It is a sad day when a democratic government has to be ordered by a high court judge to do the right thing: adopt a plan to save the nation’s babies from HIV using proven, affordable methods.

The Treatment Action Campaign’s victory over the Minister of health and her provincial counterparts should serve as a warning to the ANC government that, while it enjoys popular support, it should not become complacent.

South Africans can, and will, continue to challenge government policy where it is found to be lacking.

Certainly, government’s defence of its slow pace of providing the anti-AIDS drug Nevirapine to all pregnant HIV positive women was lacking.

Government’s defence – resting largely on a long affidavit by Health Director General Dr Ayanda Ntsaluba – was mainly technical. It failed to address TAC’s arguments that dispensing the anti-AIDS drug Nevirapine was cheaper than treating children with HIV (and the drug itself has even been offered free for five years by it’s manufacturer).

It also failed to address TAC’s argument that, by restricting access to Nevirapine to women who attended ante-natal clinics at 18 specific sites, government was discriminating against poor women who could not afford to go to private doctors to get a prescription for the drug.

Instead, government relied on two main arguments. One was that not enough is known about various aspects of the use of Nevirapine – a more subtle version of President Thabo Mbeki’s favourite AIDS bogeyman, toxic drugs.

The other argument was that there was not enough research on whether a child who was given Nevirapine at birth would be HIV-negative at the age of two, as HIV can be transmitted by breastfeeding.

However, this week renowned paediatrician and AIDS expert Professor Jerry Coovadia rubbished this argument, saying that exclusive breastfeeding forsix months then rapid weaning could contain HIV transmission from mothers to babies.

Ntsaluba also argued that allowing doctors in public hospitals the right to dispense Nevirapine at their own discretion was not a solution. He said hospitals may lack services such as counselling services and the supply of milk formula.

High court judge Chris Botha has destroyed that argument by ordering government to ensure, by the end of March, that all health facilities have a plan to get their acts together to supply Nevirapine to pregnant women.

An affidavit by Prof Helen Schneider of the Centre for Health Policy in support of TAC’s case showed that most clinics do, in fact, have that capacity.

My own visits to many of the test sites showed exactly that. In fact, the site at Church of Scotland Hospital in Tugela Ferry in rural KwaZulu-Natal, which has poor facilities and serves a largely illiterate population, was one of the best organised sites I have seen.

Health workers at all the test sites said how wonderful it was to be able to offer pregnant women with HIV hope by giving Nevirapine – which can cut the transmission rate of the virus form mothers to their babies by about 50%.

A recent study of registrars at Red Cross Children’s Hospital found that the doctors often failed to form bonds with patients with HIV – partly because they felt guilty as they had little to offer them.

Now all public health workers countrywide will have access to a drug that could save the lives of thousands of babies – about 70 000 HIV positive babies are born in out country every year, and Nevirapine can potentially save half of these.

So finally there is a little cheer this Christmas in the fight against HIV/AIDS for HIV positive mothers and their babies who are, after all, the future of our nation.
– Health-e News Service.

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