Treatment Action Campaign Members ‘Shout Down’ South African Health Minister as Part of Civil Disobedience Campaign
Members of the South African HIV/AIDS advocacy group Treatment Action Campaign on Monday "shouted down" South African Health Minister Manto Tshabalala-Msimang at the opening of a health conference, BBC News reports (BBC News, 3/25). TAC last week began a week of nonviolent "mass civil disobedience" in the country to urge the government to provide HIV/AIDS drugs in public hospitals and clinics. The protest marks the first time in Africa that HIV/AIDS patients have broken the law in large numbers to demand treatment. Last week, the group filed charges of manslaughter against Tshabalala-Msimang and Trade Minister Alec Erwin over not providing "adequate treatment for people with HIV" (Kaiser Daily HIV/AIDS Report, 3/21). On Monday, TAC co-chair Zackie Achmat "scuffled" with Tshabalala-Msimang when he tried to read a statement. Achmat eventually read the statement, saying that the health minister had "deceived, misrepresented, delayed and denied for too long" regarding the provision of antiretroviral drugs to the country's HIV-positive individuals. He continued, "We hope you will prove us wrong by making an unequivocal and irreversible commitment to antiretroviral therapy" (Agence France-Presse, 3/25). About 100 members of TAC were on hand for the demonstration, part of the group's "Dying for Treatment" campaign, carrying "Wanted" posters, blowing whistles and calling Tshabalala-Msimang a "murderer." TAC National Manager Nathan Geffen said, "We would prefer not to act in this way, but our government has left us no choice." He added, "Our patience with the government is exhausted after four years of lobbying, but we will continue this assault until the government commits itself to a treatment plan for all" (U.N. IRIN/AllAfrica.com, 3/25). Government spokesperson Joel Netshitenzhe said TAC's behavior was "inappropriate" (BBC News, 3/25). He added, "The TAC's campaign is neither necessary nor helpful. ... We can make greater progress as a nation if we all lend a hand in partnership against AIDS. Our energies should be spent fighting AIDS, not one another" (Wanneburg, Reuters Health, 3/25).
Government Counters With HIV/AIDS Ad
The South African government over the weekend "set out to counter a potentially embarrassing standoff" with TAC by taking out full-page ads in Sunday newspapers around the country, SAPA/Star reports. The ads call for a "people's contract to fight HIV and AIDS" and describe government strategies such as free condoms, programs to provide antiretrovirals to pregnant women and sexual assault survivors and home- and community-based care programs. Netshitenzhe said that the ads' message "was well worth" the "tens of thousands of rands" it cost to place them, according to SAPA/Star. But Achmat said that the ads represented "a wish list, not a plan" (Michaels/Green, SAPA/Star, 3/24). TAC Co-Chair Mark Heywood said, "The advertisement is full of generalities which is not convincing. For example, when it comes to treatment, they are still raising the question of cost as a barrier to treatment. It fails to set up any targets on the issue of treatment," adding, "The ad does not get them off the hook in terms of their lack of response" to HIV/AIDS. The Congress of South African Trade Unions lauded the ads, saying they were a "huge relief," according to SAPA/Daily Dispatch. COSATU said in a statement, "[W]e expect an urgent and fruitful return to the [National Economic Development Labor Council] so that we can establish a common front against AIDS." But the Democratic Alliance, the country's leading opposition party, said, "If the minister of health cannot or will not lead the fight against HIV/AIDS, perhaps she should resign and become a human shield in Iraq. ... If South Africa wants to see the 'Partnership Against AIDS' ... taking off, then we need a new minister of health" (SAPA/Daily Dispatch, 3/24).
Government Updates HIV/AIDS Plan
The South African government also has updated its national HIV/AIDS plan, increasing the HIV/AIDS budget tenfold from about $43 million in fiscal year 2001-2002 to approximately $452 million in FY 2005-2006, according to South Africa's BuaNews. The budget includes increases in conditional grants for provinces from $26 million in FY 2002-2003 to $41.7 million in FY 2003-2004. The government said that the country has a plan to fight HIV/AIDS in terms of prevention, treatment, care and support, including plans to distribute 400 million free condoms this year. The government also said that by the end of 2002, voluntary counseling and testing services were available at 982 clinics throughout South Africa, including those sites involved with the program to prevent mother-to-child HIV transmission. The government added that it hopes to have those services available in 80% of the country's health facilities by the end of FY 2003-2004. The government's plan calls for the extension of its nevirapine program, which it says is currently available in 658 facilities. The government did not commit to providing antiretroviral therapy through the public sector, saying that a technical task force team that it established in April 2002 to investigate the financial and other resource implications of providing AIDS drugs is about to complete its work. The government said that it would take into account the findings of the task team, adding that it would consider thoroughly any policies that would incur major costs (Mohapeloa, BuaNews, 3/23).
TAC's campaign of civil disobedience "sets some uncomfortable precedents in a democratic society," Steven Friedman, a senior research fellow and former director of the Centre for Policy Studies in Johannesburg, writes in an opinion piece in South Africa's Business Day. He states that it "could be argued that working within the rules works at least as well as disobeying them. But ... disobedience inspired by HIV/AIDS policy indicts our democracy." Friedman asks if the activists and the people living with HIV/AIDS "for whom they seek to speak ... have a say in policy on this issue and therefore a democratic opportunity which they are spurning?" Friedman states that opportunities to influence the African National Congress, the country's ruling party, have "been narrowed or eliminated by the [ANC] leadership's pressure for uniformity among all its elected officials on all issues," and therefore there is little "realistic prospect of HIV/AIDS campaigners winning an open debate in Parliament." He writes that advocates have also been kept off the South Africa National AIDS Council, adding that the government "has insisted on relegating them to the margins because it wants to show that it is in charge of AIDS policy and will not be ordered around by its critics." Friedman concludes, "None of this necessarily justifies breaking the law. But it does query the idea that, because HIV and AIDS sufferers can vote, they are able to influence policy and ought to accept defeat gracefully when they lose the argument. In reality, they are able to influence it only by pressuring an ANC leadership which has made it clear that it does not see them as people who should be taken seriously" (Friedman, Business Day, 3/25).