AIDS Drug Distribution in KwaZulu-Natal Put on Hold by Province Health Minister; Premier Reiterates ‘Principled Stand’ on Plan
The KwaZulu-Natal health minister on Wednesday said that the eastern South African province would not be able to "immediately" distribute to HIV-positive pregnant women the AIDS drug nevirapine -- a WHO-approved antiretroviral that may be able to reduce mother-to-child HIV transmission by up to 50% -- "counter to a pledge" made Monday by province Premier Lionel Mtshali, the Associated Press reports. Zweli Mkhize, health minister of "South Africa's most AIDS-stricken province," said that the drugs could not yet be distributed because "adequate backup systems were not yet in place" to administer the drug. The Associated Press reports that it was not clear whether the announcement by Mkhize, who is a member of the ruling African National Congress, was politically motivated (Associated Press, 1/23). However, Mtshali, who is a member of the Inkatha Freedom Party, which controls KwaZulu-Natal, yesterday said in a statement, "No amount of political pressure would make me renege on this principled stand. If it means paying a political price for it, so be it." Mtshali added, "I reiterate for the whole to understand clearly, that I stand resolutely by the announcement I made on Monday" (South African Press Association, 1/24). The announcement that the province would provide nevirapine to all HIV-positive women was "seen as a direct challenge" to the South African government's stance on the drug. Despite a court order last year that country officials begin distributing nevirapine, the ANC maintains that the safety of the drug is "unproven" and an infrastructure to provide counseling and backup treatment to drug recipients "has to be put in place" before the drug can be distributed (Associated Press, 1/23).
Although the drugs would be provided for free to all HIV-positive pregnant women under KwaZulu-Natal's distribution plan, the "problematic costs 'lie in the provision of counseling and other staff needed to run the mother-to-child transmission program and space at institutions to run the program effectively," Mkhize said. "When [Mtshali's] announcement was made, none of us were actually ready. Yes, nevirapine will be rolled out, but we want to take all the problems into account," Mkhize said in an interview with South African Broadcasting Corporation public radio (Agence France-Presse, 1/23). However, Mtshali yesterday said that any anticipated problems must be presented to the provincial Cabinet "so that they can be dealt with swiftly." He added, "Saving lives is what we as government are called upon to do. As premier I would not like to be relegated to the dustbin of time for failure to act decisively and promptly to alleviate a desperate situation" (South African Press Association, 1/24). Nearly one quarter of pregnant women in South Africa are HIV-positive, and more than 70,000 infants are infected with HIV through vertical transmission each year (Agence France-Presse, 1/23). South Africa's national government, led by President Thabo Mbeki, who has questioned the link between HIV and AIDS, has continually "come under fire for its haphazard approach" toward fighting HIV/AIDS (Kaiser Daily HIV/AIDS Report, 1/22).