After four years of calling for a comprehensive programme to prevent the mother to child transmission of HIV, the Treatment Action Campaign (TAC) will take the Minister of Health and all nine MEC’s for health to court in an attempt to ensure that a national plan is implemented.

TAC has put two issues before the court. Firstly, it calls on the state to make nevirapine available to women who have HIV and give birth in the public health sector if the attending doctor or nurse feels this is necessary.

Secondly, TAC is asking that the state be obliged to set out clear time-frames for a national mother-to-child transmission (MTCT) prevention programme and to implement such a programme.

A once-off dose of nevirapine can reduce the number of children born with HIV by up to 50%. If it is were to be administered to all pregnant women who are HIV positive it would cost around R250 million — less than 1% of the national health budget.

TAC national chairperson, Zackie Achmat said the reason his organisation had resorted to court action was because government had ignored all TAC’s calls for treatment up to now.

“Our government has ignored science, economics, morality, good planning, good governance and the law for more than five years on this issue. We’ve organised, marched, presented petitions and government has ignored every decent plea for them to do something. That’s why we’ve taken this step,” said Achmat.

He added that it was not a step they had taken lightly. “We obviously don’t like taking our government to task, but they have left us no option. It’s a government that has no morality any longer on this issue and for those people affected by HIV it’s a matter of urgency.

“As we speak, children are dying, mothers and fathers are ill and sick and the government is not taking any notice. An action like this will give many of us hope,” said Achmat.

The more than 600-page long application is supported by some 250 doctors including Dr Haroon Saloojee a paediatrician from Chris Hani Baragwanath Hospital and Professor Jerry Coovadia from the department of paediatrics and child health at the University of Natal, Durban.

Among those represented in the application are Busisiwe Maqungo and Bongiwe Mkhutyukelwa, two women whose lives have been affected in vastly different ways by the access to – or denial of – antiretroviral drugs to prevent MTCT.

Maqungo only discovered that her month-old daughter was HIV+ when she took her to a doctor because it was unusual for such a young baby to be constantly suffering from pneumonia and diarrhoea. Her daughter died when she was nine months old.

Had she known about the options open to her Maqungo, like many other women, might have tested herself sooner and been able to seek out access to an MTCT prevention programme.

By contrast, when Mkhutyukelwa was pregnant, she met counsellors from the Khayelitsha MTCT programme and decided to test herself for the virus. When she discovered she was positive, she was able to enlist in the programme and was given AZT before birth.

“I was given AZT when I was eight months pregnant and then every three hours during labour and delivery. My child was given bactrim syrup after six weeks and today she is healthy and HIV uninfected. She’s now two years old.”

TAC said that it hoped that government would not contest the case which would save time and money. If the matter did go to court, TAC said it hoped that it would be concluded by December this year.