By Theo Smart, Cape Town, South Africa
Chants and songs of protestors from the Treatment Activist Campaign (TAC) disrupted a speech by the South African Health Minister Manto Tshabalala-Msimang parliament last week. This was TAC’s second demonstration in less than a week signalling growing frustration with the government’s failure to commit to a national HIV and AIDS treatment plan it had helped design.
Government representatives said they would reopen the negotiation process on its HIV plan but it is impossible to know whether this is a genuine offer or further equivocation — and it won’t be enough for TAC.
“If the government does not sign the treatment plan or something just as good by Friday, February 28,2003, we will start a program of civil disobedience in March,” said TAC spokesperson Nathan Geffen.
The treatment plan in question was forged last year by government, labour and business representatives at the National Economic Development and Labour Council (Nedlac) negotiations. All parties agreed to a draft framework that included providing proper nutrition, treatment for sexually transmitted infections and AIDS-related opportunistic infections as well as increasing access to voluntary testing and counselling – though there was still no consensus on the provision of antiretroviral treatment.
However, after November 29, 2002, when the draft proposal was sent back to the government’s for its mandate, the negotiations stalled. Without explanation, the government withdrew from the talks. Three months later, President Thabo Mbeki denied the existence of any draft agreement, telling an SABC television interviewer, "There is no agreement that the government is not signing [sic].”
Now in response to the TAC protest last week, the head of the government team in the Nedlac negotiations says, “it should reconvene as soon as possible to bolster existing programmes for the roll-out of treatment.”
A spokesperson for Health Minister Tshabalala-Msimang agreed and added that a joint committee of Treasury and Health Department officials were looking at the cost of providing antiretrovirals in state facilities. In a media briefing, Tshabalala-Msimang confirmed this but said the government would not be in a position to finalise a treatment plan until the joint committee completes their report at the end of April. But this contradicts earlier comments by Deputy President Jacob Zuma, who promised a decision by the end of February with the new budget.
TAC thinks the government is clearly back-pedalling. “The government has been stonewalling us," says TAC spokesperson Zachie Achmat. TAC and the trade union federation COSATU have threatened a campaign of peaceful civil disobedience unless the government commits to a treatment programme. They have the full support of the South African Medical Association (SAMA).
“We applaud the TAC's efforts to fight for everyone's right to live as good a quality of life for as long as possible,” said South African Medical Association Chairperson, Dr Kgosi Letlape. SAMA is calling “on the government to declare a state of medical emergency and come up with a treatment programme that includes affordable and sustainable life-saving drugs.”
The South African government appears to be divided on the issue. If Jacob Zuma is driving the process, there could be an answer on the treatment plan this week with the release of the budget that rumours suggest could include funding for antiretroviral treatment. That budget is due to be released on Wednesday, February 26, 2003. Expectations are high. “It’s a real opportunity for government to do the right thing,” says Geffen.
Tshabalala-Msimang has scoffed at the idea in numerous newspaper interviews and if she has the final word, it is unlikely that the current government would ever sign the draft proposal or, for that matter, any agreement to provide antiretroviral treatment. She had earlier said that she would go to prison in sympathy with a provincial Health minister who has refused to provide nevirapine to prevent mother-child transmission in direct violation of a Constitutional court order. And in the recent interview with the Mail & Guardian, she asked, "The government was already implementing what [the Nedlac draft proposal] says it should, so why should I sign it. Why must the government enter into agreements with everyone? Tomorrow, must I enter into an agreement with asthma sufferers?"
“I wouldn’t be able to say what to read into what she says in the papers,’ says Geffen. “We’ve given government every opportunity to do the right thing and now the ball's in their court. We’re certainly not going to be nice if they continue screwing us around.”
The pressure might be getting a little to Tshabalala-Msimang. On the weekend, she picked a fight with Stephen Lewis, United Nations’ special envoy for HIV and AIDS in southern Africa, complaining that he had turned down an invitation to attend a meeting of SADC health ministers (addressed by prominent Aids dissident) and accusing him of “arrogance of the first order.”
Her tirade was in response to his pronouncement in a UN report that governments who ignore AIDS may one day be held accountable for “mass murder by complacency. There may yet come a day when we have peacetime tribunals to deal with this particular version of crimes against humanity." However, his comments were directed to Western industrialized donor countries — not African governments. In an interview with the Argus, he said, "The fact that South Africa felt anxious about these comments is a commentary on South Africa, not me.”