Cape Town, South Africa - Activists and doctors on Wednesday accused the South African government of backsliding on promises to provide more effective treatment to prevent mothers passing on the AIDS virus to unborn children.
The Treatment Action Campaign said that more than 60,000 babies are infected with HIV yearly in South Africa, most of them in the womb. Many of these could be avoided by improving testing and counselling services for pregnant women and providing HIV-positive women with up-to-date therapy.
At the moment, many clinics in South Africa use just one anti-AIDS drug nevirapine for HIV positive pregnant women, even though the World Health Organization recommends a drug cocktail.
"Paediatric HIV has almost been eradicated in many countries in the world," said Francois Venter, head of the southern African HIV Clinicians Society.
"Poorer countries with far worse infrastructure than South Africa have made significant progress in decreasing transmission. In South Africa, a middle income country, the fact that HIV-infected women have access to a substandard regimen for protection of their children is a sad reflection on our health system," he said.
HIV is now the commonest cause of death among pregnant women and almost one in three pregnant women are HIV positive, according to the clinicians’ society. Because of the stigma associated with AIDS, some pregnant women refuse to take an AIDS test. Many don't get the chance.
An estimated 5.4 million South Africans have the AIDS virus the highest total in the world. Nearly 1,000 people die each day of the disease and the same number become newly infected.
Medical workers say they are particularly frustrated because preventing mother-to-child transmission of the disease is relatively straightforward.
"HIV in children is a preventable disease and we've known it is a preventable disease for more than 10 years," said Tammy Meyers, a paediatrician at South Africa's biggest hospital, Baragwanath.
The Soweto hospital sees about 90 HIV infected children a month and many die before they get treatment, Meyers told a news conference organized by the Treatment Action Campaign.
"Most kids don't even make it into the services," the South African Press Association quoted her as saying.
The government promised last November to overhaul its mother-to-child transmission programs by the end of the year to bring them into line with international standards. But the Treatment Action campaign accused Health Minister Manto Tshabalala-Msimang of stalling. Her department had no immediate comment on Wednesday.
Tshabalala-Msimang widely dubbed Dr. Garlic because of her espousal of nutritional remedies for people with AIDS has long been accused of frustrating provision of antiretroviral drugs.
Her department last December said it had finished new guidelines on so-called dual therapy and this was waiting approval by regional health bosses. She said its implementation would depend on training health professionals to use the additional drugs and getting extra money for the new drugs.
The Treatment Action campaign said that even poor hospitals in rural areas were ready to implement the new therapy but could not do this without government approval. It said that health professionals should bypass government if need be.
In the Western Cape province, the local health department started implementing dual therapy in 2004, without waiting for central government to act.
As a result, infant HIV infection in the sprawling suburb of Khayelitsha one of the hardest hit areas in the country is now under 4 per cent. Infant mortality, or deaths for children under 1, in Khayelitsha has dropped from 43 per 1,000 lives births in 2001 to 31 per 1,000 live births in 2006, according to Cape Town authorities.
Source: Associated Press, CCMC PUSH Journal, 23 Jan 2008