South Africa Announces Policy To Provide Antiretroviral Drugs To HIV-Positive Pregnant Women, Children

Main Category: HIV / AIDS
Also Included In: Pregnancy / Obstetrics;  Pediatrics / Children's Health
Article Date: 04 Dec 2009 - 5:00 PDT

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In a World AIDS Day speech on Tuesday, South African President Jacob Zuma announced a new national policy that would provide HIV-positive children and pregnant women with broader, earlier access to antiretroviral medications, the New York Times reports (Dugger, New York Times, 12/2). The announcement marks a "dramatic step forward" for South Africa, which has the highest rate of HIV-positive people in the world, and signals a significant break from the policies of Zuma's predecessor, President Thabo Mbeki, according to the Christian Science Monitor (Baldauf, Christian Science Monitor, 12/1). During nearly a decade in office, Mbeki questioned whether HIV leads to AIDS and suggested that antiretrovirals could cause harm. According to a 2008 Harvard University study, Mbeki's delays in providing antiretrovirals to prevent mother-to-child transmission led to the death of 35,000 infants. The researchers estimated that 330,000 premature deaths occurred for lack of treatment under Mbeki.

The new policy on pregnant women aligns with guidelines released on Monday by the World Health Organization (New York Times, 12/2). The WHO guidelines recommend that pregnant women with HIV be given antiretrovirals earlier and while they are breastfeeding. Experts hope that the new policy will improve survival rates for infants in South Africa, one of a handful of countries in which child mortality has increased since 1990 (Bryson, AP/San Francisco Chronicle, 12/2).

Zuma also said that by April the government would begin providing treatment for HIV-positive people with tuberculosis earlier, when their immune systems are stronger, which WHO says will help reduce death rates. According to the Times, TB is a leading killer of people with HIV in South Africa (New York Times, 12/2). Treatment for HIV patients with TB would begin when their CD4 levels drop below 350, compared with 200 now. In addition, all children younger than age one who are HIV-positive will receive treatment regardless of their CD4 levels (AP/San Francisco Chronicle, 12/2).

Donald Gips, the U.S. ambassador to South Africa, said that the U.S. will contribute an additional $120 million over the next two years to meet the higher demand for antiretroviral drugs. The U.S. already has committed $560 million in fiscal year 2010 for fighting HIV/AIDS (New York Times, 12/2). However, some HIV/AIDS experts expressed concern that the new policy would add pressure on South Africa's health care system. Andy Gray, a consultant pharmacist to the Centre for the AIDS Programme of Research in South Africa, said that the health system "is already creaking" and that the South African government will need to search for new methods of funding to meet the new policy goals (Govender, Reuters, 12/1).

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