South African Government Tells Court Most HIV-Positive Pregnant Women Do Not Need Nevirapine

Lawyers for the South African government yesterday in Constitutional Court argued that universal access to nevirapine is unnecessary because on average, pregnant women transmit the virus to their infants only 30% of the time, the South African Press Association reports. "You are giving a drug to 70% who do not need it. And you are introducing a drug of which you do not know the long-term effects," government attorney Marumo Moerane told the court during the first day of testimony in the government's appeal of a lower court order that it make the drug available to all HIV-positive pregnant women through the public health system (South African Press Association, 5/2). Although the government recently announced it might roll out a universal access program for nevirapine by year's end, it is pursuing its appeal out of constitutional concern that the ruling has improperly allowed the lower court to set government policy (Kaiser Daily HIV/AIDS Report, 5/2). Moerane explained that the government had set up 18 pilot sites to provide access to and monitor use of nevirapine in order to determine the drug's long-term effects. When Justice Richard Goldstone asked why, if nevirapine was only delivered in two doses -- one to the woman at the time of delivery and one to the newborn -- long-term toxicity was relevant, Moerane did not respond. Earlier in the day, Moerane also argued that nevirapine should not be administered if the government could not provide a "full service" of testing, monitoring, counseling and infant formula to the woman (South African Press Association, 5/2).

Thousands Demonstrate Outside Court
Between 3,000 and 5,000 AIDS advocates marched through Johannesburg yesterday to the Constitutional Court building, carrying placards calling for improved health care and access to antiretroviral drugs, the South African Press Association reports. The march was led by Zackie Achmat, chair of the Treatment Access Campaign, the advocacy group that brought the original lawsuit against the government demanding access to nevirapine (South African Press Association, 5/2). "By denying women medicine that can protect their babies from HIV, the government is denying them the right to dignity and health care," a TAC statement said, adding, "It is also denying children their right to life" (Chege, Reuters, 5/2). Achmat was joined by religious leaders, trade union representatives and civic leaders, who presented a "memorandum of their grievances" to a health department representative upon arriving at the court building (Marlowe, AP/Nando Times, 5/2).