A group of South African AIDS activists have taken the government to court. The Treatment Action Campaign is trying to force the health department to provide drugs that can prevent pregnant mothers from passing HIV to their unborn children.
About 300 anti-AIDS activists marched on the Pretoria High Court Monday before the hearing began. They sang songs from the anti-apartheid struggle and carried signs that read, "Give women a choice, give babies a chance." Many of the demonstrators held white wooden crosses, each bearing the name of someone who contracted AIDS through rape.
Parallel marches were staged in Durban and Cape Town. They were timed to coincide with the opening of the court case brought against the government by the Treatment Action Campaign and two other AIDS activist groups. They are suing both the national health minister and the heads of eight of the country's nine provincial health departments.
They want the government to provide a key anti-retroviral drug called Nevirapine to HIV-positive pregnant women. One dose, which costs about $1, can prevent a mother from passing the virus on to her child. The manufacturer has volunteered to donate the drug for free for five years - an offer the government has yet to accept.
Roughly 70,000 children are born with HIV each year in South Africa. Sipho Mthathi, Treatment Action Campaign, says Nevirapine could cut that number in half. "Really, at the core of this whole issue are human rights," she said, "constitutional rights that South Africans have all fought for and have made great sacrifices [for]. We hope that the justice system will take that into account in this case."
Nevirapine has been approved for use in South Africa. Anyone who can afford to go to a private clinic can get a prescription for it. But that excludes roughly 75 percent of South Africans, who get their medical care in public hospitals.
The government distributes the drug in selected public hospitals around the country as part of a pilot project.
But the AIDS activists want that program expanded to eventually include every public hospital and therefore make Nevirapine available to every pregnant woman with HIV. They say poverty, race, and geography should not determine which children live and which children die.
The government says it still has concerns about the side effects of the drug.
The Health Department Director General, Dr. Ayanda Ntsaluba, says a woman can still pass the virus on to her child through breast feeding. He says the pilot project is aimed at working out how Nevirapine can be used most effectively. "It does not help to give the Nevirpine, let the woman go home, she continues to breast feed," he said. "And all that we have done is, we have just pleased the public by giving Nevirapine. But the net benefit is zero. And our argument is that if you want to see an irresponsible state, it is a state that does exactly that."
Dr. Ntsaluba is an obstetrician. He says the government plans to expand its Nevirapine program, but it will take time. He says the Treatment Action Campaign is arguing from an emotional point of view, not from what he calls "a rational, public health and planning" perspective.
The Treatment Action Campaign and the government were in court together just seven months ago. But that time they were on the same side, fighting against major pharmaceutical companies who wanted to prevent South Africa from making and importing cheaper generic versions of patented anti-AIDS drugs.
The government and the activists won that battle together. But it was not long before their differences over AIDS policy drove them to opposite sides of the courtroom.
The hearing is expected to wrap up Tuesday or Wednesday. A judgment in the case could take months.