On Friday 25 January 2008, the Department of Health announced that a new Prevention of Mother-to-Child-Transmission (PMTCT) protocol would be released. The new protocol includes what is known as dual-antiretroviral prophylaxis. The TAC has welcomed this improvement which will prevent many babies from being infected with HIV.
But with this good news, also came disappointing news. Disciplinary action is being taken against Acting Medical Manager Dr Colin Pfaff, who works in Manguzi Hospital in Umkhanyakude district, Kwazulu-Natal, for providing dual antiretroviral prophylaxis to pregnant women attending the antenatal clinic. Although the nevirapine programme in the province is reaching nearly all obstetric facilities, about 22% of HIV-positive mothers transmit the virus to their babies. This is why Dr. Colin Pfaff and other medical doctors working in Manguzi Hospital have put patients before the process. The AZT he used was donated by Manguzi Mission Fund, so the provincial hospital incurred no cost for the HIV infections prevented by Dr Pfaff.
Furthermore, on 5 February 2008, the Kwazulu-Natal MEC for Health, Ms. Peggy Nkonyeni, visited Manguzi Hospital. She stated that antiretrovirals are 'toxic' and questioned the motives of rural doctors who provide AIDS treatment. She suggested that they are working for pharmaceutical companies and not for their patients. Her statements were a thinly veiled attack on Dr Pfaff. Ms Nkonyeni's statements contradict government policy, particularly the HIV & AIDS and STI Strategic Plan for South Africa 2007-2011 (National Strategic Plan, NSP), which explicitly provides for the implementation of dual-antiretroviral prophylaxis for PMTCT.
The National Antenatal Survey for Umkhanyakude district showed that 36.3% of pregnant women attending the facility are HIV-positive. Manguzi Hospital accounts for 24% of women attending antenatal Clinics in the district. The Provincial Strategic Plan (PSP) has a plan of reducing the risk of PMTCT to less than 5% by 2011, a goal we are still far from achieving without dual antiretroviral prophylaxis.
We understand that three medical officer posts in Manguzi Hospital are unfilled. Dr Pfaff has a reputation as a highly respected and committed doctor. His facility serves a rural area of the province, where it is particularly difficult to recruit doctors. The disciplinary action against Dr Dfaff raises concerns both about the provincial government's commitment to addressing the serious human resources crisis in Kwazulu-Natal health facilities and its commitment to improved PMTCT.
We demand that the Manager of Manguzi Hospital and the Kwazulu-Natal Department of Health withdraw disciplinary action against Dr Pfaff. We also demand that Ms Nkonyeni apologise for her inflammatory statements. We call for the speedy implementation of dual antiretroviral-prophylaxis.
Statement issued by the Treatment Action Campaign February 19 2008