South Africa
South African trade union breaks with government on AIDS drugs

afrol News, 29 March - The South African trade union, COSATU, which is a close ally of the ruling party ANC, yesterday issued an unequivocal statement saying it was "convinced" that the disputed HIV/AIDS drug Nevirapine could "save hundreds of babies from being born with HIV/Aids and dying an unnecessary, early death." The ANC remains reluctant to the free distribution of Nevirapine.

Nevirapine is the internationally recognised medicine that is used to prevent mother-to-child transmission of the HIV virus. As the prevalence of HIV/AIDS is as high as 40 percent among pregnant women in some parts of South Africa, the distribution of Nevirapine - preventing an estimated 50 percent of mother-to-child transmissions - could indeed save very many lives.

The free distribution of Nevirapine is a hot potato in South Africa, as it has become the symbolic case of the ANC's incompetence on health matters (the party doubts the connection between HIV and AIDS), a growing conflict between central government and the provinces (three provinces, one of them ANC-governed, have started the free distribution of the drug) and a case for the South African judiciary. The government was recently ordered to distribute Nevirapine in public hospitals pending an appeal of another court order to do so.

Pressure within the ANC is growing to give up on the unpopular principle, and yesterday's statement by the ANC-affiliate - the Congress of South African Trade Unions (COSATU) - is just one more example of the split in ruling circles. COSTAU "reaffirmed" its view that Nevirapine "should be made available as quickly as possible to HIV-positive pregnant women in all state hospitals and clinics." It welcomed the High Court ruling that the government "must roll out the medicine without waiting for its appeal to the Constitutional Court to be heard and urge the government to comply with the ruling." 

The trade union remained "convinced that this drug can prevent mother-to-child transmission of the virus and save hundreds of babies from being born with HIV/Aids and dying an unnecessary, early death," the statement read. It further agreed with the ANC that "the AIDS epidemic is one of the greatest challenges this society has faced."

However, COSATU could "not agree with the ANC's view that Nevirapine cannot be administered outside the areas where the government's research programme is being carried out until the results of this research programme have been completed and the first babies whose mothers were treated with the medicines have reached 12-18 months." This is the principle argument of the ANC against the large row of criticisers.

COSATU's argumentation is in line with that of the provincial leaders of KwaZulu-Natal, Gauteng and Western Cape, maintaining that government research programmes will only have completed by December 2002 - an optimistic view. "In this period, hundreds of HIV-positive pregnant women will lose the chance of saving their babies from contracting the virus unless they are allowed access to antiretrovirals," COSATU spokesman Patrick Craven holds. 

COSATU was "convinced" that Nevirapine had been tested sufficiently for it to be rolled out throughout the country. "While no drug can ever be 100 percent risk-free, the evidence summarised below proves that the advantages in saving lives far outweigh the possible risks and side-effects," Craven holds. "The children of those mothers who were treated in the Uganda trials in 1999 are now three years old. The time for research and debate has passed. It is time for the government to act to save lives."

Even more provocative for the government party might have been the statement saying the trade union "fully supports those provinces which have decided to go ahead with the distribution of Nevirapine at state hospitals." Two of these three provinces are ruled by opposition parties; the only ones in South Africa. COSATU even demanded other provinces should see to that their capacity for administration and counselling made it possible to follow the dissident provinces.

The trade union based its unequivocal statement on a recent release by the UN health agency, WHO, expressing its "continued support for the use of Nevirapine to prevent mother-to-child-transmission of HIV." WHO recommended that the use of Nevirapine should be included in the minimum standard package of care for HIV-positive women and their children.

The Minister of Health, Dr Manto Tshabalala-Msimang, however remains harsh on the government's policy, doubting the effects of medical treatment of HIV/AIDS. Tshabalala- Msimang maintains the High Court "stepped into the realm of policy-making in its original judgement," ordering the government to distribute Nevirapine. She still refuses to distribute the drug.

Sources: Based on COSATU, WHO and afrol archives 

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