E-DRUG: TAC demands nevirapine for MTCT from MOH South Africa
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[After supporting the SA government in its case against the pharm
industry in April, the tides have changed fast. The South African
Treatment Action Campaign (TAC, www.tac.org.za) has started a court
case against the government to demand the use of nevirapine in MTCT.
NN]
TAC Statement on Legal Action Against the Minister of Health
21 August 2001
TAC Statement on Legal Action Against the Minister of Health on
Mother-to-Child Transmission Prevention of HIV/AIDS (MTCTP)
The Treatment Action Campaign (TAC), Dr. Haroon Saloojee, a
Baragwanath paediatrician supported by more than 250 doctors and the
Childrens Rights Centre have today launched an application in the
Pretoria High Court demanding that the government institute a
comprehensive programme across the country to reduce mother-to-child
HIV transmission. This action records the tragedy of millions of
South Africans through the voices of Busisiwe Maqungo, SH, Bongiwe
Mkhutyukelwa, Thembisa Mhlongo and others. The Minister of Health and
the MECs for Health in all nine provinces are named as the
respondents.
The court case is about two issues:
1. The state must make Nevirapine (a registered drug) available
to women who have HIV and give birth in the public health sector, to
reduce the risk of HIV transmission to their babies, if the doctor or
attending nurse feels this is necessary.
2. The state is obliged to implement and set out clear
time-frames for a national programme to prevent mother-to-child
transmission of HIV, including voluntary counselling and testing,
antiretroviral therapy and the option of using formula milk for
feeding.
More than 150 children are born with HIV every day in South Africa.
They live short and miserable lives, encountering respiratory
infections, malnourishment, diarrhea and fungal infection. Repeated
regular visits to health facilities helps a little, but after a short
life with much pain, these children die. The South African government
can stop HIV in half these children if it implements a mother-to-child
HIV prevention programme. It refuses to do this.
More than 1 million women give birth in South Africa every year. One
out of every four will have HIV/AIDS. The majority of pregnant women
do not know their HIV status. Many women with HIV/AIDS become ill
during their pregnancy with a range of illnesses. Women feel terrible
guilt when they learn that they have transmitted HIV to their
children. A comprehensive mother-to-child HIV prevention programme
will allow women to make choices about pregnancy and their own health.
It will give them control over their bodies and healthIt will give
their children a much better chance of being born in good health.
A comprehensive MTCTP programme including voluntary counseling and
testing, nutritional supplements, early detection of ill-health in the
woman, anti-retroviral therapy to reduce HIV transmission and informed
choices on breastfeeding and formula milk substitutes -- where
possible -- will dramatically reduce transmission.
But, our Government has ignored science, economics, morality, good
planning, good governance and the law for more than five years on this
issue.
SCIENCE
Our Court papers number more than 600 pages. This represents a
fraction of the detailed and careful scientific research on preventing
HIV transmission from mother-to-child. The WHO shows that
antiretroviral drugs such as AZT and Nevirapine are safe and effective
when used to prevent mother-to-child HIV transmission. The government
constantly invents new obstacles and when they are resolved creates
further obstacles to pursue an unscientific policy. Professor Robin
Wood of Somerset Hospital has provided TAC with an expert affidavit on
the science of preventing mother-to-child HIV transmission.
COST
For less than 1% of the health care budget, less than R250 million or
approximately R250.00 per pregnancy, the government can implement a
programme that will save over 20,000 children a year. MTCTP has been
subjected to extensive economic analysis. The governments own studies
show that they will save lives and may even save money.
GOOD PLANNING
The government ignores the demands of good planning in the epidemic.
Reducing mother-to-child HIV transmission will have an immediate
impact on the health care system. Fewer babies will become ill and be
admitted to hospitals. Fewer babies will return to hospital because
of HIV/AIDS. Nurses,
ctors and other health care workers can be used to assist in illnesses
that cannot be prevented. Hospital beds can be allocated to those
whose illnesses cannot be prevented.
MORALITY
The government ignores moral pleas from every sector in society to
save childrens lives and to improve the condition of women. Doctors
and nurses are increasingly angry with government because they have to
ignore their ethical duties and comply with an immoral policy.
GOOD GOVERNANCE
For more than four years, TAC and our allies have negotiated,
petitioned, picketed, prayed, fasted, marched and rallied. We have
presented government with scientific, economic, moral and legal
arguments. Government has promised and broken their promises. Now
they have 18 pilot/research sites. This covers almost 10% of pregnant
women. In January 2001, the World Health Organisation issued a
consensus statement on the safety and efficacy of antiretrovirals for
use in MTCTP programmes. The WHO Technical Consultation concluded:
There is currently no justification to restrict use of any of these
regimens to pilot project or research settings. South Africa was a
part of that consultation.
LAW
The government continues to ignore its legal obligations. Government
policy on MTCTP violates the following rights.
Government:
- Denies women with HIV/AIDS and their children access to health
care services including reproductive health. (section 27)
- Denies children born to women with HIV/AIDS their right to
basic health care services (section 28)
- Denies women the right to make choices regarding reproduction
(section 12)
- Discriminates against poor women who use the public sector
(section 9)
- Discriminates against black women (African and Coloured), a
majority of whom use the public sector (section 9).
- Denies children who are infected during and after birth with
HIV, the right to life (section 11).
- Denies women with HIV/AIDS and their children the rights to
human dignity and equality (section 10 & 9).
- Violate the rights of doctors and nurses in the public sector
who have a duty to promote and maintain a high standard of
professional ethics.
The South African government also violates a range of international
covenants and agreements on women, children, race, life and access to
health care services.
CALL FOR ACTION AND INTERNATIONAL SOLIDARITY
Every person in South Africa has a constitutional and moral duty to
support this court case. Our government fails to take decisive action
to prevent new infections and to help those of us who already live
with the virus. People living with HIV/AIDS include your brothers,
sisters, partners, wives, husbands, parents and children.
- TAC will organize meetings, demonstrations and pickets on 27
August 2001 to take this campaign to people. We ask you to join us.
- TAC calls on all health care workers to show support for the
Court Case.
- TAC calls on our international allies to support this action
and to pressupize any and all representatives of the South African
government abroad.
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