South African Opposition ‘Demands’ Statement From Government on Nevirapine Project

South African opposition party leaders yesterday "demanded" that the government clarify its plans regarding the possible expansion of a pilot project to reduce vertical transmission of HIV by providing HIV-positive pregnant women with the antiretroviral drug nevirapine, Reuters Health reports (Boyle, Reuters Health, 2/12). South African President Thabo Mbeki, who has long been criticized for questioning the link between HIV and AIDS, indicated on Sunday that the government may expand the program even though problems at the pilot project's 18 test sites have not yet been resolved (Kaiser Daily HIV/AIDS Report, 2/12). However, Health Minister Manto Tshabalala-Msimang said yesterday that the government is "not yet ready" to expand the project until further research is conducted. "We need to have a policy that is informed," she said, noting that a report made to national and provincial ministers at the beginning of the month found a "range of problems" with the prevention program, including "hostility from nurses toward HIV-positive mothers in rural areas" and a reluctance by mothers to forego breastfeeding due to the social stigma of baby formula use as an indicator of HIV infection. Tony Leon, leader of the opposition Democratic Alliance, asked the government yesterday for an "unequivocal statement" regarding its plans for the nevirapine program, saying, "Why, on this life and death matter, this war which is devouring our nation, do we have to ... read between the lines or study tea leaves? Why on earth, if he is changing his policy, can the president not say so himself in a manner that is intelligible and straightforward?" Leon also "demanded" that Mbeki acknowledge the causal link between HIV and AIDS.

KwaZulu-Natal to Move Ahead
In related news, Mangosuthu Buthelezi, a senior cabinet minister and leader of the Inkatha Freedom Party, said yesterday that he had told the premier of the KwaZulu-Natal province to move ahead with plans to offer pregnant women nevirapine, in defiance of the national government and without testing and counseling "if necessary." Buthelezi said, "Our nation is dying of HIV/AIDS. We can no longer hesitate or falter," noting that 40,000 babies were born with HIV last year in KwaZulu-Natal. "Henceforth, health facilities in KwaZulu-Natal will ensure that children are not born with a death sentence. Nevirapine will be made available to all mothers, whether or not they are HIV-positive," he stated (Reuters, 2/12).