Nevirapine to stay, for now

Nevirapine will remain the drug of choice in government’€™s prevention of mother to child transmission programme following a meeting between the national health minister, her provincial counterparts, scientists and other drug experts.

Experts from the Medicines Control Council (MCC), Medical Research Council, Essential Drug List (EDL) Committee and researchers from the Perinatal HIV Research Unit and National Institute for Communicable Diseases participated in the consultative workshop in the hope of ‘€œbetter understanding the implication of the reported resistance to nevirapine when used to reduce the risk of mother to child transmission’€.

Health minister Dr Manto Tshabalala-Msimang and the MCC caused an outcry at the International AIDS Conference in Bangkok last month when they announced that nevirapine should no longer be used as a monotherapy.

The minister’€™s spokesperson Sibani Mngadi said in a statement on Thursday that the purpose of the workshop was not to review the government programme, but to provide a forum where information could be shared and to discuss the results of investigations into nevirapine resistance.

Mngadi said that Minmec (meeting of provincial health minister and the national health department) had been informed as far back as June about the MCC findings, but had at the time resolved to convene a workshop after the Bangkok conference.

Mngadi said there had been agreement at Thursday’€™s meeting to do further research and that the results would be presented to Minmec.

‘€œThe Department of Health continues to provide nevirapine in its current form until a new approach has been decided upon,’€ Mngadi added.

Professor James McIntyre, director of the Perinatal HIV Research Unit described the meeting as cordial and constructive, but added that an opportunity needed to be created to ‘€œreally discuss and argue the science with a smaller group that can synthesize it and try to translate it for policy makers’€.

A participant, who asked to remain anonymous, said the meeting was a step in the right direction as it at least gave scientists and researchers the opportunity to (again) explain the issues.

The source said the MECs appeared to be well aware of the potential chaos that ‘€œwithdrawal of nevirapine’€ would cause.

Another development was the decision that the MCC would not advise on regimens that are not part of the council’€™s registered indications. A similar example is Misoprostol which is used in the termination of pregnancy although it is not indicated for this use.

The manufacturers of nevirapine. Boehringer Ingelheim also made a presentation to the workshop.

E-mail Anso Thom

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