SOUTH AFRICA / NEVIRAPINE - 2002-02-13

In South Africa – a country with one of the highest AIDS infection rates in the world – the debate over how to fight the disease has been long and heated. For example, the government and its critics have differed over the use drugs such as Nevirapine, which has been shown to greatly reduce the risk of an HIV-infected pregnant woman from passing the AIDS virus to her newborn. Nevertheless, the government has resisted its use. VOA’s Joe De Capua says the Colleges of Medicine of South Africa has now joined the debate.

The “Colleges of Medicine of South Africa” represents seven thousand specialists and two thousand family practitioners. The group says it is unethical and against medical principles to withhold preventive treatment for mother-to-child transmission of HIV, the virus that causes AIDS.

Professor Ralph Kirsch is president-elect of the organization. He said, "Well, our main concern is that we believe that there’s absolutely incontrovertible evidence that one can prevent most of the children of mothers who are HIV positive from acquiring the virus. The virus can be blocked in its passage from mother to child by a single dose of an anti-retroviral agent to the mother – and a second single dose to the infant."

Professor Kirsch says Nevirapine is safe and very effective. "With that," he said, "one has some 80 to 90 percent of the infection stopped. And one would save those children from AIDS – and one would save those children from death."

The South African government has been critical of the drug, questioning its safety and effectiveness. As a result, NGO’s, some local governments and even political parties have obtained Nevirapine and made it available to pregnant women.

Professor Kirsch says criticism from the Colleges of Medicine is not only directed at the South African Government. He said, "It’s directed at any person or persons who don’t comply or follow the evidences. In part it’s directed at our government, who although they are trying, are dragging their heels somewhat."

He says the public health care system cares for 80 percent of the South African population. So, he says it’s very important for President Thabo Mbeki and his administration to support the use of the drug.

"AIDS is not an instant death," said Dr. Kirsch. "It’s a long and very debilitating disease and people suffer significantly with AIDS. And there are many expensive complications, both infectious and non-infectious. So that government is in fact spending a great deal of money. And the South African government will tell you that they spend more per capita than most countries do. But we would argue that they are not spending it entirely appropriately."

Professor Kirsch also says more investment is needed in vaccine research and adds AIDS fighting drugs should be made widely available. He says anti-retroviral drugs could double the life span of HIV infected adults, allowing them to be productive members of society.

The South African Colleges of Medicine says the cost of treating HIV/AIDS would be less than the increasing burden of treating AIDS complications. The United Nations AIDS program says out of a population of about 40-million, 4.7-million South Africans are infected with HIV.

NEB/JDC