South African Government ‘Questions’ Obligation to Comply with Court Order to Provide Nevirapine to All HIV-Infected Pregnant Women
South African government officials said this weekend that they are "unperturbed" by a court ruling last week ordering the government to provide nevirapine to all HIV-infected pregnant women through the public health system, adding that the government will not "immediately comply" with the ruling, Reuters reports (Reuters, 12/15). Last summer, the Treatment Action Campaign, the Children's Rights Center and Harron Saloojee, a physician in charge of community pediatrics at the University of Witwatersrand, filed a lawsuit against the South African Department of Health and eight provincial health departments to force the government to provide the antiretroviral drug to all HIV-positive pregnant women through public hospitals and clinics to prevent vertical transmission of the virus. The government has been dispensing nevirapine to pregnant women only through two pilot projects initiated last spring, not on a national scale (Kaiser Daily HIV/AIDS Report, 8/21). On Friday, Pretoria High Court Judge Chris Botha ruled that the government is "obliged" under the constitutional right to health treatment to provide the drug to all HIV-infected pregnant women. Botha gave government officials until March 31 to devise a comprehensive plan to dispense the drug and reduce the nation's HIV vertical transmission rates (Kaiser Daily HIV/AIDS Report, 12/14). South African Health Minister Manto Tshabalala-Msimang said on Saturday that the ruling is "not a blow to government policy." In a statement issued late Friday, the health department "questioned" whether the government is obliged to comply with the ruling, saying, "Government is studying the detail of the judgement in order to establish its premise, including such critical issues as the role of the judiciary in relation to executive policy decisions." The statement also says that the government is committed to providing the drug to all state clinics and hospitals, but it will "wait for results" of the nevirapine pilot project (Reuters, 12/15). The project makes nevirapine available to HIV-infected pregnant women in 18 sites around the country, and pregnant women in those areas also can receive counseling, AIDS testing and other support. About 10% of the one million women who give birth each year in South Africa have access to the program (Murphy, Baltimore Sun, 12/15). A health department spokesperson said he was not certain when the project would be completed or when results would be available. Tshabalala-Msimang indicated that the government will issue a statement on the ruling sometime this week (Reuters, 12/15).
Advocates Weigh In
The government may appeal the ruling to the country's Supreme Court, although activists have said that they hope officials will not do so, the Los Angeles Times reports (Simmons, Los Angeles Times, 12/15). Various groups and individuals have praised Botha's decision. Manny da Camara, a spokesperson for the Democratic Alliance, said, "It is the most powerful statement yet of the harmfulness of the government's AIDS policies in general, and its policies on mother-to-child HIV transmission in particular" (Kraft, AP/Washington Times, 12/15). Saloojee added, "Potentially this is going to save the lives of 50,000 babies next year" (Los Angeles Times, 12/15).