TAC Electronic Newsletter
5 May 2003
TAC Supports Health-Care Workers
Launch of Conditions of Service Campaign - 5-6 May
5 May 2003
Over 200,000 South Africans will die of HIV/AIDS this year. Health-care
workers experience the brunt of this epidemic. Yet, the public health
care system which is responsible for most people, is under enormous
stress. SAMA, HOSPERSA, SADNU, NEHAWU Western Cape and TAC have called
for 5 and 6 May to be used to begin mobilising health-care workers on
the need for (1) an HIV/AIDS treatment and prevention plan, (2) the
implementation of antiretroviral therapy and (3) the improvement of
conditions of service of public health-care workers.
In this regard, TAC welcomes the announcement by the Treasury
Department that additional funds will be committed to HIV/AIDS,
treatment and improvement of conditions of service of health care
workers in this year's budget. Clear policies are are now needed on how
this money will be used to improve conditions of service and implement
an HIV/AIDS treatment and prevention plan that includes antiretroviral
We encourage doctors, nurses and all people working in health care,
both the public and private sectors, to express solidarity with the
above three issues by wearing HIV-positive t-shirts on 5 and 6 May. We
are also circulating the letter below, addressed to the Minister of
Health, for people working in South African health care to sign.
Electronic endorsements of this letter can be sent to email@example.com.
Simply write in the subject line:
Endorse HCW letter
In the email body, please indicate your title, name, whether you work
in the public or private sector, your position/job and your health care
Written copies of the signed letter can be posted to: 34 Main Road
Muizenberg 7945 or faxed to 021 788 3726.
A joint press conference will be held by SAMA, HOSPERSA, SADNU, NEHAWU
Western Cape and TAC on Tuesday, 6 May 2003 at COSATU, 358 Victoria
Road, Cape Town.
[END OF STATEMENT OF SUPPORT]
Letter by Health-Care Workers to Minister of
Our public health care system is faced with the tremendous strain of
the HIV epidemic. Daily many of us see patients die unnecessarily of
HIV/AIDS. In many cases patients die because they do not have access to
antiretroviral medicines. Often they die or suffer needlessly because
our facilities are not stocked with essential life-saving treatments
for opportunistic infections. And often they die or suffer because our
facilities are under-staffed or because we have not been sufficiently
trained to deal with the epidemic. However, It is not only patients
with HIV who are experiencing the burden of this epidemic; the
management of all diseases suffers because of the burden of HIV.
Patients are being excluded from the health-care system because there
are often no beds for them, no doctors or nurses to see them and no
support services to ensure that critical programmes work.
Health-care workers in the public health system are so often exposed to
the painful effects of HIV Aids infection and death, particularly in the
absence of treatment. This contributes to their fears to establish and
manage their own HIV Status. It also results in undue occupational
stress because Health care workers want to see their patients live, not
die without treatment.
The public health care system also does not sufficiently comply with
the Occupational Health & Safety Act. There is a high risk of
occupational exposure to hazardous biological products of which HIV
forms a risk factor. Some health care workers still cannot access
post-exposure prophylaxis in time. This must be remedied. The difficult
work conditions that health care workers endure threaten to deplete our
health care system to the point that the skills required for the
administration of all treatments and other critical health care
interventions will become scarce.
We do not believe the dire state of the public health care system is
inevitable. With political will and resources our health-care system can
be greatly improved. Together we can ensure that our health facilities
are adequately staffed, job freezes are removed, sufficient counsellors
are trained and hired for every clinic, enough condoms are always
available both for counsellors to distribute and patients to take from
convenient places, nurses and doctors are trained to manage
opportunistic infections and provide antiretroviral therapy and that
pharmacies are stocked with all essential medicines for all common
diseases. We can slow or even stop the exodus of health-care workers to
other countries by improving our conditions of service and building a
health-care system that we can be proud of: one that meets the needs of
the poor. We call upon you to commit to increase the state's investment
in the public health sector, to develop a comprehensive HIV/AIDS
treatment and prevention plan and to commit to the rollout of
antiretroviral treatment for people with AIDS. By doing this, you will
demonstrate leadership. Let us work together to build a better
health-care system for all.
Title & Name Public/Private Sector Position /
Job Health Facility Date
[END OF PETITION]
Mobilise Every Community to Support TAC's
Demand for a Treatment and Prevention Plan! Organise for a Public Sector
The rain poured down gently across the Western Cape soaking its
landscape and making the shanty-townships pools of misery. Inside, a
hall in Site C Khayelitsha more than 300 determined TAC branch leaders
from Ashton, Atlantis, Khayamandi, Zwelenthemba, Ceres, Mitchell's
Plain, Cape Town City Centre, from across, Nyanga, Langa, Gugulethu and
Crossroads. From 10h00 to 13h00, activists from across the province
demonstrated democracy in action.
The decision by the TAC National Executive Committee to postpone the
civil disobedience campaign was explained by Zackie Achmat. He told the
TAC branch leaders that this was government's last opportunity to show
its good faith. The Cabinet Report on anti-retroviral therapy, the
NEDLAC Draft Agreement, the SA Human Rights Commission Report creates a
legal and moral basis for government to act. Failure to take this
opportunity will open the road to intensified mass protest by TAC and
An intense debate ensued. Speaker after speaker, branch after branch
expressed scepticism of government motives. As one person said
"Government is trying to make us dance to its tune."
Grief, pain, anguish and anger against government neglect united every
person in the room: "Every day our comrades, family and friends die.
How long must we wait? Will government drag out this process?"
There was agreement over the following statements made by various
"Government is trying to demobilise our protest."
"SANAC is toothless. It ignored TAC until our civil disobedience, now
it wants to meet with us. But, it has no power."
Then we examined what we can do: "Civil disobedience is a tactic to win
us medicines. TAC is not fighting government because we like fighting.
We are struggling to save millions of lives." was the message made by a
number of people.
Other comrades demanded: "We must use mass action and launch a court
case for a treatment plan."
Several speakers put forward these proposals which received unanimous
support:"We will use the suspension of civil disobedience to strengthen
our forces in every branch and community. We can convince many more
people that TAC's cause is just -- the many people in the union
movement, those in the religious sector, NGOs and countless ordinary
people who agree with treatment but are not yet ready for civil
disobedience action. If government fails to act, we will win these
people to our side."
After three hours discussion, consensus emerged. Our civil
disobedience is suspended until 17 May 2003. Our anger, pain and anguish
cannot be suspended.
* We will use our anger to mobilise larger numbers of people for
mass protest across South Africa in support of the NEDLAC Draft
Treatment and Prevention Plan.
* TAC will ask our allies internationally to be ready for further
mass international protest should government fail to deliver
* If SANAC fails us, we will mobilise a range of actions locally,
provincially and internationally to ensure that government implements a
[END OF ARTICLE]
A Selection of Recently Published Articles
by TAC Activists
TAC Develops the Non-Racial Traditions of the Freedom Charter -
South Africa Belongs to All Who Live in it!
By Zackie Achmat, TAC Chairperson (Published in the Mail & Guardian)
According to reports, the Minister of Health recently attacked Mark
Heywood in public as a white man who manipulates Africans to take part
in the Treatment Action Campaign actions. This is a betrayal of the
tradition of non-racialism of the Freedom Charter and the Congress
movement. It is not the first time it has happened, nor will it be the
last. Through whisper campaigns, party caucuses and innuendo TAC
leaders have all been denigrated as agents of whites, imperialism, US
drug companies, Indian drug companies or as a part of a sinister,
racially inspired plot against the government.
Ironically, this tactic has been employed before to undermine the
struggle of black people for justice. Apartheid kingpins such as John
Vorster, Jimmy Kruger, Louis le Grange also used precisely this
tactic. Those of us who lived during that period will remember that
every strike, school boycott, community action or social mobilisation
was depicted as 'white communist' (or liberal) manipulation. The
message of the Health Minister and those who use the same ploy is an
insult to all black people (African, Coloured and Indian). It suggests
that black TAC members cannot think or act as equals to white members
just as black members of the ANC were regarded by the apartheid
government as cannon-fodder for white liberals and communists. The
Minister herself has a white advisor - Patricia Lambert. Imagine the
suggestion that the advisor was really the architect of national health
policy - how would we all respond?
The end of the apartheid state and institutionalised racial oppression
represents an irreversible achievement. But, racism and racial and
social inequalities remain major stumbling blocks to development and
freedom. No person in South Africa is free of racial prejudice,
stereotypes or fears. Racism as a manifestation of individual psychology
can only be addressed through open discussion, appeals to reason,
social solidarity and removing structural reinforcements to racist
prejudice. Censorship, racial innuendo, labeling and crass attacks have
no place in achieving equality.
Racism remains alive not only because of discrimination or prejudice
against individuals though, the impact of prejudice and discrimination
on individuals, families and communities should never be
under-estimated. The social structure of racism is central to its
perpetuation. Racism is unwittingly reinforced through social and
economic choices made by government. The vast majority of people who
live in government built dormitory housing, use over-crowded and
over-burdened public health services, cram into third-rate schools, fail
to receive social grants, lose their jobs and who remain insecure in
their neighbourhoods are black, mainly African. They are also poor. Of
course, the class dimensions of racism and poverty reinforce each
other. But dignity, freedom and equality continue to be denied to people
who are mainly black and poor, particularly women - not simply because
of a few die-hard racists but because social policies themselves
TAC's struggle for a treatment and prevention plan (including social
upliftment initiatives) and the use of anti-retrovirals in the public
sector hospitals clearly illustrates this paradox. The vast majority of
people who die avoidable and predictable AIDS-related deaths are black
people who use the public health services. People who have access to
medicines are predominantly (black and white) middle-class people who
have access to private health care. The continued denial of
anti-retroviral and other essential medicines reinforces the suggestion
that black lives have no value to those in power. It suggests that the
lives of the majority of people living with HIV/AIDS are expendable
because they are poor and black.
The Minister of Health and those who share her advantageous social
position, who all have access to private health-care at tax-payers
expense, misapply the oppression of black people to disguise anti-poor
and, in effect, anti-black policies. TAC makes no apology for the fact
that the overwhelming majority of our members are poor, black, African
people, particularly women. We are accused of bussing black people to
demonstrations. Of course. We can only plead guilty. The people who
use buses don't have cars. If we had money, TAC would use more buses,
and more cars. The TAC could bus hundreds of thousands of black (and
white) people to our demonstrations. This is not because black people
allow white people to think for them, or, to write their speeches. It
is simply because our mothers, fathers, sisters, brothers, friends,
colleagues and children are dying because of a health policy that
reinforces racial prejudice. We join TAC demonstrations in our
thousands to counteract the racial and class hypocrisy of the
government's HIV/AIDS treatment policy.
TAC has remarkable leaders. Many are black working class, poor.
Others are middle class. There are men and women. Mandla Majola,
Thembeka Majali, Vuyiseka Dubula, Terence Crow, Bongiwe Mkhutyukelwa,
Theo Steele, Thabo Cele, Zodwa Ndlovu, Pholokgolo Ramothwala, Nonkosi
Khumalo, Sharon Ekambaram, Portia Ncgaba, Sipho Mthathi, Edna Bokaba
and countless others cannot take seriously the Minister of Health's
imputations about the quality and nature of our leadership.
Mark Heywood, our comrade, friend and a leader of the Treatment Action
Campaign is a white, middle class, Oxford educated, Nigerian-born male.
These were all elements of his identity when he became an
anti-apartheid activist in the early eighties and when he committed
himself to freedom in South Africa. We welcomed him then. He does not
hide his racial or class privilege but consciously uses it to challenge
racism and social inequality. He leads the ranks of other white people
- too few, alas - such as Hermann Reuter, Sue Roberts, Orly Stern,
Nathan Geffen and Jonathan Berger, who are dedicated members of TAC. We
welcome all their contributions equally.
TAC makes no apology for its conscious development of the non-racial
traditions of the ANC, the Congress Alliance and the United Democratic
Front. South Africa needs examples of non-racial, cross-class,
inter-generational and gender co-operation on the basis of equality. We
are not naïve. Racism, sexism, homophobia, religious and social
prejudice are a part of all our daily lives. In TAC, we struggle against
it together. We do not retreat into ghettoes to reinforce inequality
and prejudice. Our non-racialism is not an expedient to retain to
skills or capital. Although, we unapologetically utilise the privilege,
education, skills and resources of our middle-class members, black and
white to develop a strong pro-poor and working class leadership in TAC.
But these skills are no more important that the organising and social
skills that poor, under-educated people bring to our organisation.
Genuine non-racialism asserts the equality, dignity and freedom of all
people and it is essential to ensure social justice for all.
[END OF TAC AND NON-RACISM]
TAC's focus on Anti-retrovirals is not "narrow"
By Mark Heywood, TAC National Secretary (Published in the Star)
On April 1st Kebareng Moeketsi was lowered into her grave in a cemetery
in Midrand. It was an early Autumn morning, a Tuesday, and several
hundred people had gathered to say farewell. They stood carefully around
the edges of other fresh graves: a company of the living mingling with
the growing company of the dead. Kebareng was not alone in her young
age. Many of the other recently departed were also born in the 1960s.
Here and there adult mounds are interrupted by those of children.
Kebareng had died suddenly of her HIV infection. On March 20th she had
been 'well'. She had marched as a leader of 200 TAC volunteers to the
Sharpeville police station, and personally handed in an affidavit
placing responsibility for the HIV-related death of one of her friends
at the doors of the Ministers of Health and Trade and Industry.
I had noticed her at the TAC workshop the day before, marked out by the
depth of feeling in her eyes, a pretty and dignified young woman, strong
in her silence. A week later, the sudden onset of pneumonia, diahorrea
together with the TB she was already being treated for was enough to
Why did Kebareng die of AIDS when others live with HIV? The Alexandra
clinic was only kilometres away, but it did not keep anti-retroviral
medicines -- because that is government policy. It's nurses and doctors
are mostly not trained to use ARVs - because that is government policy.
Across the health curtain that separates public health from private
health, there were a plethora of modern clinics and pharmacies stocked
with the medicines that would have kept her alive. But these clinics and
medicines are for the old rich (apartheid's beneficiaries) and new rich
(the rapid risers of new South Africa) -- people who are secure that in
their time of need they will get help. Kebareng might have bought
herself temporary access to health, but at over R1000 a month it would
not have been sustainable.
Kebareng is not a statistic. She was a new South African, a mother of
an 11 year old boy, a daughter, a resident of Alexandra township, a
young woman who had chosen to care for others in her situation. Kebareng
chose to campaign for anti-retrovirals because it was a campaign for her
own life: for her right to continue to be a mother, a breathing,
feeling human being, a rights-holder in the new South Africa. It is
these facts that make accusations by ANC leaders such as Cameron Dugmore
that TAC has a "narrow" focus on anti-retroviral medicines so unfounded
TAC is made up of thousands of people whose work takes them daily into
the homes and wards of the sick and dying. TAC is made up of people of
many hats: people who work tirelessly to prevent new HIV infections;
nurses who treat the illnesses it causes, people with HIV in their own
bodies or those that they love. All these people have drawn the
conclusion that if medicines exist which help to restore wellness for
rich human beings then they should also be available to the poor.
Government's excuses and delays - its insulting attempts to deny the
human toll of this epidemic - don't wash. Time runs out literally.
To assert the right to life, to continue to breathe, is not "narrow".
Unfortunately, the AIDS epidemic is a reality, and for many people in
the late stages of HIV infection access to medicines determines whether
or not that right is extinguished.
120 years ago in one of his novels Charles Dickens used the death of
young Joe the street sweeper to rage against the premature deaths of the
poor. Today, his words should ring for Kebareng, and sound shame in the
ears of those who could have saved her:
"Dead, your majesty. Dead, my lords and gentlemen. Dead, right
reverends and wrong reverends of every order. Dead, men and women born
with heavenly compassion in your hearts. And dying thus around us every
[END OF ANTIRETROVIRALS NOT NARROW]
Why I Disrupted the Minister of Health's
By Nonkosi Khumalo, TAC Women's Health Co-ordinator (published in City
I helped disrupt the Minister of Health's speech at the Health Systems
Trust Public Health Conference. I even put my finger near her lips and
shouted "Tula Manto". My mother would have been shocked. I have been
brought up to be polite. I cannot remember having done something like
this before. But I would do it again. Thousands are dying without access
to life-saving medicines and Minister Tshabalala-Msimang's response is
to brag about AIDS denialist, Roberto Girraldo. For too long she has
denied, delayed, misrepresented and deceived the South African public.
For too long she has ignored the Constitutional rights to life, dignity
and health-care. I remember when the minister laughed grotesquely when
in a meeting I attended, she was questioned about treatment. She is
clearly not a person who cares about the lives of poor people. The
Treatment Action Campaign (TAC) has been forced to go beyond polite
diplomacy and court cases, though these are still needed. Peaceful
civil disobedience is now also a necessary part of our campaign.
The HIV epidemic has created a social crisis that is being felt in
thousands of households. It is threatening the reconstruction and
development of this country and its people. At least 600 people will die
daily on average in South Africa this year. Yet there is no treatment
and prevention plan plan to try and address this situation. Government
has simply discontinued negotiations that took place at NEDLAC with the
business, labour and community sectors. This demonstrates enormous
callousness towards the millions of South Africans living with HIV/AIDS
who will die over the next decade if they do not get treatment. This is
why TAC is calling for civil disobedience after four years of
discussions, debates, negotiations, court cases and many polite
demonstrations and marches. On 14 February over 10,000 people marched to
the opening of Parliament to call on government to come up with the a
comprehensive prevention and treatment plan that includes
antiretroviral therapy in the public sector. We are still awaiting
government's response, as well as their response to numerous other memos
we have given them.
During the last few months of 2002, an HIV/AIDS treatment and
prevention plan was negotiated between government, business, labour and
the community sectors at NEDLAC. Agreement was reached on 28 November
2002. The agreement also contained square-bracketed text to indicate
points on which further discussion was needed, but all the negotiators
were ready to sign the document. However, it seems that the Minister of
Health and other Cabinet ministers were not in agreement with their
negotiators, because government has refused to sign the agreement.
Instead of using the last four months to resolve their concerns,
government has engaged in a propaganda campaign to argue that no
agreement was reached. During this time, they have ignored continuing
negotiations at NEDLAC.
The Minister of Health has said that the government has a plan, known
as the HIV/AIDS and STI's strategic plan 2000-2005. Unfortunately it
says little about treatment generally and nothing about antiretroviral
therapy. It also contains no targets or dates, which makes it read more
like a wish-list than a plan. TAC is not calling for this plan to be
scrapped, but for the NEDLAC agreement to complement and strengthen it.
The prevention and treatment plan that was negotiated at NEDLAC, gives
firm targets and timeframes for all sectors to take responsibility for
meeting those targets. This indicated clearly that the government would
not be implementing the programme alone, but with assistance and
commitment from other sectors. This was an opportunity for government
and the Department of Health to create a partnership with business,
labour and civil society to improve the HIV epidemic and save millions
of lives. But it is clear that government does not really believe in
partnership, despite their expensive Sunday newspaper advertisements
claiming they do.
Some have accused TAC of being obsessed with antiretrovirals, but our
track record over the last four years demonstrates that we have pushed
for access to social grants, run numerous workshops on nutrition and
worked to make all medicines more affordable. The reality is that the
Minister of Health is obsessed with antiretroviral treatment. She
obsessively believes, despite all the scientific evidence to the
contrary, that antiretrovirals do not work.
The Minister's latest propaganda campaign to avoid her Constitutional
duties is to deceptively argue that nutrition, not medicines, holds the
solution to HIV/AIDS. Of course, nutrition is a critical part of the
response to AIDS, as it is to many other diseases. But medicines are
also critical; without them people will die. There should be no need for
South Africa to choose between nutrition and medicines for people with
HIV/AIDS. We can afford both. Indeed, the Minister of Finance has put
aside a substantial sum of money for HIV/AIDS for the next 3 years,
including nearly R2 billion to start antiretroviral programmes, if
government changes its policy.
The demands of TAC's civil disobedience campaign are that government
makes an irreversible and unequivocal commitment to a public sector
antiretroviral programme and that it signs the NEDLAC agreement. TAC
has politely urged government to do this for a long time. The response
has been gross intransigence, incompetence and arrogance. A journalist
took one of my TAC colleagues to task this week, asking why we do not
use the courts to get government to commit to antiretroviral treatment
as we did in the mother-to-child transmission case. Indeed, we will use
the courts, but there is no guarantee that this will change
government's policy. Also, for the hundreds of thousands who will die
before such a court case is over, government must have its lack of
conscience exposed through civil disobedience. For those who are dying,
their friends and families, being polite will not be enough.
[END OF PEOPLE ARE DYING]
Nutrition is a Basic Right, But so is
Access to Life-Saving Medicines
By Sipho Mthathi, TAC Treatment Literacy Co-ordinator (Published in
For reasons including natural disasters, corruption and bad governance,
the crisis of food security continues to plague the Southern African
region. The UN estimates that almost 14.5 million people are in urgent
need of food aid in the SADC region alone. The HIV/AIDS epidemic
currently plaguing the Southern African region heightens the urgency
with which food security must be addressed. Health and nutrition are
inextricably linked. The World health Organisation (WHO) has
repeatedly affirmed, "proper nutrition and health are fundamental human
rights. Nutrition is a cornerstone that affects and defines the health
of all people, rich and poor. It paves the way for us to grow, develop,
work, play, resist infection and aspire to realization of our fullest
potential as individuals and societies. Conversely, malnutrition makes
us all more vulnerable to disease and premature death (Gro Harlem
Brundtland, WHO)". However, no internationally recognised institution
including the World health organisation has ever said that food alone is
enough to prevent and treat diseases. If anything, UN agencies like the
WHO recognise the comprehensive nature of responses needed to address
ill health and have proactively promoted greater understanding of
treatments, including medical treatments, for all illnesses.
On the issue of HIV/AIDS treatments, the World Health Organisation
published guidelines for the treatment of HIV associated illnesses as
long as 10 years ago and updated them in 1998. In 2002, the WHO
published guidelines on the use of ARVs in resource-limited settings and
has since included them in its Essential Drugs List (EDL). These
guidelines clearly demonstrate that not only is it possible to use ARVs
even in settings worse than the South African one, it is morally,
politically and economically plausible. Uganda is a country with the
oldest AIDS epidemic in Africa and a $6 billion gross domestic product
compared to South Africa's $130 billion. However, the government of
Uganda has recognised that continuing with a strategy that excludes
treatment with antiretroviral therapy is not only ineffective and
morally unjustifiable, as it denies people an equal the chance to live
longer and healthier lives , but it is also not cost-effective. To this
effect, Uganda is finalising its plans to put 100 000 people on
antiretroviral therapy by 2005, in keeping with the WHO commitment to
treat 3 million people living with HIV with ARV in the developing
Many opportunities have been presented to the South African government
to improve access to medicines for all who need it. Both the Medicines
Act and the Patents Act contain provisions for importing or producing
lower-priced medicines. The international Declaration reached in DOHA in
2001 reaffirms the right of governments to put public health interests
over and above patents or any other measures that create barriers to
accessing affordable medicines. Not even Trevor Manuel can successfully
convince the South African public that South Africa does not have the
money to start antiretroviral therapy. According to Dr Ayanda
Ntsaluba's presentation to the Portfolio Committee on Health on 18th
March, SA already spends R 4 billion to treat HIV opportunistic
infections and TB every year. This shows clearly that not using ARVs, as
part of the treatment strategy for HIV is not necessarily cheap.
Research at Somerset Hospital in SA demonstrates that with
Antiretroviral therapy, TB in people living with HIV can be reduced by
80%. This would free up resources that can be used to scale up
treatment programmes to benefit more of the approximately 500 000 people
who currently need antiretroviral treatment in SA.
These are the issues we should be discussing in South Africa now. How
are we going to enhance our strategies by incorporating the experience
gained over the past years through small private and public projects
using antiretroviral therapy? But instead, our health minister creates
confusion and insecurity in those already taking antiretrovirals. In a
Parliamentary Portfolio Committee on Health presentation on 18th March
2003, the health minister went on record as saying that "taking garlic,
drinking lemon juice and use of virgin olive oil has more benefits than
these AZTs [sic]". She also said that she has videotapes to show how
the health status of people living with HIV improved after being put on
a nutrition program in Lesotho (run by a discredited charlatan who
denies the link between HIV and AIDS). Thus, according to her, the
department of health is going to focus on nutrition this year.
No scientist or rational person, including those who advocate for
antiretroviral treatment, has tried to dispute the value of nutrition in
the health status of any person, irrespective of their HIV status. It is
internationally accepted that for people living with HIV, nutrition is
a critical part of strategies for maintaining good health. However,
even the most well fed person with HIV in the White House of the United
States will not be saved by a good plate of food every day when the
immune system is too broken to fight disease. That is why the European
Union and the United States have clearly stated policies to use
antiretrovirals as part of a comprehensive strategy to treat HIV/AIDS.
600 people die as a result of HIV/AIDS in SA everyday. Most of them are
poor, because parliamentarians and the better off middle-class can
afford antiretroviral treatment. While a lot of work has and is being
done by government, civil society and all other sectors to curtail new
infections and mitigate the impact of HIV/AIDS on individuals,
households and the society at large, our strategies are clearly not
enough. In Minister Skweyiya's words uttered in 2000, "we need a
Marshall plan" to address HIV. We need a co-ordinated, coherent,
all-inclusive and clearly communicated plan with clear targets and time
frames. This plan must incorporate a clear programme to address food
security for all, including people living with HIV/AIDS. This is what
the NEDLAC process had intended to do. We need this plan, not tomorrow,
not in a few months but today. We have a crisis that with government's
own admission "is of enormous proportions". The thing we lack more
than answers on what antiretrovirals will cost is leadership. We have
enough answers on the costs of HIV/AIDS medicines and how to reduce
those costs. We we really need is unwavering leadership steered by the
person primarily charged with duties to take care of our health. Not
someone who will tell us to take lemon juice to treat AIDS.
[END OF NUTRITION AND MEDICINE]
ANC's Dugmore Has Serious Questions to Answer
By Nonkosi Khumalo, TAC Women's Health Co-ordinator and Nathan Geffen,
TAC National Manager (Published in the Argus)
In a report in the Argus (27 March), Western Cape ANC Spokesperson on
Health, Cameron Dugmore claims that government has a comprehensive AIDS
strategy. We are perplexed by this claim. Could we trouble him to answer
some simple questions?
Why does the government's 5 year HIV/AIDS and STD strategic "plan" have
no targets and no dates? Surely a plan without these is a wish-list not
a plan. Why does their plan not include antiretroviral therapy? If
government is committed to treating all opportunistic infections as the
Department of Health so often claims, then can Dugmore explain why
almost no clinics have the medicine, called acyclovir, needed to treat
Herpes? Why do only one in four clinics have the medicine, called
fluconazole, needed to treat systemic thrush and cryptococcal
meningitis? (It is worth noting that the fact that any clinics have
this medicine at all is almost entirely due to a TAC campaign that took
place two years ago.)
In July 2001 a draft version of a Department of Health document on an
appropriate response to the HIV epidemic provided for the possibility of
antiretroviral therapy. Does Dugmore know why this was excised from the
version that came out in September?
If government is so concerned about managing the HIV epidemic, why have
so many public health-care positions been frozen? Why have so few nurses
been trained to deal with HIV/AIDS?
If government is so concerned about prevention, why did it require a
court case and years of pressure to get government to implement
mother-to-child transmission prevention? Why is it that some provinces
only started implementing and rolling out this programme after TAC
threatened contempt of court charges?
Dugmore, like the Minister of Health has had a sudden realisation that
we have a food security problem in South Africa. But does he really
believe that a middle-income country like South Africa has to make the
stark choice between preventing hunger and preventing access to
life-saving medicines? Surely our government manages the economy well
enough to be able to afford both?
Dugmore correctly points out that the ANC accepts the role of
antiretrovirals. Government has also had this as its official view --
despite the frequent bizarre utterances of the Minister of Health --
since 17 April 2002. But then can Dugmore please explain why nothing
has been done to expedite the availability of treatment in the public
sector since then? Also, why have all efforts to reduce medicine prices
come from civil society and a few local officials, but not at all from
national government which still has not promulgated the Medicines Act?
Dugmore and his colleagues have disputed that an agreement was reached
by negotiators at NEDLAC. If the Cabinet was unhappy with what was
agreed at NEDLAC, surely government should have wasted no time in
sorting out these problems by continuing to negotiate at NEDLAC? Why
has government not returned to negotiations at NEDLAC for nearly four
Dugmore expresses outrage at TAC's non-violent disruption of the
Minister of Health's speech at a recent conference. Can he explain why
he does not express outrage that our Minister allows at least 600 people
to die daily, on average, simply because they do not have access to
life-saving medication? Does Dugmore believe that it is sufficient that
some of his colleagues in Parliament, who are strangely silent, have
access to these medicines? Does it worry Dugmore that many ANC
supporters (many of whom are also TAC members) are dying because unlike
his colleagues, they cannot buy life?
We hope that when Dugmore agrees to a public debate with Zackie Achmat,
he will provide the answers to all our questions.
[END OF DUGMORE HAS SERIOUS QUESTIONS TO ANSWER]
Response to ANC Youth League
By Zackie Achmat, TAC Chairperson (Published in Sowetan)
ANC YOUTH LEAGUE LEADERS DESCEND INTO IRRATIONALITY
By Zackie Achmat
The descent of the ANC Youth League leaders into irrationality is a
tragedy. In the last few years, Youth League leaders have praised every
wrong policy of government while ignoring the plight of youth in our
country. One may be justified to regard the voice of its leaders as the
undemocratic songs of cruelty and crassness inside the ANC. Malusi
Gigaba's defence of Robert Mugabe in Business Day, Khulekani
Ntshangase's attack on the Treatment Action Campaign (The Sowetan, 22
April 2003) and the Youth League's attacks on Judge-President of
Transvaal Bernard Ngoepe and Archbishop Njongonkulu Ndungane are obvious
examples of this irrationality. We can list many more. This is a
departure from the 1950s when the Youth League leadership by Nelson
Mandela, Anton Lembede, Walter Sisulu and others inspired the weak ANC
to take on the Apartheid regime in the Defiance Campaign.
Ntshangase's attack on TAC is so devoid of truth, that at first we
thought it too laughable to respond to. However, the confusion created
by the Youth League's spokesperson is dangerous and misleading.
Ntshangase claims that: "every honest person knows that the
overwhelming majority of our people die from accidents and violence".
This is a lie. The Medical
Research Council has concluded that AIDS was already the single biggest
cause of death in 2000. But Ntshangase probably does not trust
independent research that does not emanate directly from government
itself. He therefore should have consulted the report released by
Statistics South Africa's last year, which demonstrates that
Tuberculosis was the biggest reported cause of death in 2001 followed by
HIV-disease (i.e. AIDS). It is almost certain that if we take into
account HIV-related TB deaths then AIDS was by far the biggest single
cause of death in 2001. Statistics South Africa also demonstrates that
HIV-disease has been the biggest single cause of death among women since
Ntshangase says that TAC "is a conglomeration of drug-dealers who serve
as marketing agents of toxic drugs which are not even used where they
come from, America." This is a compounded set of lies. Antiretroviral
medicines are approved by the United States Food and Drug
Administration and are used by far more people in that country than in
South Africa. Furthermore, the Medicines Control Council, an
independent statutory body that has to make decisions solely on the
safety and efficacy of medicines, has approved over 15 different
antiretrovirals for use here. The Cabinet recognised that
antiretrovirals are effective on 17 April 2002. This position was also
restated as ANC policy in December at Stellenbosch.
Ntshangase is the not the first ANC member to allege that TAC receives
funding from the pharmaceutical industry. President Thabo Mbeki made
that allegation in a secret Parliamentary caucus. It is unfortunate
that The Sowetan did not check this before allowing a falsehood and
defamatory allegation to be made. TAC's funders are listed in our
audits which can be downloaded from our website by the public. We do
not accept money from pharmaceutical companies or the South African
government. Much of our funding does, however, come from the former
The Youth League spokesperson further suggests that: "Government should
investigate ways of arresting people such as those who campaign for the
poisoning of our people." Perhaps the Youth League is playing a
childish game of tit-for-tat: We have called for the arrests of the
Ministers of Health and Trade and Industry for culpable homicide, so the
Youth League calls for the arrest of TAC members. Ntshangase is in
effect suggesting that we be arrested for expressing views shared by the
scientific community. However, the charges of culpable homicide against
the Ministers follow from their negligent failure to do their jobs.
This obstruction and negligence has resulted in thousands of deaths. As
dangerous as we think Ntshangase's AIDS denialist views are, basic
respect for freedom of speech means we would never call for his arrest
for expressing his views. He should extend the same courtesy to those
with whom he disagrees.
The comparison Ntshangase draws between TAC, a peaceful movement
campaigning for basic human rights, and PAGAD, a violent group that
campaigns for vigilante justice, is ludicrous. It is also irresponsible
and dangerous. He writes, "Pagad was destroyed so will be TAC!" This
is incitement and hate speech.
Ntshangase claimed in a radio interview that the article was written in
his personal capacity. However, he is the spokesperson of the Youth
League and there is no indication anywhere in the article that he was
writing in his personal capacity. We
therefore demand the ANC Youth League to print corrections to the
factual errors. We also demand that they apologise for their false claim
that TAC is funded by pharmaceutical companies and the suggestion that
we engage in "the poisoning of our people." Ntashangase also falsely
charges Cosatu and the labour movement with conspiracy to kill its
members. As a leader of the Youth League he displays a profound
ignorance of HIV science and the suffering of our people.
Ntshangase and his friends say we attack the ANC. The ANC is a powerful
party with more than 10 million voters and quite a few floor-crossers.
It is also the party of government with a profound history of resistance
and a record on social development that should speak for itself. As a
party of power, the ANC is one of the most pervasive institutions in
our country. Ntshangase and his friends defends ANC leaders and the
powerful against people living with HIV/AIDS, TAC and poor people who
cannot access medicines. The ANC needs thinkers whose loyalty is based
on pointing out in public the weaknesses of the organisation, especially
where the right to life of the weak and vulnerable are at stake. Youth
League leaders at its national offices appear to be job-seekers in the
ANC bureaucracy not youth campaigners for social justice. TAC members
and leaders proudly represent the non-racial and campaigning traditions
of the ANC and the United Democratic Front.
It is sad that the Youth League, with its heroic history in the 1950s,
cannot find the moral strength to agree to TAC's demands that Government
must develop and implement a treatment and prevention plan for people
with HIV/AIDS and commit to the rollout of antiretroviral treatment. It
is this sort of moral cowardice that is resulting in thousands of
[ENDS OF RESPONSE TO ANC YOUTH LEAGUE]
President Mbeki Must Break His Silence
By Mark Heywood, TAC National Secretary (Published in the Sunday
During 2002 South Africans were given more information about the scale
of the AIDS epidemic in this country than ever before. As if to spite
those who claim that HIV/AIDS is an imagined disease, that has been
conjured up by researchers in the pay of foreign pharmaceutical
companies, all of this information was home-grown.
In May the Department of Health's annual ante-natal survey estimated
that 4.7 million South Africans had HIV infection.
In October Statistics South Africa, released a report requested by the
President, which showed dramatic changes in causes and patterns of death
in our country. More people are dying young. More people are dying of
illnesses such as TB and pnemonia. This was attributed mostly to HIV.
Then at the end of the year a study commissioned by Nelson Mandela
showed that almost one in ten people of all ages in South Africa tested
positive for HIV.
The "news" was frequently concerned with the statistics provided by
these reports. But behind the official news HIV took its toll on real
people, mostly poor and mostly black. Every Friday for 52 weeks the
Sowetan carried funeral notices of young people who had died, many of
AIDS. Nurses watched mounting numbers of child fill paediatric wards.
Pastors and priests spent their weekends conducting funerals.
At the beginning of this year a study of 771 households, conducted by
the Health Systems Trust, an NGO that works closely with the Department
of Health warned that in "already poor households HIV/AIDS is the
tipping point from poverty into destitution" because "AIDS-affected
households are spending up to a third of their incomer on private
Thus, for most people in SA what researchers say increasingly collides
with everyday life. There is no doubt that HIV has established a
terrible foothold in our society and is taking its toll - and in the
face of this there is an expectation of leadership.
At last, leadership is emerging - amongst doctors, within churches,
from trade unionists and occasionally even from self-interested business
people. Slowly society seems to be rallying to the reality of HIV/AIDS.
But, in the face of this awakening there is a terrible dearth where
government should be. Frequently, instead of leadership there is
questioning and confrontation. Of course, the Minister of Health claims
that she is offering leadership. But this leadership has a gaping hole.
It is incomplete - and will be for as long as the President continues to
abdicate responsibility for this area of the national life.
In response to criticisms, Mbeki's office says that dealing with AIDS
is 'the duty of the Deputy President'. Given the scale of the problem,
and the amount of time that should be given to its management, this may
be a justifiable delegation of power. But ? handing over management
responsibility is one thing - declining to say anything on the crisis is
The 'Mbeki page' on the ANC website proves the point. It contains 51
speeches by the President made during 2002. In reality he will have made
many more. Not one is devoted to the AIDS crisis. Even general speeches
that set priorities for the country or the ANC show that, except for
rare occasions, the President has little to say about AIDS and nothing
to say about HIV. It seems that HIV is still a virus this President
refuses to legitimize by direct reference.
For example, his recent speech marking the 91st Anniversary of the ANC,
made on behalf of the NEC of the ANC, made only one - in passing --
reference to AIDS, as part of an injunction that "we must also raise the
awareness of the people with regard to the other important maters
relevant to the health of our people."
Silence is inexcusable because silence is not neutral. Silence on a
matter of utmost national importance is in fact its opposite. It is a
clamorous statement of denial, and disbelief about HIV/AIDS. Silence on
HIV/AIDS in an address to the ANC national Congress is in fact an
instruction by omission to ANC members: it says 'HIV is not a national
issue. It is less pressing that poverty, transformation and delivery.'
It is an injunction that there are other matters more demanding. It
demobilizes. Arguably it throws a cloud of disapproval over those ANC
members who might consider this issue of grave importance. It degrades
the memory of those who have died. It gags ANC members who know they
have HIV and would like to find support in the party.
This is a terrible and costly error. It is self-defeating of Mbeki as
an individual and of his mission. Correctly, the President's main
mission is to tackle poverty. But as much as poverty makes AIDS, AIDS
makes poverty. The illness and death of millions of poor people will
erode the benefits of house, health and service delivery. Things will
fall apart. HIV/ AIDS will make us run, just to stand still in the
battle for reconstruction and development.
In his New Year message to the nation Mbeki promised that in "2002 the
sun will continue to shine on the South African people as we build this
non-racial, non-sexist and democratic country, instilling in all a
shared sense of nationhood and human solidarity." But refusing to talk
about AIDS is a denial of solidarity with millions of South Africans who
are frightened or sick by this virus. It is hard to appreciate the sun,
if you are paralysed with diahorrea, thrush or TB. The death of a child
clouds even the brightest day. It is hard to appreciate the sun when it
is government policy to deny you medicines - and when your poverty makes
you a victim of state discrimination between those who can buy life and
those who cannot.
I hope that the President reads this article, and that he responds. I
hope his response is forthright. I hope that he accuses me of calumny
and brings forward facts to prove that I am wrong. I want to be wrong.
The reason I write this is because, in the face of one of the greatest
challenges facing our nation his Presidency is silent. A leader who
disarms his country in the face of threats to its future is making a
calamitous mistake. 2003 must be the year when the President breaks his
silence on HIV, and builds unity. Otherwise it will be too late.
[END OF PRESIDENT MBEKI MUST BREAK HIS SILENCE]
[END OF NEWSLETTER]