Reaction on new PMTCT guidelines

The audio is in isiZulu. See the English summary below.

MABUTHO: Ukwethulwa kohlaka oluphathelene nokusetshenziswa kwekhambi le AZT ngaphezu kwe nevirapine, nokwaziwa ngeledual therapy, iNational Health Council kuzwakala njengezindaba ezinhle kwabesifazane abakhulelwe kodwa benegciwane lengculaza. Kepha komama abanabantwana abazalwe benegciwane, njengo Portia Seroto, kufike emva kwesikhathi, umonakalo sewudalekile. USeroto ungumama wabantwana ababili. Umntwana wakhe wokugcina oneminyaka emithathu unegciwane lengculaza nathi walithola kuyena ngenxa yokusetshenziswa kwe monotherapy okuyi nevirapine kuphela ukuvumbela omama abanegciwane ukuba bangalidluliseli kubantwana babo. Ngesonto eledlule uthole ukuthi ukhulelwe kodwa waphoqeleka ukuthi akhiphe isisu ngenxa yokuthi ubebona ukuthi umntwana wakhe uzozalwa enegciwane lengculaza uma esebenzisa imono therapy, okuwuhlelo olukhona njengamanje lapho kunikezelwa nge nevirapine kuphela ukuvimbela omama ukuba bangatheleli abantwana babo ngegcinwane lengculaza.

PORTIA SEROTE: Nginomntwana engamthola eHIV-positive ngoba esulelwe yimi ngengculaza. And I found out last week that I was pregnant. And ngathola ukuthi ngina eleven weeks (and) three days pregnant. Ngiye ngaphoqeleka ukuthi nakanjani ngihambe ngiyokhipha isisu because bengigula by the time I was pregnant and amasotsha ami omzimba bewehla and iviral load yami beyikhuphuka. As umuntu onolwazi bengazi ukuthi uma ngabe ngingahamba or ngihlale nalesisisu ngize ngiyo deliver bengazi ukuthi umntwana uzozalwa either ane HIV or mina bengizoshona ngoba bese ngigula kakhulu.

MABUTHO: UPortia uthi ukholwa ukuthi ukuba bese kuqaliwe ukusetshenziswa kwedual therapy umntwana wakhe ubezophila.

PORTIA SEROTE: Ngiyazi ukuthi ukuba beseyikhona idual therapy beyizozama ukuthi isave impilo yami ngoba iCD4count yami beyizokhuphuka and nomntwana bengazi ukuthi noma kanjani ubengeke asuleleke ngegciwane likagawulayo’€¦..Ugovernment kumele afeze izethembiso zakhe ‘€¦.idual therapy siyayicela abomama bayashona, abantwana bayashona, abaningi basazalwa benengculaza. So siyamcela kakhulu so that abantu bazokwazi ukuphila.

MABUTHO:   UDr Tammy Meyers, uyi Paediatrician esibhedlela iChris Hani Baragwanath eSoweto, okuyisibhedlela esikhulu kunazozonke ezwenikazi laseAfrica.  Uthi kuyadabukisa kakhulu ukuthi kuthathe isikhathi eside ukukhipha uhlaka okumele lulandelwe ukunikezela nge dual therapy. Uthi ukusho lokho ngoba ngaphambi kokuba iWorld Health Organisation income ukuthi kusetshenziswe idual therapy ngo 2006, bekuvele kwaziwa ukuthi idual therapy isebenza kangcono kune nevirapine okuyiyona esanikezelwa komama abazithwele okwamanje ukuvimbela igciwane lingadluleli kubantwana babo.

DR TAMMY MEYERS: It is unacceptable that it has taken us long to release guidelines. We knew that these regimens are more effective before’€¦ 2006 when the WHO were putting their recommendations. ‘€¦ We have the resources and we have the ability to go even beyond what the WHO is recommending.

MABUTHO: UDr Meyers uthi loluhlaka olulawulwa ukusetshenziswa kwedual therapy ngeke lwenze lutho lulodwa. Uthi okubalulekile ukuthi uhulumeni aqinisekise ukuthi loluhlaka luyalandelwa ngokuthi kuqaliswe ukugqugquzela nokufundisa abasebenza emitholampilo nasezibhedlela zikahulumeni ukulandela nokusebenzisa loluhlaka.

DR TAMMY MEYERS: There also needs to be a clear implementation plan because guidelines alone cannot help to clear the situation in the country. There needs to be a concerted effort’€¦ on the government (part) to make sure that these services are available… And that can require a lot of education and training and implementation programme around the guidelines as well.

MABUTHO: Njengoba omama abathelele izingane zabo ngegciwane kanye nezinhlangano ezifana ne TAC begxeka umnyango ngokungaluqalisi ngesikhathi loluhlelo lwe dual therapy, umnyango wezempilo uthi isizathu salokho ukuthi kunemigudu obekumele ilandelwe ukuqinisekisa ukuphepha ngaphambi kokuba luqaliswe loluhlelo.

See the English summary below.

Reaction on new PMTCT guidelines

 

The adoption of new guidelines for the prevention of mother-to-child HIV transmission by the Policy Committee of the National Health Council is good news to HIV-positive pregnant women. But it is too little too late for some.

 

Portia Seroto is an HIV-positive mother of two. Hers is a story of many South African women living with the virus.

 

‘€œI had an HIV-positive baby who was infected by me. And I found out last week that I was eleven weeks (and) three days pregnant. I was forced to do an abortion because I was very sick. My CD4count was very low and the viral load was high. I had to choose between doing an abortion or infecting my child and dying’€, said the outspoken Seroto with tears rolling down her face.

 

She believes that if dual therapy ‘€“ a combination of nevirapine and AZT ‘€“ was there, her baby would have been saved.

 

‘€œI know that if dual therapy was there my CD4 count was going to increase and I was not going to infect my baby. The government must fulfill its promises. We need dual therapy because women are dying and many babies are born with the virus. So we really need it’€, said Seroto.

 

Up until recently government policy recommended that HIV-positive pregnant women be given mono therapy ‘€“ a single dose of nevirapine ‘€“ which is regarded by medical experts and activists alike as not sufficiently effective in preventing HIV-positive women from infecting their babies with the virus.

 

Dr Tammy Meyers is a paediatrician at Chris Hani Baragwanath in Soweto, the biggest hospital on the continent. She says dual therapy should have been implemented much earlier, in response to recommendations by the World Health Organisation in 2006.

 

‘€œIt is unacceptable that it has taken us long to release guidelines. We knew that these regimens are more effective before 2006 when the WHO put up their recommendations. ‘€¦ We have the resources and we have the ability to go even beyond what the WHO is recommending,’€ said Meyers.

 

Meyers warned that the adoption of the new guidelines on dual therapy implementation by the Policy Committee of the National Health Council should be backed by ‘€œa clear implementation plan, because guidelines alone cannot help to clear the situation in the country. There needs to be a concerted effort’€¦ on the government (part) to make sure that these services are available… And that can require a lot of education and training around the guidelines as well’€.

 

With mounting pressure on the government to implement dual therapy its argument is that more time is needed for training and consultation with all stakeholders to ensure safety.

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