The
supply of AZT at Baragwanath hospital's HIV perinatal unit is almost
tapped out because at the end of last year the South African government
decided to stop funding the Petra study.
The
government sites budget constraints, equitable distribution of resources
and limited findings as the reason for its decision.
"Our
budget is 57 million and the cost estimate given [for supplying
AZT nationwide] is 80 million. It's much more than you even have
for all of the medical programs that the government department of
health is to provide," Similela says.
Similela,
a trained OB/GYN, defends her boss health minister Dr. Nkosazana
Zuma and the decisions of the ANC government.
"Because
you can't discriminate, it means you are going to have to provide
AZT to everybody," Similela says.
Beyond
the issue of equity, Similela is skeptical that AZT will have the
desired effect given that use of the drug in a breast feeding population
only reduces transmission by 37 percent.
"So
you still have a certain percentage of women who will transmit the
virus to their babies despite your efforts," Similela says,
"You've got to make sure that whatever resources you have you
don't throw them into a bottomless pit."
So
this Wednesday as they have done every week since the funding dried
up, Gray and her staff huddle around a brown cardboard box, counting
what is left of their stock of AZT. The pills are so precious, that
they count the 100 milligram tablets down to the half bottle.
"Forty-three
and a half," Dr. Violai Avy announces. That means that Gray
has enough AZT to start seventeen more HIV positive women on the
four-week regimen of three blue tablets two times a day for the
last month of their pregnancies.
"We
can't take too many women at the same time. If we put 100 women
on it might only last a week," Gray says, "We are holding
out hope to some women and none to others."
Gray
is outraged by her predicament and the health ministry's stance.
In December she filed suit against the government.
"No
longer are we researchers. We are activists taking the government
to court," Gray says.
Gray
is making her presence known in the courts and on the political
landscape.
Gray
designed the black and white photocopied "No AZT, No Vote"
sign that stands out among the pamphlets and colorful AIDS awareness
posters in her office -- proving once again that in the fight against
AIDS, Gray is as she repeatedly says "an activist first and
a physician
second."
She
hopes the slogan will become a rallying cry for the ill-fated women
she sees at her clinic. She wants the women to let the country's
health minister, Dr. Zuma know that they will fight to get AZT.
But
not one of the 28 HIV positive expectant mothers at Ngobeni's Wednesday
morning support group has attended any of Gray's anti-Zuma protest
marches and rallies in Guateng province.
"We
have done this type of march three times and no pregnant women showed
up," Ngobeni admonishes the women.
"You
don't come because you are scared you will be identified, scared
your neighbor will recognize you," Ngobeni says, "but
you will have a dying baby on your hands because of AIDS.
Like
many of the women, Ngobeni knows the ravages of HIV/AIDS firsthand.
She lost her husband and her daughter to the virus four years ago
and is herself suffering from the disease.
But,
even Ngobeni's example cannot convince women like Mpho Moloi, a
25-year-old support group member, to share her story with family
and friends.
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