While the rest of country is trying to get the pilot sites on the use of the drug nevirapine to prevent mother-to-child HIV transmission (MTCT) up and running, the Western Cape has announced the further expansion of it’s programme that will cover 95% of the Cape metro.

Western Cape health MEC Nick Koornhof said it made economic sense to expand this programme, adding that it was “very sustainable”.  

“There is no doubt in my mind that this makes economic sense despite the budget constraints.”

Dr Fareed Abdullah, Deputy Director General in the Western Cape health department, confirmed that the programme would be extended to the Helderberg, South Peninsula, Kraaifontein, Elsies River and Bishop Lavis districts by the end of the year.

The programme will be up and running in Mitchells Plein by March next year, Abdullah said.

He said the MTCT programme would be expanded even further to reach Plettenberg Bay, Knysna, Hermanus, Grabouw and Stellenbosch by March next year.

Pregnant women will be given nevirapine at all the sites, except Khayelitsha.  

Nevirapine sites have been running in Gugulethu, Langa, Bonteheuwel, Paarl, Worcester and George since early last year.  

For the past two and a half years, the Western Cape’s department of health has been running an MTC pilot programme in Khayelitsha in partnership with Medicines Sans Frontieres (MSF). Women are given AZT and already 16 280 women have been reached, of whom 18,5% tested HIV positive.

Abdullah said the costs for the new sites would be shared between the province and the unicity.

“MTCT is do-able and cost effective,” he said.  

Abdullah said the province’s interventions were aimed at achieving a two to three percent reduction in HIV infections by 2010.  

“This would mean that the Western Cape has 200 000 HIV positive people at its peak. This would not be a catastrophe and a situation we can control,” Abdullah said.

He said the province was committed to looking at ways to treat the HIV positive mothers as well.

“We are approaching the treatment step-by-step. All mothers have access to bactrum prohylaxis (anti-biotic), treatment for opportunistic infections (three clinics) and fluconazole (26 facilities). If her CD 4 count goes below 200 she will be included in the triple combination therapy pilot being run by MSF (in Khayelitsha).

“Our approach in the province is to rather do fewer programmes, but to do them well,” Abdullah said.

Koornhof said he was convinced they were “doing the right thing”, despite constant criticism.

“If we happen to be scoring political points then it is coincidental. Many of the people on the provincial AIDS council are ANC members, including Ebrahim Rasool. Fareed Abdullah is ANC,” Koornhof said.

He said criticism from the national government was fueled by jealousy.  

“I have urged Manto (Tshabalala-Msimang – Health minister) to brag with us because we are part of South Africa. She should be propagating to the world that we are doing it right in this province,” Koornhof said.

The Western Cape is also providing anti-retrovirals to rape survivors in the province.