TAC E-Newsletter 10 March 2003
Dying for treatment
TAC Briefing Document on the Civil Disobedience campaign
This Briefing document is intended to help TAC activists and supporters
to understand the background to TAC's decision to embark on a civil
disobedience campaign in March 2003. Hundreds of pages could be written
about TAC's efforts to persuade government to work with civil society on
an HIV/AIDS treatment programme - but this is just a summary. In
addition, although there is a great deal of independent research and
information that could be cited to support TAC's demands, in this
document we refer only to government's own research and policy
statements to show how, in reality, the reluctance to commit to a
treatment plan, including antiretroviral (ARV) medicines, contradicts
its own findings, policies and constitutional duties.
1. What are TAC's two main demands?
1. That government make an irreversible and unequivocal commitment
to a public sector ARV programme.
2. That government return to the negotiations at Nedlac and make
a commitment to signing a
Framework Agreement with business, labour and community on a
National HIV/AIDS Prevention and Treatment Plan.
2. What is the background to TAC's Civil Disobedience campaign?
2.1 Why we are calling for a National Treatment Plan?
The HIV/AIDS epidemic is a crisis that threatens South Africa's
reconstruction and development. Up to five million people are infected
with HIV and AIDS is now killing approximately 600 people every day.
In late 2002 an investigation by Statistics SA, titled Causes of Death
in SA, 1997-2001 found that:
"throughout the study period, the emergence of HIV, TB and influenza
and pneumonia as the main causes of death is observed. ... female South
Africans in the age category 15-39 died primarily as a result of HIV
infections. The data show a unique racial topology of mortality in the
Dealing effectively with a crisis of this scale requires a recognition
that HIV/AIDS is an emergency as Cosatu, the religious sector, business
and the international community has demanded. It requires mobilization
of all of society and a plan to save lives.
South Africa has a five-year HIV/AIDS and STDs Strategic plan, which
was adopted in 2000. TAC is not calling for this plan to be scrapped, or
replaced. We are calling for a National Treatment and Prevention Plan to
strengthen the Strategic plan, which says very little about treatment
generally and nothing about anti-retroviral treatment. We are calling
for firm targets and timeframes and for all sectors of society to take
responsibility for meeting those targets.
This is why TAC and COSATU supported by more than 500 organisations
including FEDUSA and NACTU decided to take our call for a National
Treatment Plan to Nedlac. Nedlac is a statutory body that has a
responsibility to create a forum for negotiation and agreement between
labour, business, community and government on issues to do with labour,
the economy and development. Among its functions are:
"seek to reach consensus and conclude agreements on matters pertaining
to social and economic policy." And
"to encourage and promote formulation of co-ordinated policy on social
and economic matters."
HIV/AIDS is an epidemic, disproportionately affecting the labour market
and the poor. It clearly has a major impact on social policy.
Between October and November 2002 a senior HIV/AIDS task team at Nedlac
jointly developed and negotiated a 'Framework Agreement for a National
HIV/AIDS Prevention and Treatment Plan.' In this document there are
major areas of agreement.
Originally the aim was to sign the agreement by December 1st 2002,
World AIDS day. However, government and business requested additional
time. Business has now completed its consultation and supported the
document. To date, however, government has not returned to Nedlac.
Instead it has used the media to try to discredit and misrepresent the
TAC does not agree that it is forcing the government to make 'policy
choices' at Nedlac. We do believe that the government has a
Constitutional duty to act and take effective measures against this
epidemic. This is because it must "respect, protect, promote and
fulfill" all people's rights to equality, dignity, and life. This can be
done by improving access to health services in general, and HIV/AIDS
treatment in particular.
2.2 Why is TAC demanding an ARV programme?
TAC has been accused of being only interested in anti-retrovirals. This
is not true. The Nedlac Framework Agreement, for example, deals with
many interventions that must be improved. But for those people with HIV
who are dying ARVs are an absolute and urgent necessity.
In considering TAC's demand for an ARV programme the following points
need to be borne in mind:
- Anti-retroviral drugs, including generics are registered by the
Medicines Control Council. This means, like all other medicines, they
have been approved for use in SA and are considered safe and effective.
- In 2002 the World Health Organisation (WHO) strongly recommended
the scaling up of ARV programmes in poor countries, so that people with
AIDS in Third World countries could have the same benefits from medicine
as people in Europe and America. Many countries with less resources that
SA have heeded this call, including Botswana and Namibia.
- In South Africa several conferences organised by the Department
of Health have recommended that there should be ARV treatment. The
National Health Summit, in November 2001, called for pilot projects on
ARVs. The draft report from the National Scientific Consultative Forum
on HIV/AIDS in August 2002 stated:
"As far as anti-retroviral therapy is concerned, there
was complete consensus that anti-retroviral programmes are efficacious,
and therefore carry the potential to keep many people with HIV alive for
many more years than would be possible otherwise. .. unanimous on the
need for the DOH to develop a more pro-active plan for the
implementation of ARV programmes."
TAC believes that the delay by government in acting on its own policies
and recommendations is leading to immense suffering and loss. It is also
creating new inequalities in SA. MPs have access to ARVs. People with
medical aid have access to ARVs. Parastatals such as Transnet and Eskom
provide employees with ARVs. The SANDF is designing an ARV programme. It
is only the poor, those employed in the informal sector and small and
medium sized enterprises, and the unemployed - ie those who are totally
dependent on the public health service - who, as a matter of policy are
denied these medicines.
- Most importantly the Cabinet Statement of April 17th 2002,
recognised that anti-retrovirals work when used according to
internationally accepted protocols.
The government has said that we must wait until April or May, when the
report of an investigation into the costs of an ARV programme is
complete, before a decision is made. TAC disagrees with this. TAC says a
policy decision and commitment must be made now.
3. The history of TAC's discussions with government,
particularly the Deputy President;
The TAC has been accused of being anti-government. This is not true.
The TAC supports this government, and its agenda to reconstruct and
develop SA, to eradicate poverty and create equality. It is because we
support this agenda that we demand an end to political denial about HIV.
Our demonstrations, petitions, court cases etc are all an affirmation of
the rights we won under our new Constitution.
TAC was founded in December 1998. From that moment on we have led the
march for access to treatment, including ARVs, for people with AIDS. Our
first march to Parliament to call for a National Treatment plan was in
2000. Since then Memos have been written and marches organized that have
repeated the call for a National Treatment Plan. The last was our march
on Feb 14th 2003 of 20,000 people.
But in addition to demonstrating we have made many other efforts to
assist government to overcome the barriers to treatment. These have
This contribution was recognised by the Deputy President, Jacob Zuma,
when TAC met with him in October 2002. The Deputy President agreed the
Nedlac process was important, but said that the government may need
until February 2003 to sign any agreement. "However, both parties
recognized the need for urgency based on the impact of the disease and
the suffering and death in communities."
- Our intervention in the PMA case, which led to the pharmaceutical
- Our campaign against Pfizer which led to to the multi-million
Rand Diflucan donation to the SA government;
- The research we have commissioned into the costs and impacts of
- Our complaint to the Competition Commission regarding excessive
pricing by pharmaceuticals companies;
- The community based 'treatment literacy' programmes we run to
improve knowledge of HIV.
The Nedlac negotiations went extremely well and consensus was reached
within the HIV/AIDS task team on most areas of the Framework Agreement,
including the principles and challenges of ARV access. Unfortunately
though the Nedlac process has now been de-railed by political
opposition. From the optimism of the negotiations we now feel that we
are back in a dark and difficult situation - once gain charcterised by
political denial about HIV. President Mbeki's refusal to recognize
gravity of the HIV epidemic in his State of the Nation address seems to
be proof of this.
4. Why did TAC and COSATU organize the 'Stand up for Our Lives'
march at the opening of Parliament on February 14th?
The agreement with Deputy President Jacob Zuma did not include a
promise by TAC to cease social mobilization for its demands, although
TAC did decide not to proceed with its threatened civil disobedience
campaign. It was in this spirit that the TAC NEC decided to organise a
"Stand Up for Our Lives" march on the opening day of Parliament 2003.
The purpose of this march was to link the year's most important
political event with one of the country's most important social
challenges, HIV/AIDS, and to demonstrate to our MPs the strength of
feelings that exist behind calls for treatment and a treatment plan.
The march turned out to be the largest march in the history of the AIDS
epidemic, not only in South Africa but in any developing country. It
involved people of all races and classes as well as all faiths; it was
led by people living with HIV and AIDS; it included 650 delegates who
traveled on a train from Johannesburg. The demonstration was
disciplined and peaceful and, as we said repeatedly, it was not an
anti-government demonstration but a demonstration to show government
what could be mobilized with TAC support to prevent and treat HIV.
A memorandum was handed over to government representatives from the
Presidency, Deputy Presidency, Health Portfolio Committee and Finance
Committee. The memorandum was respectful and requested a response by
the end of February to its demands. Those who received the memorandum
publicly stated that it would be given serious consideration. But, to
date, there has not been any response from the government.
5. What is meant by civil disobedience?
For the most part, the TAC is committed to lawful protest. Our short
history bears testimony to this.
We wish to state clearly: the TAC civil disobedience campaign is not
promoting ungovernability. It is not promoting gratuitous law-breaking.
It is not calling for the overthrow of the government!
The aim of the campaign is to demonstrate anger and compel our
political leaders to deal with our demands. For millions of people AIDS
is a personal and community crisis. It must be felt by our politicians
as a political crisis. If there is time to negotiate on behalf of
Burundi and the Congo (which we support) - there must be time to resolve
policy questions on AIDS.
This year our Minister of Health has had time to go to Iraq,
Switzerland and the United States. She has not had time to take a
decision on ARV treatment. This is immoral.
As will be seen, this campaign will follow in the traditions
established by the ANC and United Democratic Front in their protests
against unjust laws. However, our protest is against political
negligence and unjust policies which willfully withhold life-saving
medicine and other resources from people in desperate need.
AIDS in South Africa has created a social crisis that is being felt in
millions of households. This crisis has to be addressed visibly,
urgently and at the highest possible levels of political leadership.
This is not happening at the moment. The TAC's actions are intended to
draw renewed attention to this crisis.
In conclusion, we state plainly that government can avert this campaign
by responding to our cries. Partnership is our strongest desire. We end
with a repetition of TAC's two reasonable demands:
1. That government make an irreversible and unequivocal
commitment to a public sector ARV programme.
2. That government return to the negotiations at Nedlac and make a
commitment to signing a Framework Agreement with business, labour and
community on a National HIV/AIDS Prevenytion and Treatment Plan.
We ask you to support this campaign. Stand up for Our Lives!
Volunteer for Civil Disobedience
Every day more than 600 people in South Africa die of HIV/AIDS-related
illnesses. Many lives could have been saved had our government shown
urgency and commitment. We still have a chance to save millions of
lives. Regrettably, the Minister of Health continues to equivocate.
After four years of negotiations, petitions, marches, litigation and
appeals, the Treatment Action Campaign (TAC) has decided to begin a
peaceful campaign of civil disobedience on 21 March 2003. TAC requests
your support in this campaign. We are mobilising 600 people across the
country who will volunteer to get arrested in our civil disobedience
campaign. To volunteer, please fill out the form below and fax it to 021
788 3507. Please state if we can use your name in adverts of people who
will volunteer to be arrested.
We require volunteers with easy access to Cape Town, Johannesburg,
Pretoria, Durban, Pietermaritzburg, East London, Port Elizabeth and
Nelspruit. If you volunteer, please be prepared to be asked to
participate in an action some time between the 18th and 25th of March.
If you can only make it at certain times or dates, please note these on
your reply form. We aim to sustain our campaign until government makes
an unequivocal and irreversible commitment to anti-retroviral therapy
for all people who need it in the public sector. We also demand that
government returns to NEDLAC to negotiate the national treatment and
All civil disobedience actions will be peaceful and dignified, but
those participating are almost certain to be arrested. We will try to
arrange immediate release after arrest, but there is a possibility of
spending between one and three nights in police cells. TAC will provide
full legal support, bail and other resources related to civil
disobedience actions. We will not provide legal support or bail for
anyone who commits an act of violence. Our aim is to change government
policy and to unite people to condemn government culpability in the
deaths of more than 600 people every day. We will not be provoked into
acts of violence. We aim to expose the violence of allowing 600
children, men and women to die because they are poor and cannot afford
We urge government to act immediately to prevent the civil disobedience
campaign. We appeal to every person in South Africa to call on
government to act with speed, commitment and humility to fulfill its
Show your solidarity. Join the TAC civil disobedience campaign. Sign
on with the form below.
Forward to a national treatment and prevention plan.
Zackie Achmat on behalf of the TAC National Executive Committee
Reply by fax only to: 021 788 3726 or hand in to your provincial
I Volunteer for TAC Civil Disobedience
I volunteer to participate in the TAC Civil Disobedience campaign. I
am participating in civil disobedience because millions of people with
HIV/AIDS in our country are dying unnecessary, premature and avoidable
deaths. They die because they do not have access to anti-retroviral
medicines and proper care. My conscience is guided by our Constitution
that guarantees the right to life, dignity, equality and access to
health care. I want government to sign the NEDLAC framework agreement
for a national HIV/AIDS treatment and prevention plan. I also want
government to commit to rolling out antiretroviral therapy for people
I volunteer to (scratch out "Be arrested" if you do not wish to be
- Be arrested
- Organise activities in support of the civil disobedience campaign
including support for people who may be arrested.
If I have chosen to be arrested:
- I am over 18 years of age.
- I understand that this might mean spending a short time in prison
and ultimately getting a criminal record. However, I understand that TAC
will try to defend me from getting a criminal record and do all it can
to ensure that I spend as little time in prison as possible.
- So long as any act I commit is non-violent and within the
instructions of the TAC National Executive Committee, TAC must provide
me with legal support for any charges I face resulting from my civil
Full Name: ____________________________________________________
ID Number: ____________________________________________________
Work Tel: ___________________ Home Tel:
Cell: ___________________ Email:
Person to Contact if I am arrested:
Telephone number of person to contact:
Dates and times that I cannot participate:
Below is my suggestion for a civil disobedience action (optional):
Call for International Day of Action on
27 April 2003
TAC appeals to our international allies to organise a day of action on
27 April 2003 to urge the South African Government to save millions of
lives by signing the NEDLAC treatment and prevention plan and making an
unequivocal, irreversible commitment to the implementation of
antiretroviral therapy in the South African public sector. Pressurising
the South African Government to changing its policy is a crucial part of
the international campaign to improve access to treatment. Not only
does South Africa have the highest number of people living with
HIV/AIDS, but by successfully implementing a treatment programme in
South Africa, the path will be opened for improving the capacity of
other Sub-Saharan African countries to treat. This is because South
Africa has the generic pharmaceutical industry, skills and resources to
assist other African countries. Furthermore, the pandering to HIV
denialism by the South African Government has taken much of the focus
off the pharmaceutical industry's profiteering and the failure of
developed countries to sufficiently fund the Global Fund.
Through international solidarity, activists have made enormous progress
in the struggle for access to treatment. We believe a day of
international action will play a critical role in reversing the South
African Government's failure to treat.
As with our previous international days of action, we will place
planned events up on our website. We encourage organisations to come up
with their own ideas for action, but we request that all actions be
peaceful and dignified. For TAC's civil disobedience campaign in March,
we encourage organisations to continue letter-writing campaigns and
meetings with SA consulate officials. We will be increasing the
intensity of the civil disobedience campaign in April, but we hope that
the South African government will change its policies on HIV/AIDS so
that this will not be necessary.
Review of 14 February March
Get up stand up!
By Ralph Berold, February 2003
I wasn't sure whether I would go to the march for HIV treatment,
organised by the Treatment Action Campaign (TAC) at the opening of
Parliament. The thought of the 36 hour train journey, only 12 hours in
Cape Town and then another 36 hours back, had something to do with it.
But I realised last week that this was an important journey for me. I
had become passionate about the issues. I scan the papers and email
for news on changes in HIV/AIDS policy. It is time for government to
take care of some of its 4 to 5 million citizens who are living with
HIV. This must be shown not in empty promises and policies, but in
practical terms, through a better public health system and universal
access to life saving medicines. These changes have been proposed in a
document which has been under discussion for the last three months at
"Don't go there and insult our President" one comrade said. I
explained that TAC was not trying to insult or take over our
government. We are open about our motives - We want government and
organised business to sign the framework agreement that have been
negotiating. Let us stop fighting and move forward on this issue.
Together, as South Africans we are facing one big challenge.
We left at 9pm on Wednesday night from Park Station. About 600
activists from Gauteng, Mpumalanga, KZN and Limpopo province boarded
the train and began singing. The songs did not stop for three days. On
Thursday we ran workshops in the dining car. We looked after people
that were on TB treatment. Logistics such as catering for 600 through
one narrow passage was a nightmare. But people were patient and
efficient and there was an air of respect, a partnership amongst
I met a policeman who had disclosed his status and was an active HIV
role model and educator. I met counsellors, toyi-toyi boys, nurses,
old people, students, researchers and journalists on the train - each
with a common purpose. We stopped at Beaufort West in the afternoon.
Staggered into an air conditioned Wimpy for a coke and to our delight
and surprise we found an oasis in this dusty town - a deep blue public
swimming pool. We swam in our clothes.
Friday morning we hit Cape Town station. In the light rain we gathered
and were issued our "HIV positive" T-shirts. 600 people walked to St
George's cathedral distributing pamphlets to people on the streets. At
the former church of Archbishop Desmond Tutu, we ate breakfast and met
up with our Cape Town compatriots. Six of us split the scene, with
some hours to kill before the march was scheduled to begin. We roamed
the Company Gardens, past the back of Parliament, Tuynhuis - the
official residence of the President, past the National Gallery. We
were allowed into the National Museum for free where we saw the
massive bones of whales and million year old rocks and crystals.
The six of us then made our way to the start of the march down Adderly
Street, where the presidential guard stood at attention, dressed in
full colours. Clad in our "loud" T-shirts we passed them handing out
flyers to the growing crowd. When we reached the TAC crowd, the
president and his armoured BMWs drove past. TAC activists lining the
streets. Our marshals, identified in red T-shirts kept the crowd from
pushing forward to meet the President's motorcade. Anxious police
The rally started at about 12:30. Amampondo hammered out some
beautiful melodic rhythms on their marimbas. A flatbed truck served as
a stage for speakers and a sound system. Patricia de Lille was one of
the first to speak. She said that today she had left Parliament to
march with TAC. She reported that the President, in his "state of the
nation speech", talked about the US and Iraq for 20 minutes and just
mentioned HIV/AIDS in passing, not even by name. Archbishop
Njongonkulu Ndungane did not mince his words - "they say that we do
not have money for antiretroviral drugs, yet we can pay R60 billion
rand for arms!". Where are our priorities?
Then about 20 000 people stood up and arranged themselves in legions
-groups in which they would march up Adderley Street. First the people
living openly with HIV and AIDS. Then the religious and political
leaders. Then the unions. Gays and lesbians. Students. NGOs and
community based organisations. Each activist knew why they were there.
"HIV treatment for all". We sang, shouted, toyi-toyed, clapped hands
and moved forward. Shop workers came to their doors to give their
support. Pedestrians were swept into the tide of our wave. I looked up
the street and as far as I could see were thousands of people. The
power of our bodies and our determination.
In front of Parliament we stopped. A mass meeting at the gates of
power. TAC chairperson Zackie Achmat told us how the great rivers of
Africa were not big enough to hold our tears, our grief of loved ones
lost or dying. He said that we needed to move into a new era, where
the people of this country will be cared for, and we will all be
afforded the dignity and rights that we deserve. Comrade Willie
Madisha, president of COSATU, reminded us that we had spent six months
negotiating this deal. Representatives from government, business,
labour and the community had come to a consensus and had drafted a
framework agreement for a treatment plan. This was meant to be signed
on the 1st December. It has not yet been signed. The President and
minister continue to deny that it is worth anything.
Each day over 1000 people die of AIDS-related illnesses. Each day
without good doctors, nurses and medicines, means another 1000 die.
That is 7000 a week, and over 28 000 a month, 300 000 per year, until
more than 5 million South Africans will die. Mr President - we plea
you, we ask you, we demand of you, to declare a national emergency and
to agree to a national HIV/AIDS treatment plan!