The dismissal of the Deputy Minister of Health was a wretched day for South Africa. The country lost one of its strongest unifying forces in the struggle against the AIDS pandemic.
But as great a loss as her firing may be, it says far more about the President of South Africa and his Minister of Health than it does about Nozizwe Madlala-Routledge.
What outsiders perceive, yet again, is a betrayal of trust. It never seems to end. Every time there is evidence of progress, the President and the Minister of Health combine to crush the glimmers of hope. In this instance, the Strategic Plan, crafted by every sector of South African society, has been put in jeopardy.
After years of denial, the Government finally abandoned the demented absurdity of beetroots and opted, instead, to roll out treatment in a fashion around which the entire country had rallied. The world looked upon it as a nearly miraculous reversal of fortune. But we were too quick to make assumptions. We underestimated the sheer willful malice of the Minister of Health. When she emerged from hospital, a vengeful personal vendetta was unleashed and the Deputy Minister paid the price. However, it's the President who appoints and fires members of cabinet. And as much as we may feel collective dismay at the behaviour of Manto Tshabalala Msimang, it's President Mbeki who lowered the axe.
I'll never understand his disastrous response to the AIDS virus. I don't think I've ever met anyone, inside or outside of South Africa, who fully understands. After all, this is a man of immense intelligence, who fought against apartheid with every intellectual and organizational weapon at his command. But his place in the annals of South Africa is forever sullied by the inexplicable unwillingness to confront HIV/AIDS. No matter the astuteness of his economic policy, social interventions, financial acumen, or peace-keeping initiatives across the continent, he will always be known as the President who presided over the AIDS apocalypse. It's a terrible legacy with which to haunt the pages of history.
In the face of the record, the silence of the international community is truly bewildering. The leadership of the United Nations has no problem --- rightly --- eviscerating the President of Sudan over Darfur, or lacerating the Junta in Myanmar for the erosion of human rights, or condemning Iran for the export of weapons to Iraq and the possible development of nuclear arms . indeed, Kofi Annan, the former UN Secretary-General, during an election campaign in the United States, courageously declared the war in Iraq to be illegal. How then to explain the silence on South Africa? Why the double standard? Are lives lost to AIDS somehow less worthy than lives lost to conflict?
Two years ago, the countries that comprise the United Nations embraced, by consensus, a new principle called the 'Responsibility to Protect'. It was rooted in the theory that if a country cannot or will not protect its own people from heinous violations of human rights, then sovereignty is forfeit, and the international community has the 'Responsibility to Protect'. That responsibility can be exercised in a variety of ways from economic sanctions to military intervention. But whatever the response, the motive is clear: no longer can the citizens of a country be sacrificed on the altar of destructive and deadly state behaviour. Admittedly, 'Responsibility to Protect' was forged in the shadow of conflict. It was the Darfurs of this planet that prompted the governments of the world to take so unusual a step. Never before had the unlimited power of sovereignty been so frontally challenged.
But I'd like to argue that it shouldn't stop with conflict. I'd like to argue that 'Responsibility to Protect' must have a broader application; it should apply equally to AIDS. If a government, like that of South Africa, refuses to roll out anti-retroviral treatment to save the lives of millions of its people, then the international community has a responsibility to intercede. What is desperately needed at this moment in time is to make certain that the Strategic Plan is not derailed. There can be no retreat; there can be no bad faith.
I'm not suggesting an extreme response. But I am suggesting that if the firing of the Deputy Minister of Health imperils the indispensable plan of treatment, prevention and care, then the world should take action. South Africa should no longer be invited to the World Health Assembly in Geneva, or to meetings of the SADC Health Ministers, or to the Board meetings of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Such censure makes particular sense because the Minister of Health no longer authentically represents the people of South Africa in matters of health. And if those penalties don't change government policy, then South Africa should experience the suspension of its membership in the World Bank, the IMF and the WTO.
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President Mbeki will scoff. But he's running against the universal tide of public dismay. That dismay should be turned into an international civil society campaign, pressing governments on the one hand, and the various South African embassies on the other to carry a message to the President of South Africa: the Strategic Plan must prevail. The world will not stand idle in the face of wanton, monumental death.
We call it the Responsibility to Protect.
It is said that 900 men, women and children die every day in South Africa of AIDS-related illnesses. It's Armageddon every 24 hours. Other than South
Africa, every government in the high-prevalence countries is moving heaven and earth to keep its people alive.
There are no excuses left for President Mbeki and his Minister of Health.
The day of reckoning is surely coming.
* Stephen Lewis, the former UN Special Envoy for HIV/AIDS in Africa, is co-director of AIDS-Free World, a new international advocacy organization (www.aids-freeworld.org).
