South Africa Government moves to treat HIV+ mothers
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by Charlene Smith
Mail & Guardian, South Africa, January 26, 2001
President Thabo Mbeki has given the go-ahead for South Africa to be-
gin implementing a massive programme to provide free anti-retrovirals
and milk powder to HIV-positive pregnant women to retard the trans-
mission of the virus to babies.
In a dramatic move, the government, while not officially changing its
policy stance on the treatment of HIV/AIDS, is swiftly rolling out a
comprehensive approach to prevent babies from being infected with
HIV. This will save the lives of tens of thousands of babies each
year. It follows approval - unannounced - by the Medicines Control
Council of Nevirapine for the prevention of mother-to-child transmis-
sion of HIV/AIDS. This makes South Africa the second Southern African
country to implement such a programme after Botswana, which is pro-
viding universal access to anti-retrovirals for pregnant HIV-positive
women and rape survivors.
The responsibility for funding the programme is shared by the govern-
ment and nine provinces. All pregnant women presenting at public hos-
pitals and clinics covered by the programme will be tested for
HIV/AIDS. This will greatly improve South African statistics on the
prevalence of the virus.
The Department of Health has been moving toward this approach for two
years. Provinces approached milk formula companies to slash costs in
1999. Since then the companies have bid against each other in tenders
and, along with pharmaceutical companies, are likely to come under
pressure from international AIDS activists this year to slash profits
on milk formula.
Late last year each province had to present data to the government
detailing the numbers of babies born each year with HIV; how they
could give access to free anti-retrovirals for mothers and babies;
how they could provide free milk formula to mothers; and what funding
sources were available.
The rapid HIV test the government plans to use in the programme costs
less than ZAR 3 a time. The government will, for the present, take up
the Boehringer Ingelheim offer of free Nevirapine delivered to clin-
ics by the drug manufacturer for the next five years. The govern-
ment's stance comes at a time when conflict has erupted between
UNICEF, doctors and mothers about HIV-positive mothers breastfeeding.
UNICEF has been lambasted in some quarters for endangering babies by
sticking to what its opponents say is a long-held antipathy to the
makers of milk formula and for telling HIV-positive mothers to
breastfeed. A third of HIV-positive mothers will pass the virus on to
their babies through breastfeeding.
But things are not that clear cut. In many areas, a lack of clean wa-
ter imperils the lives of babies who receive formula milk. A report
last week by the World Health Organisation showed a community of
800,000 in KwaZulu-Natal had no access to clean water.
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