The Pretoria High Court reserved judgment on Tuesday in the application by the Treatment Action Campaign (TAC) to force government into making Nevirapine available to HIV-positive pregnant woman.
Judge Chris Botha said judgment would definitely be delivered before Christmas.
Earlier, TAC attorney Gilbert Marcus told the court there was nothing that resembled a timetable for the expansion of the government's programme to distribute the drug.
Marcus challenged argument presented on behalf of the Minister of Health and the provincial MECs, saying that the State had failed to address key elements of the TAC's case.
Marumo Moerane, for health authorities, argued there were insufficient resources to expand its present programme, which was limited to certain pilot sites. He also said that the long-term efficacy of Nevirapine had yet to be proved.
He said South Africans had a constitutional right to healthcare, not Nevirapine and the government's present cautious approach was responsible and reasonable.
Marcus said the truth was that the government's current policy had nothing to do with the ideal of achieving 100 percent Nevirapine coverage.
That was why doctors at the Johannesburg Hospital, who bought and dispensed Nevirapine at their own cost, were denigrated as being irresponsible when they took steps to achieve the ideal.
He quoted from the affidavit of one Johannesburg paediatrician, who said withholding Nevirapine to HIV-positive pregnant mothers, was morally and ethically wrong.
According to the affidavit Nevirapine was easy to administer with no side effects except extreme gratefulness.
Marcus said it was clear that besides the Western Cape and Gauteng, where the Nevirapine programme had been extended, there was no timetable to extend the programme to other provinces.
He said it was not good to refer to the Northern Province's lack of resources and say that nothing could be done about it.
It was an obligation that rested on the national government to ensure that the poorest provinces were assisted.
Marcus said if the State fell short of its constitutional duties, it was for the court to provide alternative remedies.
Doctors in the public health system should be allowed to decide whether or not to prescribe the drug based on individual case merits.
Marcus said his clients had been trying to persuade health authorities for years to come up with a comprehensive programme to prevent the transmission of HIV from mother to child.
TAC could therefore not be accused of acting impetuously or impatiently by approaching the court for the present relief.
The respondents seem to be saying they're not going to make any promises because they might not be able to keep them. That's simply an excuse not to implement any programme at all, Marcus said.
He said the State's understanding of equity seemed to be that all babies were equal, but some babies - such as those in the Western Cape and Gauteng where the Nevirapine programmes were being expanded - were more equal
than others".
He charged that health authorities had done nothing to explain why their present policy were forcing some doctors in the public health sector to act unethically by preventing them from prescribing Nevirapine, while they regarded it as in the best interest of a patient.
Source: SAPA, 27 November 2001
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