Doctors defy South African ban on Aids drug for expectant mothers

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South African doctors are giving an Aids drug to patients in defiance of a government ban, fuelling an underground medical revolution.

South African doctors are giving an Aids drug to patients in defiance of a government ban, fuelling an underground medical revolution.

In what one medical source described as "an astonishing and courageous stand by South Africa's medical corps" the drug nevirapine is being brought into state hospitals by whatever means possible. In some cases the drug is stashed in children's toys, including cuddly animals. Trusted staff administer it, often in the middle of the night. Funding comes from the private sector and overseas donors.

Disclosure of the clandestine delivery network followed an announcement last week by Lionel Mtshali, the KwaZulu-Natal premier, that a nevirapine programme would be in place within three months, in defiance of government policy.

In Gauteng province, more than 20 state medical institutions are offering doses of the drug, most of them illegally.

The defiance, however, is not going unnoticed. Several hospitals in Zululand and Maputaland, including two where the HIV/Aids figures are among the worst in the world, have been censured for prescribing and giving nevirapine to pregnant HIV-positive women to stop the disease being passed to their unborn children.

A High Court judge ruled last month that the vital drug should be available in all state hospitals to expectant mothers infected with HIV, but the government is challenging the ruling. A single dose of nevirapine has been shown to cut mother-to-child infection rates by more than 50 per cent. Up to 100,000 babies are born HIV-positive in South Africa every year.

Thys von Mollendorf, the superintendent of a hospital in north-eastern Mpumalanga province, has been suspended because he refused to comply with government policy.

Many doctors in the same area have had contracts cancelled for failing to follow government policies.

A doctor, who asked not to be named for fear that the hospital where these "illegal" practices were taking place would be punished, admitted that the policies of the country were being ignored.

"Not only are we prescribing nevirapine for our HIV- positive pregnant women, but we are also finding ways to [help] ... rape victims. I don't want to disclose how we do it.

"We would be breaking our own code of conduct if we as doctors and nurses sat back and did nothing, knowing that lives are at stake. We know that our careers and livelihoods are on the line. But we have all taken a decision to risk our jobs for what we know is right."

In support of the doctors' stand, the South African Medical Association has said: "Doctors are obliged to do what is in the best interests of their patients by allowing them access to medical treatment."