Today is World Aids Day. In South Africa, perhaps more than anywhere else in the world, we may want to take a moment to ponder the significance of this day as South Africa now has more H.I.V.-infected people and annual AIDS deaths than any other in the world. As someone personally affected by HIV, this is an important issue for me.
We may observe a moment of silence for the hundreds of thousands of people who have already died of AIDS related illnesses in South Africa. Many of them died needlessly because of the greed of pharmaceutical companies, the criminal neglect of some of our public health system officials and the madness that was then President Thabo Mbeki’s flirtation with AIDS denialism. With some notable exceptions, one must also decry the lack of leadership from many politicians across political party lines who through their actions, utterances or silence have contributed to the stigma and shame that still attach to HIV and prevent many South Africans from getting tested and treated for this manageable disease.
Ten years ago then President Thabo Mbeki first suggested that AIDS drugs could pose “a danger to health” in a speech to Parliament, setting the stage for the denialism and obfuscation to follow. This year, for the first time in ten years, World Aids day is not the depressing event filled with anger and frustration at all the wasted lives that we have become accustomed to over the previous ten years. Last month President Jacob Zuma made a ringing speech in which he rejected the absurdities of the Mbeki era and stated:
South Africans must know that they are at risk and must take informed decisions to reduce their vulnerability to infection or, if infected, to slow the advance of the disease. Most importantly, all South Africans need to know their H.I.V. status, and be informed of the treatment options available to them.
What we tend to forget is that we would not be where we are today if it was not for the Treatment Action Campaign (TAC) and for the Constitutional Court. The TAC took on Mbeki and his government at the height of Mbeki’s power. It played a brilliant and strategically astute role in challenging the government’s confusing, intellectually arrogant and destructive, and often heartless policies and actions on HIV.
Making use of a combination of political mobilisation and legal action, the TAC won a famous victory in the Constitutional Court. This forced the then Minister of Health to swallow her words – uttered live on the TV news – that she would refuse to obey a Constitutional Court order to provide ARV’s to HIV pregnant mothers to save their new born babies from HIV infection.
The Constitutional Court, arguably going further than it had in the Grootboom case, found that the government had acted unreasonably by restricting the provision of ARV’s to HIV pregnant mothers to a few pilot sites. The Court rejected all the arguments presented on behalf of the Minister (the same arguments which President Mbeki also peddled) regarding the efficacy and dangers of ARV’s and found that the government action was so unreasonable that it was acting unconstitutionally by preventing poor women from accessing life saving ARV’s for their babies.
Shortly after this judgment was handed down I attended a workshop with members of the Department of Health to discuss the possibility of providing wider access to ARV’s to South Africans living with HIV. Two things struck me at that meeting: all the officials were terrified of Tshabalala-Msimang and all the officials were terrified that their HIV policies will be successfully challenged in the Constitutional Court.
Shortly afterwards the government announced that it would progressively roll our ARV’s to all who needed it. Without the TAC and without the potent judgment of the Constitutional Court, this would not have happened and many more people may have died needlessly. Some lawyers dismiss the social and economic rights (including the right of access to health care) enshrined in the Bill of Rights on the basis that the do not mean much and has little effect. But they forget that these rights have an effect not only in courts but also more broadly.
The TAC understood from the start that the right of access to health care in the Bill of Rights provided them with a tool through which it could mobilise civil society and the ANC alliance partners against Mbeki and his allies. They understood that social and economic rights battles should be waged strategically, both inside courtrooms and on the streets.
Much still has to be done to fix the HIV/AIDS mess. Many poor people and people in our prisons still die because they have no access to ARV’s. Some government officials still peddle the utterly counter productive ABC message of prevention instead of focusing on condom use and the difficulties experienced in our patriarchal culture by many vulnerable women in trying to protect themselves from infection. But at least something is being done.
Meanwhile, I can only hope that former President Thabo Mbeki (for once) takes advice from Zwelenzima Vavi and apologises for the way in which his government dealt with HIV. Who knows, an apology might even enhance his reputation, which must surely be at rock bottom in South Africa at the moment.
Nkosi Johnson
@Pierre,
This is not enough!! You need to trash Mbeki more. Bring on the mortality stats, bring on the Harvard report bring on the bed sheets. Trash him for crying out load, you have a lot of apologizing to do.
@King Zwakala,
What I never got about Nkosi Johnson was that he was made popular for saying words put in his mouth by adults. Those words were advocating for the drugs that he started using when he was 11 and then died when he was 12, after a year of taking the very drugs. It just does not make sense.
load = loud
Hey Dworky.
Happy World AIDS Day.
How are you?
Last month Zuma says: ‘…South Africans must know that they are at risk and must take informed decisions to reduce their vulnerability to infection or, if infected, to slow the advance of the disease. Most importantly, all South Africans need to know their H.I.V. status, and be informed of the treatment options available to them. …”
Me says: “Halala Zuma, halala. Way to go!”
Yesterday there are reports that Zuma will take an HIV/AIDS test.
Me says: “Way to go Zuma. That’s leading by example.”
Today, on World Aids Day, the Presidency reports that Zuma will NOT be taking an AIDS/HIV test.
Me says: “Woa oh!” (red flag)
Do I smell chicken, or is it a chameleon I see before me?
What hypocrisy.
We can take this to its logical conclusion can’t we? Or we could let the tabloids do their dirty work for us.
Dumisani Mkhize, are you sure this latest statement is correct. Zuma was reported today as saying not only that he is taking the test, but that he had taken it in the past, that he knew his status, and emphasized that tests were confidential. Why bother not to take it when the issue is so important, politically as well.
Having the priviledge of working in townships as a volunteer community worker for now nearly 10 years, I’ve had enough of HIV/Aids, and am mostly speachless on the disaster. My years in 80’s, 90’s San Francisco, I thought hardened me to Aids indifference and sloppy ignorance, and yes, the political inaction… however it just goes on and on. Feels like a 30 year nightmare, so far, will it be 50 and still climbing? The absurd public attitudes and general government ineptitude must be part of the desease itself. Don’t we get it, it effects all us, global community, right?
You may not know but many in the west thinks SA’s Aids denialism was Mibeki and the ANC’s deliberate approach to diminishing their expensive poor(to the state) and non income tax paying population. Even tribal issues. Anyone remember what Mibeki’s spokesman (who died of Aids) said to US News re “are you willing to look after all the orphans.”
On another matter, my apologies Prof, the decision at http://politicsweb.co.za/politicsweb/view/politicsweb/en/page71656?oid=152981&sn=Detail
very interesting, and a boon to Lady Justice.
Is it possible, Zuma being a man and all…. is he afraid.
Here is my source, sirjay jonson:
http://www.iol.co.za/index.php?set_id=1&click_id=79&art_id=iol1259656795667A323&newslett=1&em=21138a6a20091201ah
Dumisani Mkhize, thanks for the link.
“However, Motsoaledi cautioned at the time that a task team first had to establish whether the country had the capacity to meet a sudden upsurge in demand for tests and particularly, counselling.”
What bull! The western world has been desperately trying to get SA to act, offered tons of funds, many which were denied and even blocked. I’ve followed this nonsense in SA since 2000.
Because, lo and behold, the infection rate in SA does actually affect the entire world… how much international travel takes place, and now the world cup coming, right, all that jags; as a result the entire world is at threat when a country doesn’t act effectively… Time for SA to realize we’re part of a greater world and global community, right, slim hope.
Even with the recession we have just exited, if SA shows the will, I belileve the international community will come on fast. Thus the quote above is a) not a reasonable excuse, or b) self interested ulterior motives.
And for smug africans who think the whole thing was a CIA plot, try to recall facts, AIDS comes from Africa even if white Beligians brought it about with their illegal monkeying around.
I think when it comes to the aids issue we should all forget the past and rather work for the future. The mortality stats are there, every well informed South African knows that an estimated more than 5 million people were living with HIV and AIDS in South Africa in 2008, more than in any other country. In 1997 316,559 people died in South Africa, and in 2006 607,184 people died. The rise in the death rate must be attributed to aids. Just think what the death rate will be in 2010 and 2011 without antiretrovirals.
If you want a good example of what antiretrovirals coupled with a healthy lifestyle can do, just look at judge Cameron.
sorry to be off topic, but this made me think our judicary is actually in reasonable shape …
http://www.philly.com/philly/news/homepage/20091130_Civil_cases_against_judges_involve_emotional_suffering.html
Chris, you say one should look at Judge Cameron to see a good example of what ARVs can do. Yes he is indeed a good example of how long can one live after being infected with HIV/AIDS if one takes ARVs appropriately with all its required supportive conditions. But would you agree that, he is a good example only for a certain class of people – meaning those who can afford basic needs such as, among others, DAILY balanced meal, live in HEALTHY and HYGIENIC environment, means of TRANSPORT to honour medical consultation times and regular collection of medications that support ARVs and STRONG family support which is a luxury to many unemployed and poor rural and shack dwelling HIV/AIDS sufferers?
Would you also agree that if you take the very same HIV/AIDS related medication that Judge Cameron takes and give it to a poor rural person HIV/AIDS sufferer exposed to the opposite living condition to that of the honorable judge described above may often not yield the same results we see with Judge Cameron?
Would you have problem in agreeing that poverty situation caused largely by unemployment which is also caused largely by lack of employable skills, relevant education to job market needs and illiteracy among other causes is one of the primary causes for majority of our rural people to die even when they can access ARVs?
Based on the above, would you maintain the position that ARVs alone are the solution to lengthening the life expectatncy period of ANYONE infected by HIV/AIDS irrespective of affordability refered to above and one’s living ccondition?
And based on the above again, what in your view is the cause of HIV/AIDS and not AIDS? I am asking this questions with specific reference to the South African situation and its poor African people who constitute the majority of the HIV/AIDS infected people which I am at least familiar with?
@ Khosi……how about trashing all those people who screw anything that moves with absolutely no regard for:
1/ All the orphans that will be left behind
2/ Massive volumes of evidence that irresponsible sexual behaviour has serious consequences in the context of HIV
3/ The need to accept some responsibility for their idiotic behaviour
4/ The deleterious consequences for all those of us who do behave responsibily
5/ The terrible impact on our very limited and rapidly deteriorating health resources
I am sick and tired of this mindset which says that people can behave as stupidly as they please and somebody else (Government, medical aids, donors, responsible society, etc) must feel sorry for them and pick up the pieces.
Maybe it is time to put out a message which says…..if you behave stupidly then you deal with the consequences.
The “climategate” has hardly been covered in RSA’s media. It shows clearly what those good ethical men in white coats get up to when not in the public view (especially when money is a motive). They have been revealed to prevent dissenting voices form being heard in scientific papers, doctoring results, fraud and blatant lies, manipulation of media, ostracizing of opponents (inter alia with terms like climate change “denialist”), etc. Inspite of it all, they have captured policy internationally. Reminds me of the TAC and like minded souls in the AIDS arena.
I am indifferent to the climate change issue but I am not amazed at the scandalous fraud, after all, where there’s potential for profits, there’ll always be deceit. Hence, I hold no vbrief similarly for the HIV “consensus” nor of the so-called “AIDS denialists”, but I am daily amazed that South Africans are being sucked into a policy measure (ARVs rollouts) with such long term ramifications without serious debate, particularly for a disease for a virus that would stop spreading simply by people behaving responsibly.
http://www.thedailymaverick.co.za/opinionista/2009-12-01-Climate-fraud-kills-people
Applies similarly to the AIDS debate:
http://esr.ibiblio.org/?p=1436
Assuming a full rollout of ARVs at a conservative R 500 per drug treatment per person per month (R30 Billion, for 5 million cases), is paying R 30 Billion per annum on ARVs justifiable (particularly for a apparently easily preventable disease/condition? Has this issue been considered? What of the impact on other socio-economic rights (does it foster them or reverse them)?
Articles like the below about a report from UNAIDS:
http://www.independent.co.uk/life-style/health-and-families/health-news/aids-the-pandemic-is-officially-in-decline-1826914.html
Which states that:”The HIV epidemic has repeatedly defied predictions… HIV is likely to have additional surprises in store that the world must be prepared to address.” Yet in RSA we know the gospel truth, we will fight AIDS with ARVs, because we were told by the TAC that this is the way to combat them!
Sadly the media will not cover issues like climategate, and their implications to policy debates a great deal, because they raise uncomfortable questions and lead us to question orthodoxies (such, what if ARVs don’t really work, actually, how many people have died directly because of ARVs ?). Neither will Pierre, a self confessed proponent of socio-economic rights (his too busy telling “truth” to power), so pass the pills and sorry if you have no water to gulp them down with (the budget was blown to buy the life saving pills) ! PS: Well Done (!), seems “power” has noticed