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Reuters New Media
South Africa Limits Role of Key Drugs in AIDS Fight
Steven Swindells
October 24, 2000
SOWETO, South Africa (Reuters) - South Africa issued new guidelines in its battle against AIDS on Tuesday that limit the availability of key anti-AIDS drugs such as AZT, which the government labeled expensive and toxic.

Health Minister Manto Tshabalala-Msimang used the surroundings of a Soweto township clinic to announce minimum national standards of health care for the country's estimated 4.2 million HIV-AIDS sufferers.

The new guidelines, designed to combat one of the world's fastest growing rates of HIV infection, will limit the use of AZT, denying it even to pregnant women to stop transmission to their children and to rape victims.

The reluctance to widely dispense antiretrovirals, which have been proven to help cut the risk of HIV transmission and help alleviate opportunistic infections, is expected to prompt renewed criticism of Pretoria's response to the AIDS crisis.

Government policy on AIDS has been shrouded in controversy since President Thabo Mbeki questioned scientific orthodoxy that HIV causes AIDS and questioned the efficacy of AZT, which was first approved back in 1987.

"There is a narrow view again that continues to associate prevention of mother to child transmission of HIV with the use of antiretrovirals only," Tshabalala-Msimang said.

"We know there are other medical interventions...We know they (antiretrovirals) are toxic," she said.

The government could not afford to dispense expensive Western antiretroviral drugs and pharmaceutical companies should reduce the cost of their drugs, she said.

"At no time has South Africa said it will never use anti-retrovirals, but there are constraints," she added.

The new government guidelines estimate there are 50,000 HIV-positive children who have been infected by their mothers.

Safer sex, nutritional supplements, vaginal cleansing with an antiseptic solution, and alternatives to breastfeeding are part of the policy recommendations to cut the risks of mother-to-child HIV transmission.

The guidelines take a different view on the use of antiretrovirals to treat healthworkers infected with HIV by patients in their care, acknowledging the success of drugs such as AZT in fighting the disease.

The department also acknowledged a study in Thailand that showed that antiretroviral therapy reduced mother-to-child transmission by up to two-thirds if the medication was given during pregnancy and labor and to the newborn infant.