LAST week’s premature death of an African National Congress spokesman, widely
believed to be from AIDS, may herald a reversal in the South African
government’s controversial policies on HIV. But pregnant women with HIV still
aren’t being told that drug treatment can prevent their babies becoming
infected.
To the relief of health workers battling South Africa’s spiralling HIV
epidemic—which has already infected one in five adults—the ruling
ANC last week put adverts in national newspapers telling people to protect
themselves from AIDS by using condoms. Until recently, President Thabo Mbeki has
touted the idea that HIV might not cause AIDS.
Celicia Serenata, deputy director of the HIV/AIDS programme in the South
African health ministry, told 91av: “HIV does cause AIDS.
There is a clear scientific link.”
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But information sent to health workers has infuriated both them and
campaigners. Leaflets that supposedly provide guidance on managing HIV in
pregnancy fail to mention that the risk of mother-to-child transmission can be
slashed by taking anti-retroviral drugs in late pregnancy.
Serenata says pilot projects are under way to test the practicality of giving
nevirapine to pregnant women in South Africa.
But last week a panel of experts from UN agencies, including the World Health
Organization and the Joint UN Programme on HIV/AIDS (UNAIDS), issued a statement
that the safety and efficacy of nevirapine, at just 30 rand (about £3) per
person, in preventing mother-to-child transmission were beyond doubt. “There is
no justification to restrict use of any of these regimens to pilot or research
projects,” it said.
Glenda Grey, director of perinatal HIV research at the University of
Witwatersrand medical school, told 91av: “What is so shocking
is that they not only don’t supply it but that they don’t even allow women to
know about it.”
Some observers, including key figures in the WHO, believe South Africa’s
reluctance to give antivirals to pregnant mothers with HIV stems from the fear
that if one group gets anti-HIV drugs, then the rest of South Africa’s 4.2
million HIV-positive people will demand them too. Such widespread anti-HIV
therapy is something the country clearly cannot afford.
But rumours abound that the government’s bizarre position on AIDS results
from HIV affecting the upper echelons of the ANC itself. Last week one of
President Mbeki’s key spokesmen, 36-year-old Parks Mankahlana, died from an
unspecified illness, widely believed to be AIDS. It was Mankahlana who stated
that an international declaration by scientists earlier this year that HIV
caused AIDS “should be thrown into the dustbin”. “There’s massive denial going
on,” says Morna Cornell, director of the AIDS Consortium, a network of three
hundred AIDS community groups in South Africa. Pressure is now mounting on other
key ANC figures to reveal their HIV status.
While the general public—apart from the very rich—go without
combination drug therapy, members of the South African parliament with HIV are
exercising their right to free treatment, as parliamentarians, courtesy of the
taxpayer.
“It’s spectacularly cynical and at the cost of many lives,” Cornell says. But
as a result of such publicity, Awa-Marie Coll-Seck, policy director of UNAIDS,
feels South Africa is about to turn a corner. “I sense things are changing,” she
says. “In a few weeks or months we will see them coming on board.”