Sunday Times (Johannesburg) - November 7, 2008
Nivashni Nair and Werner Swart

AIDS activists want former president Thabo Mbeki and his health minister, Manto Tshabalala-Msimang, to account to a commission of inquiry for the deaths of hundreds of thousands of people.

This follows the publication of a study by the Harvard School of Public Health that found that more than 330 000 lives were lost because of the pair's failure to roll out HIV-Aids drugs between 2000 and 2005.

The report, published on October 20, blames the deaths on the reluctance of the Mbeki-led government to implement a feasible and timely antiretroviral treatment programme.

Attempts over the past week to get a response to the study from Mbeki and Tshabalala-Msimang have hit a brick wall.

Zackie Achmat of the Treatment Action Campaign (TAC) said Mbeki had "blood on his hands".

The study, led by Dr Pride Chigwedere, concluded that more than 330,000 people - enough to fill Ellis Park stadium six times over - died in the six years because an ARV treatment programme was not implemented timeously.

The study found that almost 35,000 babies were born with HIV during the same period because of mother-to-child transmission because Mbeki and his health minister failed to make the preventative drug nevirapine widely available.

"The total lost benefits of ARVs are at least 3.8 million 'person-years' for the period 2000 to 2005," said Chigwedere, whose team used death and Aids-affected patient records from the World Health Organisation and UNAids in their calculations.

The study found that South Africa lagged behind neighbours Botswana and Namibia when it came to treating HIV-Aids.

Mbeki's spokesman refused to comment. Mukoni Ratshitanga referred The Times to the head of Government Communication and Information Systems, Themba Maseko, who said it was not his place to speak on behalf of the former president.

The Presidency's ministerial liaison officer, Samson Phakwago, failed to respond on behalf of Tshabalala-Msimang, who is now the minister in the Presidency. He acknowledged she was aware of the query.

The ANC said the study and the country's Aids policies were a government matter, not a party issue.

Achmat - whose organisation's battles in the courts eventually forced the Mbeki administration to roll out the drugs - said: "The TAC has repeatedly said exactly what has been found in [the Harvard] study. This study clearly demonstrates that there is a direct link between the deaths of thousands of people and Mbeki's HIV denialism.

"This is why the TAC believed the ANC should have impeached him a long time ago because he has blood on his hands," he said.

As health minister, Tshabalala-Msimang was outspoken about her mistrust of ARVs. She promoted lemons, garlic, olive oil and beetroot instead.

She was supported by Mbeki, who did not give the go-ahead for the roll-out until August 2003.

Achmat has called for the new government to summon Mbeki and Tshabalala-Msimang to explain what went wrong.

"My colleagues have spoken about Mbeki going to the Truth and Reconciliation Commission, but I feel that both Mbeki and the former health minister should be held liable," Achmat said. "They should be called to address an independent judicial board so that justice can prevail for those who lost loved ones at their hands.

"They must be held accountable," he said.

Constitutional expert Professor George Devenish said this was a possibilty - if President Kgalema Motlanthe willed it.

Motlanthe would need to appoint a commission in terms of section 84 of the constitution. "Such a commission has the power to subpoena anyone to appear before it," he said.

Dr Francois Venter, of the Reproductive Health and HIV Research Unit at Wits University, said the study pointed to a "disgraceful lack of leadership".

He is, however, hopeful that the country's new leadership will turn the tide.

"It's not only Barbara Hogan, whom I think is an inspirational leader. I've seen that even in our local provinces there is a greater sense of urgency to deal with it."

Barack Obama, in a speech at the Global Summit on Aids, in California a few months after he visited South Africa in 2006, said: "I visited an HIV-Aids hospital ... that was filled to capacity with people who walked hours, even days, just for the chance to seek help.

"I met courageous patients who refused to give up, for themselves or their families. And I came across Aids activists who meet resistance from their own government but keep on fighting anyway."

Obama laid into Mbeki and Tshabalala-Msimang: "That's why it was so frustrating for me to go to South Africa and see the pain, and see the suffering, and then hear that the country's minister of health had promoted the use of beetroot, sweet potato and lemon juice as the best way to cure HIV.

"Thankfully, the South African government eventually repudiated this, but it's impossible to overestimate how important it is for political leaders like this to set a good example for their people."

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