Africa: AIDS Inaction Critiqued, 09/30/01

Africa: AIDS Inaction Critiqued, 09/30/01

Africa: AIDS Inaction Critiqued Date distributed (ymd): 010930 Document reposted by APIC

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Region: Continent-Wide Issue Areas: +economy/development+ +health+


This posting contains a joint statement from the Treatment Action Campaign, COSATU, the Anglican Church and the Southern African Catholic Bishops Conference calling for stronger national action on AIDS. It also includes summaries from the Kaiser Family Foundation of news reports on recent critiques of both South African and international failures of leadership, and a September 19 statement from South Africa's Medical Research Council, promising release of their new report on AIDS mortality as soon as consultations and briefings with other agencies have been completed.

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We Must Take Strong Action to Stop AIDS

Congress of South African Trade Unions (Johannesburg)


September 21, 2001


Joint Statement of the Anglican Church, Southern African Catholic Bishops Conference (SACBC), COSATU and the Treatment Action Campaign (TAC), Bishopscourt, Cape Town, September 20, 2001

In an historic meeting on September 17, 2001, representatives of the Anglican Church, the Southern African Catholic Bishops Conference, COSATU and the Treatment Action Campaign met, out of a common commitment to life and dignity, to join forces against the AIDS epidemic.

It can no longer be denied that AIDS is by far the leading cause of death for adult South Africans, especially those between 20 and 50. The report by the Medical Research Council (MRC) says that, unless we can ensure that all HIV-positive people get treatment, between four and seven million South Africans will die over the coming decade.

The MRC report only confirms the experience of our organisations. Our clergy report that every week, they are burying people who die of AIDS. Young workers are disappearing and dying from "natural causes" in the prime of life, leaving their families behind with no income or support. Educators and learners are buried alongside each other. Mothers watch their babies die prematurely and unnecessarily from AIDS. We could continue this list indefinitely.

No one in our country can afford to deny the terrible extent of this epidemic. The meeting expressed concerns over the attempts of some in government to downplay its impact. The data are clear, and must not be obscured by wishful thinking. No organisation or individual should try to suppress the facts - that way lies disaster.

Faith-based organisations, trade unions and TAC are committed to building an effective alliance of civil society to prevent new HIV infections and ensure that people with HIV/AIDS get life-prolonging and effective treatment. This includes the development of a national treatment plan that includes anti-retroviral therapy. We have agreed:

- To set up a working group that will develop shared campaigns to overcome the denial syndrome that has emerged in some official and unofficial circles; and

- To work with representatives of civil society in the South African National AIDS Council (SANAC) to guide and challenge our national leaders to take more positive action on AIDS, to replace the cycle of controversy and denial with co-operation, common purpose and courage in the national interest.

Government must ensure that its policies face up to the national emergency caused by AIDS, or it will fail our people in both human and economic terms. We call on it:

- To declare that the AIDS epidemic constitutes a National Emergency.

- To take into account the extent and impact of AIDS in all its policies and public statements, providing the moral and political leadership our country so desperately needs.

- To increase the health budget and ensure cheaper anti-retrovirals and other medications, in order to provide adequate care for HIV-positive people, and to expand prevention and educational campaigns.

Even one death from AIDS is a death too many. We need to use every tool at our disposal, from education and prevention to treatment, to address this national emergency. We call on all faith-based organisations, every trade union, and all civil society organisations to join us. We are making HIV/AIDS a top priority. We call on our government to do the same.

Njonkulu Ndungane, Archbishop of Cape Town, Chairperson of the AIDS Commission of the Council of Anglican Provinces in Africa.

Willie Madisha, President of COSATU

Zackie Achmat, Chairperson of TAC

The Rev Father Richard Menatsi, General Secretary of the SACBC

Patrick Craven and Moloto Mothapo, Acting COSATU Spokespersons.


Kaiser Family Foundation

Daily HIV/AIDS Report

Friday, September 21, 2001

CONTACT DAILY REPORTS STAFF Editorial phone: 202-672-5952 FAX: 202-672-5767 Editorial e-mail: E-mail registration:

South African Health Ministry Report 'Challenges' Government's AIDS Policy

[Sep 21, 2001]

A confidential document issued by the South African Ministry of Health "directly challenges many of" South African President Thabo Mbeki's HIV/AIDS policies, stating that they are "increasingly politically dangerous" and encourage the country's health system to provide "inadequate" care for people with HIV, the London Guardian reports. The report, which was obtained by the Guardian, was drafted in July, before Mbeki wrote a "controversial" letter to South African Health Minister Dr. Manto Tshabalala-Msimang instructing her to "consider a cut" in the country's HIV/AIDS budget. The report states that it is government policy to "'not provide any meaningful care' for large numbers of South Africans" with HIV/AIDS.

The health ministry states that it has prevented public hospitals from "disintegrating under the demand for HIV treatment" through a policy of "providing 'inadequate quality of care' for some, and 'not providing any meaningful care for a proportion of those with HIV/AIDS, especially in areas with generally poor access to health care.'" However, the report states that these policies are "'increasingly unstable' from a political, moral and legal perspective" as HIV infection rates rise, especially among the poor. "Failing to provide care for population sub-groups (primarily the rural poor with poor access to health care) will become increasingly politically dangerous as the absolute number of people sick with AIDS rises among poor and vulnerable groups," the ministry writes. Mbeki has "consistently rejected" offering antiretroviral drugs in public hospitals, stating that the medicines are toxic. However, the report refutes his statements and calls for the creation of trial distribution programs of antiretrovirals.

Refuting Mbeki's Other Claims

In the report, the ministry also challenges a number of Mbeki's other positions on HIV/AIDS, including his questioning of the causal link between HIV and AIDS and his declaration that AIDS-related causes are responsible for only a "tiny proportion" of annual deaths in South Africa. The report "concede[s]" that HIV causes AIDS, that antiretroviral drugs "extend lives" and that 3.5 to 4.5 million South Africans will have died of AIDS-related causes by 2010, a figure much higher than Mbeki's claim, based on 1995 WHO data, that AIDS-related causes lead to approximately 5,000 deaths each year in the country. The health ministry document "confirms" what the WHO has said: that AIDS is "the single largest killer" in South Africa. Health ministry officials urge the government to allocate "much greater funding" toward AIDS treatment and broaden access to antiretroviral drugs. The authors of the report include health ministry officials "known to be unhappy" with the South African government's AIDS policies, but it is unclear whether the report has the backing of Tshabalala-Msimang (McGreal, London Guardian, 9/21).

[From Daily HIV/AIDS Report, Sept. 27, 2001

Tshabalala-Msimang Responds

In her letter to the Guardian, Tshabalala-Msimang states that the report was only a first draft and had not yet reached her desk or "been discussed or edited at any level." Tshabalala-Msimang refutes many of the report's statements, including its claim that the government does not provide adequate HIV treatment. She writes that the government "is not opposed" to antiretrovirals, but that the cost of the drugs puts them "beyond our reach." Tshabalala-Msimang states that although areas of South African AIDS policy "require further improvement," she adds that "to twist this statement into the suggestion that South Africa has a deliberate policy of providing inadequate care or even withholding care is a disgraceful distortion" and "an insult to all those who struggle daily to fight the challenges posed by poverty and underdevelopment, including HIV/AIDS in our country." She added that the latest version of the report calls for additional funding to fight HIV/AIDS and "contradict[s] Mbeki's 'assertions' on HIV/AIDS by conceding that HIV is the cause of AIDS." She concludes, "All our HIV/AIDS strategies are based on the premise that HIV causes AIDS" (Guardian, 9/26).]

Groups Call for Swift Release of MRC Report

A number of religious, labor and AIDS groups gathered in South Africa this week to "challeng[e]" the South African government to "overcome the denial syndrome" of HIV/AIDS and release a Medical Research Council report that supposedly points to AIDS as the country's leading cause of death, Reuters reports. The Anglican and Catholic churches, the Congress of South African Trade Unions and the AIDS group Treatment Action Campaign met on Monday to draft a statement asking the government to "acknowledge the scale of the HIV/AIDS epidemic" in South Africa. The coalition said that it has created a program to help government officials and others overcome their "denial" of HIV/AIDS. However, the delegates declined to say whether Mbeki numbered among those "in denial." COSATU delegate Derrick Cele said, "We don't want to separate the president from the government. We are making a call on the government, led by the president."

The group has also called for the "immediate release" of the MRC report, which, according to media reports, states that AIDS-related causes accounted for 40% of deaths of South Africans ages 15 to 49 in 2000 and names AIDS "the country's biggest killer" (Boyle, Reuters, 9/20). The MRC report compiles the official South African mortality figures for 1997 through 2000 and is scheduled to be released by the end of the year (Kaiser Daily HIV/AIDS Report, 9/20). Catholic Bishop Reginald Cawcutt said, "[The government] cannot withhold that report. It is our report. It was paid for with taxpayer's funds and it belongs to the people." TAC Chair Zackie Achmat said that his group has written to Tshabalala-Msimang, giving her one week to publish the report. After that, he said, TAC will take the issue to court (Reuters, 9/20).

Industrialized Nations 'Fail' to Show Leadership in AIDS Fight, UNICEF's 'State of the World's Children 2002' Report Says

[Sep 21, 2001]

HIV/AIDS is one of the "cruellest political and social problems in the world," particularly for children, UNICEF reports in its "State of the World's Children 2002," released Sept. 13 in preparation for the U.N. General Assembly Special Session on Children. The assembly, originally scheduled for Sept. 19-21, has been postponed because of the recent terrorist attacks on New York City and the Pentagon. HIV/AIDS is "destroying families, communities and nations," causing life expectancy to "plumme[t]" while AIDS orphans "overwhelm family networks, social services and health care institutions," the report states. One of the goals set forth at the 1990 World Summit for Children was to "improve protection of children in especially difficult circumstances," including children affected by HIV/AIDS. According to the report, the impact of the disease is "crushing the attempts of countries all over the world to put human development and the rights of women and children first," especially in Southern and Eastern Africa. The poverty of the regions has exacerbated the epidemic, illustrating that AIDS is the "most savage index of the inequality of our world," the report states. Projected child mortality rates for 2000-2005 in Botswana, Zimbabwe and South Africa are equal to or greater than 50%, and the southern and eastern regions of the continent had 6,400,000 AIDS orphans as of last year.

Leadership Needed

Industrialized nations have "markedly failed to show the requisite global leadership" on HIV/AIDS-related issues, responding with complacency once the epidemic had been contained within their own nations, the report states. However, HIV/AIDS has begun to receive global attention, first with the U.N. Security Council recognizing in January 2000 that the disease poses a threat to worldwide security and then with the U.N. General Assembly Special Session on HIV/AIDS in June, which produced targets for worldwide HIV prevention and established the Global AIDS and Health Fund to fight the disease. Leadership in the most affected nations has also been "markedly varied," the report states. Successful initiatives in Uganda have lowered the HIV infection rate from 30% of adults in 1990 to 10% today, and in Botswana, officials have begun to implement a national program to reduce vertical transmission. Thailand, Venezuela and Brazil have also successfully implemented programs to reduce HIV transmission.

However, other nations have "pursue[d] an ostrich-like approach, taking no account of the rising tide of infection" until the numbers were overwhelming, the report states. Corporations have also begun to take initiative, according to the report. The Coca-Cola Co. recently said it will use its distribution network to distribute condoms, HIV testing kits and educational materials to remote areas. The company is part of the Global Business Council on HIV and AIDS, to which companies like AOL Time Warner, MAC Cosmetics and Unilever also belong. Drug companies have also begun to offer steep discounts to developing nations, the report notes, citing Bristol-Myers Squibb's offer to sell its medicines didanosine and stavudine for $1 a day to African nations and Pfizer's donation of fluconazole to the least developed nations. Pfizer is also spending $11 million on a medical training center for doctors treating HIV/AIDS patients in Uganda.


Medical Research Council of South Africa PO Box 19070, 7505 Tygerberg, South Africa Tel +27 (0)21 9380911 / Fax +27 (0)21 9380200

19 September 2001

Impact of HIV/AIDS on adult mortality in South Africa

The MRC has conducted rigorous research on the pattern of mortality in South Africa over the last fifteen years. This research has been commented upon and reviewed by a panel of leading world authorities on demography, epidemiology and medical statistics. As an institution the MRC is proud of this work and stands by the findings of this report. We recognise that the findings are of major public interest with enormous and serious policy and public implications for our country in the future, particularly in relation to the HIV/AIDS pandemic. We also consider this work will contribute significantly to the global understanding of the HIV/AIDS pandemic.

Given the significance of the findings, the MRC decided to pursue the process of informing the policy-makers of our country through several briefing and discussion processes. These processes are currently underway during which the MRC has received useful and constructive feedback from the other government agencies who are using different methodologies and approaches to analyse the same problem. When these processes are completed the MRC will release the report. We have every confidence that our country's policy-makers will expedite this process in the interest of informing the public.


Message-Id: <> From: "Africa Action" <> Date: Sun, 30 Sep 2001 10:11:11 -0500 Subject: Africa: AIDS Inaction Critiqued

Editor: Ali B. Ali-Dinar

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