HIV/Aids activist Zackie Achmat is no stranger to struggle — but he has come face to face with one of his biggest challenges: to take the drugs that can keep him healthy, or to put his life at risk because of his moral convictions.
Four years ago Achmat took a controversial stance that he would not take anti-retroviral drugs until the government set up pilot anti-retroviral programmes at community clinics in all of South Africa’s nine provinces.
But over the past few weeks Achmat’s fight became crucial when he contracted a lung infection that doctors fear is tuberculosis. If the diagnosis is confirmed, given the weakness of his immune system, he will have stage four, or full-blown, Aids. The results will be known by July 12.
Diagnosed with HIV in 1990, Achmat has been at the forefront of HIV activism as leader of the Treatment Action Campaign (TAC). It is rare that he would miss any event, meeting or conference on HIV/Aids but his health has deteriorated so much that he was too weak to attend the 14th International Aids Conference, held in Barce-lona this week, and videotaped his speech, which was aired on Wednesday.
His doctor has strongly advised that he start taking anti-retroviral drugs as his CD4 count is 228, which is low.
Achmat is being treated for opportunistic infections and doctors are trying to keep him as healthy as possible.
”His condition is stable and he has been responding to medication,” says Rukia Cornelius, his personal assistant.
Achmat says he is not a martyr nor does he want to die. But he is adamant that he will not reconsider his position, even it costs his life.
”The political scenario in South Africa has lost its moral content. The poorest of the poor are dying, only the rich have access to treatment. My fight is essentially about this. If we don’t have morals in our politics, then South Africa is doomed,” says Achmat.
He is contemptuous of the government’s refusal to implement programmes that could save South African lives. He was reported to have said that it is wrong to purchase life.
”The right to life should be inviolable and available to everyone. All other rights come from it. But more important, the state has within its means the money to keep people productive, but it doesn’t.”
Achmat’s brave stance has caused an outcry from colleagues, concerned people, family and friends. But he is resolute that he will not back down.
”Almost everyone I speak with nationally and internationally is insisting he take anti-retrovirals and saying he’s worth more to us healthy and alive than dead,” says Cornelius.
She says his stance has been difficult for his family and friends but they are supportive of his decision.
”The same goes for us at the TAC. There is worry, concern and pain at the possibility of losing such a brilliant mind and humble person, but we understand his plight, we see it in so many that have died for lack of access to anti-retroviral drugs,” she says.
There are concerns that Achmat is the driving force behind the TAC’s success and without him the organisation will not be as successful in putting pressure on the government. But Achmat disagrees, saying that the TAC has dedicated, competent and committed staff and volunteers. He is confident the TAC will continue and sustain the fight, with or without him.
”I guess we are fortunate in that it’s not just his fight, but that we all believe in his course,” says Cornelius.
The strength of the organisation was evident at the Constitutional Court last week when the government suffered defeat through the judgement forcing it to extend access to anti-retrovirals for pregnant mothers to all public health sectors.
”We are ecstatic, of course. Our only concern is that things don’t move fast enough from here. We hope that government does not once again drag its feet and not deliver,” says Cornelius.
The TAC is far from ready to give up its battle with the government.
”The battle will only be over when the government complies and we don’t have people dying because not enough has been done, especially since so much can be done for so little. How do you put a price on life?” asks Cornelius.
She says the next step for the TAC will be to ensure that all provinces have nevirapine or a comprehensive mother-to-child-transmission (MTCT) programme in all clinics and hospitals and that the anti-retroviral pilot sites are up and running.
Achmat vows to continue his fight, no matter how long it takes.
In reports he said even though the government promised on April 17 to give drugs to prevent MTCT and post-exposure prophylaxis after rape, ”this has yet to happen, with little indication of when exactly it will, and there is still not medication for everyone infected”.
In his address to 14 000 people attending the Barcelona Aids conference he called for affordable medicines and anti-retroviral drugs for poor countries and communities. He also reiterated that these drugs do work.
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