Chicago Tribune - November 30, 2003

Achmat's labor of several years has finally paid off. Health officials in his country have unveiled details of a massive plan to provide South Africans with antiretroviral drugs and other AIDS medicines that have been unaffordable and unavailable to most of the population. For South Africa and other developing countries ravaged by AIDS, this could be a turning point.

According to a report issued last week by the Joint United Nations Program on HIV/AIDS, this year alone 5 million people became infected with HIV worldwide, and 3 million died of the disease. One in five adults in southern Africa is living with AIDS today, the highest rate of infection since the onset of the epidemic.

South Africa has been notorious regarding its blindfolded approach to AIDS. It is one of the most developed economies in Africa, yet it has one of the highest levels of AIDS infection in the world--nearly 12 percent of a population of 45 million people. About 600 people die of the disease every day there. South Africa could have developed an effective strategy against AIDS much earlier. It just didn't want to do it.

Part of the problem was President Thabo Mbeki's endorsement of a fringe of researchers who denied the link between HIV infection and the disease. Such quackery undercut efforts to buy drugs to treat infection and reduce transmission. Another obstacle was the refusal by pharmaceutical firms to allow the manufacture or sale of cheaper generics for people with AIDS.

In his campaign against indifference and for cheaper medicines, practically no protest tactic was beyond Achmat. He filed charges against some government officials for "murder." He was arrested for smuggling--quite openly--generics from South Asia. Achmat enlisted the support of Nelson Mandela, an easy match since both were veterans of the fight against apartheid.

Two years ago Achmat won an epic victory when 39 international drug firms dropped lawsuits against South Africa to prevent the importation or manufacture of lower-cost generics. But without a national strategy for testing people for HIV and distributing the drugs, AIDS victims could do little but wait for the benefits.

So Achmat--a 41-year-old activist who is gay, HIV-positive and a former prostitute--announced he would not take antiretroviral drugs until they were available to the general population. For months he refused treatment, even when Mandela publicly pleaded with him. Achmat's health declined.

Achmat's campaign caught the attention of former President Bill Clinton, who negotiated with four generic drug manufacturers to cut the cost of medication to about $11 a month, compared to several hundred dollars a month in the U.S. and other developed countries.

Earlier this year, when the Mbeki government announced it had changed its mind and would distribute the drugs, Achmat began taking his.

The 600-page plan, approved by the South African Cabinet, will provide medications to an estimated 1.4 million people in the country. That exceeds even most activists' expectations. The first year it's expected to cost around $45 million and in four years rise to $680 million annually.

Most important, the government will develop a system of clinics to test people for HIV and administer the potentially dangerous medications. Drugs will go to those in the late stages of the disease and the government will continue to press for education and prevention to lower the current rate of 1,500 new infections daily. South Africa, at last, has removed the blindfold.

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