AIDS conference ends with emotional appeal

South Africa's first national AIDS conference came to an emotional end on Wednesday when AIDS activist Prudence Mabele made a passionate plea to end the "political game" being played with the lives of HIV-positive women and their babies. Mabele was speaking during a special plenary session on the safety of nevirapine, where she asked the government to give HIV-positive pregnant women the choice of continuing to use the drug in the prevention of mother-to-child transmission (PMTCT). The plenary was arranged at the last minute, after the Medicine's Control Council (MCC) announced last week that it was considering deregistering the use of nevirapine for PMTCT, conference organiser Professor Salim Abdool-Karrim told a packed audience. Commenting on how the drug regulatory body had arrived at its decision, MCC registrar Precious Matsoso talked of problems with a Ugandan study on nevirapine, HIVNET012, and a major South Africa trial, the SA Intrapartum Nevirapine Trial (SAINT). The MCC had rejected the Ugandan trial as a "pivotal study", and the SAINT report could not be accepted as comprehensive, as there were "problems with its design", Matsoso said. Professor James McIntyre, head of the Perinatal HIV Unit at Chris Hani Baragwanath hospital in Soweto, who participated in SAINT, pointed out that such differences were part of scientific research and did not rule out the findings of either trial, and that nevirapine was safe and efficient in PMTCT. Matsoso admitted that nevirapine was important in public programmes, and had been proven to be safe. Although the MCC was "mindful of the government's constitutional obligation to provide" the drug - as a result of a Supreme Court verdict - she recommended that researchers and policymakers explore other options in the event of the drug being deregistered. The MCC had given nevirapine's German drug manufacturers a three-month grace period to present new evidence supporting the use of the drug in PMTCT.