Court battle over AIDS drugs begins

The South African government was challenged by a leading AIDS activist group in court on Monday over its reluctance to distribute Nevirapine to all HIV positive pregnant women.

Nevirapine can block the transmission of HIV from mothers to their babies. Treatment Action Campaign (TAC) Executive Secretary, Nonkosi Khumalo, told PlusNews that the refusal by the authorities to provide the potentially life-saving drug was "insane".

According to a report by the South African news agency SAPA, TAC lawyer Gilbert Marcus argued in court that the only "real hope" for HIV-positive mothers and their babies was Nevirapine, which has been offered to the government free of charge for five years by leading pharmaceutical company Boehringer-Ingelheim. The government has still not accepted the offer.

TAC is seeking a court order to force the minister of health, and health provincial ministers to distribute Nevirapine to all HIV-positive pregnant women. The drug is currently available in the private sector, but is priced beyond the reach of most South African mothers. A pilot programme initiated by the government earlier this year, and intended to cover 18 testing sites, has only taken off in the Western Cape and Gauteng provinces.

Sarah Hlalele, an HIV-positive mother, wrote an affidavit supporting TAC's court application. In 1997, she was diagnosed with HIV and has been "in and out" of hospital since then. Speaking at a legal briefing held last week, she nervously related how "every day I'm scared that my baby is HIV positive because I didn't get Nevirapene when I was pregnant". She has a four-month old son.

Hlalele told PlusNews that she is now taking antiretroviral drugs through a project run by the PeriNatal Research Unit at the Chris Hani Baragwanath Hospital.

Busisiwe Maqungo is another mother who filed an affidavit in support of TAC. She lost her nine-month old baby to HIV/AIDS last year and has become an active TAC member in the Western Cape province.

In her affidavit, Busisiwe stated: "I gave birth to an HIV positive baby who should have been saved. That was my experience, and I shall live with it until my last day."

Dr Haroon Saloojee, a paeditrician and a member of the "Save Our Babies" campaign, was cited in TAC's court papers as the second applicant in the court case. In his affidavit, Salojee said that the government's refusal to implement a countrywide Nevirapene programme undermined the clinical independence of health care professionals.

But the government has countered that TAC's proposal for universal Nevirapine for HIV-positive expectant mothers was impractical and far too costly.

In the government's affidavit, Director General of Health Dr Ayanda Ntsaluba said TAC ignored, "the vital infrastructural and operational considerations which accompany treatment with Nevirapine, such as voluntary counselling and testing and the monitoring and evaluation of the mother and child to ensure effectiveness and to alert to the development of resistant viral strains which may lead to other public health crises".

Simply allowing doctors in public hospitals the right to dispense Nevirapine at their own discretion was not a solution, Ntsaluba said.

His affidavit was supported by affidavits from eight provincial heads of health, and Dr Nono Simelela, manager of the National AIDS Programme, as well as the Medicines Control Council.

The court hearing continues on Tuesday.