29 October 2001

HIV: state 'unethical, negligent'

Government's refusal to provide anti-retroviral drugs to pregnant women with HIV and rape victims, constitutes an ethical offence and no less than gross negligence.

Government's refusal to provide anti-retroviral drugs to pregnant women with HIV and rape victims, constitutes an ethical offence and no less than gross negligence.

These views are expressed by Professors Willem Landman, Ethics Institute of South Africa chief and Udo Schnklenk, head of bio-ethics at the faculty for health sciences at the University of the Witwatersrand in the latest issue of Developing World Bioethics. The writers are co-editors of the journal.

They refer to a government statement following the court case in which pharmaceutical companies withdrew their suit involving cheaper drugs earlier this year, that it would not provide anti-retroviral drugs in the state sector.

"We cannot allow ethical questions resulting from this viewpoint to go unchallenged. The court actions unequivocally placed the South African government's ethical commitment to its citizens on the agenda."

Is government policy over HIV/Aids mainly driven by an ideology inspired by a "weird and extreme viewpoint" supported by President Thabo Mbeki over the connection between HIV and Aids in favour of the well-being of patients?

"How else are examples of gross ethical offences and even criminal negligence on the part of government to be explained?" the writers ask. Up to now the government claimed that infrastructure was inadequate, the drugs were too expensive and complicated to administer and in addition harmful to patients.

They refer to rape victims at the Rob Ferreira Hospital in Mpumalanga who were refused a course of anti-retroviral drugs as part of a comprehensive programme - even though the drugs were provided by the private sector.

Landman and Schnklenk lash out at the government over its refusal to provide HIV pregnant women with nevirapine, "even though transmission between mother and child is reduced by 40 percent". The government and Treatment Action Campaign are currently involved in court proceedings over the issue.

"Rape victims and pregnant women are defenceless. In their case the usual arguments against anti-retroviral drugs are not applicable. Administering the drugs is controlled, advantages are proven and known side-effects are negligible.

"Respect for a patient's autonomy requires women to have a choice. Costs are already under control and the infrastructure in place. The private sector has already indicated it would provide free anti-retroviral drugs to rape victims."

The only other counter argument the government has to offer is that if it cannot provide anti-retroviral drugs to everybody, then nobody will have access to them. Thalyta Swanepoel, Beeld


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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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