February 21, 2008

HIV Doc Under Fire for Prescribing Combination Therapy

Supporters of Colin Pfaff, MD—a South African AIDS doc—are rallying in his defense, reports the Associated Press (AP)/Fox News (foxnews.com, 2/18). Pfaff, a staff member at a rural hospital in the city of KwaZulu-Natal, is facing disciplinary actions for giving a pregnant HIV-positive patient a combination of two ARVs as opposed to the hospital’s standard, a single-drug therapy.

His defense as to why he broke protocol: The single dose of nevirapine is outdated and ineffective in preventing mother-to-child transmission.

The KwaZulu-Natal Health Department spokesperson Desmond Motha told the AP, “He works in a small hospital and he has no right to receive donations on behalf of the South African government and provincial government. He didn’t discuss it with us.”

In a petition signed by 500 people, the Southern African HIV Clinicians Society wrote, “Dr. Pfaff should be saluted as a hero—he demonstrates the level of commitment, creativity and care for his patients that we should be demanding from all health care practitioners.” They also wrote, “To discipline him for doing his ethical duty is disgraceful. We demand the immediate dropping of all charges against him.”

Although combination therapy is recommended by the World Health Organization and is proven to be the best way to decrease vertical transmission rates, it has yet to reach many hospitals in this region.

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