South Africa is gearing up for the International AIDS Conference which starts on July 18th, Mandela Day. And nobody is gearing up more than the SA Government. That’s a very good thing.
AIDS denialism is dead! Long live AIDS? Uh? No, long live a united campaign to overcome HIV, TB and the social inequalities that drive them. But unity needs truth-telling. Worryingly truth-telling about where we were with AIDS and where we are with AIDS sometimes seems in short supply. There’s a new denialism in the air and unless we nip it in the bud we are in trouble.
As part of it’s ‘good-story-to-tell’ offensive the Presidency is on overdrive with with media statements in the run up to the conference. These statements, welcome as they are, tell only half the truths.
At the weekend a statement came out reporting that the Deputy President Cyril Ramaphosa would address the opening plenary of the conference with such luminaries as… Charlize Theron. The statement did not mention that he would also share the stage with civil society organisations like TAC – who have sacrificed just a little more that the honourable Charlize to get us to where we are.
Which seems to confirm that our government seems not to want TAC to engage in telling the others truths at the conference. This should worry us. TAC, very responsibly, has not fed the media with details of a recent incident in which smutty untruths were told to try and stop Nkhensani Mavasa, the TAC chairperson, from speaking on the opening plenary. An e-mail from the conference co-chair Dr Olive Sishana to all the members of the Conference Co-ordinating Committee a few weeks ago stated:
“I went … to a SANAC meeting chaired by the Deputy President and this was followed by the Inter-ministerial committee last week, and the chorus is the same: “Withdraw Khensani Mavasa from speaking at the opening”.
Is this not just a little bit Hlaudi-esque?
On Wednesday an important article was published by the Deputy President in Daily Maverick. It starts by paying tribute to Nkosi Johnson. Yet the truth is that Nkosi was not treated well by our government. During his life or after. President Mbeki rudely left before Nkosi finished his speech at the International AIDS Conference in 2000. The Department of Social Development has declined to fund Nkosi’s dream of a Haven for mothers and children like himself. An apology for the way young Nkosi was treated by President Thabo Mbeki 16 years ago might have been a nice.
In the same article Mr Ramaphosa, or more likely his article writer, bends time and truth to fit a new narrative about AIDS. In the truth-according-to-the-DP, in 2005 the government miraculously experienced a Damascan conversion in which its AIDS denialism just melted serenely away. In his words: “In 2005 South Africa embraced the problem with energy, rolling out a massive antiretroviral treatment programme through its public health system.”
Really? “Pull the other one…” as the Brits like to say.
That is not true.
What really happened was this.
In March 2003 TAC had launched a civil disobedience campaign to demand a national ARV treatment programme. The campaign was suspended after a meeting with then Deputy President Zuma, and the promise that an ARV treatment plan was in the offing. Then more delays. In late 2003 TAC’s threated to resume its civil disobedience campaign. This forced the government to announce its ARV plan. I know because I was I was phoned by Dr. Nono Simelela, then the Head of the AIDS Directorate, in tears of relief, immediately after the Cabinet decision. I remember the moment well. I was driving in Fourways and nearly crashed my car.
But another delay soon followed. Evenually ARV treatment wasn’t provided officially until April 2004. Then, even when it did start it was rolled out in as difficult, grudging, confusing and miserly way as possible, thanks to Dr Manto Tshabalala-Msimang and her lieutenant, the former DG, Thami Mseleku.
As a result, between 2004 and 2006, people continued to die at a rate of 1000 a day; and as a result the conflict between TAC and the government intensified again. It peaked at another International AIDS Conference, this time in Toronto, where Manto made such a disgrace of our country with her exhibition booth of garlic and lemons that TAC activists trashed it.
While the head cat was away the mousy members of Thabo Mbeki’s cabinet decided enough was enough. A rebellion was provoked by Zola Skweyiya’s report-back on the conference in which he said he felt “ashamed”. At this point the government sued for peace with TAC. I know this too because in September 2006 I was part of the meeting at Tuynhuys with then Deputy President Phumzile Mlambo-Ngcuka.
The result of these talks was a process of genuine consultation that led to SA’s first rational and reasonable National Strategic Plan on HIV, TB and STIs, launched in May 2007.
That, DP Ramaphosa, is when the change really began.
Am I raking over coals? No. In those two conveniently overlooked years the truth is hundreds of thousands more preventable AIDS deaths took place. That is people with a capital P died unnecessarily. We knew quite a few of them. We were there throwing earth on their coffins. We owe the truth to them. They died at the hand of AIDS denialists and a government that couldn’t stand up to No 1. TAC doesn’t want awards, but we do want honesty about our past or we are doomed to repeat it.
TAC wants peace. TAC wants to do all it can under government leadership to stop AIDS and TB. TAC commends the sterling leadership of Dr Aaron Motsoaledi, our Minister, DG Precious Matsoso, Dr Yogan Pilay, Dr Anban Pillay, Dr Fareed Abdullah, Dr Gavin Steele, and others who work tirelessly to fix AIDS.
Raise your hats to them. They are model public servants. They all deserve a standing ovation. Really.
But DP Ramaphosa this is not time for self-congratulation and for burying the ugly truths. Next week the ugly truths must be put on the table before the whole world and we must discuss what can be done to overcome them.
What is an ugly truth?
It’s ugly that according to Stats SA in 2015 2015 30% of all deaths were due to AIDS; that 18 People with a capital P an hour, 440 People a day.
It’s ugly, that according to SANAC, 30% of all new HIV infections take place in girls and young women.
It’s ugly that Multi Drug Resistant (MDR)-TB has doubled in the last five years. These are truths of equal weight to the good-story-to-tell truths DP Ramaphosa wants to boast about.
You can find a great deal of truth in the Enhanced Progress Report on AIDS, a recent publication of SANAC. Here are some of the good truths and the bad truths it reveals:
- Good truth: The mother to child HIV transmission rate has been reduced to 1.5%.
- Good truth: Over 17 million people in SA had tested for HIV by 2012 and over three million people were on ARV treatment by 2015.
- Bad truth: the percentage of adults adhering to their ARV treatment after 5 years is less than 50%.
- Bad truth: the percentage of young people who have sexual intercourse before the age of 15 has not changed, whilst the number of people having sexual intercourse with more than one partner in the last 12 months has increased by 80%. Condom distribution has increased but condom use has not.
- Bad truth: although we have conducted three million voluntary circumcisions in the last five years, it’s not yet enough to contribute to an overall reduction in HIV incidence
- Ugly truth: rates of HIV infection amongst female sex workers range from 39 – 71 %. Sex workers, that is young girls who have no other way to eat or dream, are still a prohibited people.
- Ugly truth: South Africa still has no recent to measure gender based violence.
- Ugly truth: No municipalities have reported on having HIV programmes despite the fact that they are Ground Zero for the AIDS epidemic.
Finally at this conference TAC will have to tell some truths about our government. We cannot not pretend to the world that we can separate AIDS prevention (both of the virus and the illnesses it gives rise to) from our deepening social inequalities and the infection of corruption.
One truth is, that if one of the only things South Africa did for the next two years was to fix our basic education system and focus on ensuring that girls and boys who are still at school have access to condoms, HIV testing, friendly clinics that provide ARVs, the offer of medical circumcision for boys and proper information about sex and sexuality, we would be on our way.
Is the need to tell half-truths about finding absolution? If it is, then sorry DP Ramaphosa, our government can never achieve absolution for so many those lost lives. There can only be regret, some repair and a commitment to do everything in your power to protect the next generation from HIV. TAC will fight until the end of AIDS and we will do what this hand in hand with our government, but to do so needs truth, transparency and accountability from all of us.
We are ready. Are you? DM
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