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Note: This document is from the archive of the Africa Policy E-Journal, published by the Africa Policy Information Center (APIC) from 1995 to 2001 and by Africa Action from 2001 to 2003. APIC was merged into Africa Action in 2001. Please note that many outdated links in this archived document may not work.

South Africa: Treatment Action Update

Africa Policy E-Journal
April 15, 2003 (030415)

South Africa: Treatment Action Update
(Reposted from sources cited below)

This posting contains an article by Zackie Achmat of South Africa's Treatment Action Campaign (TAC) and an update from Kaiser Daily HIV?AIDS Report on demands that the South African government implement a national AIDS treatment program. The TAC has called for international actions of support on April 24. Health GAP and ACTUP-NY have taken the initiative for a demonstration at the South African embassy in Washington, supported by other groups including Africa Action. For details on the protest in DC, go to: or email:

For information on the launch of TAC's current civil disobedience campaign, see>

For additional background, see the website of the Treatment Action Campaign [], which includes the April 9 deathbed statement of TAC activist and poet Edward Mabunda, and the international solidarity page of the Healthgap website [], which includes sample letters to South African consulates. For more general background and updates on treatment access, see

Another posting today provides an update on the failure of rich countries to fund the Global Fund to Fight AIDS, TB, and Malaria.

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Why We are Angry: The Path to Civil Disobedience

Article by Zackie Achmat that appeared in the Mail & Guardian (

04 April 2003

When my comrades and I disrupted Minister of Health Manto Tshabalala-Msimang's speech at the Health Systems Trust conference last week, a public health official taunted one of the Treatment Action Campaign (TAC) members by saying: "How did you get HIV anyway?"

We also received an angry letter from a man who feels our demand for treatment is unfair. This article is written for them. It is also written for people like Western Cape African National Congress health spokesperson, Cameron Dugmore, who called us bullies for disrupting the minister.

First, I apologise unconditionally to the minister for referring to her personal appearance during our disruption. Any reference to the personal appearance of an opponent to discredit them is wrong.

It's also wrong because it undermines the dignity of the protest of thousands of TAC volunteers and allows people who need to curry favour with officials a cover for their lack of courage and morality. It is also no excuse to say that I was angry, because a few minutes before my own anger against indifference became uncontrollable I had told a comrade whose mother had been hospitalised with a CD4 count of 54 and raging tuberculosis that she should use her anger to demonstrate peacefully.

But there are many things I do not apologise for. I do not apologise for holding Tshabalala-Msimang and Minister of Trade and Industry Alec Erwin responsible for thousands of HIV/Aids deaths.

Second, neither the TAC nor I will make any apology for making the minister of health, any politician or bureaucrat feel uncomfortable through a disruption of any meeting, office or event where they may find themselves. Hundreds of premature, painful, awkward, silent and screaming deaths of children, men and women daily are caused by the failure of the government to implement a comprehensive treatment and prevention plan for HIV/Aids.

To Dugmore and the other detractors of our campaign who call us bullies, let me ask: were you at the many lawful marches to Parliament to give memoranda to the minister and the president begging for HIV treatment? Perhaps you did not see our march of about 15 000 people on the South African Parliament asking the government to sign a treatment and prevention plan on February 14? What about our early pickets of Parliament, drug companies and the United States government?

Civil disobedience is action of last resort for us, because exhaustive efforts at engagement have not worked. Let me ask further: did you attend any of more than 10 submissions to various parliamentary portfolio committees begging, cajoling, charming and arguing for HIV treatment? Did you attend any of more than 30 interfaith services held by the TAC and our allies across the country appealing to the conscience of the health minister and the government?

Do you know that we tried quietly to persuade Dr Ayanda Ntsaluba, Dr Nono Simelela, Dr Essop Jassat, Dr Ismail Cachalia, Dr Saadiq Kariem, Dr Kammy Chetty, Dr Abe Nkomo and other doctors who are members of the ANC to ensure that the government change its policies or to let their scientific training, their Hippocratic oaths and their consciences allow them to speak the truth?

Maybe you also tried to persuade them that real loyalty to the ANC and the ideals of the Freedom Charter required open criticism after numerous private pleas? Have you reminded the ministers of health and trade and industry that they are undermining the ANC's traditions of freedom, equality, solidarity and dignity?

Do you remember that the health minister and her supporters in Cabinet really represent the anti-democratic traditions of the former Stalinist states that supported them? Perhaps one should expect people who denied the existence of the Gulag or applauded the invasion of Czechoslovakia, Hungary, Poland and East Germany by Soviet troops and called the latest Zimbabwean election legitimate to deny the existence of HIV/Aids and the efficacy of antiretrovirals?

Did you attend hundreds of community meetings addressed by TAC volunteers across the country to educate ourselves and our people about HIV, prevention and treatment? Did you help late into the night, in support of the government, to develop a court case against the drug companies to reduce the prices of all medicines including HIV/Aids medicines? Do you remember how the health minister spurned the TAC after the case?

Do you know the anguish of the person who made the poster that said: "Thabo your ideas are toxic"? Were you at the funeral of Queenie Qiza (one of the first TAC volunteers) or did you hear Christopher Moraka choke to death after appealing to Parliament to reduce the prices of medicines?

Maybe, like me, you avoided the funeral of my cousin Farieda because I cannot face the pain of death? Did you feel as encouraged as we were by the Cabinet statement of April 17 2002? Are you as disappointed a year later that so little has been done? Were you there when we illegally imported a good quality generic antifungal drug (Fluconazole) and shamed drug company Pfizer for profiteering?

Maybe you followed the TAC/Congress of South African Trade Unions's treatment congress where unemployed people, nurses, scientists, cleaners and trade unionists invited the government to develop a treatment plan? Do you remember our meeting with Deputy President Jacob Zuma that led to a promise that a treatment and prevention plan would be developed by the end of February 2003?

Did you miss the word-games played by the government over negotiations at the National Economic and Development Labour Council (Nedlac)? Are you one of the people who phone Nedlac regularly to hear when the government will return to the negotiating table? Or, are you one of the people too busy taking care of someone dying but who have a little pride in your heart when an activist says to the president: "Comrade, you are not listening to our cries. You are denying the cause of our illness. You are not helping us get medicines."

After countless attempts at talking, public pressure and even a court case to prevent HIV infection from mother-to-child, the government allows the deaths to continue while it plays the caring, right-minded diplomat in Africa and the Middle East. Politeness disguises the moral and legal culpability of these politicians and officials. We believe that the personal crises faced by many of our families, friends, nurses, doctors, colleagues and their children should be turned into discomfort and a crisis for the politicians and bureaucrats who continue to deny our people medicine.

The fact that the health minister is obstructing the departments of health, finance, labour and the deputy president's office from signing and implementing a treatment and prevention plan costs our society more than 600 lives and many new HIV infections every day.

The government uses Parliament, Cabinet, provincial governments and all its resources including the Government Communication and Information Service, in the person of comrade Joel Netshitenze, or health communications officer, Joanne Collinge, to justify its denial of life-saving medicines to people who need them. It uses these resources to protect the reputation of the minister of health. And you add your voices to their chorus? When will you join reason, passion and anger to win treatment for people living with HIV/Aids and a decent public health system for all?

The TAC will win in this campaign because its members act in good faith. And when we win, we will sit down on any day with the government for as long as it takes to tackle all the difficult problems of HIV/Aids and the health system. These wounds between ourselves and the government will not be healed easily. But they will heal easier than the pain of the millions who are denied life-saving treatment and those who have succumbed to that pain.

South African Government, Global Fund Fail To Sign Grant Agreement for Second Time in One Week

April 14, 2003

Access this story and related links online:

Contact Kaiser Daily HIV/AIDS Reports at
Phone: 202-672-5952 FAX: 202-672-5767
E-mail registration:

The South African government and the Global Fund to Fight AIDS, Tuberculosis and Malaria on Friday failed to sign an agreement that would provide more than $40 million in grants to KwaZulu-Natal, one of the country's provinces hardest hit by the epidemic, Reuters reports (Reuters, 4/11). Richard Feachem, head of the Global Fund, arrived in South Africa early last week to sign the deal to release the first distribution of a five-year, $165 million grant (Associated Press, 4/11). In April 2002, the fund approved a one-year, multimillion-dollar grant to KwaZulu-Natal to expand an HIV/AIDS treatment program to all of the province's clinics. In June 2002, the South African government tried to block the grant, stating that the grant application did not go through the national government before being submitted to the fund as specified in the application guidelines. KwaZulu-Natal officials said that they applied directly to the fund because South Africa had not yet established a Country Coordinating Mechanism at the time of application. The South African National AIDS Committee has since been designated as the nation's CCM. In a statement released in July 2002, KwaZulu-Natal Health Minister Zweli Mkhize said that he and South African Health Minister Manto Tshabalala-Msimang had agreed to pool the funds under the National AIDS Council, which would use the money "in a manner that will benefit all the provinces equitably and within programs contained within the proposals submitted to the Global Fund." Fund officials would not allow South Africa to reallocate the funds and said that the country should reapply for the grant in order to alter the arrangement (Kaiser Daily HIV/AIDS Report, 11/4/02).

Further Delays

Dr. Nono Simelela, head of the health department's AIDS directorate, on Thursday night said that there were still "some outstanding issues" with the agreement. This was the second time in a week that officials failed to approve the agreement, the Cape Times/Independent Online reports. The first time, officials said all that remained to work out were "technical details," including which government department would be responsible for the grant money. Feachem said at that time that the officials were simply "dotting the i's and crossing the t's" (Altenroxel/Majors, Cape Times/Independent Online, 4/11). However, government officials on Friday released a statement saying that there were going to be "further delays" due to "relatively complex legal processes," Reuters reports. Feachem said he would allow South Africa as much time as it needed, but added, "This is very disappointing. The money needs to flow. These are life and death issues. Delay is measured in human life ... and we have urged them to complete the steps they need to complete as quickly as they can" (Reuters, 4/11).


Treatment Action Campaign Chair Zackie Achmat, who has threatened to take legal action if the agreement is not approved, said, "This is costing lives and if necessary we will make an application to court to get the minister's reasons for it" (Cape Times/Independent Online, 4/11). Speaking on Tuesday at a formal gala event to welcome Feachem to South Africa, Tshabalala-Msimang said that the Global Fund was to blame for the delays in the agreement, according to the Mail & Guardian. She said, "We had hoped to sign the agreement, but there are a few loose ends. The reason we have not moved with speed is because the Global Fund had to set their house in order and not that SANAC was not ready. Geneva was not ready." Speaking after the health minister, Feachem did not address her comments but called on "all sectors to apply to the fund" for grants to help provide antiretroviral therapy to those who need it, according to the Mail & Guardian (Deane, Mail & Guardian, 4/11). Anglican Archbishop Njongonkulu Ndungane at a joint news conference with Feachem said, "I have no words to express my dismay. It seems that the health ministry or whoever is responsible for [the agreement is] fiddling while Rome is burning. People are dying" (Associated Press, 4/11).

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Date distributed (ymd): 030415
Region: Southern Africa
Issue Areas: +health+ +political/rights+

The Africa Action E-Journal is a free information service provided by Africa Action, including both original commentary and reposted documents. Africa Action provides this information and analysis in order to promote U.S. and international policies toward Africa that advance economic, political and social justice and the full spectrum of human rights.

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