TAC chairperson Zackie Achmat and deputy chair Sipho Mthati appealed for a ‘€œscience and human rights-based approach’€ to health policy and implementation in South Africa.

Achmat asked all ‘€œdecent’€ scientists attending the conference to issue a statement similar to that produced at the Durban AIDS conference in 2000. This time it should endorse the right to life and access to safe and effective treatment to prevent the transmission of HIV from mothers to babies.

Four years ago at the International AIDS conference in Durban, scientists published a document re-iterating their conviction that HIV caused AIDS in response to questions raised by President Thabo Mbeki about the link between the virus and the Acquired Immune Deficiency Syndrome. It came to be known as the ‘€œDurban Declaration’€.

‘€œWe believe in the best science. We also believe in public health. We appeal to public health scientists here to speak the truth,’€ said Achmat.  

Achmat said his organization had always believed that there were better regimens than a single dose of nevirapine to prevent mother to child transmission of HIV.   He added that the reason this regimen was used in the South Africa public health system was because the government had argued that it could not afford more complex and expensive regimens.

‘€œI want to say right here and right now, that the TAC will do everything we can to work with government. We appeal to every government official here [at the conference] to make clear that it is not government position to say that the [constitutional] court order was wrong,’€ said Achmat.

Mthathi told the conference that government representatives had accused the TAC of using international podiums to embarrass the South African government and of not being patriotic.

‘€œThe issue is not about politics here,’€ she said. Rather it was about honesty and a need to avoid undermining the prevention of mother to child transmission (PMTCT) programme.

Mthathi appealed to the South African Medicines Control Council and health department to stop sowing confusion at a time when ‘€œour efforts need to go into how we provide treatment for the 400 000 people who need AIDS treatment now’€.

Reminding delegates that the South African health department was currently without a director-general and without a national director of HIV/AIDS and that many health workers operated within a system of ‘€œdeep confusion’€, Achmat requested all South Africans attending the conference to work together with government.

On Monday the MCC released a statement which recommended that nevirapine no longer be used as a single dose therapy to prevent the transmission of HIV from mother to child. It said that nevirapine could still be used in PMTCT programmes, so long as it was used in conjunction with another antiretroviral drug.

The Western Cape’€™s PMTCT programme is based on a regimen that combines AZT and nevirapine. Every other provincial PMTCT programme currently uses a regimen that offers pregnant women just a single dose of nevirapine and a dose of syrup to the baby.

Head of HIV/AIDS in the Western Cape, Dr Fareed Abdullah said the statement by the MCC would not affect the PMTCT programme in his province. ‘€œThere will be no changes until there is new science,’€ he said.

E-mail Sue Valentine