The KwaZulu-Natal health department has chosen to identify a quiet rural doctor as a troublemaker, charging him for misconduct for ‘wilfully and unlawfully without prior permission of [his] superiors rolling out prevention of other-to-Child HIV transmission dual therapy to pregnant mothers and newborns’.
But in charging Dr Colin Pfaff, the department has poked a hornet’s nest of discontented public service doctors who are tired of being punished by bureaucrats for putting patients before process ‘ especially when dealing with HIV/AIDS.
There has been a flurry of condemnation from medical organisations and doctors countrywide are currently signing a petition in support of Pfaff and demanding that the charges against him are dropped immediately.
Dr Francois Venter, on behalf of the SA HIV Clinicians Society, said that disciplining Pfaff ‘for doing his ethical duty is disgraceful’.
‘We call on KZN to immediately implement dual therapy across the province with the same energy they have expended on his case,’ said Venter.
Pfaff, a deeply committed Christian decribed by friends as a ‘humble visionary’, raised money from overseas donors to supplement his hospital’s nevirapine-only treatment programme for HIV positive pregnant women with another antiretroviral drug, AZT.
These donations were channelled through the Manguzi Mission fund, not the hospital.
The Western Cape has been using AZT and nevirapine since 2004 and has cut the mother-to-child HIV transmission to 8%. In KZN, which still uses nevirapine only, 22% of HIV positive mothers infect their babies.
Dr Victor Fredlund, the medical manager of Mseleni Hospital, also in the Mkhanyakude district in the far north of KZN, explains what drove Pfaff to seek donations to buy AZT for his patients.
‘Our nevirapine programme was reaching nearly all pregnant mothers. Yet still more than 100 babies a month were still being born infected with HIV,’ said Fredlund.
‘All the scientific literature, and the Western Cape experience, suggested that we could further reduce the transmission to a quarter of that, saving 75 or more babies a month, by introducing AZT during pregnancy.’
Fredlund has written to Dr Sandile Buthelezi, head of HIV/AIDS in KZN, to express support for Pfaff and to say he will also do the same unless the department speeds up the introduction of dual therapy.
However, far from backing down, this week health spokesperson Leon Mbangwa confirmed the charge against Pfaff and added another: that he ‘acted beyond his authority in accepting a donation’.
Mbangwa also declared: ‘We will not allow anyone to pull vulturistic theatrics to mystify this matter for their own political gains (sic). We will continue to put the interest of our people first.’
Ironically, far from being in the interests of KZN’s people, the department’s decision to charge Pfaff is likely to impact badly on health service delivery in the province.
A number of doctors who did not want to be named said this week that they felt ‘demoralised’ and ‘angry’ about the incident, and one said he was suspending a major health initiative at his hospital that involved donor funds until there was clarity about the use of donations.