08 August 2008

SA Aids-pariah image in rehab

A lambasting at 2006's World Aids Conference in Toronto appears to have spurred South Africa's efforts to rehabilitate its Aids efforts - and the 2008 picture is altogether better.

The young HIV-positive mother takes a deep breath as her name is called, scurrying behind the doctor who will tell her, after a torturous wait, whether she has infected her six-week-old baby.

"Oh God, I don't want to see," she says breathlessly, fidgeting as she clutches her daughter in the Johannesburg clinic. "It's so nerve-wracking."

Smiling, Dr Charl Verwey appeases her. "She is negative," he says, pushing the results across the table, delivering the good news that successful prevention of mother-to-child transmission (PMTCT) has made possible.

"Oh thank God," the 25-year-old sighs as the relief shudders through her, her hands clasped in prayer position.

Back in the waiting room, another 30 mothers sit tense as their babies wail in staccato. It's their first chance to test their baby after receiving the life-saving drugs to prevent them from passing on Aids to their children.

SA still has highest number of HIV+ babies
While transmission of HIV from mother to child in the developed world has largely been eliminated through the use of anti-retrovirals, thousands of children in South Africa are still born infected.

Getting treatment to pregnant mothers has been one of the biggest battles in South Africa, which was publicly lambasted at the World Aids Conference in Toronto two years ago for its approach to treating the pandemic.

"You can see the difference between the old treatment and the new treatment," says Verwey, who is fortunate enough to deliver mostly good news to the mothers in his waiting room at Johannesburg's Coronation Hospital.

The hospital, the only mother-and-child facility in the Gauteng province, delivers 10 000 babies a year. A sample of 45 mothers, whose children tested shortly after the new guidelines were rolled out, showed only two were positive.

"It's the one area in HIV where we could see the immediate product of HIV prevention, where we can give more good news than bad news," says paediatrician Ashraf Coovadia.

Criticism spurred on local govt
The then UN special envoy for Aids in Africa, Stephen Lewis, told the conference the government would never achieve redemption for theories were "more worthy of a lunatic fringe than a concerned and compassionate state".

Controversial Health Minister Manto Tshabalala-Msimang was widely condemned after opening the South African stall displaying a selection of beetroot, garlic and vegetables. However, heading to Mexico for the 17th International Conference, South Africa is in a much different place as the criticism has spurred it to launch a new national Aids plan and national Aids council.

"Certainly garlic and beetroot are not part of the National Strategic Plan," said Coovadia, referring to what he called a "major embarrassment".

The NSP aims to reduce transmission from mother to child, which varies from eight percent in the Western Cape to 22 percent in Kwazulu-Natal, to five percent nationwide, and cut all new infections in half by 2011.

TAC says SA still not meeting targets
However, Treatment Action Campaign spokesman and deputy head of the South African National Aids Council Mark Heywood says meeting treatment targets, and improved prevention, are still far off.

"We don't know how many people are on treatment, and that is a disaster in itself. Government only knows how many people have been started on treatment, which was about 480 000 in June," he told AFP. "But there are certainly well over a million people in need of treatment."

"Compared to Toronto, we are in a completely different political environment around Aids," said Heywood. "I don't think there is going to be any repeat in Mexico of the kind of anger seen in Toronto." – (Sapa, August 2008)

Read more:
Africans lobby govts to fight Aids
Dire shortage of Aids docs


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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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