BY RICHARD PITHOUSE
DURBAN — South Africans spend their weekends at funerals of children and people in their 20s and 30s. In some hospitals doctors report that as many as 70% of their patients are HIV+. The country's best medical scientists estimate that well over five million South Africans are living with AIDS.
Militant activism has resulted in a reduction of the price of the cheapest triple-drug anti-retroviral therapy to over R2000 per month. But most employed South Africans earn less than R1500 per month and well over 20% of South Africans are unemployed. This means that only around 10,000 South Africans can afford the medicines that can keep HIV+ people healthy in the West.
In 1997 President Nelson Mandela signed into law an act that would enable the South African government to emulate the Brazilian government and provide affordable medication by breaking the power of the pharmaceutical companies. The pharmaceutical companies, arguably the most powerful corporate lobby in the world, responded by taking the South African government to court to protect their ability to make enormous profits from the AIDS crisis.
A vibrant Treatment Action Campaign (<http://www.tac.org.za>) emerged, alliances were formed with progressive organisations in South Africa and around the world and the pharmaceutical companies were put under relentless pressure.
Early in 2001 they withdrew, unconditionally, from their court action against the South African government. Since then, Mandela's successor, Thabo Mbeki, has made it very clear that he does not intend to provide treatment for HIV/AIDS.
Mbeki's failure to seize the opportunity provided by the defeat of the pharmaceutical companies cannot be explained by a desire to put the market before people's health. Even market fundamentalists agree that it is cost effective to provide the medicines that can prevent new infections and treat existing infections rather than endure the cost of mass ill health and early death.
Mbeki's inaction can only be explained by the fact that he genuinely takes the denialist view, supported by a tiny group of right-wing Americans, that the HI virus doesn't cause AIDS and that AIDS medicines are toxic. Mbeki is reported to have told his colleagues that AIDS is a conspiracy by the CIA to discredit him personally. He recently used outdated statistics to argue that AIDS is not a leading cause of death in South Africa and recommend that government redirect money away from AIDS.
A few weeks ago Mbeki complained that: "Others who consider themselves to be our leaders take to the streets carrying their placards, to demand that because we are germ carriers, and human beings of a lower order that cannot subject its [sic] passions to reason, we must perforce adopt strange opinions, to save a depraved and diseased people from perishing from self-inflicted disease.... Convinced that we are but natural-born, promiscuous carriers of germs, unique in the world, they proclaim that our continent is doomed to an inevitable mortal end because of our unconquerable devotion to the sin of lust."
Mbeki, not surprisingly, is hypersensitive to racism and it is clear that he believes that concern about AIDS in Africa is a fallacious racist projection with its roots in white stereotypes of Africans as promiscuous and disease ridden.
Of course, these and other racist stereotypes do, often, creep into Western discourse about the southern African AIDS crisis. But racism hardly legitimates Mbeki's use of the pseudo-science of ultra-right wing Americans, some of whom are members of the Klu Klux Klan, to deny that there is an AIDS crisis in South Africa.
In fact, there's no mystery as to why the rate of infection is so high in South Africa. It can be explained by a combination of the legacy of apartheid, neo-liberal cut backs in social spending, deeply entrenched sexist attitudes which have resulted in appalling health care (untreated sexually transmitted diseases greatly increase the risk of infection), widespread nihilism among young people who see no worthwhile future for themselves and a high rate of sexual violence.
Black intellectuals and trade union, church and community leaders of the stature of Archbishop Desmond Tutu, Professor Magalaperu Makgoba and Willie Madisha have condemned Mbeki's failure to deal with the crisis in the strongest terms. And in increasingly militant mass demonstrations black South Africans have been carrying homemade posters with slogans like "Mbeki, AIDS is as real as cancer" and "Mbeki's denialism is toxic", wearing T-Shirts with slogans like "Fight Mbeki's AIDS genocide!" and chanting "Phansi Thabo Mbeki! Phansi!" ("Down with Thabo Mbeki! Down!").
Mbeki is unbowed and has created a climate of fear in the ruling African National Congress and the government bureaucracy. Aside from notable exceptions like Pregs Govender and Ruth Bhengu, whose daughter is HIV+, very few ANC members and government officials have been prepared to publicly challenge the president's views.
On November 26, 2001 the Treatment Action Campaign, with the support of a range of mass based progressive organisations, took the South African government to court to demand that it make nevirapine available to HIV+ pregnant women and their babies.
One dose of nevirapine costs R30 and one dose for the mother and another for her child is all it takes to reduce the rate at which the virus is transmitted from a pregnant woman to her child by 50%.
Around 70,000 babies are born with HIV every year. So a comprehensive national program to provide nevirapine, counselling and milk formula (the virus can also be transmitted through breast milk) would prevent 35 000 infections a year. It is estimated that such a program would cost R250 million.
The ANC government has argued that nevirapine is toxic and that it can't afford the R250 million. However, nevirapine has been used in many countries to prevent mother to child transmission of the human immuno-deficiency virus without a single major side effect being reported. The World Health Organisation has also endorsed nevirapine as safe and effective.
The government has provided "evidence" to back up its claim that nevirapine is toxic but this "evidence" is a dishonest misrepresentation of research done into the possible use of nevirapine as an ongoing daily life-long treatment for AIDS. The government's claim about the toxicity of nevirapine is like saying that because a barrel of whiskey will kill you scotch should be banned.
The claim that government can't afford the R250 million that a nevarapine program would cost is belied by its recent signing of a R66 billion arms deal. Clearly, it is political will and not money that is lacking.
Judge Chris Botha has said he will pass judgement in the case before December 25. Most legal experts are confidant that the government will loose and that the judge will compel it to set up a comprehensive national program to prevent mother to child HIV transmission.
The next struggle will then be to get AZT for rape survivors and triple-drug anti-retroviral therapy to all of the 5 million HIV+ South Africans for whom it is medically recommended.
From Green Left Weekly, December 12, 2001.
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