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South Africa: Mbeki Still in Denial Says HIV Treatment Activist

Ofeibea Quist-Arcton

29 May 2003

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interview

Johannesburg — South Africa's most famous Aids activist is called Zackie Achmat. He has been HIV positive for more than ten years and leads the Treatment Action Campaign, which is fighting for the right of HIV positive South Africans to receive anti-retroviral drugs through the state. A former anti-apartheid activist, he was locked up seven times by the old regime. Achmat says Aids is South Africa's new struggle. "It is morally wrong to be able to purchase life," he says: "That is exactly what is happening with HIV. Poor people are regarded as dispensable, because they cannot afford to pay for their medicines."

Achmat and the Treatment Action Campaign (TAC) have led the campaign on the streets, in a bid to force a change in government policy on the treatment of HIV/Aids.

South Africa's undisputed moral leader, Nelson Mandela, has lent his support to the cause of TAC's anti-Aids campaign. Mandela said of Achmat, who he has visited several times in Cape Town, "He is a role model and his action is based on fundamental principles which we all admire."

Zackie Achmat continues to campaign despite persistent ill-health and he has been nominated for a number of awards for his work. The latest comes from Global Health Council which has announced that at a special Awards Banquet on May 29, 2003, in Washington, D.C., Achmat will be presented with the Jonathan Mann Award for Global Health and Human Rights. He will share the award with Zimbabwean doctor and campaigner, Frenk Guni.

According to the Council, "Zackie has used his own HIV+ condition as a platform upon which to advocate for equity and illustrate that health care is a basic human right. His private insurance would pay for the ARV treatment he needs, but he refuses to take any treatment that isn't available to everyone. He is a man willing to die for his convictions that all should have an equal right to care. His unwavering tenacity has kept this issue on the forefront of the South African government's agenda."

Ofeibea Quist-Arcton recently spoke with Zackie Achmat in Johannesburg. Excerpts:

Anyone who knows anything about the fight against HIV/Aids in South Africa probably knows the name Zackie Achmat. But tell us a little more about yourself.

My name is Zackie Achmat. I am a 41 year-old gay, male South African. I was born in Baragwanath Hospital in Johannesburg. I grew up in Cape Town.

I have HIV and I live with HIV. I’ve had it since 1990 at least. I am starting to get sick. I’m in the third stages of HIV, probably getting ready to go over into full-blown Aids. I am very active and a member of the Treatment Action Campaign (TAC) in South Africa. We campaign for treatment for people living with HIV/Aids. We are a grassroots organization, which is nationally based in five of the eight provinces. We have nearly 10,000 members spread across about 70 branches across the country. We bring together nurses, doctors and cleaners in hospital as well as people living with HIV and their parents, their friends, businesspeople, trade unionists and so on.

What we’re doing is campaigning to make medicines affordable in our country, for a better public health-care sector. And most importantly, we are campaigning to ensure that our government’s policy on treatment changes.

You are very outspoken - some say provocative - about the South African government’s official stance on HIV/Aids and the treatment issue. What is the problem with the authorities’ policies?

The government we have now is the most progressive this country has ever had when it comes to a legal framework, policy on HIV and broad pro-poor policy. However, on HIV and Aids and certain other development and job creation questions - but let’s stick to HIV/Aids specifically - the government’s policy, which was one of the best under (former President) Nelson Mandela, has changed to one of denial under President Thabo Mbeki.

And by denial I don’t simply mean psychological denial, but also scientific denial in which our government is flirting openly and now collaborating openly with people who are HIV 'denialists', people who don’t believe that HIV causes Aids and that Aids leads to death and people who don’t believe that HIV is sexually transmitted.

Therefore, this year alone - in our country - 250.000 people will die of Aids-related illnesses, that’s over 600 people a day. And yet our country is a country that believes it is New York, when we have to host meetings like the WSSD (World Summit on Sustainable Development) or when we need to host a World Conference against racism. But, when we need to meet the needs of poor people, then we pretend that we are Afghanistan and that we don’t have any infrastructure.

And yet we know that we are economically the most powerful country in Africa. We play an imperialist role in other African countries. We invest there, we take their wealth away and we force them to buy our goods. We take labour from Mozambique, from Zimbabwe, from Angola, from across the continent and so on. So South Africa is a fairly developed country in this region. It has played a very important role and it should play a role, not only in looking after its own people’s health, but assisting in the healthcare of all people in the region.

But are you making any progress in your efforts to pressure the government?

Let’s take the simple example of mother-to-child transmission of the virus. As you know, South Africa now has the biggest mother-to-child transmission prevention programme in the world. How did that come out? For five years, for six years, we struggled against our government to recognise that a simple pill could reduce mother-to-child HIV transmission in our country.

We struggled against all odds. We negotiated. We had prayer meetings. We met with them, we had workshops with them, but they continued denying. In the end we went to court.

So, in that sense, the government showed that despite the fact that it had the resources, it didn’t have the policy or the understanding to deal with the epidemic and it had to be forced by the highest court in our country, together with enormous public pressure from every layer of society, to change its policy.

Now we have the biggest programme. It’s not the best programme or the best-run programme, but it’s there. It’s a start. And I believe we’ll get much more if we stand together.

That’s why we formed the important organisation called the Pan-African Treatment Access Movement (Patam). That’s important for us because we want to work with other activists in other African countries. We want to work with doctors and nurses in other African countries and with village and civil society leaders to demand, not to beg, from America, not to beg from Europe, but to say, we’re here, you take our goods and you give us peanuts for them. You take our cocoa, you take our gold, you take our silver and diamonds. You take everything from us and give us a pittance for them. That is not what we are asking for, what we are asking for is fair trade and our fair share.

We are not going to let our people continue dying, because there are medicines that save their lives and we are going to fight for them.

When South Africans think of Zackie Achmat, they see a man who is an emblem and symbolic in the struggle against HIV/Aids in your country. But you are also just a human being living with HIV/Aids and asserting your rights.

It may have been true a few years ago that I was emblematic, because when we started our organization, there were about a hundred people, fewer than a hundred people here in South Africa who openly lived with HIV/Aids. But I think what has really become emblematic in South Africa is our organisation, the Treatment Action Campaign, and our HIV+ T-shirt and the fact that people are prepared to identify and the fact that there are now thousands of people living with HIV in our country.

And I think it’s not only what we’ve done as an organisation for people living with HIV and for treatment, but we’ve created a certain openness, not enough by any means, but a lot more than there was before.

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