SOUTH AFRICA – JOHANNESBURG (BUSINESS DAY) - AIDS activists have urged doctors and nurses to ditch the government's outdated guidelines for preventing HIV transmission from mothers to their babies, and to start providing a two-drug cocktail instead of nevirapine alone.
The development reflects growing impatience among activists and the medical fraternity at the health department's slow progress in updating its seven-year-old guidelines for the prevention of mother-to-child transmission of HIV.
Experts say improvements to the guidelines would save babies' lives and help SA meet the National Strategic AIDS Plan target of cutting the mother-to-child transmission risk to 5% by 2011.
AIDS lobby group the Treatment Action Campaign (TAC) yesterday urged provinces to implement improvements to the guidelines. These include the provision of dual therapy, extra drugs for mothers after giving birth (to cut the risk of future resistance), and provision of anti-retroviral therapy for the mother, at an earlier stage of her illness.
Their call was backed by the Southern African HIV Clinicians Society. "There is such torpor at the top, and such frustration on the ground," said the society's president, Dr Francois Venter.
He said many clinics and hospitals had the resources to provide dual therapy but state doctors were afraid of invoking the ire of their employers if they did so before government gave the go-ahead .
Johannesburg's Coronation Hospital's paediatric HIV head, Dr Ashraf Coovadia, said doctors needed the backing of provincial authorities to provide what was best for their patients.
"Unfortunately, HIV being the politicised disease that it is, doctors and health care managers are afraid not to toe the line," he said.
The TAC said no laws prevented doctors and nurses from providing dual therapy . The guidelines say HIV-positive, pregnant women and their infants should get a single dose of nevirapine, which cuts the risk of transmission from about 22% to 12%. The World Health Organisation, however, in 2006 recommended two- or three-drug combinations.
Health department spokes-man Sibane Mngadi said the National Health Council, chaired by Health Minister Manto Tshabalala-Msimang, would be meeting tomorrow to finalise the new guidelines .