[Ip-health] Kaiser News: KwaZulu-Natal's Nevirapine program delayed

[Mike Palmedo]

http://www.kaisernetwork.org/daily_reports/rep_hiv.cfm#9126

AIDS Drug Distribution in KwaZulu-Natal Put on Hold by Province Health
Minister; Premier Reiterates 'Principled Stand' on Plan
[Jan 25, 2002] 

      The KwaZulu-Natal health minister on Wednesday said that the
eastern South African province would not be able to "immediately"
distribute to HIV-positive pregnant women the AIDS drug nevirapine -- a
WHO-approved antiretroviral that may be able to reduce mother-to-child
HIV transmission by up to 50% -- "counter to a pledge" made Monday by
province Premier Lionel Mtshali, the Associated Press reports. Zweli
Mkhize, health minister of "South Africa's most AIDS-stricken province,"
said that the drugs could not yet be distributed because "adequate
backup systems were not yet in place" to administer the drug. The
Associated Press reports that it was not clear whether the announcement
by Mkhize, who is a member of the ruling African National Congress, was
politically motivated (Associated Press, 1/23). However, Mtshali, who is
a member of the Inkatha Freedom Party, which controls KwaZulu-Natal,
yesterday said in a statement, "No amount of political pressure would
make me renege on this principled stand. If it means paying a political
price for it, so be it." Mtshali added, "I reiterate for the whole to
understand clearly, that I stand resolutely by the announcement I made
on Monday" (South African Press Association, 1/24). The announcement
that the province would provide nevirapine to all HIV-positive women was
"seen as a direct challenge" to the South African government's stance on
the drug. Despite a court order last year that country officials begin
distributing nevirapine, the ANC maintains that the safety of the drug
is "unproven" and an infrastructure to provide counseling and backup
treatment to drug recipients "has to be put in place" before the drug
can be distributed (Associated Press, 1/23). 

'Desperate Situation' 
Although the drugs would be provided for free to all HIV-positive
pregnant women under KwaZulu-Natal's distribution plan, the "problematic
costs 'lie in the provision of counseling and other staff needed to run
the mother-to-child transmission program and space at institutions to
run the program effectively," Mkhize said. "When [Mtshali's]
announcement was made, none of us were actually ready. Yes, nevirapine
will be rolled out, but we want to take all the problems into account,"
Mkhize said in an interview with South African Broadcasting Corporation
public radio (Agence France-Presse, 1/23). However, Mtshali yesterday
said that any anticipated problems must be presented to the provincial
Cabinet "so that they can be dealt with swiftly." He added, "Saving
lives is what we as government are called upon to do. As premier I would
not like to be relegated to the dustbin of time for failure to act
decisively and promptly to alleviate a desperate situation" (South
African Press Association, 1/24). Nearly one quarter of pregnant women
in South Africa are HIV-positive, and more than 70,000 infants are
infected with HIV through vertical transmission each year (Agence
France-Presse, 1/23). South Africa's national government, led by
President Thabo Mbeki, who has questioned the link between HIV and AIDS,
has continually "come under fire for its haphazard approach" toward
fighting HIV/AIDS (Kaiser Daily HIV/AIDS Report, 1/22).