TAC E-newsletter - 12 April 2003

Short Comment on Failure of Government to Sign Global Fund Deals

We are angry that government has once more delayed concluding the Global Fund deals. Yesterday government pulled out of signing the necessary contracts with the Global to Fight HIV/AIDS, TB and Malaria, despite assurances from government earlier this week that the deals would be concluded. This is a clear demonstration that government does not see the urgency to save lives and to implement a range of programmes to alleviate the HIV epidemic. This is further evidence that TAC must continue its civil disobedience campaign. As director of the Global Fund, Richard Feachum, said in a press conference at Bishops Court, Cape Town this morning, these delays are not measured in inconvenience, they are measured in human lives.

It took the government a couple of months to change the Constitution to allow floor-crossing, not to benefit the country but  in order to reinforce political power. It is a year since the Global Fund proposals were made, a little less since they were accepted, and government has delayed signing them at every opportunity.

Open Letter by Doctors to Deputy-President Jacob Zuma


Mr J Zuma (Deputy-President)
Dr ME Tshabalala-Msimang (Minister of Health)
Mr A Erwin (Minister of Trade and Industry)
120 Plein Street
CAPE TOWN
8001

 

Dear Mr Zuma, Dr Tshabalala-Msimang and Mr Erwin,

We write as a group of doctors working at primary health care clinics in the public sector.

We want to state that we have reached the point where we are asking ourselves daily how we can possibly continue working with integrity in the context of our many terminally ill HIV-positive patients not having access to life-saving medications.

Every day we are faced by patients who are sickening and suffering awfully and dying in spite of all we can offer them. The support of a caring and skilled health care team, good nutrition and timely treatment of opportunistic infections are inevitably eventually not enough.

The few who can afford Anti-retroviral medications (ARVs) or who are fortunate enough to be on pilot programmes providing ARVs are, like Lazarus, rising from the dead. The many mothers, fathers, sons and daughters who are not as fortunate, are fading and quietly dying. Daily we see the devastating effects of the disease on families and communities.

Five years ago, the use of ARVs was still semi-experimental. Dosing was difficult, pill burdens were very high and the expense was prohibitive. For these reasons, we could live with the dilemma. But now it is no longer tenable for us to do this. An affordable WHO-approved generic, well tolerated by most patients, can make the dramatic difference between life and death. Consisting of one combination tablet twice daily, it is obtainable in Maseru for around R400 a month. It can be carefully monitored clinically and with simple, cheap blood tests.

Knowing this, we as doctors, are unable to fulfil our Hippocratic Oath to do everything to relieve suffering and prevent death. We find ourselves standing by and watching the survival of those who can afford drugs while the poor suffer and die and their families spiral deeper into poverty and social dislocation.

Yes, we acknowledge that the health-care infrastructure is often inadequate and that the provision of ARVs should not be at the expense of the broader health-care system. Yet they are interdependent. Clinics and hospitals are overwhelmed by ill patients with opportunistic diseases that could be prevented by ARVs. Staff are feeling hopeless and demotivated. The implementation of systems to properly administer an ARV programme would hopefully provide a spur to improve other aspects of health-care delivery as well as the morale of health-care workers.

Yes, nutrition is very important. The rich and well nourished may take longer before progressing to AIDS but, inevitably, the immune system eventually fails in spite of the best nutrition. Without ARVs, many of our previously formally or informally employed poor patients are now too ill to work to obtain food. With treatment, they would be strong enough to provide better nutrition for themselves and their families through continued work.

Yes, prevention is also important. Yet it is clear that with 4.7 million people already infected, treatment is not only a humane response, but is also a vital aspect of prevention. It has been shown to increase voluntary counselling and testing and decrease stigma in communities, and thus lead to more openness and awareness.

Yes, ARVs are not a cure and are not tolerated by all and need careful dispensing and monitoring. Yet we know that Highly Active Anti-Retroviral Treatment significantly enhances the quality and quantity of life for the tens of thousands of people all over the world who have been using it for 5 to 6 years now. Withholding it can be compared to withholding insulin from diabetics.

Caught in this moral and professional dilemma, we ask ourselves:

·         Do we continue in this situation of frustration and demoralisation?

·         Do we break patent laws and try to import affordable generics for our patients, raising money through the private sector?

·         Do we join civil disobedience campaigns and get arrested to highlight the plight of our patients?

·         Do we resign and work elsewhere?

We are told that moves are being made towards the provision of ARVs in the public sector yet we hear with dismay that our Minister of Health asks "What is the hurry?" and that the Ministry is "awaiting the outcome of studies". Daily, in the interim, we are facing people who are dying prematurely and families who are losing loved ones, parents and breadwinners.

We can no longer in good conscience simply continue providing palliative and terminal care for our patients with Aids, when we know that effective life-saving treatment is available.

Whilst we understand the huge challenges of implementing an ARV programme, we urge that the AIDS crisis be acknowledged as a national emergency and addressed with urgency. We therefore add our voice to the call for immediate steps towards a comprehensive national prevention and management plan which includes access to antiretroviral therapy in the public sector.

Sincerely

Dr Karen Cohen
Dr Ruth Cornick
Dr Beth Harley
Dr Francois Louis
Dr Catherine Orrell
Dr Eve Subotzky

10 April 2003

[ENDS]

Memo Handed to Human Rights Commission on 1 April 2003

1 April 2003


The Chairperson, Commissioners and Staff
SA Human Rights Commission


MEMORANDUM TO THE HUMAN RIGHTS COMMISSION:
INVESTIGATE THE FAILURE TO PREVENT PEOPLE DYING OF AIDS. WHY IS THERE NO NATIONAL TREATMENT PLAN?


Dear Human Rights Commissioners and Staff

We have come to you today as part of our 'Dying for Treatment / Civil Disobedience' campaign. We come in the spirit of Kebareng Moeketsi, a young mother and TAC Civil Disobedience volunteer who was buried in Alexandra this morning.

We are here to demand to see you on behalf of people living with HIV/AIDS, children whose parents have HIV/AIDS, care-givers, HIV/AIDS workers including health care professionals and many others.  Many of the people who participate in our civil disobedience campaign are parents, children, colleagues, partners and family members of people who have lost loved ones.

We have not asked for permission to gather here to meet you because our concerns are matters of life and death.

TAC has embarked on this campaign because for more than four years (10 December 1998) we have engaged in efforts to convince the government of its legal, constitutional and humanitarian responsibility towards people living with HIV/AIDS.  We have also struggled to convince government to improve its prevention strategies. At present approximately 600 people die every day of AIDS-related illnesses and nearly 1000 people are infected with the HIV virus daily. According to the government's conservative estimates at least 4 million people will die of AIDS-related illnesses over the next 10 years. 
 
On 14 February 2003, TAC and our allies, Cosatu, Fedusa, the South African Council of Churches (SACC) and many other organisations appealed to government to announce its commitment to provide antiretroviral therapy to people living with HIV/AIDS at the TAC organised "Stand Up For Our Lives March".  The organizations and individuals witnessed our appeal to government to avoid civil disobedience by fulfilling its legal and constitutional obligations. More than 15 000 people attended a peaceful and lawful march. Despite the size and diversity of the march, our memorandum has gone unanswered.  The memorandum was accepted by among others Mr Lincoln 'James' Ngculu MP and Ms Barbara Ann Hogan (MP) and representatives from the office of the President and Deputy-President.
 
In our civil disobedience campaign we know that we will, at times, be breaking the law. But our consciences no longer can allow us to stand by and let people die needlessly while government procrastinates, delays and impedes the development and implementation of an HIV/AIDS Treatment and Prevention plan.  We support our Constitution. In fact our civil disobedience actions draw attention to the fact that the government does not respect the right to life, dignity, equality and health care access of children, men and women who live with HIV/AIDS.
 
We are using peaceful civil disobedience to express the anxiety, anger, anguish and need for action by a majority of people whose pleas government continues to ignore. We will stop breaking the law once government has committed to the constitutional right of people living with HIV/AIDS to treatment, adopted a treatment and prevention plan and agreed that the public sector will use antiretroviral therapy as part of its range of interventions agreed at NEDLAC.


OUR DEMAND TO YOU: CARRY OUT YOUR RESPONSIBILITY URGENTLY - STAND UP FOR OUR LIVES

We support the Human Rights Commission but we demand that you fulfil your constitutional and legal duties as an independent statutory body.  We are pained by your inaudible and vacillating utterances on one of the most important human rights issue facing South Africa and our continent today: the rights of millions of people with HIV/AIDS to life and dignity. These rights can only be achieved through the realisation of our right of access to health care services and fair international trade practices.

We draw your attention to the Guideline 6 of the International Guidelines on HIV/AIDS and Human Rights, issued by UNAIDS and the Office of the UN High Commissioner for Human Rights in 2002.

The Constitution says you must exercise your powers "without fear, favour or prejudice." It says you must promote the "protection, development and attainment of human rights". The rights we ask you to protect are our rights to life and dignity.

In particular we call on you to:

1.Urgently investigate and report on the death of Kebareng Moeketsi, to establish why she died and whether access to anti-retrovirals would have prolonged her life;
 
2.Immediately publish your investigation into the running of health services in Mpumalanga;

3.Assist us with our right to freedom of information by requesting that you be provided with the report of the joint Department of Health/Treasury. We have reason to believe that the sections dealing with the costing of ARV therapy has been completed for at least a fortnight. This report should be published as an emergency and in the public interest. 

4.Intervene to ensure that government returns immediately to the NEDLAC negotiations.

5.Issue a public statement setting out the Commission's views as to whether government is fulfilling its constitutional duties to provide access to health care services to people with HIV, and whether government has a duty to provide us with the choice of access to life saving treatment.

We request all of the above be completed or commenced by no later than April 16th 2003. We will return en masse to receive your reply if it is not published urgently before then.

Yours sincerely

(Various signatories)


ON BEHALF OF THE TREATMENT ACTION CAMPAIGN

Memo Handed to Commission on Gender Equality on 1 April 2003


The Chairperson, Commissioners and Staff
Commission on Gender Equality

Dear Chairperson, Commissioners and Staff

YOUR SILENCE ON THE IMPACT OF HIV/AIDS ON WOMEN IS DEAFENING

The Commission on Gender Equality (CGE) is one of the most important state institutions created to support constitutional democracy. In particular, the CGE is mandated to protect, develop, promote and attain gender equality in South Africa.  Our rights to freedom and equality as women and men mean little without the right to life and dignity. 

We have come to you today as part of our 'Dying for Treatment / Civil Disobedience' campaign. We come in the spirit of Kebareng Moeketsi, a young woman, mother and TAC Civil Disobedience volunteer who was buried in Alexandra this morning. She lived openly with HIV/AIDS. One of her last political acts was to lay a charge of culpable homicide against the Minister of Health and the Minister of Trade and Industry. On 20 March 2003, she sat in the Methodist Church in Sharpeville holding our poster that says: "Wanted: Manto Tshabalala-Msimang (Minister of Health) and Alec Erwin (Minister of Trade and Industry) For not stopping 600 deaths a day." 

Since that day many people in our country have died of AIDS-related illnesses. Most of them women, the majority of them black women and the vast majority of them poor. Kebareng Moeketsi is a face of that statistic.

As a publicly funded human rights institution guarding constitutional democracy and rights, we would have expected the CGE to lead the struggle for the prevention and treatment of HIV/AIDS. Instead, you have been silent on the reproductive rights of women who desire to minimise HIV transmission to their children during birth, You ignore the public calls that government should operationalise a plan to ensure that women and children have access to antiretroviral post-exposure prophylaxis. You stand by silently while women die.

We appeal to you to speak out and to act against unnecessary, premature and avoidable deaths. We highlight the additional vulnerability and responsibility of women in the HIV/AIDS epidemic in a few areas: mortality (death), morbidity (sickness), care, risk of infection and limited prevention efforts. We ask for evidence of practical interventions by the CGE in all these areas to protect women and girl-children and to promote their rights to life, dignity, access to health services including reproductive rights and their right to equality.


WOMEN DIE IN LARGE NUMBERS BECAUSE OF HIV/AIDS

According to Statistics South Africa (Causes of Death in South Africa: 1997-2001), HIV-disease had become the biggest single cause of death among females by 1999.
In 1997, HIV was indicated as the cause of death for 5.6% of female deaths. In 2001 it was indicated as the cause of death of 9.8% of women.
Influenza and pneumonia were indicated for 5.1% of female deaths in 1997. By 2001, this had increased to 8.7%, making it the second biggest cause of death. The only reasonable explanation for the bulk of this increase is an escalation of the HIV epidemic.
TB was indicated as the cause of 5.2% of female deaths in 1997. By 2001 this had increased to 8.4% making it the fourth biggest cause of death (ill-defined causes of mortality was third). The only reasonable explanation for the bulk of this increase is an escalation of the HIV epidemic.
Among women aged 15-29, HIV was indicated as the cause of death in 23% of cases in 2001. It was 18.5% in 1997. Substantial increases of influenza, pneumonia and TB as indicated causes of death also took place between 1997 and 2001. A similar pattern occurs in females aged 30-39 and 40-46.
Earlier this year, the Minister of Health revealed that HIV/AIDS is the leading cause of maternal mortality. This is at least the third annual report that has made the same claim.

We ask for real and hard evidence of the CGE programme of work to ensure that women have access to life-saving treatment for HIV/AIDS.  As an organisation of people living with HIV/AIDS, our families, friends, caregivers and health care workers, we ask you to provide us with your workplan to reduce AIDS-related morbidity and mortality among women. 

WOMEN CARRY THE BURDEN OF CARE FOR THE SICK AND DYING

The burden of caring for sick family members falls mostly on women.

A study by the Kaiser Family Foundation and Health Systems Trust of 771 households with HIVI/AIDS related illness and death found that "women or girls were the primary caregivers". Nearly a quarter or 23% of the caregivers were over sixty and nearly 75% of the elderly caregivers were women.

In a report commissioned by the Department of Health it was estimated that 24% of all public hospital admissions were for AIDS related illnesses. In 2000 that represented more than 600 000 hospital admissions. Currently health care workers, mostly women, take care of these patients. As health care services become more overstretched, this burden will increasingly be pushed onto women as mothers, wives, partners, grandmothers, sisters, girl-children and home-based carers.

The Kaizer Family Foundation Study found that in households with HIV/AIDS 10% of girls were out of school compared to 5% of boys.

We ask the CGE to give hard evidence of its workplan to ensure that women are adequately remunerated for taking care of the sick and dying.  We ask for evidence of your work to ensure that girl-children do not carry the burden of caring for the sick and dying and that they attend school.


WOMEN ARE MORE AT RISK OF HIV INFECTION

In South Africa the HIV epidemic affects a large number of young women.

The Department of Health's annual national survey of women attending antenatal clinics, indicates that the number of women with HIV visiting antenatal clinics for the first time, has risen from less than 1% in 1990 to 10,4% in 1995 and 24,8% in 2001. HIV prevalence refers to all HIV infections (old and new). Women between the ages of 20-29 have the highest prevalence of HIV infection. It is estimated that 15,4% of women under 20 years, 28,4% of women between 20 and 24 years and 31,4% of women between 25 and 29 years are living with HIV/AIDS. Other studies have had similar results.

Women have a higher risk of HIV infection than men during unprotected sex.

Biologically, the risk of HIV infection during unprotected vaginal intercourse is 2-4 times higher for women than men.

Women have a larger surface area of vaginal and cervical skin that is exposed to their partner's secretions during sexual intercourse.  The skin in the vagina can also tear easily, especially during dry or forced sex, making it easy for the virus to enter the body.

Semen infected with HIV is more infectious than vaginal fluids. Semen is left in the vagina, making it easier for HIV to infect women. Semen also carries live cells, which is necessary for HIV transmission and has a high concentration of HIV.  

Women have a higher risk of infection during or just after menstruation.

Sexually transmitted infections that cause sores inside the vagina, makes it easy for the virus to enter the body.

Women's position in society increases their risk of infection.

Women's risk of HIV infection depends on the extent to which they can make decisions about their lives, their bodies and their relationships. Women are not always able to decide when and whether to have sex, to engage in certain sexual practices and to use contraception.

Society does not stigmatise men who have multiple sex partners.

Men often control whether safe sex is practiced and the barrier methods that are used. There are few prevention methods that women have control over. The female condom is not widely available. Other barrier methods like microbicides are still being researched and this research has not been prioritised. Women and girls have the right to access user-friendly and affordable prevention methods such as microbicides and female condoms.

Women in society and single mothers are economically disadvantaged and their economic position makes them and their families dependant on men. Their economic status also compromises their access to health care services. Women's poverty and lack of access to services, increases the likelihood that they will enter relationships where they are not always able to insist on safer sex practices. Some women have to give sex in return for food, shelter or money.

Women and girls have a right to information on HIV/AIDS and sexuality.

We ask for evidence and a workplan of your work to show that women have access to information, health services, social security and prevention methods to reduce the risk of HIV transmission.

Violence against women increases their risk of HIV infection.

Rape is most common between younger women aged 15-19, which is simultaneously the group with a high risk of HIV infection.

Rape involving multiple perpetrators is on the increase, placing women at higher risk of HIV infection due to repeated exposure and injuries.

It is difficult for women to discuss safer sex practices, such as condom use, especially in the context of abusive relationships, as this could be construed as disrespect, infidelity or lack of commitment to the relationship.

Women who decide to go for an HIV test often face violence or threats of violence from their partners and women's fear of their partner's reaction hampers HIV testing further. 

Women's experience of violence limits their ability to take preventive health action, thereby placing them at risk of HIV infection and limiting their access to care and support services.

Women in violent relationships are also limited in their ability to leave because they have few economic resources.

 Post-exposure prophylaxis to prevent HIV infected after rape is not yet widely available to women and few women are aware of this option.

Men often seek very young women for sex in the belief that they won't be infected with HIV or that this can cure their HIV status. On the other hand, young women engage in relationships with older men for their own financial security. These practices place young women at risk of HIV infection because of their inferior status in relation to the men, their sexual immaturity and the physiological trauma of the act.

We ask for evidence of your work to ensure that the rights of women and girl-children to freedom, security of the person including psychological and bodily integrity, as well as movement is protected and promoted.

WOMEN LIVING WITH HIV/AIDS FACE DISCRIMINATION AND STIGMA

Women who do disclose that they are infected with HIV face emotional and physical abuse, discrimination and even abandonment from their partners and the broader community, losing their access to family care and maintenance. Women have the right to choose to disclose their status in circumstances of safety and security without threat of violence, discrimination and stigma.

There have been many cases where women with HIV have been evicted from their homes once their illness becomes known. Women and girls have the right to food security, safe water and shelter.

A women's HIV status makes it difficult for her to gain economic autonomy by applying for jobs, insurance, loans, subsidies or bonds.

Women do not receive adequate social assistance to help them look after themselves and their children when they are sick.

Women living with HIV/AIDS have the right to emotional and financial support.




We have not asked for permission to gather here to meet you because our concerns are matters of life and death.

TAC has embarked on this civil disobedience campaign because for more than four years (10 December 1998) we have engaged in efforts to convince the government of its legal, constitutional and humanitarian responsibility towards people living with HIV/AIDS.  We have also struggled to convince government to improve its prevention strategies. At present approximately 600 people die every day of AIDS-related illnesses and nearly 1000 people are infected with the HIV virus daily. According to the government's conservative estimates at least 4 million people will die of AIDS-related illnesses over the next 10 years. 
 
On 14 February 2003, TAC and our allies, Cosatu, Fedusa, the South African Council of Churches (SACC) and many other organisations appealed to government to announce its commitment to provide antiretroviral therapy to people living with HIV/AIDS at the TAC organised "Stand Up For Our Lives March".  The organizations and individuals witnessed our appeal to government to avoid civil disobedience by fulfilling its legal and constitutional obligations. More than 15 000 people attended a peaceful and lawful march. Despite the size and diversity of the march, our memorandum has gone unanswered.  The memorandum was accepted by among others Mr Lincoln 'James' Ngculu MP and Ms Barbara Ann Hogan (MP) and representatives from the office of the President and Deputy-President.
 
In our civil disobedience campaign we know that we will, at times, be breaking the law. But our consciences no longer can allow us to stand by and let people die needlessly while government procrastinates, delays and impedes the development and implementation of an HIV/AIDS Treatment and Prevention plan.  We support our Constitution. In fact our civil disobedience actions draw attention to the fact that the government does not respect the right to life, dignity, equality and health care access of children, men and women who live with HIV/AIDS.
 
We are using peaceful civil disobedience to express the anxiety, anger, anguish and need for action by a majority of people whose pleas government continues to ignore. We will stop breaking the law once government has committed to the constitutional right of people living with HIV/AIDS to treatment, adopted a treatment and prevention plan and agreed that the public sector will use antiretroviral therapy as part of its range of interventions agreed at NEDLAC.

These are the demands we place on the Commission on Gender Equality:

1.We ask for real and hard evidence of the CGE programme of work to ensure that women have access to life-saving treatment for HIV/AIDS.  As an organisation of people living with HIV/AIDS, our families, friends, caregivers and health care workers, we ask you to provide us with your workplan to reduce AIDS-related morbidity and mortality among women.
 
2.We ask the CGE to give hard evidence of its workplan to ensure that women are adequately remunerated for taking care of the sick and dying.  We ask for evidence of your work to ensure that girl-children do not carry the burden of caring for the sick and dying and that they attend school.

3.We ask for evidence and a workplan of your work to show that women have access to information, health services, social security and prevention methods to reduce the risk of HIV transmission.

4.We ask for evidence of your work to ensure that the rights of women and girl-children to freedom, security of the person including psychological and bodily integrity, as well as movement is protected and promoted.

5.Assist us with our right to freedom of information by requesting that you be provided with the report of the joint Department of Health/Treasury. We have reason to believe that the sections dealing with the costing of ARV therapy has been completed for at least a fortnight. This report should be published as an emergency and in the public interest. 

6.Intervene to ensure that government returns immediately to the NEDLAC negotiations.

7.Issue a public statement setting out the Commission's views as to whether government is fulfilling its constitutional duties to provide access to health care services to people with HIV, and whether government has a duty to provide us with the choice of access to life saving treatment.

We request all of the above be completed or commenced by no later than April 16th 2003. We will return en masse to receive your reply if it is not published urgently before then.

The impact of HIV/AIDS on women is particularly severe. An HIV/AIDS Treatment and Prevention plan would go some way towards alleviating the impact of HIV/AIDS on women and girl children. This will give women wider access to medications and other health services that can improve their quality of life and that of their families. It will also achieve many other broader societal gains. We call on all women's organisations and governmental institutions created to promote women's interests, to work towards addressing the impact of HIV/AIDS on women and girl children. This necessarily includes a campaign for a National HIV/AIDS Treatment and Prevention Plan that will allow women and girl children the space to regain control over their health and their bodies, an important step in the fight against HIV/AIDS.


Yours sincerely

[various signatories]

[ENDS]

Why We are Angry: The Path to Civil Disobedience


Article by Zackie Achmat that appeared in the Mail & Guardian last week

04 April 2003 12:13

When my comrades and I disrupted Minister of Health Manto Tshabalala-Msimang's speech at the Health Systems Trust conference last week, a public health official taunted one of the Treatment Action Campaign (TAC) members by saying: "How did you get HIV anyway?"

We also received an angry letter from a man who feels our demand for treatment is unfair. This article is written for them. It is also written for people like Western Cape African National Congress health spokesperson, Cameron Dugmore, who called us bullies for disrupting the minister.

First, I apologise unconditionally to the minister for referring to her personal appearance during our disruption. Any reference to the personal appearance of an opponent to discredit them is wrong.

It's also wrong because it undermines the dignity of the protest of thousands of TAC volunteers and allows people who need to curry favour with officials a cover for their lack of courage and morality. It is also no excuse to say that I was angry, because a few minutes before my own anger against indifference became uncontrollable I had told a comrade whose mother had been hospitalised with a CD4 count of 54 and raging tuberculosis that she should use her anger to demonstrate peacefully.

But there are many things I do not apologise for. I do not apologise for holding Tshabalala-Msimang and Minister of Trade and Industry Alec Erwin responsible for thousands of HIV/Aids deaths.

Second, neither the TAC nor I will make any apology for making the minister of health, any politician or bureaucrat feel uncomfortable through a disruption of any meeting, office or event where they may find themselves. Hundreds of premature, painful, awkward, silent and screaming deaths of children, men and women daily are caused by the failure of the government to implement a comprehensive treatment and prevention plan for HIV/Aids.

To Dugmore and the other detractors of our campaign who call us bullies, let me ask: were you at the many lawful marches to Parliament to give memoranda to the minister and the president begging for HIV treatment? Perhaps you did not see our march of about 15 000 people on the South African Parliament asking the government to sign a treatment and prevention plan on February 14? What about our early pickets of Parliament, drug companies and the United States government?

Civil disobedience is action of last resort for us, because exhaustive efforts at engagement have not worked. Let me ask further: did you attend any of more than 10 submissions to various parliamentary portfolio committees begging, cajoling, charming and arguing for HIV treatment? Did you attend any of more than 30 interfaith services held by the TAC and our allies across the country appealing to the conscience of the health minister and the government?

Do you know that we tried quietly to persuade Dr Ayanda Ntsaluba, Dr Nono Simelela, Dr Essop Jassat, Dr Ismail Cachalia, Dr Saadiq Kariem, Dr Kammy Chetty, Dr Abe Nkomo and other doctors who are members of the ANC to ensure that the government change its policies or to let their scientific training, their Hippocratic oaths and their consciences allow them to speak the truth?

Maybe you also tried to persuade them that real loyalty to the ANC and the ideals of the Freedom Charter required open criticism after numerous private pleas? Have you reminded the ministers of health and trade and industry that they are undermining the ANC's traditions of freedom, equality, solidarity and dignity?

Do you remember that the health minister and her supporters in Cabinet really represent the anti-democratic traditions of the former Stalinist states that supported them? Perhaps one should expect people who denied the existence of the Gulag or applauded the invasion of Czechoslovakia, Hungary, Poland and East Germany by Soviet troops and called the latest Zimbabwean election legitimate to deny the existence of HIV/Aids and the efficacy of antiretrovirals?

Did you attend hundreds of community meetings addressed by TAC volunteers across the country to educate ourselves and our people about HIV, prevention and treatment? Did you help late into the night, in support of the government, to develop a court case against the drug companies to reduce the prices of all medicines including HIV/Aids medicines? Do you remember how the health minister spurned the TAC after the case?

Do you know the anguish of the person who made the poster that said: "Thabo your ideas are toxic"? Were you at the funeral of Queenie Qiza (one of the first TAC volunteers) or did you hear Christopher Moraka choke to death after appealing to Parliament to reduce the prices of medicines?

Maybe, like me, you avoided the funeral of my cousin Farieda because I cannot face the pain of death? Did you feel as encouraged as we were by the Cabinet statement of April 17 2002? Are you as disappointed a year later that so little has been done? Were you there when we illegally imported a good quality generic antifungal drug (Fluconazole) and shamed drug company Pfizer for profiteering?

Maybe you followed the TAC/Congress of South African Trade Unions's treatment congress where unemployed people, nurses, scientists, cleaners and trade unionists invited the government to develop a treatment plan? Do you remember our meeting with Deputy President Jacob Zuma that led to a promise that a treatment and prevention plan would be developed by the end of February 2003?

Did you miss the word-games played by the government over negotiations at the National Economic and Development Labour Council (Nedlac)? Are you one of the people who phone Nedlac regularly to hear when the government will return to the negotiating table? Or, are you one of the people too busy taking care of someone dying but who have a little pride in your heart when an activist says to the president: "Comrade, you are not listening to our cries. You are denying the cause of our illness. You are not helping us get medicines."

After countless attempts at talking, public pressure and even a court case to prevent HIV infection from mother-to-child, the government allows the deaths to continue while it plays the caring, right-minded diplomat in Africa and the Middle East. Politeness disguises the moral and legal culpability of these politicians and officials. We believe that the personal crises faced by many of our families, friends, nurses, doctors, colleagues and their children should be turned into discomfort and a crisis for the politicians and bureaucrats who continue to deny our people medicine.

The fact that the health minister is obstructing the departments of health, finance, labour and the deputy president's office from signing and implementing a treatment and prevention plan costs our society more than 600 lives and many new HIV infections every day.

The government uses Parliament, Cabinet, provincial governments and all its resources including the Government Communication and Information Service, in the person of comrade Joel Netshitenze, or health communications officer, Joanne Collinge, to justify its denial of life-saving medicines to people who need them. It uses these resources to protect the reputation of the minister of health. And you add your voices to their chorus? When will you join reason, passion and anger to win treatment for people living with HIV/Aids and a decent public health system for all?

The TAC will win in this campaign because its members act in good faith. And when we win, we will sit down on any day with the government for as long as it takes to tackle all the difficult problems of HIV/Aids and the health system. These wounds between ourselves and the government will not be healed easily. But they will heal easier than the pain of the millions who are denied life-saving treatment and those who have succumbed to that pain.

[ENDS]

TAC Calls for a Democratic Swaziland

Swaziland has one of the world's highest HIV rates at over 35% and it is experiencing food shortages . It is also run by a despot, Africa's last absolute monarch, King Mswati III. The king and the political elite have  no respect for the rule of  law, the rights of women, people with HIV/AIDS or freedom of speech. The Swazi government recently  rejected a court ruling that would have limited the King's power, thereby resulting in the resignation of a number of judges. Last year, the King was involved in a scandal when he forcibly took a eighteen year woman as his wife. The rights of Swazi women are reportedly ignored throughout society with women having very little control of sexual relations. The King's example has reinforced the lack of rights of women.  Recently Senator Walter Bennett, told a rally in Manzini that the government might stop wasting medical support to people with HIV because they contracted the disease by choice.

Where such intolerance exists, it is extremely difficult to make progress in dealing with the HIV epidemic, the development of an effective public health system or malnutrition. There is little scope for an effective civil society to function. The Treatment Action Campaign (TAC) calls on the Swazi government to implement policies that will further human rights and development.

The TAC supports the following demands made by the People's United Democratic Movement of Swaziland:
We regret the general silence by the South African government on human rights abuses in Swaziland, Zimbabwe and many other African countries. As the leader of the African Union, there is a great responsibility on the South African government to be more proactive in advocating  for democracy and human rights on the continent.

The People's United Democratic Movement of Swaziland has supported TAC for a long time, by participating in many TAC events and marces.  We express our solidarity with them. TAC endorses their picket at the Swazi consulate on Saturday 12 April.  (11am, Jorrissen street, Braamfontein Centre, Jhb)

[ENDS]