We really did plumb the depths during the Mbeki years. There was the nonsense around whether HIV caused Aids, then the nonsense about whether he actually said HIV didn’t cause Aids, followed by weird definitions of “syndrome” and “disease”. On the ground this meant one simple thing. The people who needed anti-retroviral drugs didn’t get them. Mpumalanga health MEC Sibongile Manana fired a doctor because he allowed an NGO to give rape victims ARVs. And that’s before we even start on Manto. Never mind the shouting match with Talk Radio 702’s John Robbie over her name, she was clearly bonkers. Up until she was fired as health minister, she was trying to put garlic in pride of place on Aids exhibition tables in Canada. It was the Nevirapine case in the Constitutional Court that really made government look criminal. Mbeki just wasn’t interested in helping the dying. Hell, things got so bad, and so embarrassing for the country, that he even got a mention in an episode of “The West Wing”.

Of course, the main change came with Mbeki’s loss at Polokwane, Zuma’s ascendency and, eventually, the Mbeki recall. There was no bigger symbol of how things had changed than the appointment of Barbara Hogan as health minister. That’s what got tongues wagging. It was the cue for the Treatment Action Campaign to walk to her house that night and serenade her. She came out to join them in their celebrations. During the announcement in the national assembly, Manto Tshabalala-Msimang had sat on her green bench, alone, with her legs sticking over the edge, her lips pursed, petulant to the last.

Photo: Former President Mbeki (Reuters)

But, to be precise, the change in government policy started long before then. It was in 2004 that Mbhazima Shilowa proudly arrived at the then Johannesburg Hospital to keep an eye on the roll out of a pilot phase of ARVs. He was very happy to do interviews about it and be the face of the programme. That was despite his close friendship with Mbeki.

But forever it seemed the South African National Aids Plan was stuck in the mud of minutiae. There were all these objections, and it was very clear that there was simply no political will. Then, Manto’s liver entered the stage.

She took ill, and was finally placed on long leave. All of this while the second national Aids plan was being drawn up. On the day it was unveiled, the news broke that she had had a liver transplant. You really couldn’t have made that up. Jeff Radebe was acting in her stead. Compared to Manto, he looked downright presidential and drove the process pretty well.

Photo: Manto Tshabalala-Msimang (Reuters)

In the meantime, something else was stirring. It was the relationship between the Treatment Action Campaign leadership and Phumzile Mlambo-Ngcuka. She was technically the chairperson of the South African National Aids Council. The council hadn’t really functioned properly for ages (its previous leader was one JG Zuma). But out of the blue (to the public at least), she agreed to address a TAC event at a hotel in Randburg one arbitrary Friday afternoon. It wasn’t grand, but for the TAC it was glorious. She gave a speech in front of a TAC banner that read “give us ARVs now”. On her way out, Zackie Achmat (who had just started taking his ARVs) talked with her earnestly. It was obvious they knew each other well.

With Manto still on liver-enforced leave, and Mbeki on a weird self-enforced exile from the Aids debate, Mlambo-Ngcuka did most of the running. At one SA National Aids Council press conference I asked a very rude question about a person who had died that morning, reeking of the garlic she believed would save her. She castigated me for my lack of manners, but when asked, cheekily for an interview, looked at her watch and said “of course dear” .

The other person heavily involved, who’s almost disappeared from the scene now, was Nozizwe Madlala-Routledge. She and Mlambo-Ngcuka were close friends, and it showed. She was also one of those who would dare to use the words HIV and Aids in the same sentence, both in public and in private. Eyewitness News ran several stories based on the relationship between her and Manto, asking who was in charge. She drew me aside one afternoon and said, “Look, I can’t talk about this, but you are on the right track, this is a big part of the story”.

Several months later, she was gone.

The TAC lost that battle, but the ANC, and with them the country, eventually won the war. We’ll never really know how Mbeki’s attitude to Aids hurt him at Polokwane. It wasn’t the main basis for the bloodless revolution that happened there, but in the minds of some, it must have been much easier to vote for Zuma. Similarly, it was easier for branches to make decisions about who to support, when the deaths Mbeki’s politics had caused were so public. For the Zuma doubters, it must have been the spoonful of sugar to make the somewhat bitter medicine of voting for him go down more easily.

Many of the victims of Mbeki’s stubbornness are dead. Not all, but many. He’ll dispute they’re his victims, but he should take responsibility. The numbers are difficult to quantify, but the one you’ll hear most is from the Harvard University academics who point to more than 300,000. To put it as Zwelinzima Vavi did yesterday, that’s six times the capacity of Ellis Park.

Let that sink in for a moment. Six full stadiums of people. Most of them would be alive now. But they are dead.

Like any war situation, the scars will take time to heal. Children are still growing up without parents, mothers are not sure if the Nevirapine has really worked. It’s impossible to really know the true cost of denial. Sometimes old echoes crop up, like when the Geoff Budlender told the Judicial Service Commission only three months ago, that he’d been told by a cabinet minister he would never be a judge because he acted for the TAC in the Nevirapine case.

In case you’re wondering, Zuma himself doesn’t come through all of this with flying colours either. He was Sanac’s chairman himself for a while. As the Democratic Alliance couldn’t resist pointing out this week, he also told Parliament, in 2000, that no one had died as a result of not getting ARVs. Then there’s his rape trial. While he was acquitted, he did acknowledge that he had unprotected sex with an HIV-positive woman. Hardly the stuff of great examples.

But, as sometimes happens in politics, his personal mistake, could be the basis for a public success. He has had a public dressing down about Aids. He knows it’s the most important problem this country faces. And, finally, we have a leader who’s willing to put his health policy where his mouth is, and talk about it. Today, he will address the nation and say that we must work together. We must fight this disease. We will give you the ARVs. We must stop sleeping around. And no one should snigger. We should take him seriously on this. It’s what his government could stand or fall on, to some extent.

South Africa is a country that produces heroes with amazing regularity. Also today, we should pay tribute to the people who turned around the madness. Sure, many of them were at Polokwane. But raise a glass tonight to the TAC, to Mark Heywood and Zackie Achmat. Have a dram for Nozizwe Madlala-Routledge, and Phumzile Mlambo-Ngcuka. And remember the people who’ve died, the families who’ve been ruined, and the orphans who never got a fair start in life.

By Stephen Grootes

(Grootes is an Eyewitness News reporter)