TAC E-Newsletter 10 March 2003

Dying for treatment

TAC Briefing Document on the Civil Disobedience campaign

March 2003

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 registered deaths."

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 process.

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:

"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.

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 included:
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."

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

Dear All

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 prevention plan.

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 medicines.
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 constitutional obligations.
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 TAC office.

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 with HIV/AIDS.

I volunteer to (scratch out "Be arrested" if you do not wish to be arrested):

If I have chosen to be arrested:

Full Name:         ____________________________________________________

Signature:         ____________________________________________________

ID Number:        ____________________________________________________

Date:            ___________________________

Address:         ____________________________________________________

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!