A second senior public hospital doctor has been reprimanded for supplying the antiretroviral drug zidovudine to a rape victim. When given within two days of the rape, this drug can stop the virus replicating.
What scandalised commentators was that the much publicised rape, in Kimberley in the Northern Cape province, was of a 9 month old baby. She was given the drug as part of extensive treatment after being gang raped by several men.
Dozens of babies in South Africa have been raped, and the crime is on the increase. People speculate that the increase is due to a myth believed by some men that sex with a young virgin will cure AIDS.
The doctor concerned was reprimanded by health department officials, who pointed out that giving antiretroviral drugs in cases of rape is not department policy.
Zidovudine is on the essential drugs list, but only for use by hospital staff who are injured while dealing with contaminated blood.
This incident, together with the government's confusing policy on the supply of antiretrovirals to prevent transmission of the virus in pregnancy, has prompted doctors to act. The South African government remains locked in a legal battle with a group that lobbies for AIDS treatment, the Treatment Action Campaign. It fought and lost a court battle with the campaign over the provision of antiretroviral drugs for HIV positive pregnant women.
The government is to appeal the decision of the High Court, which ordered the government to set up a service offering treatment to all women who test positive and are pregnant and who wish to avoid passing the virus to their unborn babies. Its appeal is based on fears that the finding could unleash claims for all manner of treatment not available from the state and that the court's perceived interference in policy matters was inappropriate.
But pending the appeal, which could take several months or longer, the campaign is to ask the court to enforce the order.
The case arose from the fact that the health department is running a limited experimental programme that provides a few women with nevirapine to prevent transmission of HIV to babies. At present, there are only 18 official test sites, two per province, which are allowed to provide it.
The drug has been offered free by its manufacturer, Boehringer Ingelheim. If the drug was widely available, up to 20000 babies' lives a year could be saved. The Treatment Action Campaign's court case is in the name of a paediatrician employed by the state and hundreds of his colleagues.
Figure.
YOAV LEMMER/AFP
A baby—one of dozens who have been raped in South Africa—is treated by a Johannesburg hospital nurse