The South African government has rejected a common treatment used to reduce the transmission of the AIDS virus by pregnant women to their babies. Instead, it has recommended a 28-week regimen that combines nevirapine (Viramune generic) and generic zidovudine (Medication Retrovir® AZT, GlaxoSmithKline), a more complex schedule that might reach fewer women.
The Medicines Control Council recommended against giving pregnant, HIV-positive women a single dose of the drug nevirapine just before childbirth, even though the practice has become common in Africa. The Council ruled that mothers who took the drug would be likely to develop drug resistance to anti-retroviral therapy and that nevirapine was more effective when used in combination with other drugs.
Health experts have condemned the decision as another example of South Africa’s reluctance to confront the AIDS epidemic head-on, even though more than 5 million of its citizens are infected with HIV.
Although the regimen recommended by the regulators is theoretically better, the risk of creating a generation of infected children is thought to outweigh the risk of creating drug resistance.
The country’s register of medicines claims that treating pregnant women with single doses of nevirapine during childbirth increases the likelihood that antiretroviral therapy would not work for them when they become sick later in life.
The World Health Organization supports the treatment of pregnant women with nevirapine alone. In many African nations, pregnant women wait too long to begin a 28-week course of therapy. Usually, a shorter course of antiretrovirals or a single dose of nevirapine for the mother and baby are the only options. Although a single dose of nevirapine increases drug resistance, it reduces the risk of transmission from 30% to nearly 15%.