Inter Press Service - September 20, 2001
Farah Khan

The front met this week in Cape Town and exhorted government to "provide the moral and political leadership our country so badly needs" to end what it called the "denial" that has continued to dog the Mbeki administration.

Since 1999, President Thabo Mbeki has been embroiled in a damaging debate on the causation of AIDS. The President is sceptical of the view that the HI-virus causes AIDS and believes it can lead to the "medicalisation" of social ills like poverty and early that have economic roots too.

Always critical of the President's views, the coalition has decided to pool its resources to undertake joint campaigns, which, from its first communique, suggests a no holds barred and opposition-like stance against government.

A fortnight ago, a letter from Mbeki to health minister Manto Tshabalala-Msimang was leaked to the media. It revealed that, despite gargantuan efforts by his spin-doctors, Mbeki has not changed tack on his HIV/AIDS stance -- he remains a sceptic.

In his letter, Mbeki used 1995 World Health Organisation (WHO) statistics to back up his view that the pandemic is not the leading cause of death.

Influenced by a rather simplistic reading which showed that HIV was the cause of just over 2.2 percent of deaths, he instructed the health minister to interrogate the statistics and ensure that health spending reflected the mortality causes.

Holes were quickly shot through his letter -- the statistics were old and predated the peak in South Africa, replied critics. The President read selectively, they said, and excluded Tuberculosis (TB) deaths, widely regarded as symptomatic of AIDS mortality.

Most disturbing, was the defiant, almost arrogant tone of the letter. Mbeki instructed his health minister to persevere. "It will provoke a howl of displeasure and a concerted propaganda campaign from those who have convinced themselves that HIV/AIDS is the single biggest cause of death in South Africa."

Less than a fortnight later the degree to which Mbeki had embarrassed himself emerged as leaked copies of a Medical Research Council (MRC) report started finding themselves into the major media.

It found that about 40 percent of adult deaths that occurred in 2000 were AIDS-related. The report, titled "Impact of HIV/AIDS on adult mortality in South Africa" appeared to have been deliberately stalled in Cabinet since May. It found that half the deaths of young people aged 15 to 49 are now due to AIDS -- a stark contradiction to Mbeki's assertion.

MRC president William Makgoba, said the report had been sent to six international researchers to test methodology and that South Africa had been consulted.

He said the report was a clarion call to end the culture of "denial" that still gripped South Africa.

It further found that by 2010, between 4 million and 7 million people will have died of AIDS. Until 1995, adult deaths peaked between the years 65 to 69. From 1995, the peak in death rates of young adults is almost as high.

For young African women regarded as most susceptible -- the peak death rate is higher than of the "normal" dying years of older than 65 years. Researchers also studied Durban cemeteries and crematoriums and found their statistics had increased.

The report does acknowledge that death rates in South Africa are still under-reported; and that its model is slightly outdated.

In addition Mbeki's view that the key method of AIDS surveillance - testing of pregnant women - does have support.

But there is ample, visible, evidence to support the view that the rate of HIV/AIDS is growing in South Africa. "Our clergy report every week, they are burying people who die of AIDS. Young workers are disappearing and dying from "natural causes' in the prime of their lives," said the new front in a statement this week.

"We have all -- church, govt and civil society -- been guilty of moving too slowly and of sins of commission," said the Anglican Archbishop Njongonkulu Ndungane, in response to Mbeki's letter. "I had hoped we had finally shifted from denial to recognition that we have a responsibility to humanity, all of which is either infected or affected."

He is likely to be the key symbol of the movement. Its formation will turn the class action suit imploring government to provide antiretrovirals to pregnant women and new-born children into a major campaign.

It will, arguably, be as big as they made the government's case against the pharmaceutical industry in March. This time, though, their action is against and not with government.

In the court action, marshalled by the Treatment Action Campaign, doctors and nurses have joined NGOs to press government to provide Nevirapine to pregnant women and newborn babies. It has been found to significantly reduce the rate of mother to child HIV transmission.
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