A Breakthrough Provides Hope

Despite the pall that HIV-AIDS casts across Africa, a few bright spots offer some relief. One of the most promising is a new way to reduce mother-to-child transmission rates using the long-acting antiviral drug nevirapine.

While not quite as effective as the method used in Western countries, nevirapine costs just $3 per course of treatment. Unlike its far more expensive counterparts, a single dose of nevirapine is administered during labor and another during the infant’s first week after birth. AZT, the drug of choice in the West, must begin to be administered in the last two months of a woman’s pregnancy to be most effective, and the infant must continue to receive the drug for the first six weeks of life. The AZT treatment costs about $800 per mother and child, an amount beyond the means of most people in developing countries.

In a study in Uganda released this summer, babies whose infected mothers received experimental short-term courses of AZT—still a far more involved process than the nevirapine treatment—had a 25 percent HIV infection rate. Babies whose mothers were given the nevirapine regime had only a 13 percent HIV infection rate.

With counseling and HIV testing—a necessary part of any prevention program—the cost of nevirapine will be higher than just the cost of the drug. But with a discount that the manufacturer of the drug is expected to offer, nevirapine looks like a positive breakthrough for even the poorest countries, provided they use the opportunity to address their AIDS crisis. Douglas Wilson, an executive of the German company that makes nevirapine, Boehringer Ingelheim, told The Washington Post when the Ugandan study was released that the company "is committed in principle to making the drug as widely available as possible."

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