Sunday Times, South Africa - May 30, 1999
Tim Trengove Jones

Between April 1994 and June 1999, South Africans with the necessary resilience have been trying to re-imagine the massively fractured social space inherited after apartheid by constructing dreams of cultural synthesis. Variously labelled "the rainbow nation", "Madiba magic", "the RDP", or "the African renaissance", these rallying cries all aimed to provide focal points around which a new collective consciousness might emerge.

These terms are verbal talismans aimed at talking ourselves into a brave new world. And, as we prepare to vote, it is worthwhile remembering that central to these terms is the desire to recognise sameness and difference, to find ways of embodying and living out the awkward truth that our culture is a deeply various thing.

The imperative pressures to dream forward have had their inevitable concomitant echoes in the doom-laden talk that seems endemic to all cultural achievement. However this is glossed - crime, affirmative action, redistribution of wealth, economic restructuring - this talk offers an idiom of decline and crisis.

One area of crisis identified by the government and opposition alike is the HIV/AIDS epidemic. Yet, when the editors of both The Star and The Mail & Guardian recently threw their support behind the ANC, they did not mention the epidemic or the government's record on this issue.

Since March, when members of the Treatment Action Campaign lay down in the streets outside Soweto's Chris Hani Baragwanath Hospital and, more especially, since the April declaration by Judge Edwin Cameron that he is "living with AIDS", HIV/AIDS has received more media coverage than ever and has been unambiguously established as an election issue.

Both Deputy President Thabo Mbeki and the Minister of Health, Nkosazana Zuma, have identified the epidemic as a matter of national importance.

Given these facts, editorial silence on the issue when punting the ANC as party of choice is not only surprising, but scandalous.

Then again, to identify HIV/ AIDS as a national crisis, to honestly record the government's record in dealing with it, and then propose unqualified support for the ANC, would beggar belief in even the most jaded of minds.

I think it necessary to suggest that anyone who votes for the ANC should do so only on the firm understanding that they will oppose, loud and long, the reappointment of Zuma as health minister. On assuming office in 1994, Zuma rightly identified HIV/AIDS as a key area of concern. She has reiterated, indeed intensified, this original acknowledgement of crisis.

But everything she has done on the matter has been lamentably inefficient or inappropriate.

First, she squandered millions on Sarafina 2, a debacle little short of a national disgrace. Then she backed the Virodene team, riding arrogantly and ignorantly over the Medicines Control Council, giving the false hope of quack medicine her official imprimatur. Then she obtusely insisted the government could not afford AZT for pregnant women and that such therapy was not, in any event, cost-effective. And now she declares that, within three short months, HIV will not only become a notifiable illness, but those who are HIV-positive must, by law, inform their families, care givers and sexual partners.

This history is one of spectacular ineptitude.

Notifiability alone implies massive insensitivity to the vulnerabilities of many who are HIVpositive. Insistence that the government cannot afford to supply HIV/AIDS patients with appropriate therapies makes a mockery of notifiability and the gathering of statistics. (What will be done with these statistics - will they be used to work out how much money the government can't afford to pay?)

What integrity is there when Mbeki himself tells petitioners to go to the pharmaceutical companies and not the government when, in reality, Glaxo had a long while back offered the government substantial discounts on AZT, and had sponsored pilot treatment projects? What "price" is to be put on the heads of the new-born children who will be HIV-positive because government red tape and bungling deprived their mothers of free AZT donated by UNAIDS?

What credence can we attach to appeals to poverty when the government approves billions for the purchase of military hardware? What confidence can we attach to a situation where the president-elect uses Cameron's carefully worded statement as an occasion to promote the policy of notifiability and mandatory disclosure?

No, I'm afraid none of this will do. And it is an awfully long list. If this sounds angry, it should. Because anger can rouse us from apathy and blow away sophistry. And if this anger is directed largely at members of the government, this is not hostility towards a particular political party but towards those who had the opportunity and responsibility to make a difference.

Only last week, Zuma's spokesman, Khangelani Hlongwane, stated that "for the government, the most telling impact . . . will be made by intensifying education". Also last week, Mbeki linked control of the epidemic to the moral regeneration of the nation, proposing the avoidance of pre- and extra-marital sex as solutions. Nowhere else in the world have appeals to "family values" halted HIV. One thing we really can't afford to do is re-invent the wheel, and so squarely at that.

Obviously, through notifiability the impersonal imperative of gathering statistics and thereby making calculations about the socio-economic future of the country might be enhanced. But this has to be carefully balanced against the inflexible right to remain silent should it appear that disclosure will jeopardise job security or personal safety.

On the matter of disclosure to sexual partners, it must be emphasised that the state cannot successfully legislate sexual mores and ethics. If the test of sound legislation is its enforceability, what is proposed here - with all its potential for distortion and vindictiveness - should be a non-starter.

HIV/AIDS, in its competition for resources and potential to evoke fear and loathing, could become one of the most deeply fracturing elements in our process of transformation. But precisely because of the personal and economic imperatives that inform the need to "be well", it could equally emerge as an issue around which we can unite. It transcends the imperatives of party politics, points to our shared interests and proclaims deep kinship in terms of shared vulnerabilities and responsibilities.

It is a crisis that threatens to take the lustre out of the rainbow nation. But, rather than histrionics, our individual and national responses to this crisis should become instruments for measuring how far we have gone towards realising a more humane social order predicated on improving the quality of life for all.

If, when voting and, more importantly, if after the installation of the new government, one does not act in ways designed to ensure the government deals efficiently and humanely with this crisis, one will be guilty of the gravest social irresponsibility. And one will indeed have made a difference. For the worse.

990530
ST9905

Always watch for outdated information. This article first appeared in 1999. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1999. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .