Kaiser Daily HIV/AIDS Report - Wed, 22 Aug 2001
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* South African Government Sued for 'Refusing' to Provide HIV-
Positive Pregnant Women With Access to Nevirapine
* South African Officials Propose Making HIV/AIDS Education Part of
School Curriculum for 6- to 16-Year-Olds
* Tanzanian Officials Shut Down Men's Magazines for 'Encouraging'
Spread of HIV
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South African Government Sued for 'Refusing' to Provide HIV-Positive
Pregnant Women With Access to Nevirapine
The South African AIDS advocacy group Treatment Action Campaign and
two other parties filed a lawsuit Tuesday against South African
Health Minister Dr. Manto Tshabalala-Msimang and nine provincial
health ministers in an effort to require the South African government
to provide nevirapine to HIV-positive pregnant women cared for in the
public health sector, Reuters/South African Broadcasting Corporation
reports. TAC, the Children's Rights Centre and a pediatrician at the
Chris Hani Baragwanath Hospital say that the government needs to en-
sure that more HIV-positive pregnant women are receiving nevirapine
to prevent vertical transmission of HIV (Reuters/South African Broad-
casting Corporation, 8/21). Mark Heywood, national secretary for TAC,
said that the lawsuit has two aims: to "force" the South African gov-
ernment to make nevirapine available "throughout the public health
system" and to require the government to develop a "clear national
policy" on the prevention of vertical transmission, "including all
components, such as counseling" (Agence France-Presse, 8/21). The
suit also contends that by "refusing" to make nevirapine "widely
available" to HIV-positive pregnant women, the South African govern-
ment is "denying women and children their constitutional right to
health care" (AP/Washington Post, 8/22). TAC said that by not provid-
ing greater access to nevirapine within the public health system, the
government is "creat[ing] a two-tier health care system in violation
of the country's constitution," which "guarantee[s] equal access to
health care for all South Africans." Tshabalala-Msimang has expressed
doubts about nevirapine, stating that it "may not be appropriate be-
cause it could be toxic and might create a new drug-resistant strain"
of HIV (Block, Wall Street Journal, 8/22). The government is expected
to receive the suit today, and the health ministers listed as defen-
dants will have until Sept. 12 to respond (South African Press Asso-
ciation, 8/22).
Creating a National Program
A spokesperson for the South African health ministry yesterday
stressed that officials have not yet seen the suit, but noted that
the health department has launched 18 pilot programs to evaluate
"certain operational challenges" linked to the use of nevirapine
(Wall Street Journal, 8/22). However, TAC spokesperson Anneke Meer-
kotter said that these programs are "inadequate" (Reuters/South Afri-
can Broadcasting Corporation, 8/21). TAC estimates that the programs
include only 10% of the country's HIV-positive pregnant women (Kaiser
Daily HIV/AIDS Report, 8/21). Boehringer Ingelheim, which produces
nevirapine, offered more than one year ago to make the drug available
for free to developing nations, but South Africa had not accepted the
offer "until recently," when it decided to use the drug in the pilot
programs (South African Business Day, 8/21). Joanne Collinge, spokes-
person for the South African health ministry, said that the health
department has "been talking to the company about being part of the
program, but that some aspects remained to be settled" (South African
Broadcasting Corporation, 8/21). TAC has stated that the pilot pro-
grams "are no substitute" for a national nevirapine program, adding
that the government could treat pregnant women with nevirapine for
approximately $30 per pregnancy. A national program "could save more
than 20,000 children a year" and would cost less than 1% of the coun-
try's health care budget, the group said (Swindells, Reuters, 8/21).
Support Among Medical Community
Several of South Africa's "most prominent doctors and AIDS research-
ers" have lent their support to the lawsuit, the Guardian reports.
Dr. Haroon Saloojee, the pediatrician named as one of the plaintiffs
in the suit, said, "Health professionals have almost been sidelined
from these issues, issues we deal with on a daily basis. It is us in
the health profession and not the politicians and policy makers who
have to deal with the consequences of this policy. ... Every day we
have to inform parents that their children have HIV when it could
have been prevented at minimal cost" (McGreal, Guardian, 8/22). Hey-
wood said that the suit may have a significant impact on AIDS policy
in South Africa. "If we are successful in this case regarding chil-
dren it begins to beg the question about the parents. This may take
us closer to the rational view of medicine proven effective and safe
for people with HIV," he said (Wall Street Journal, 8/22)
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South African Officials Propose Making HIV/AIDS Education Part of
School Curriculum for 6- to 16-Year-Olds
Several delegates to a conference convened to revise sex education in
South African schools on Monday called for HIV/AIDS education to be
integrated into all eight subject areas for students between the ages
of six and 16, South Africa's Business Day reports. Education Minis-
ter Kader Asmal said that the rising rate of HIV/AIDS "proved there
was a need to educate children about the disease." The National Cur-
riculum Statement currently mentions HIV/AIDS in two subject areas --
language instruction and health promotion, a subcategory of the sub-
ject Life Orientation. However, teachers are not required to incorpo-
rate HIV/AIDS education in language instruction, and health promotion
only receives a half hour of classroom time per week, of which infor-
mation on HIV/AIDS only receives a fraction of time. Wayne Alexander,
a life orientation teacher, said that the subject is the "home" for
compulsory instruction in HIV/AIDS, but added that the disease should
receive attention in all eight subject areas. MP Albertina Luthuli, a
doctor, added that although HIV/AIDS is "directly related to biol-
ogy," it is "about much more than science; it is about much more than
just sex." She said that HIV/AIDS education could easily be worked
into the curriculum for math and statistics, as well as literature,
gender and social studies. "This is about our very survival as a na-
tion," she added (Jones, Business Day, 8/21).
--
Tanzanian Officials Shut Down Men's Magazines for 'Encouraging'
Spread of HIV
The New York Times today reports that the Tanzanian government has
permanently shut down nine magazines and imposed a six-month ban on
two others that "prominently display[ed] photographs of bikini-clad
women and fill[ed] their pages with tantalizing articles and car-
toons," saying that these features "encourag[ed] the spread" of HIV.
Government officials, who are sponsoring an "aggressive campaign" on
AIDS education, decided that the periodicals were "downright deadly"
and "not just frivolous," and ordered police to seize all copies and
arrest individuals who continue to publish or distribute them. Omar
Ramadham Mapuri, a top government minister, announced the move, say-
ing, "Publishing pictures of half-naked persons promotes amorous be-
havior and frustrates the move by the government and the society to
fight against the killer disease AIDS." He added, "Editors of various
media houses should display maturity in their work to save their in-
stitutions from publishing indecent materials which undermine Tanza-
nia's esteem." But Salva Rweyemamu, chair of a Tanzanian media or-
ganization, called the move "draconian," adding that it represented a
"negation of freedom of the press and freedom of expression, which
are core pillars of any democratic and tolerant society." Zoe Titus,
a press freedom monitor for the Media Institute of Southern Africa,
added that it is "far-fetched to suggest that [the magazines] have
actively contributed to the AIDS death toll." An estimated 10% of
Tanzania's population lives with HIV/AIDS, with a country total of
600,000 AIDS cases and two million HIV-positive citizens (Lacey, New
York Times, 8/22).
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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. � 2001 by National Journal Group Inc. and Kaiser
Family Foundation. All rights reserved.
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