South Africa criticised for its AIDS policies

The South African government was criticised for its handling of the HIV crisis by speakers at the 16th international conference on Aids in Canada. The conference was held from 13 to 18 August in Toronto, Canada. Stephen Lewis, the UN special envoy on Aids, told the closing session: "It is the only country in Africa, amongst all the countries I have traversed in the last five years, whose government is still obtuse, dilatory and negligent about rolling out treatment." The country has the single biggest HIV-positive population in the world, estimated at five million or 11% of its population. About 70,000 children in South Africa are born with HIV each year. According to the Joint UN Programme on HIV/AIDS (UNAIDS), by the start of 2006 there were an estimated 39 million AIDS sufferers worldwide. Most of these people live in developing countries. In the last 12 months alone, 4.1 million people were infected and 2.8 million died of AIDS related illnesses.

The concluding report from the conference with a call for a quickening of the pace of HIV prevention measures and care and treatment programs in resource-strapped environments. The theme echoed the sense of hope tempered with growing impatience at government inaction. Of 7 million sufferers in the lowest GDP countries in need of antiretroviral medication, barely a quarter of these people have access to the drugs. The treatment access gap is even worse for children under 15. Approximately 90% of the 800,000 children in need have access to the treatment. In total, barely 1 in 5 people of high risk of infection have access to effective prevention. The new President of the International AIDS society, Dr Pedro Cahn, called for political action. “All the knowledge, innovative research and new tools will not be effective without the political leadership that is essential to halting the disease,” he said on the final day of the conference.

Thabo Mbeki's government was openly criticised by many speakers at the conference for denying that the human immunodeficiency virus is a cause of Aids and for its resistance to offering HIV drugs to its people. Dr Manto Tshabalala-Msimang, the Soviet-educated South African health minister prefers to promote traditional cures such as garlic, beetroot and lemon while also referring to possible toxicities of AIDS medicines. Stephen Lewis told the conference "It is the only country in Africa whose government continues to propound theories more worthy of a lunatic fringe than of a concerned and compassionate state."

The South African government denies the charges and issued a statement that said "The ANC reaffirms its support for government's comprehensive plan for management, care and treatment of HIV and Aids, and for an approach that aims to combat HIV and Aids in an all-embracing and integrated manner.". Nelson Mandela has weighed in on the argument and criticised the government for not making drugs freely available across the country. Several South African provinces announced that they would ignore the government policy and start distributing a key anti-retroviral drug, nevirapine.

Many believe that Tshabalala-Msimang is merely carrying out the pseudo-scientific wishes of President Thabo Mbeki. In 2002, Mbeki, convened an international panel to consider the causes of and appropriate solutions to AIDS in the African context. The panel included representatives from the so-called AIDS dissident community. The willingness of the President to entertain, if not unequivocally endorse, dissident science created an international stir. Although the conference’s outcome, known as the Durban Declaration, supported the orthodox view of AIDS, Mbeki continued to stall the pilot of antiviral drugs.

The question is why South Africa’s leadership is so obdurate on this question? The answer probably lies in the speed and force of the AIDS epidemic in South Africa. There are neither clear reasons nor simple solutions for the spread of AIDS and its complexity has made it extremely difficult to assimilate. And so, in a denial of reality, leaders proclaim that the presence of AIDS is not true. President Mbeki publicly questioned the importance of HIV in causing AIDS, controversially suggesting that the main cause was "poverty." The appearance of AIDS as an everlasting affliction precisely at the point when the end of apartheid should have brought a better life for all has also rankled with the ANC government. As one South African journalist put it “how is it possible that, at the very moment we assume our victorious place as the leaders of a democracy we struggled for decades to bring about, we are presented with a dying populace, with a plague to which we have no answers?” And so while the South African government argues that the drugs are too expensive, they ignore the high costs of not preventing the further spread of the world’s worst killer virus.