Mbeki May Expand Nevirapine Program for Pregnant Women Despite Unresolved Problems
South African President Thabo Mbeki indicated on Sunday that he may expand a government pilot project to distribute nevirapine to HIV-positive pregnant women beyond the current 18 test sites, Agence France-Presse reports. Mbeki said on a South African Broadcasting Corporation television show that he will "not necessarily" wait until problems at the 18 sites have been resolved before broadening the program. "I am quite sure that what the minister of health will decide will be that, in the instance that in one area where we are ready to move, then let us move. I don't think they would say, let us wait for the slowest [site]. They would have to say let us make sure that the slowest catches up with the rest," he said. He also explained that "merely ... dispensing" nevirapine is not enough to prevent vertical HIV transmission, pointing out that breastmilk can act as a conduit for the virus. "That's one of the issues we have to address: what capacities do we have to assist poor women, who don't have enough food for themselves to eat, to ensure that they then are able to access the necessary food for this infant?" he added.
Reaction to Mbeki's State of the Nation Speech
The remarks mark the second time in the past week that Mbeki has addressed the nevirapine program. The health ministry was ordered in December by the Pretoria High Court to expand the nevirapine program to all public hospitals, but it is in the process of appealing that verdict (Agence France-Presse, 2/10). In his state of the nation address on Friday, Mbeki said that the government was "committed to fighting AIDS," but he did not say that the program would be expanded. AIDS advocates and political opposition leaders were dismayed by Mbeki's remarks, which did not "depart dramatically" from his previous statements. He has been criticized in the past for questioning the causal link between HIV and AIDS. "We had expected the president to come out clearly and say that HIV causes AIDS," Zackie Achmat of the Treatment Access Campaign, the group that brought the lawsuit challenging the government to expand treatment access, said (Maykuth, Knight Ridder/Pittsburgh Post-Gazette, 2/9). Democratic Alliance leader Tony Leon said that the speech represented a "business-as-usual approach to the major crises that need to be addressed," adding that it was a "massive missed opportunity" for the president to address HIV/AIDS. Mangosuthu Buthelezi, a member of Mbeki's coalition Cabinet and leader of the Inkatha Freedom Party, said HIV/AIDS is "the biggest challenge, the major disaster facing [South Africa], and we would have wished for something more specific and far-reaching" in the state of the nation address. United Democratic Movement President Bantu Holomisa added that if Mbeki does not expand the nevirapine program, "it means that the classrooms he plans to build will not be occupied" and "the homes he says he is going to build, nobody is going to occupy those homes" (Simmons, Los Angeles Times, 2/9). A Sunday Independent editorial also noted that the government's current stance on nevirapine "defies rationality" and "begs the question of just whose interest" the policy serves (Sunday Independent/Washington Times, 2/9).
Calls for New Grant Money
In other South African news, the Democratic Alliance on Friday sent a letter to Finance Minister Trevor Manuel asking the government to apply for HIV/AIDS assistance from the now operational Global Fund to Fight AIDS, Tuberculosis and Malaria, saying that the government "could not afford to ignore this opportunity," the South African Press Association reports. Applications must be submitted by March 10, but Manuel said at the recent World Economic Forum that South Africa would not be applying for funds because they are unnecessary. "This statement belies the reality of South Africa as a country wracked by poverty and crippled by disease," DA social development spokesperson Sandy Kalyan said, adding, "There are countless projects across the country which are workable and easily implemented, but which are being hamstrung by a lack of money" (South African Press Association, 2/10). South Africa's National Association of People Living With HIV/AIDS also called on the government to import cheaper generic AIDS drugs and to set aside a "social grant" for poor people with the disease to use to purchase food and other necessities (South African Press Association, 2/11). Meanwhile, the Western Cape Networking AIDS Community of South Africa has asked HIV/AIDS organizations and the government to "present a united front" against the disease. "(The) problem is that the debate is too antagonistic. We must work more close[ly] with government to ensure that people on the ground get the help they need desperately," NACOSA Chair Saadique Karriem said (SABCNews.com, 2/9).