South African government urged to take action in preventing mother-to-child HIV transmission

March 21, 2002

Leading South African scientists, writing in a Commentary in this week's issue of THE LANCET, are calling on their government to implement antiretroviral drug programmes without delay to reduce the vertical transmission of HIV-1 infection from pregnant women to their children.

Around 75,000 South African children were born with HIV-1 infection in 2000; half these infections could have been prevented, the authors state, if short-course antiretroviral treatment had been available. The South African government has cited cost, toxicity, drug resistance, breastfeeding, and pressures on the South African Health Service as reasons why antiretroviral drugs, such as nevirapine and zidovudine, have not been made available-even though the manufacturers of nevirapine have offered the drug for free to African countries over the next five years.

Lead author Salim Abdool Karim, from the University of Natal, comments: "In a developing country such as South Africa the few opportunities for controlling HIV spread need to be maximised. Over 5 million of the 42 million people living in South Africa are HIV-infected, and with more than half these infections occurring in women, vertical transmission will continue to increase. There is a moral and public-health imperative to provide cost-effective interventions of known efficacy. The South African Government has an exemplary record by providing free immunisations against major childhood infections to children under the age of 6 years. The lack of a similar policy to prevent the single most common perinatally transmitted cause of mortality in children is of concern."

He concludes: "As scientists and clinicians, we share a deep commitment to our patients and the public health of our nation. We have conducted and/or supported research aimed at decreasing vertical transmission. We remain fully committed to the implementation, within the broader government programme for AIDS prevention and care, of a national programme against vertical transmission, and to do further research in support of this goal. There is strong evidence in support of the use of antiretrovirals to reduce vertical transmission. The challenge remains in translating these research findings into policy and practice in South Africa."
Contact: Professor Salim S Abdool Karim, University of Natal, 232 King George V Avenue, Durban 4041, South Africa; T) +27 31 260 2381; F) +27 31 260 2384/2093; E)

Contact details for other authors:
Prof Jerry Coovadia, University of Natal; T) +27 (0) 31 260-4622; e)
Prof Miriam Adhikari, University of Natal; T) +27 (0) 31 260-4405;
Prof Greg Hussey, University of Cape Town; T) +27 (0) 21 689-8312; E)
Dr Mark Cotton, Stellenbosch University; T) +27 (0) 21 938-9506; E)


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