South African Officials React to KwaZulu-Natal’s Decision to Provide Nevirapine to HIV-Positive Pregnant Women
South African officials had mixed reactions to Monday's announcement that KwaZulu-Natal province will defy national drug policy and supply HIV-positive pregnant women with the antiretroviral drug nevirapine to reduce vertical transmission of the virus, the South African Press Association reports (South African Press Association, 1/22). KwaZulu-Natal Premier Lionel Mtshali, leader of the Zulu nationalist Inkatha Freedom Party-controlled province, said he made the decision to allow the drug's distribution "on principle," adding that an HIV-positive woman "should not have to contend with a hopeless situation of her unborn child facing the same affliction if it can be prevented." KwaZulu-Natal is the second South African province to make nevirapine available; health officials in the Western Cape, which was controlled solely by the Democratic Alliance, began distributing the drug in 2000. Although nevirapine is WHO-approved and may be able to reduce mother-to-child HIV transmission by up to 50%, the African National Congress, which controls "outright" the other seven South African provinces and the national government, has restricted use of the drug to "a few pilot sites," saying that the drug's "safety remains unproven" and that "inadequate structures are in place to administer it" (Kaiser Daily HIV/AIDS Report, 1/22). National Health Minister Manto Tshabalala-Msimang said she was "surprised" by the announcement, adding that Mtshali did not consult national health officials "as we would have expected him to do (under) section 40 and 41 of the Constitution which binds us to cooperative governance." She said she was not upset that she was not contacted, but noted that "consultation with the provincial (AIDS) council would have assisted (Mtshali) to gain a better understanding of the challenges that come with the use of this drug for reducing" vertical transmission of HIV. Tshabalala-Msimang said that the health department will form a policy on nevirapine "after we have analyzed data from research and received other information," adding, "The (policy) will be determined by the people and not by a few doctors. I am confident that what we are doing is absolutely correct."
A Welcome Change
The New National Party and the Democratic Alliance yesterday both welcomed Mtshali's announcement. "It is now clear that the government's defenseless policy on this issue is slowly but surely starting to lose ground," NNP health spokesperson Dr. Kobus Gouws said (South African Press Association, 1/22). Sandy Kalyan, the provincial spokesperson for the Democratic Alliance, said the decision was indicative of a escalating "national revolt" against the national government's HIV/AIDS policies. "The Democratic Alliance welcomes the KZN government's decision ... we give them our full support, and we are willing to provide them with any help we can from our experience in the Western Cape," she added (South African Press Association, 1/22).