While central government is pursuing further pilot studies on the use of the drug nevirapine to prevent mother-to-child (MTC) HIV transmission, the Western Cape is rolling out an MTC prevention programme using the drug, AZT.

Ironically, the Western Cape has the lowest HIV rate in the country. Despite this, the New National Party-controlled province has committed R6-million a year to providing HIV testing and anti-retroviral drugs to pregnant women.

Western Cape Health MEC Nick Koornhof said his province had taken the decision, “not to play politics”, but because it was ready and “it would have been immoral for us not to proceed”.

“I urge all other provinces to follow suit as soon as possible,” said Koornhof. “We are ready, willing and able to assist them.”

For the past 20 months, the Western Cape’€™s department of health has been running an MTC pilot programme in Khayelitsha in partnership with Medicines Sans Frontieres.

This will now be extended to Gugulethu, Langa, Bonteheuwel, Paarl, Worcester and George between January and April next year.

A special task team under the University of Cape Town’€™s Professor Gary Maartens is looking into whether ‘€“ in the longer term — AZT, nevirapine or any other anti-retroviral drugs should be used for the programme. At present, nevirapine cannot be used outside of drug trials as the Medicines Control Council has not yet licensed it.

Results from the SA Intrapartum Nevirapine Trials (SAINT) conducted in Johannesburg and Durban and released in July, showed that nevirapine was as effective and much more cost-efficient than AZT. However, the health minister has since insisted that further nevirapine pilots are run in all nine provinces.

The Western Cape will base its extended programme on its Khayelitsha pilot study. In this pilot, women attending ante-natal classes were given talks on HIV by specially trained counsellors from Lifeline and Childline.

The women were then offered HIV tests and the chance to get AZT to reduce HIV transmission if they tested positive.

“Nine months after the programme started, clinic staff accompanied by our counsellors, did home visits to test the HIV status of the babies,” said Stephanie Schutte, executive director of Lifeline/Childline.

“There is another test scheduled for 18 months, but this initial test showed that a large number of babies were negative.”

The task team is also looking into the feasibility of providing anti-retrovirals to the province’€™s rape victims.