South African Government Seeks to Close Rape Counseling Program that Provides Free Antiretrovirals to VictimsSouth Africa's government has pushed to close a rape counseling and treatment program that provides rape victims with free antiretroviral medicine to reduce the risk of HIV transmission, saying that the program is "creating expectations that the government should provide anti-AIDS drugs it could ill afford," the Philadelphia Inquirer reports. The Greater Nelspruit Rape Intervention Project, based in Nelspruit, South Africa, has set up private examination rooms exclusively for rape victims in two public hospitals and has raised about $20,000 to provide the combination AZT/3TC drug Combivir to rape victims who agree to take an HIV test. The program has counseled 188 individuals over the past year, and half of the patients over age 18 tested HIV-positive. However, according to the Inquirer, South Africa's health ministry has denounced the program, maintaining that it is "better not to provide antiretrovirals to anybody, including rape victims, than to create an inequitable situation where some patients get treatment denied to others." Despite these claims of equality, seven million citizens with private health insurance as well as parliamentarians and government officials are eligible for the treatments. In addition, the government provides post-exposure prophylaxis drugs, the same as those provided to the rape victims through GRIP, to health care workers who have accidental needlestick injuries. But the health ministry has ordered GRIP to vacate the two public hospitals -- Rob Ferreira Hospital and Themba Hospital -- and plans to replace the program by training public nurses in rape counseling. However, Dr. Thys von Mollendorff, the medical superintendent at Rob Ferreira Hospital, said the hospital staff was "already stretched thin," as 30% of nursing positions remain vacant.
According to the Inquirer, the government "suspects that [GRIP] is a plot by the political opposition to embarrass the government." Mpumalanga Health Minister Sibongile Manana said in a statement that GRIP was "masquerading as good Samaritans 'while the truth is they have a clear agenda to undermine the present government.'" In addition, there is "an element of race" in the dispute, as most of GRIP's organizers are "white women from Nelspruit's comfortable suburbs," and most of its recipients are "poor blacks from rural townships." Bongani Twala, a black physician who dispenses free antiretrovirals to patients treated through GRIP, said, "Many people interpret this as something the white community is doing for the black community, and hence, government doesn't like to be shown up." He added, "To many people, it looks as if the government isn't doing much. It becomes an embarrassment." Barbara Kenyon, one of six GRIP founders, has "vow[ed]" to maintain the program at the two hospitals, despite the government's order, but the other five founders have stepped down from the program (Maykuth, Philadelphia Inquirer, 4/9).