The New York Times - November 1, 2009
Celia W. Dugger

Almost 10 years to the day after President Thabo Mbeki first suggested that AIDS drugs could pose "a danger to health" in an Oct. 28, 1999, speech in Parliament, Mr. Zuma declared Thursday in the same chamber, "Knowledge will help us to confront denialism and the stigma attached to the disease."

In a country that now has more H.I.V.-infected people and annual AIDS deaths than any other, Mr. Zuma's clarion call for a battle against the disease, six months into his term as president, led to rejoicing among advocates who had long sought such national leadership.

Mr. Zuma said in his address: "All South Africans must know that they are at risk and must take informed decisions to reduce their vulnerability to infection or, if infected, to slow the advance of the disease. Most importantly, all South Africans need to know their H.I.V. status, and be informed of the treatment options available to them."

After Mr. Mbeki's ouster from the presidency a year ago by his own party, the African National Congress, which has governed the country since 1994, a caretaker president appointed a new health minister, Barbara Hogan, who said in an interview that what she called "the era of denialism" was over.

Dr. Aaron Motsoaledi, her successor as health minister under Mr. Zuma, has accepted the government's responsibility for past failings and begun charting a more comprehensive approach to the AIDS crisis here.

Plain-spoken national leadership has proved critical to combating the disease in Uganda, Kenya and Botswana -- and disastrous where it was lacking, as here. Harvard researchers estimated that South Africa could have prevented 365,000 premature deaths had it acted sooner to provide antiretroviral drugs to treat people with AIDS and to prevent H.I.V.-positive women from infecting their newborns.

In his speech, Mr. Zuma laid out the horrifying toll of AIDS.

Among the statistics he cited was that overall deaths registered in South Africa in 2008 jumped to 756,000 from 573,000 the year before, which he said posed the possibility that deaths annually could eventually outnumber births.

He also said life expectancy for South African men is 51, compared with 70 in Algeria and 60 in Senegal.

"These are some of the chilling statistics that demonstrate the devastating impact that H.I.V. and AIDS is having on our nation," Mr. Zuma said. "Not even the youngest are spared."

And though the country now has a strategy to fight the disease and the largest antiretroviral treatment program on earth, he said: "We are not yet winning this battle. We must come to terms with this reality as South Africans."

He also called for "a massive mobilization campaign" to spur South Africans to safeguard their health, educate them about the risks and convert "knowledge into a change of behavior."

Mr. Zuma did not go into detail about the behavior changes that were needed.

Many anti-AIDS advocates hope the president will speak out about the dangers of multiple sexual partners and urge people to take the difficult, and in some cases culturally charged, steps that could help prevent the spread of H.I.V.: condom use and male circumcision, which more than halves the risk of infection for men, among other things.

Mr. Zuma is Zulu, the country's largest ethnic group, and Zulus do not generally practice circumcision.

Mr. Zuma vowed that on World AIDS Day, Dec. 1, the country would begin what he called a "renewed onslaught against this epidemic."
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