctors and superintendents.

Limpopo isn't the only place where dissension is brewing. The Eastern Cape Health Department insists that it needs three weeks to determine which of its hospitals have the capacity to provide Nevirapine - a claim which the province's former health MEC, Dr Trudy Thomas, describes as absolute nonsense.

Thomas has accused the government of creating spurious obstacles to introducing Nevirapine.

Any hospital or institution with a qualified doctor had the capacity, if the HIV test kits and the drug were made available, she said.

Doctors from nine Eastern Cape hospitals say their institutions are willing and able to provide the treatment.

Even at national level, delays are preventing the immediate implementation of the court order.

The circular that the Health Department has promised provinces, outlining instructions and a guideline on how to deal with the issue, is still awaiting approval by Health Minister Dr Manto Tshabalala-Msimang, a department source said.

Source: The Star & SAPA, 10 April 2002