PARIS--Controversy has erupted over the South African government's decision to withhold the antiviral drug AZT from pregnant women infected with HIV--despite the compound's demonstrated effectiveness at preventing transmission of the virus to offspring.
AIDS officials, physicians, and activists say they are perplexed by the decision, in which the South African government last month said it would not provide AZT to pregnant women in any publicly funded health program. "We consider the price of the drug unaffordable," says Ian Roberts, special advisor to South African health minister Nkosazana Zuma. But Peter Piot, UNAIDS's executive director, argues that South Africa "clearly [hasn't] done enough" to stem the alarming mother-to-child infection rate: In some regions, more than a fifth of pregnant women are HIV-positive, and one Soweto-based hospital delivered nearly 1000 HIV-infected infants this year. Overall, nearly 15% of South African adults harbor HIV, says Bernhard Schwartländer, UNAIDS's senior epidemiologist.
While Africa is currently bearing the brunt of the epidemic, the latest figures released by the United Nations last week  reveal disturbing trends elsewhere. In India, sampling in rural areas has uncovered adult HIV infection prevalences reaching 2%. Even in Western Europe and North America, where AIDS deaths are down thanks to antiviral therapies, the proportion of the population infected with HIV continues to rise; epidemiologists logged 74,000 new infections on the two continents during 1998. Some 5.8 million people worldwide were newly infected with HIV in 1998, bringing the total number of HIV-infected people to 33.4 million.