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South Africa to make AIDS a notifiable disease

27 May 1999 (See Nature Volume 399 page 288)

[CAPE TOWN] South Africa's Minister of Health, Nkosazana Dlamini Zuma, has proposed that AIDS should be made a notifiable disease in the country, a move intended to help reduce the spread of an infection that now affects one in ten South Africans.

The proposals would require doctors to inform local health authorities (anonymously) of persons diagnosed as having AIDS, as well as immediate family members and health care workers involved in the treatment of the patient concerned. AIDS, rather than just "natural causes", must be recorded as the cause of death on death certificates.

But the proposals have also raised concern that, if the government were to go one step further and deny entry to South Africa to persons who either have AIDS or are HIV positive, this would pose a serious problem for potential delegates to the World AIDS Congress, scheduled to take place next year in Durban.

Announcing the proposals at a joint meeting last month with the health ministers from Namibia and Zimbabwe, Zuma said ; "We can't afford to be dictated to by human rights or AIDS activists. We want to know who is dying of AIDS, and relatives and partners must be notified. It is time we treated AIDS as a public health issue like TB. We don't go about treating that with secrecy."

No changes have been proposed for those who are HIV-positive, which is not required to be reported. The government has invited comments on the proposals for a three-month period before it promulgates the regulations.

Meanwhile Ian Roberts, a special adviser on health affairs to Zuma, has issued a statement denying press reports that the minister had changed her mind about using the anti-AIDS drug AZT for the prevention of mother to child transmission (see Nature 396, 504; 1998).

This reports appeared after the provincial government of Gauteng allowed the Chris Hani Baragwanath Hospital in Johannesburg to accept a donation from UNAIDS to cover the cost of using the drug in research trials.

Despite the government's stance, Mark Wainberg, chairman of the International AIDS Society, says that he remains strongly opposed to any moves to boycott next year's conference in protest at the minister's stand.

"There is consensus among its scientific community, including some of Zuma's most severe critics, that holding the meeting in South Africa will do far more good than harm," he says. "We should press ahead -- unless something as horrible as a restrictive border-crossing policy were to be imposed."

In another development, Zuma has informed the US pharmaceutical company Bristol-Myers Squibb that the government could not endorse a proposal to invest $100 million over the next five years on AIDS-related research in South Africa, including clinical trials on their products (see 13 May 1999). The initiative was announced earlier this month without the prior consent of the government.


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