Politics and HIV/AIDS in South Africa

I’ve been reading the BBC News coverage of Secretary of State Hillary Clinton’s African trip, including this article, which mentions Clinton’s attendance at “a conference with Health Minister Aaron Motsoaledi before attending National Women’s Day events” in South Africa’s capital.

The issue of health looms large in South Africa today.  Basic health challenges, inextricably linked with poverty, are widespread; further, it is one of the countries most beleaguered by HIV/AIDS.  Accoridng to UNAIDS,  in 2007 South Africa was home to 5,700,000 people living with HIV/AIDS.  The country had an adult HIV/AIDS prevalence rate of 18.1%.

Most disheartening of all: it is believed that much of the suffering inflicted by this disease — along with hundreds of thousands of lives — could have been spared if the nation’s government had responded effectively to the crisis. 

Former South African leader Thabo Mbeki was (and remains) an “AIDS dissident,” subscribing to discredited theories that downplay or deny the link between HIV and AIDS, and reject the use of antiretroviral (ARV) drugs.  As Chris McGreal reported in The Guardian in 2007,

Mr Mbeki blocked the distribution of anti-retroviral (ARV) drugs in public hospitals because he believed pharmaceutical companies were overstating the link between HIV and Aids to sell drugs, and underplaying the toxic side effects of ARVs which dissidents said killed more people than the disease.

While Mbeki was forced to largely withdraw his arguments from public discourse after a confrontation with Cabinet members in 2002, he continued to cling to his unorthodox beliefs about HIV/AIDS.  Though the South African government began to expand HIV access in the coming years, for many South Africans the damage was done.

You can get a sense for the magnitude of the results of Mbeki’s skepticism by looking at the percentage of HIV/AIDS patients who received ARV treatment in South Africa, compared to its neighbors.  According to a WHO/UNAIDS/UNICEF report, in 2007 only 28% of South Africans who needed anti-HIV drugs were receiving them.  In neighboring Botswana, on the other hand, ARV coverage was about 79%.  Another neighbor, Namibia, led the world’s low and middle-income countries with a rate of 88%.

Using similar data, a group of Harvard researchers concluded that, “the Aids policies of the former South African president Thabo Mbeki’s government were directly responsible for the avoidable deaths of more than a third of a million people in the country.”

According to Sarah Boseley of the UK’s Guardian, the Harvard report, released in late 2008,

quantified the death toll of Mbeki’s stance, which caused him to reject offers of free drugs and grants and led to foot-dragging on the part of his government over bringing in a treatment programme, even after Mbeki – under intense international criticism – had taken a vow of silence on the issue.

Mbeki was “ousted” from leadership of his African National Congress (ANC) party in September 2008, and the new government “moved quickly to implement effective measures against Aids.”  New ANC leader Jacob Zuma became president of South Africa in May 2009.  Some critics are nervous about Zuma’s own views, in light of his infamous statement that he took a shower to reduce his risk after having sex with an HIV-positive woman.

What does the future have in store for South Africa’s HIV/AIDS fight?  It’s hard to say.  A recent analysis by the BBC’s Farouk Chothia stresses the great challenges faced by Zuma’s government, including massive inequality, serious financial problems, and frequent protests stemming from widespread discontent and frustration among disadvantaged citizens.  According to Chothia,

In its manifesto, the ANC promised a Canadian-styled National Health Insurance System; a “food for all” scheme; “adequate housing” for the military veterans who fought white minority rule; more child grants to poor families; bringing down “unacceptably high” levels of unemployment and “universal access” to water and sanitation by the time of the next election.

These are lofty goals, and Chothia quotes an anonymous “former anti-apartheid activist” as saying that the ANC has to “deliver on a big scale”  if it wants to hang onto popularity and influence — a task that has proved difficult for many “liberation movements” after years in power. 

South Africa remains a hot spot to watch on HIV/AIDS, as with many other issues.  The country desperately needs HIV/AIDS relief, but how that will fit in with the many other issues the country faces, remains uncertain.

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~ by h.e.g. on August 9, 2009.

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