The formation of the National AIDS Council (NAC) could be an extremely important step forward in South Africa's campaign against AIDS.
However, the initial reaction of many sectors of civil society has been one scepticism and suspicion.
Questions are being asked about the process by which councillors were appointed. 'Why have experts in the science of AIDS been excluded?' 'Why has the angry voice of the activists campaigning for treatment been ignored?'
People fear that the Council that has been selected is not angry enough, not informed enough, not determined enough, and not representative enough. Some, such as Dr Costa Gazi of the PAC, have gone so far as to already pronounce on the failure of the Council.
These fears are justified. They must not be dismissed. But rather than demoralise the NAC they must make it more determined to succeed.
The members of the NAC have accepted the most challenging and responsible task that could be taken up by any South African. On the leadership of the NAC now rests the hopes of millions of people already living with HIV/AIDS for access to treatment.
On the leadership of the NAC rests the responsibility for creating and directing a tidal wave of information and awareness that will wash around the lives of all South Africans and eventually prevent thousands of new HIV infections.
Or put another way, failure of the NAC to mobilise churches, trade unions, businesses and NGOs carries with it the price of direct responsibility for millions of blighted and lost lives.
The route to success will not be easy. At the start of 2000 nearly four million people in South Africa have HIV. Most are poor and unable to afford the drugs that promise to make AIDS a life-threatening but no longer fatal condition. This means that most could succumb to illness and death. And yet this huge epidemic is still buried in silence. Understand this: responsibility for this silence lies foremost with those who have power. Most politicians still refuse to talk about AIDS. The SABC fails in its responsibility to use television and radio to make millions of people more informed about HIV.
Business leaders complain bitterly about protections for people with HIV in new legislation, but do almost nothing to prevent new infections in the companies they own.
The national airline, South African Airways, refuses to employ people with HIV on its aeroplanes. The first challenge of the NAC, therefore, is to break the silence of the people in power who are ignoring AIDS. If you do this you will build a genuine partnership.
The second challenge is to mobilise resources for treatment, care and prevention. The political commitment that the government has started to show against AIDS is welcome. But it has not been enough. Since the launch of the 'Partnership Against AIDS' in October 1998 the number of new HIV infections has risen (not fallen). It is now estimated to be 1,700 per day. What is lacking is a commitment in every man and woman to protect themselves and protect others --- and to use their individual power as church leaders, or business people, sports stars or celebrities to advance this message.
Up to now the government and the private sector have not made available the resources that are needed to fight AIDS. The NAC must challenge and change this.
Wearing red ribbons is not enough. Red ribbons don’t buy drugs. Red ribbons don’t convey basic facts about HIV. Resources must be found for visible programmes.
Guidelines must be given by the NAC to teachers, workers, churches and employers on how to make HIV prevention part of their daily activities. If necessary the NAC must be given legal powers to enforce its measures.
The NAC should publicly extend an offer of partnership to the drug companies and ask them to drop their High court action against the government. But the basis for the Partnership must be a recognition that access to health is a human right – and one that is enshrined in our Constitution. The intransigence of those drug companies that refuse this offer and do not make essential drugs affordable must be broken.
If it is to succeed, the NAC needs to be highly visible. Over the Xmas holiday the Arrive Alive campaign made itself felt through saturation advertising. But this lasts only for a month. The ‘Partnership Against AIDS’ needs to achieve this visibility on a daily basis. Arrive Alive calculates the cost to the nation of several thousand lost lives as billions of Rands. What then will be the cost to the nation of several million lives?
This is the context in which the NAC must fight the presumption that deaths of people with AIDS is a cost only to themselves and one the country can afford, particularly if people continue to die quietly and invisibly. This is not true.
The death of one person because of AIDS has cost implications for family who sit and care for them in their last months, for hospitals who try to treat them, for communities who lose teachers, workers or able students. We therefore call on the NAC to act boldly and to urgently: Set a target for the nation to reduce new HIV infections by 75% by 2005. Identify the steps that must be taken to meet this target. Resolutelyexpose the social factors that make poor and marginalised people additionally vulnerable to HIV infection and insist that development projects address these factors.
Overcomeobstacles that prevent people who have HIV from gaining access to treatment and care and ensure the rapid finalisation of Standard Treatment Guidelines for HIV/AIDS. In conclusion, one final word of advice, AIDS has spawned an immoral international gravy train. Many ‘AIDS workers’ are in perpetual motion around the globe, feted by drug companies that can spend millions of dollars on AIDS conferences and advertising, whilst withholding life-saving drugs from the people who need them. Establish a Code of Conduct and avoid this temptation at all costs. On this basis the whole country will rally to support the NAC.
