On Wednesday, AIDS activists and a medical society called for doctors and nurses in South Africa to use a dual-drug regimen to prevent mother-to-child HIV transmission (MTCT). The move reflects critics' frustration with what they see as the health department's desultory efforts to update the government's seven-year-old recommendation of nevirapine monotherapy to prevent MTCT.

Provinces should act on their own to improve short-course prophylaxis to prevent MTCT, said the Treatment Action Campaign and the Southern African HIV Clinicians Society (SAHCS). TAC also called for provinces to provide mothers extra treatment after the birth, to reduce the chance of future drug resistance, and at an earlier stage of her illness.

"There is such torpor at the top, and such frustration on the ground," said Dr. Francois Venter. He said that while many clinics and hospitals have the resources to provide dual therapy, state physicians worry about angering their employers if they do so ahead of the government's recommendations. "Unfortunately, HIV being the politicized disease that it is, doctors and health care managers are afraid not to toe the line," he said.

No law prevents health care providers from giving mothers a dual-drug regimen, said TAC. With single-dose nevirapine, MTCT risk is reduced from about 22 percent to 12 percent. In 2006, the World Health Organization recommended two- or three-drug combinations to cut MTCT.

The National Health Council, chaired by Health Minister Manto Tshabalala-Msimang, is meeting Friday to discuss final treatment guidelines, said Sibane Mngadi, a health department spokesperson.

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