Speakers at the Second South African AIDS Conference last week warned that unless South Africa adopted a war footing against HIV whilst maintaining vigilance on human rights, any limited gains in the struggle against AIDS in South Africa could be swiftly eroded.
Mr. Clem Sunter, former Chairman and CEO of Anglo American, and current Chair of Anglo American’s Chairman’s Fund discussed impact scenarios and battle plans that would be needed to keep this enemy “from wiping the nation out.”
“The limited rollout of antiretrovirals does not mean that the war on AIDS is over,” said Sunter. He warned the country to scale up its efforts to fight the disease or face a steady state of “occupation” by the virus, or even worse, total defeat.
South Africa’s forces must:
- Improve cooperation: According to Sunter, one of South Africa’s biggest challenges is a lack of cooperation and coordination between sectors — with most HIV/AIDS efforts, he said “take place in isolation.” South Africa needs to become “a united nation” with all sectors working together as a team, collectively, pooling resources and information.
- Increase intelligence gathering: Another problem is inadequate information about the enemy’s strength and tactical position in the field. Sunter called for the creation of a national database with regularly updated prevalence and incidence data which could generate the type of information needed to develop effective strategies in the fight against HIV. "One antenatal survey per year is not enough," he said. He also said the country needed to conduct a “National Survey of Sexual Behaviour” in order to create more effective prevention measures.
- Minimise losses: Sunter urged the government to accelerate the rollout of antiretrovirals and to build on existing home-based-care initiatives to reach more people in remote areas. He also said that South Africa must do whatever it can to increase the rate of voluntary counselling and testing — even up to the point of making testing compulsory (almost, but not quite).
- Protect human rights: Mandatory testing would be going too far. Sunter said that this war would need its own "Geneva Convention" to make certain that ethics and basic human rights are not ignored in South Africa’s fight against AIDS.
Ms. Fatima Hassan of the AIDS Law Project) warned of a number of impending threats to the human rights response to HIV in South Africa:
- Scaling up voluntary testing: There is a dramatic need to scale-up HIV testing moving some to suggest different approaches such as routine, mandatory, coercive, “opt-out.” But there is need for human rights protections. “Scaling up requires creative approaches to testing, but we need to protect the vulnerable [and] avoid the reintroduction of imposed, coercive, or mandatory testing,” said Hassan. Routine testing would only be acceptable as long as the right to opt-out is widely known and easily available.
- Countering denialism: “Denialism,” said Hassan “is subverting the discourse of safe medicine.” Misleading information and mixed messages are “having an enormous impact” confusing the nation — especially those with little access to health services. It also, “undermines work of legitimate social movements by alleging alignment with the ‘colonial masters and profiteers,’” said Hassan. Echoing Mamphele Ramphele’s call from the previous evening, she said that people must take to the streets to combat denialism.
Hassan also stressed that any product being sold should subject its medical claims to adequate and rigorous review. “No health product should be sold or used unless independently shown to yield claimed results,” she said.
- Intellectual property rights vs. human rights: In a context of “widening inequities in health, wealth, education and quality of life,” multinational corporations are trying to expand their “intellectual property (IP) rights” at the expense of access to medicine and health services. In 2015, US-styled systems of patent law are scheduled to be imposed upon lesser-developed countries.
Hassan said that this was tantamount to pitting property against dignity and life. “Judicial and moral consensus must favour life,” she said.
Hassan believes that it is necessary to redefine the intellectual property needs of the developing world and put pressure on the drug companies to relax their drug patents. The developing also must use and expand flexibility in international trade law (TRIPS).
- Reproductive autonomy: “In 2005, we are going to see consistent global challenges against sexual and reproductive autonomy,” she said. “Existing reproduction autonomy rights should not be watered down.”
She concluded the plenary session with the following quote by Nobel-prize winning philosopher-economist, Amartya Sen “There can be no development without freedom."
Links
For more conference information see the conference website.