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AFRO-NETS> Kaiser Daily HIV/AIDS Report - Fri, 14 Dec 2001

  • Subject: AFRO-NETS> Kaiser Daily HIV/AIDS Report - Fri, 14 Dec 2001
  • From: Cecilia Snyder <csnyder@ccmc.org>
  • Date: Sun, 16 Dec 2001 13:51:15 -0500 (EST)

Kaiser Daily HIV/AIDS Report - Fri, 14 Dec 2001

Pretoria High Court Rules That South Africa Must Provide Nevirapine
to All HIV-Positive Pregnant Women

Pretoria High Court Judge Chris Botha today ruled that the South Af-
rican government must supply the antiretroviral drug nevirapine to
all HIV-positive pregnant women in the public health system in order
to reduce transmission of the virus from mother to child, the South
African Press Association reports (South African Press Association,
12/14). When administered to the woman at the onset of labor and
again to the infant 72 hours after delivery, nevirapine can reduce
the risk of transmitting HIV by 50%. In South Africa, about 200 in-
fants a day are born with HIV (BBC News, 12/14). The Treatment Action
Campaign, the Children's Rights Center and Haroon Saloojee, a physi-
cian in charge of community pediatrics at the University of the Wit-
watersrand, this summer filed suit against the South African Depart-
ment of Health and eight of nine provincial health departments in an
effort to force the government to provide the drug to all HIV-
positive pregnant women through public hospitals and health clinics.
Last spring, the government launched two pilot programs in each of
the country's nine provinces to examine the effects of nevirapine
treatment on pregnant women with HIV, but according to TAC, the pro-
grams reached only 10% of the country's HIV-positive pregnant women.
In addition, the lawsuit asked the government to plan and implement a
national program to prevent vertical transmission (Kaiser Daily
HIV/AIDS Report, 8/21). In a 70-page ruling, Botha said the govern-
ment was "obliged" to provide the drug under the constitutional right
to health treatment and gave the government until March 31 to draw up
a comprehensive plan for dispensing the drug and reducing vertical
transmission overall in the country (Swindells, Reuters, 12/14). The
government had argued that nevirapine's safety "remained unproven"
and that officials lacked the resources needed to implement a na-
tional scheme. Lawyers for the government also noted that even if the
drug were provided, women would still transmit the virus to their in-
fants through breastmilk and argued that the courts had "no right to
rule on policy decisions" (BBC News, 12/14). Boehringer Ingelheim,
the German manufacturer of the drug, had previously offered to supply
it free-of-charge for five years to the South African government, but
officials had rejected that offer. According to Kevin McKenna, Boe-
hringer's managing director in South Africa, the offer still stands.
"If the government decides to move forward we would be happy to sup-
ply the product," he said.

Paving the Way

AIDS advocates hailed the ruling, saying it could halve vertical
transmission rates and pave the way for expanded HIV/AIDS treatment.
"This is a very important victory, a great step forward. The judge
granted everything that the TAC sought," Mark Heywood, TAC national
secretary, said (Reuters, 12/14). He added that the ruling will bring
"hope to tens of thousands of pregnant women" and could eventually
lead to expanded HIV/AIDS drug availability to others in the country.
"We don't want to save the lives of children only to have a genera-
tion of orphans," he explained (Kraft, Associated Press, 12/14). The
government won a "landmark" court case against 39 drug companies ear-
lier this year that would allow it to import generic AIDS drugs, but
officials have not taken action to do so. The government is expected
to appeal Botha's ruling to the country's Supreme Court (Reuters,
12/14). South African Gold Producer, Mining Unions Sign Deal on
HIV Transmission Prevention Program for Mine Workers

South Africa's second-largest miner of gold, Gold Fields Ltd.,
signed an agreement on Wednesday with the representatives of several
mining unions to create "one of the most advanced" workplace HIV/AIDS
programs in the country, Reuters reports. The National Union of Mine-
workers, the United Associations of South Africa and the Mineworkers
Union Solidarity ratified the deal with the company to create an em-
ployee program that will focus on curbing the spread of HIV through
education, voluntary HIV testing and promotion of condom use. More
than 25% of Gold Fields Ltd.'s miners are currently infected with
HIV, and South Africa has the greatest number of residents who are
living with HIV/AIDS of any nation. Although antiretroviral drugs
will not be offered as part of the company's program, counseling and
management of "opportunistic diseases" and other STDs will be in-
cluded. Due to the decline in productivity and increased absenteeism
among employees, the high prevalence of HIV infection in the company
had previously been predicted to add $4 to $5 to the cost of each
ounce of gold produced by the group within five years. Without these
newly agreed-upon measures, the prevalence rate of HIV/AIDS among the
workers was expected to rise to 40% and add $10 to the cost of an
ounce of gold by 2009 (Reuters, 12/12).

The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org,
a free service of The Henry J. Kaiser Family Foundation, by National
Journal Group Inc. (c) 2001 by National Journal Group Inc. and Kaiser
Family Foundation. All rights reserved.

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