AZT price break (3)
-------------------
Prof Richard Laing's question on cost of AZT in pregnant women remains
unanswered. What is the total cost of drugs, counselling and test per
case? For a developing African country, this will be a major issue.
Kenya is totally dependent on donors for its vaccine procurement. If
AZT is to be introduced (and the National AIDS Control is thinking
about it) who will bear the cost? The National AIDS Control is financed
by the World Bank. When the World Bank pulls out, the Ministry of
Health will not be in a position to finance it.
There are other interventions in pregnancy which may reduce maternal
and infant mortality. This includes good antenatal care for all preg-
nant women and reducing incidence of anaemia and malaria in pregnancy.
Before a national AIDS program considers AZT, it should look at other
interventions that are cost-effective. But from bitter experiences, I
know that a vertical program approach will ignore all other interven-
tions and only focus on introduction of AZT. Transmission of HIV by x%
will be the main indicator of progress to be mentioned. Costs will not
be in the programme report. And those who die from anaemia in pregnancy
will be excluded as deaths due to other causes.
Dr S K Sharif
Provincial Medical Officer
Mombasa, Kenya
mailto:sksharif@AfricaOnline.co.ke
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