SOUTH AFRICA: Government Releases AIDS Treatment Guidelines
South Africa's Health Minister
Manto Tshabalala-Msimang yesterday distributed the country's
first published guidelines on the treatment of HIV and
AIDS-related illnesses to health care workers nationwide, the
Associated Press reports. The guidelines cover
issues ranging from "ethical considerations in AIDS research to
managing occupational exposure to the virus." The release of the
guidelines marks a turning point in South Africa's policy
surrounding the epidemic. The Associated Press
reports that the guidelines' advice on treatment of mother-to-infant HIV
transmission "is likely to cause the most controversy." While
the booklet "recommends giving HIV-positive pregnant women
vitamin supplements, treating their STDs and using vaginal
cleansing during childbirth to prevent transmission of the
disease," it "makes no mention" of
antiretroviral medications, considered "the most effective
treatment" by health experts. Morna Cornell, director of the
AIDS Consortium, said, "What is absolutely lacking ... is any
reference to the fact that we have available to use a range of
antiretroviral therapies that is extremely effective in
preventing up to 50% of mother-to-child infections. Does this
mean that government is absolutely refusing to consider these
options?" Tshabalala-Msimang responded, "At no time has South
Africa said, 'We shall never, never, never give antiretrovirals
to pregnant women,'" but she "condemned" the "narrow view" that
antiretrovirals are "the only way" to prevent mother-to-infant
transmission. The health minister explained that the government
would not provide AZT to pregnant women because it was "too
expensive." President
Thabo Mbeki recently
approved the distribution of antiretrovirals to HIV-positive
individuals. The health minister said that the "launch of this
new set of guidelines is an important step forward for ensuring
optimal care for people living with HIV and AIDS" (Nessman,
Associated Press, 10/24).
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