Government Inaction and the Spread of AIDS in South Africa
“South Africa has the largest absolute number of HIV-positive people in the world. In KwaZulu-Natal, studies suggest that over a third of all adults may be infected. Yet, from the president down, there is a failure to talk publicly about the scale of the problem. If these people were dying in war, it would be considered an emergency. But South Africa is in denial. Why?[1]”
The HIV/AIDS epidemic in South Africa is a primary example that the response of political elite to HIV/AIDS matters, particularly to women. In South Africa women are disproportionately affected by HIV/AIDS, 58% of women[2] and 30% of pregnant women[3] are HIV positive; this makes the reaction of the government incredibly important for women’s access to treatment and prevention programs as women, children, and the poorer subgroups in South Africa are more likely to need and use government services.[4] I will argue that the lack of leadership from the African National Council (ANC) in response to the HIV/AIDS epidemic, particularly the unwillingness of President Mbeki to acknowledge the disease, has been a form of gendered violence that has made women more vulnerable to the disease.
The epidemic came late to South Africa, in 1990 less than1% of the population was estimated to be HIV positive[5]. Perhaps because they were so focused internally, the South African government did not seem to take note of the disease ravaging countries to their north.[6] The government was certainly busy establishing their constitution and transitioning from an apartheid regime, it was unfortunate timing for an epidemic that necessitated an immediate prevention response. Unfortunately for future victims, it was the apartheid government that first took steps of action against HIV/AIDS. This lead to speculation by the anti-apartheid activists that the suggested programs were less than well-meaning:
“Anti-apartheid activists claimed the programmes were a government plot to control population growth by convincing black people to have less sex and produce fewer babies and herby check the advance of African liberation; they lampooned the AIDS acronym saying it stood for ‘Afrikaner Invention to Deprive us of Sex.[7]’”
Mandela did little to address the AIDS epidemic. However, his successor, President Thabo Mbeki actively aligned with a small group of scientists known as AIDS denialists.
As late as 2000 Mbeki called the traditional view of the relationship between HIV and AIDS as “no more than a ‘thesis,[8]’” this group believed that poverty caused AIDS and HIV was nothing more than a malicious conspiracy created to marginalize blacks. “’AIDS is Acquired Immune Deficiency Syndrome,’ he told Parliament. ‘I don’t believe it is a sensible thing to ask: “Does a virus cause a syndrome?” It can’t. A virus will cause a disease.[9]’”Mbeki would not allow anti-retroviral drugs (ARVs) to reach the afflicted because he believed they were unsafe for use[10].With regards to ARVs, Mbeki publicly stated that “’Our people are being used as guinea-pigs and conned into using dangerous and toxic drugs.’[11]”
This alliance created fertile grounds for the disease to grow to epidemic proportions. It wasn’t until the Thirteenth International AIDS Conference in Durban, South Africa and the TAC’s global march for access to ARVs and the 2001 TAC amicus curariae until the government was forced into taking action against HIV/AIDS. The amicus brief declared access to health a human right and that the South African constitution and international law required the government to provide access to heath care services to its citizens[12]. The TAC march and a Constitutional Court case in which the Legal Resources Center (LRC) sued the government of South Africa to provide ARVs to pregnant women brought the epidemic to the political forefront. It drew attention to blatant inaction by the ANC, such as the dismissal of Behringer-Ingelheim’s offer to supply nevarapine for free for five years to decrease mother-to-child transmission of HIV. The South African government declined the offer on the basis that anti-retroviral drugs (ARVs) were unsafe for use[13]. Thus, slowly, a national response to AIDS began. Some provinces, such as Gauteng, disregarded the President’s stance on HIV/AIDS and made nevarapine available in all hospitals[14].In 2002 the Constitutional Court mandated that the government provide free nevarapine to all HIV-positive pregnant mothers at all public hospitals, before complying with the Court and implementing this treatment Manto Tshabalala-Msimang, the Minister of Health, recommended garlic, beetroot, and olive oil as HIV/AIDS therapy.[15]
Although a step in the right direction, as Petchesky points out, the ruling did nothing to elucidate a plan for continued therapy for the HIV-positive pregnant women, non-pregnant women, children, or men suffering from the disease[16]. Furthermore, the reaction of the government happened after the death of approximately one million South Africans.[17] South Africa is far from the only country in which women are more affected by HIV/AIDS, however as a result of not acknowledging HIV, not instituting prevention programs or providing ARVs, the government further gendered the disease. Women, rural women in particular, are the poorest in South Africa. Despite globalization and development in South Africa, women remain unable to access resources and basic services.[18] Leaving women dependent on a government that would not acknowledge the disease effectively denies them treatment. The marginalization of women in South Africa has brought to light the intersection of women’s rights with the epidemic. The situation in South Africa may largely be the reason there was such a change in tone between the 2001 UNGASS on HIV/ADIS and the World AIDS Conference in 2000. The 2001 UNGASS on HIV/AIDS was focused completely on public health and human rights[19]. The Declaration from this General Assembly formally recognized the importance of gender equality for tiding the HIV/AIDS epidemic[20].
[1] The Economist, Vol. 362, Issue 8261,( 23 Feb 2002), 49-51.
[2] Petchesky, R, Global Prescriptions – Gendering Health and Human Rights, (London: Zed Books, 2003), 86.
[3] HIV/AIDS Surveillance Database http://hivaidssurveillancedb.org/hivdb/RecordSelPage.aspx 2005
[4] Petchesky, 234.
[5] Guest, R, Shackled Continent – Africa’s Past, Present, and Future (London: Macmillan, 2004), 105.
[6] Guest, 105.
[7] Meredith, M; The State of Africa – A History of Fifty Years of Independence (London: The Free Press, 2005), 667.
[8] Meredith, 668.
[9] Meredith, 670.
[10] Petchesky, 91
[11] Meredith, 670.
[12] Petchesky, pg 88; Heywood (2001), 6.
[13] Petchesky, pg. 91
[14] Economist, 2002.
[15] Meredith 672.
[16] Petchesky, 92.
[17] Meredith, 672.
[18] Phalane, M; “Globalisation and the Feminism of Poverty: A South African Perspective on Expansion, Inequality and Identity Crisis,” from Annan-Yao, E; et al., Gender, Economies, and Entitlements in Africa (Oxford: African Books Collective, 2005),159.
[19] Petchesky 121; Crossette 2001
[20] Petchesky 121; SHAAN Online 2002
Global Feminisms Fall 2008 