Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
Sunday Times (Johannesburg) - July 20, 2003
What does the report say?
It confirms that antiretrovirals work.
What does Health Minister Manto Tshabalala-Msimang's failure to act on it suggest?
That she still does not believe antiretrovirals work. That she and President Thabo Mbeki are stung by it. It's a government report and it says that government policy over the last five years has been seriously mistaken. They've been put into a corner and don't want to lose face. If they give in now it would seem to be because of extensive civil-society pressure.
What of their argument that without effective monitoring antiretrovirals will be a waste of money, even counter-productive?
The point is that the longer we leave it, the less possible it will be to monitor the drugs. People will buy them at pharmacies with a doctor's prescription, and many doctors have not been properly trained so they'll mis-prescribe and so on. Or they'll go across the border to countries where antiretrovirals are being rolled out.
The government thinks the TAC thinks antiretrovirals are the solution. We think developing the healthcare system and antiretrovirals are critical.
What of Tshabala-Msimang's argument that without proper nutrition the drugs won't work?
She's making an artificial distinction between the need for nutrition and the need for antiretrovirals. We've never said antiretrovirals are the only solution to the HIV crisis. They're creating this false perception that we're ignoring nutrition. We've known since the beginning of the epidemic that nutrition is critical for managing HIV. Are they saying that, 10 years into a democratic government, 200 000 people a year are dying of nutrition-related diseases? That alone should be cause for resignation.
Some provinces are rolling out antiretrovirals. Is there a danger of national government becoming irrelevant?
It's making its capacity to develop policy in this and other areas look quite ridiculous. If provinces are left to do this on their own, without the setting of a national standard, what's to stop them turning their back on the government in other areas of policy? There's no question that some provinces are far ahead of the government on this.
How many people need antiretrovirals today ?
Between 200 000 and 300 000.
And without them they will die?
Yes.
Two years ago you were on your deathbed. Now you look quite healthy. Without antiretrovirals.
I don't know if I was on my deathbed but I was quite sick. My health has improved tremendously, but my immune system is weak. You don't need antiretrovirals at the outset, you need them in the last stage of your disease when you start showing symptoms, which I'm now starting to show.
So we shouldn't think you'll keep going forever?
No. I've had more than 30 days out of work this year and I've exhausted my medical-scheme account. If I'd been taking antiretrovirals this wouldn't be happening.
Does the TAC pack enough punch to make an impact at the polls?
We have no intention of doing any political contestation, but government must know that this issue is going to hurt it at the polls.
Surely your support makes you potentially a very powerful force?
I wouldn't want to exaggerate it, but what is important is that we have support at every layer of society.
Unless the government sees you as a threat at the polls, surely it will continue to prevaricate?
Yes, but on the other hand they don't want to see the continuation of a civil-disobedience campaign during elections. I hope they don't want to see political funerals, very large ones, during an election campaign. And this is the sort of thing they will face from us if they don't move, of that there is no question. We'll use every legal means at our disposal to ensure that people get treatment. Treatment is what the TAC wants, not seats in Parliament.
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