BY RICHARD PITHOUSE
DURBAN — On December 14, Justice Chris Botha of the Pretoria High Court found in favour of the Treatment Action Campaign's (TAC) action to force the South African government to make the anti-AIDS medicine nevirapine available to HIV+ pregnant women and their babies.
Botha said: "About one thing there must be no misunderstanding, a countrywide program to prevent the transmission of HIV from mothers to their children is an ineluctable obligation of the state."
The TAC, in alliance with a range of mass-based progressive organisations, on November 26 took President Thabo Mbeki's African National Congress (ANC) regime to court.
One dose of nevirapine costs R30 (A$7.50); one dose for the mother and another for her child will reduce the rate at which the virus is transmitted from a pregnant woman to her child by 50%. Although more than five million South Africans are HIV+, Mbeki, who has previously claimed that AIDS is a plot by the CIA to discredit him, is openly opposed to the provision of medication to people with AIDS or at risk of contracting the virus. He demands unquestioning loyalty from his officials on this matter.
Botha ordered the government "to make nevirapine available to pregnant women with HIV who give birth in the public sector, and to their babies, in public health facilities where in the opinion of the attending medical practitioner, acting in consultation with the medical superintendent of the facility concerned, this is medically indicated, which shall at least include that the woman concerned has been appropriately tested and counselled".
The court found that the government had violated section 27 of the South African constitution which guarantees access to health care services, including the right to reproductive health care. The state had not taken reasonable measures within its available resources to provide women access to program that prevent HIV transmission from mother to child, Botha found.
Dr. Haroon Saloojee, representing paediatricians and other health care workers, said: "The court has recognised the gravity of the situation and the need to avert avoidable and predictable infection and death in children. It also affirms the right of women to choose. This judgment is a superb Christmas present for all people with HIV/AIDS, their families and health care professionals."
The TAC's Sipho Mthathi, said the court "has vindicated the position of TAC. For more than five years activists, nurses and doctors have attempted to convince the government of the need for a comprehensive roll-out plan. The government has failed women with HIV/AIDS, children and all people in our country. Now, it has the opportunity to heal the wounds caused by its lack of action. We urge the government to fulfil its constitutional obligations and to respect the court ruling. The government has a choice: work with TAC or face an unprecedented national and international mobilisation."
However, the minister of health announced that the ANC government has decided to appeal the judgement in the Constitutional Court. It is likely to take a year before the matter comes before the court and during that time Justice Botha's order that the government make nevirapine available to HIV+ pregnant women will be placed on hold. The most conservative estimate is that 70,000 babies will be infected with HIV during this time.
Progressive forces in South Africa, including the ANC's alliance partners, the Congress of South African Trade Unions and the South African Communist Party, have been unanimous in their outrage at the ANC's decision to appeal the judgement. But Mbeki's leadership style is highly authoritarian and progress within the ANC is impossible for people who question him. ANC members often privately express their horror at his refusal to accept the reality of the AIDS pandemic but very few have had the courage to confront Mbeki directly or to make their views on this matter public.
In fact, ANC loyalists have accused the TAC of "treason" and ANC officials are now persecuting medical professionals that provide medication to HIV+ people or to people at risk of infection, like babies born to HIV+ mothers or rape survivors.
In the latest incident, the Northern Cape provincial health minister attacked a Kimberley hospital for providing anti-retroviral medication to a nine-month-old baby who had been gang raped. The hospital management subsequently issued a circular warning doctors that they were banned from administering anti-retroviral medicines to rape victims. Beatrix Weber, a doctor at that hospital, complained about the ban and was accused of "unlawfully and intentionally undermining the Office of the President" and suspended from her post.
In South Africa today, reason is seen as treason and obedience to the "Leader" has become the central virtue of a good subject. A bitter struggle for reason over authority, citizenship over subjecthood, truth over irrational paranoia and health and life over sickness and death lies ahead.
From Green Left Weekly, January 23, 2002.
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