Health authorities are to select clinics in each of the nine provinces for research into preventing the transmission of HIV from mothers to children,
Health Minister Manto Tshabalala-Msimang said this week.
Until now, drugs to protect newborns form the virus that causes AIDS have been available
on a trial basis at selected sites in the Western Cape, Gauteng and KwaZulu-Natal, but the government has resisted pressure to
extend the programme to all HIV-positive women attending state health services. Officials were loathe to comment on whether the announcement indicated an
imminent shift in government policy. The decision not to provide AZT to pregnant women was taken at Cabinet
level, said government AIDS director, Nono Simelela. It's not for the health department to change this policy; Cabinet would have to decide.
She could not say if the Cabinet would discuss the matter this week.
Recent research found that a R21 dose of the anti-AIDS drug nevirapine could reduce the number of children infected with HIV by a third saving
an estimated 20 000 lives a year. When nevirapine manufacturers Boehringer
Ingelheim offered to provide the drug free for use in reducing the transmission to unborn children, the
pressure on thegovernment to accept the offer reached fever pitch. Some observers believe this pressure is bearing fruit.
The plan to extend the research is clearly a step closer to a national
programme," said Fareed Abdullah, the Western Cape's chief director of healthcare.
We know there are many operational issues that need to be resolved before the programme can be phased in nationally.
What works in the Western Cape, where we have a good supply of clean water for formula feeding, might not work in another province.
Abdullah attended a weekend seminar convened by the Health Minister to discuss the implications of the research presented at the recent Durban
AIDS conference.
The gathering of health MECs, heads of provincial health departments, members of the South African National AIDS
Council and parliament's health portfolio committee received an unambiguous message from researchers and
health economists: nevirapine has been shown to be safe and effective in protecting children against HIV.
Because it is relatively cost-effective compared with other treatments, it should be considered a priority.
Nevirapine researcher, Glenda Grey, one of those who addressed the meeting, responded with caution to the announcement for further
research: We already know that nevirapine works, so if they want more research into
efficacy or safety it will be a waste of time. But if it is operational research that establishes how to implement the
programme in different environments, then it is a step in the right direction.
Meanwhile, Western Cape health MEC Nick Koornhof is expected to announce new provincial projects.
We have submitted our plan to the national authorities and hope to make an announcement soon, said Abdullah. He said new
pilot projects were planed for Langa, Gugulethu, Nyanga, Paarl and Plettenberg Bay.
(Source: Cape Times, 16/8/00)
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