South Africa Moves To Universally Distribute Nevirapine to HIV-Positive Pregnant Women in Public Hospitals

South African Deputy President Jacob Zuma announced on Wednesday that the government has undertaken steps to distribute nevirapine universally to state hospitals in an attempt to reduce the nation's mother-to-child HIV transmission rate, Reuters reports (Reuters, 10/9). The announcement follows a Pretoria High Court ruling in December 2001 that said that the government must provide nevirapine to HIV-positive pregnant women through the public health system to reduce the risk of mother-to-child HIV transmission. The government appealed the decision, citing concerns over the drug's safety and efficacy, but the Constitutional Court in July denied the appeal, saying that that the government's restriction of the drug's distribution to 18 pilot sites "fell short of its constitutional obligation to offer the best treatment available" (Kaiser Daily HIV/AIDS Report, 7/5). The government has now "accepted" the court's judgment, Reuters reports. Zuma said that nevirapine is now being distributed beyond the initial pilot sites in four of the country's nine provinces. He added that "[f]ollowing the ruling of the Constitutional Court on nevirapine, all the provinces have been provided with guidelines for the implementation of the prevention of [the] mother-to-child transmission program." Supplying nevirapine to all state hospitals will cost approximately $14 million per year, according to a senior Health Ministry official. The U.S. government has provided approximately $9.6 million to South Africa for this purpose, Zuma said, adding that different provinces will expand their programs according to their "differing capacities." Nono Simalela, who oversees the country's national AIDS program, said that the Medicines Control Council is continuing to review the safety and efficacy of the drug (Reuters, 10/9).