Mail & Guardian (Johannesburg) - August 8, 2003

The pall of divisive politics hung over the conference. This was a recurring preoccupation in corridor talk at the conference. At the same time participants were united in expressing a sense of triumph that the provision of anti-retroviral treatment is now part of the government's HIV/Aids agenda.

Aids experts, government officials and scientists gathered at the Durban Convention Centre this week for the three-day conference to share experiences and research, and to "reinvigorate" the country's efforts in dealing with HIV/Aids.

The conference was an opportunity for researchers and practitioners to build bridges, Professor Salim Abdool Karim, the conference's scientific programme committee chairperson, told the Mail & Guardian.

But the eruption of politics into science began before the conference kicked off.

Mbeki's article in his letter on ANC Today on August 1 commented on the decision by the Medicines Control Council decision to review nevirapine: "We must free ourselves of the 'friends' who populate our ranks, originating from the world of the rich, who come to us, perhaps dressed in jeans and T-shirts, as advisers and consultants, while we end up as the voice that gives popular legitimacy to decisions we neither made, nor intended to make, which our 'friends' made for us, taking advantage of an admission that perhaps we are not sufficiently educated."

His words were echoed at the opening of the conference when Minister of Health Manto Tshabalala-Msimang addressed a capacity crowd. She was allocated two minutes to introduce Deputy President Jacob Zuma, but instead defended the government's actions in fighting the spread of HIV/Aids.

While she spoke, members of the audience wearing bright yellow T-shirts, bearing the slogan "2 pills can save a life", held up posters with the names of people who have died from Aids. This was the first visible protest by the Treatment Action Campaign (TAC) with Medicines sans Fronti res since the suspension of its civil disobedience in April.

At the end of her speech the minister switched from English to Zulu, saying: "We are prepared to work together ... but we are not prepared to work with agents who are bent on misleading the people of South Africa."

A delegate said "the most disturbing part of her speech was a reference to external forces that create ambivalence in the government Aids agenda."

When Zuma took the podium the protesters sat down, suggesting that they do not see the government en bloc as the greatest barrier to the roll-out of anti-retroviral treatment. Zuma's speech promised a strong commitment by the government.

"Some people sometimes feel that the government is not caring for people that are infected with HIV and Aids by not providing them with anti-retroviral therapy," he said. "We are in the process of finalising several international agreements that will ensure access to medication to the many people infected with HIV and Aids."

Despite his statement the TAC marched to the conference the next day and handed over a memorandum calling on the conference to support a national treatment plan.

The TAC director, Zackie Achmat, said people were tired of the "foot-dragging" by the government on an anti-retroviral treatment plan. "We have given them enough time to act by suspending our civil disobedience campaign."

But the TAC also hit flak for resuming its campaign. A statement by the ANC in KwaZulu-Natal urged "all patriotic South Africans to ignore a recent call by the [TAC] to engage in a so-called civil disobedience".

In sharp contrast - and indicative yet again of divisions within the ruling party - Faried Abdullah, the deputy director in the Western Cape health department, spoke of the need for anti-retroviral treatment to prevent the collapse of the hospital system if people with Aids are not treated.

Wearing one of the TAC's bright yellow T-shirts, Abdullah said: "No Aids programme could be effective without the widespread use of anti-retroviral treatment." He also said no nutritional programme will diminish the deaths from Aids.

Zweli Mkhize, KwaZulu-Natal health minister, delivered a conciliatory speech at the end of the conference, calling on partnerships among all sectors. "The matter of anti-retrovirals does not constitute an area of disagreement. It needs to be placed on the record that the matter of anti-retroviral drugs is not an ideological issue ... Government has approached the comprehensive plan of HIV/Aids in a phased manner."

Appeal court Judge Edwin Cameron said the conference expressed a strong sense of commitment by the government to a treatment programme. "They said the question is not if, but when ... we must not delay and be disempowered by waiting for the perfect moment [to roll-out]."

Judge Cameron said the most significant session of the conference was Abdullah's presentation. "The point Abdullah made which he did not say but was implicit in his whole speech [was that the] Western Cape government is a coalition of the New National Party and the ANC ... This is not a party political issue. The Western Cape programme is being implemented by an ANC government. We want those same commitments nationwide."

He said the conference has made progress in the fight, but now the question to ask is when the treatment will be available.An obstacle course for women

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