AIDS policy

AIDS policy

SCIENCE AND MEDICINE NEWS S Africa soaks up pressure to change HIV/AIDS policy THE LANCET • Vol 360 • August 10, 2002 • www.thelancet.com 795) and ...

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SCIENCE AND MEDICINE

NEWS S Africa soaks up pressure to change HIV/AIDS policy

THE LANCET • Vol 360 • August 10, 2002 • www.thelancet.com

795) and were used as a basis for registering the drug in South Africa. Matsoso said on Aug 4 that the FDA’s action was a cause for concern and the MCC wanted to see if the data from the trial was still credible. Boehringer Ingelheim spokesperson, Kevin McKenna, said the council had not informed him of any decision to withdraw nevirapine in South Africa but said the safety and efficacy of the drug was above question. Glenda Grey, co-director of the HIV Perinatal Research Unit at Chris Hani Baragwanath Hospital, believes the MCC must review all available information about the drug. However she found the MCC’s position suspect, adding that although there were administrative problems with the HIVNET trial, WHO, UNAIDS, and the US government have still endorsed the safety and effectiveness of nevirapine She told The Lancet that the MCC must weigh up the risks and benefits. “But surely it’s criminal to undermine a safe drug when there is an epidemic and children are dying like flies.” The MCC’s motivations have also been questioned by opposition politicians who said they would defy a ban. They said the so-called independent MCC was bowing under political pressure from government. TAC national manager Nathan Geffen believes the MCC, with the backing of the government, has a hidden agenda to undermine the constitutional court’s judgment on July 5, which forced the government to provide nevirapine to all HIV-positive pregnant mothers. “We believe they continue to cast aspersions on nevirapine because they do not want to roll out. This is because there is strong support for AIDS denialists by government.” Mike Hutchings/Reuters/Popperfoto

ing AIDS activist, Zackie Achmat, outh African doctors, activists, on July 27. Achmat refuses to take and politicians have vowed to antiretrovitrals until the government fight plans by the country’s drug reg“drops its denialist agenda”. ulatory authority to withdraw neviMandela followed his weekend rapine for the prevention of meeting with Achmat by requesting a intrapartum HIV transmission. meeting with President Mbeki. The Medicines Control Council Mbeki and Mandela met on Aug 1 (MCC) said last week that it has but refused to disclose any details decided to review the registration of nevirapine because it had concerns about the drug’s efficacy Rights were not granted to and toxicity. Leading AIDS activists, the include this image in electronic Treatment Action Campaign media. Please refer to the printed (TAC), said they would challenge the MCC in court if it journal. decided to ban nevirapine because there was overwhelming evidence that the drug was safe for the prevention of mother-to-child transmission (MTCT) of HIV. Nevirapine is registered in South Africa for the treatment of HIV/AIDS patients and for Nelson Mandela takes up Zackie Achmat’s case the prevention of MTCT. The about their discussions. However MCC’s concerns are directed only at Mandela did say that he supported the latter use of the drug. The the government’s stance that MCC’s registrar, Precious Matsotso, research into antiretroviral drugs in denied the council wanted to ban the an African context was necessary to drug. The MCC will make a final ensure that if there was a nationwide decision next month after it has conroll-out of treatment, it should be sidered a report from the US FDA, safe. “But of course what worries which is reviewing data from a nevieverybody is the number of people rapine trial done recently in who are dying almost daily”, he said. Uganda, she said. Meanwhile, pressure has been increasing on the South African gov“But surely it’s criminal to ernment to improve access to antiundermine a safe drug when retroviral drugs. The South African there is an epidemic and Medical Association, which reprechildren are dying like flies” sents 16 000 doctors, said it will send a delegation to the health ministry to express their disquiet at the The MCC’s change of heart over current situation. nevirapine came after Boehringer The chairman of the association, Ingelheim told the Council earlier Kgosi Letlape, said at their annual this year that it was withdrawing its council meeting on July 27 that docapplication to the US FDA to have tors could no longer be a part of a the drug registered for prevention of system “that commits genocide”. MTCT. This came after the FDA The medical profession needs to found that the documentation condraft its own treatment policy and cerning the company’s recent nevidoctors should intervene where the rapine trial in Uganda—HIVNET government was slow to act, he 012—did not meet its requirements. added. Early results from the study were Further heavyweight support came published (see Lancet 1999; 354: from Nelson Mandela who met lead-

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