SOUTH AFRICA: ANC blocks treatment for HIV patients
EAST LONDON, Eastern Cape province — If anyone had any doubt that the era of settlerism and elitism was not over in South Africa, President Thabo Mbeki's antics around the issue of HIV/AIDS should confirm those feelings. It is now obvious that behind its apparent concern for the poorest of the poor at home and the exploitation of the poor countries by the rich countries, our African National Congress government is doing the opposite.
Mbeki's recent visit to the United States and his cosy meetings with President Bill Clinton have confirmed that South Africa is the chosen vehicle for the US to control Africa. Our president loves the idea and is preparing to spread his military power northwards to serve US interests.
By declaring HIV/AIDS a threat to the security of the US, Clinton has made it clear that his government will use this issue to "protect" its vital interests in Africa. Mbeki's idea of an "African Renaissance" is the perfect cover for operations anywhere in Africa, willingly executed by South Africa.
My first contact with how the drug AZT (azidothymidine) reduced mother-to-child transmission (MTCT) of HIV was in October 1998. At a conference organised by the Epidemiological Society of Southern Africa, James McIntyre reported on the project his team was conducting in the Reproductive Health Unit of Chris Hani Baragwanath Hospital in Soweto. Another paper from his unit showed that it was cost-effective to give the drug to HIV+ mothers — even at the prices then prevailing (R400 per short course). It was cheaper to prevent transmission than to treat infected babies for opportunistic infections.
This was very exciting. The epidemic was escalating and this looked like a breakthrough. But the denials and excuses began. Then minister for health Dr Nkosazana Zuma said the government could not afford to use AZT. She even suspended trials for a while on some pretext, but had to back down.
Her own anti-AIDS initiatives had proved disastrous. There was the Sarafina II debacle, when R14 million was spent on a musical that was to tour the country spreading the message of the danger of HIV/AIDS. Zuma's department director-general Dr Olive Shishana was fired in the aftermath of the scandal. She got a top job with the World Health Organisation in Geneva and has been silent on this subject ever since.
Then came the virodene debacle. Three researchers approached Zuma about an exciting "cure" they had developed for AIDS. They wanted the Medicines Control Council (MCC) to fast-track approval for trials for the drug. The MCC turned them down because the drug was, in the council's words, a "toxic industrial solvent". Even so, then deputy president Mbeki wholeheartedly backed virodene.
The chairperson of the MCC was replaced but she too was unable to approve the toxic substance for experimentation. The researchers fell out with each other when the billions they expected did not arrive. An inquiry was held and a letter from the researchers came to light that offered ANC 6% of the profits. The ANC denied receiving the letter.
With evidence that AZT was cost-effective and its could save thousands of babies' lives, in 1999 I decided — with the backing of the Pan Africanist Congress of Azania — to sue Zuma (now the former health minister) for negligence and culpable homicide.
Attack on freedom of speech
Within a week, the Eastern Cape provincial health department filed 13 disciplinary charges against me, ranging from bringing the minister into disrepute to revealing information I had obtained in my professional capacity (that HIV+ women were not being offered AZT in the public sector).
The magistrate conducting the hearing threw out 12 of the charges, but found me guilty of bringing the minister into disrepute. He said it was intolerable that a civil servant should bring such serious charges against his employer. The magistrate claimed that a "civil servant is a civil servant 24 hours a day" and the fact that I spoke as the PAC's secretary of health was irrelevant. He did not in any way consider the merits of AZT in preventing MTCT. He reported this to the Eastern Cape health department director-general, who fined me R1000 — R500 of which was suspended if I kept quiet for six months.
I immediately appealed to the Public Service Commission and still await a date for a hearing. Six months have passed with no word yet from the commission. The Freedom of Expression Institute took up my case and a prominent senior counsel, Gilbert Marcus, has volunteered to defend me. If the verdict is upheld, we intend to go to the higher courts — and eventually to the Constitutional Court. Freedom of speech is enshrined in our constitution.
In the meantime, I appealed to the Human Rights Commission (HRC) to take the new minister of health Dr Manto Tshabalala-Msimang to task for continuing to deny AZT (and other anti-retroviral drugs) to pregnant women who attend public antenatal clinics — 80% of patients; the 20% remaining are private and are largely white. Screening for HIV and AZT are readily available to that section of the population.
The minister reluctantly replied (after the HRC threatened a subpoena) to the HRC's question as to how she was protecting the constitutional right to life of mothers and their babies and to their right to adequate reproductive care. Her reply was not satisfactory to the commission and they requested more details. The arrival of those details is still pending.
Excuses
Both ministers of health pleaded that the government could not afford the drugs. In other words, they were saying: "If only we could afford these excellent drugs for our deserving people." Neither made a distinction between the short-course single drug given to an HIV+ women to reduce transmission to children, and the drug cocktails needed in the long-term by HIV+ individuals to delay the onset of AIDS.
In October, President Mbeki suddenly claimed that the "toxicity" of AZT must be investigated. It was a puzzling statement from a man who had wholeheartedly backed the use of an industrial poison to treat HIV not long before.
Tshabalala-Msimang took the president's pontificating on board and announced that AZT would be investigated. The MCC and the Medical Research Council (MRC) were asked to report. Three reports from these bodies were presented to the government shortly afterwards but have not been released. However, leaks indicate that they all reported that the advantages of using AZT far outweigh the risks.
There have many other manipulations to mould the facts to fit the government's theory. The appointment of an unrepresentative National AIDS Council and then a Presidential International Scientific Panel have been part of a process of obfuscation and deceit. Their deliberations will prove nothing that can help policy-making.
In the meantime, we estimate that in South Africa: 80 babies every day die from preventable AIDS-related diseases; 1500 people a day are infected; and there are more than 4 million HIV+ people — 10% of the population.
GEAR
The policy is cast in stone by the Mbeki cabinet: starve the public sector; enhance the private sector; let the weak go to the wall. It is called GEAR (the Growth, Employment and Redistribution macroeconomic program) and will subordinate our country to the global predators. The R30 billion being spent on arms will make it essential to expand South Africa's writ and the R40 billion spent every year on servicing the odious apartheid debt keeps the ANC bosses sweet with the international financiers.
Mbeki has cynically manipulated the HIV/AIDS issue to serve his purposes and hidden agendas. It is a prototype for other policy scenarios to come. ANC loyalists have been silenced or persuaded to praise the Emperor's New Clothes. That subservience will be needed when Mbeki starts invading neighbours and the bad conditions at home must be explained. The ANC must not be blamed for any setback or deficiency. The centralisation of ANC control is obvious and ominous.
The ANC-Congress of South African Trade Unions-South African Communist Party alliance is divided on the issue of anti-retrovirals, and may be a harbinger of a pending split in the alliance. Therein lies the hope for the anti-AIDS lobby. The PAC is one alternative political home, but the genuine Africanists in the alliance may form a broader united front of which the PAC would be a part.
A truly liberated Azania would create a people-centred policy and draw on all the strands of traditional and Western medicine to make war on AIDS. A war chest of R2 billion must be made instantly available. Babies, raped women and the infected must be helped now.
BY COSTA GAZI
[Costa Gazi is head of public health at Cecilia Makewane Hospital in Mdantsane, East London. He is also Pan Africanist Congress secretary of public health. In defiance of provincial health authorities, Gazi has purchased supplies of the anti-HIV drug nevirapine, using his own salary, to be administered to pregnant women and rape victims at his clinic beginning June.]