South Africa is the only country in the world that does not have a policy for the treatment of HIV/Aids. As such, millions of South Africans are dying from a disease for which there is treatment, albeit not a cure. Consequently, South Africa’s government, medical profession and society are effectively part of a system that is committing genocide.
As part of the medical profession I say we have neglected our duty for long enough. We must wake up and speak up.
The South African government’s current no-treatment policy is shocking because it discriminates against very vulnerable people and is destroying our country.
Aids affects everyone. Much of South Africa’s workforce is living and working with the disease. The longer they are kept healthy, the longer the economy benefits. If we are serious about sustainable development, we should be serious about helping our ailing population.
The number of HIV/Aids-related deaths has been equated to dropping a bomb on a high school every day. The death tolls of South Africans in both World Wars and the armed struggle against apartheid pale in comparison to the numbers of those killed by the deadly disease.
Children and other family members who rely on the resources of those living with HIV/Aids deserve support and sustenance if they are to survive. The longer parents and caregivers are kept alive and functional, the fewer infant and child orphans there will be.
A 10-year-old orphan needs more social support than a 20-year-old. It makes sense to treat the parents and help them to care for their children so that they reach an age where they have a greater chance of fending for themselves.
It must be accepted that Aids is fatal. It can be contained by taking care of those living with the disease through providing the best possible treatment. Anti-retroviral treatment and prevention programmes are key to fighting this scourge.
Making drugs readily available would give everyone with HIV the chance of a normal life. It would encourage people to be tested for HIV because there would be hope for treatment. It would remove the stigma of the disease because those affected would stay economically active and reasonably healthy.
The South African Medical Association (Sama) has applauded the government’s roll-out plans for the provision of nevirapine to prevent vertical (mother-to-child) transmission, and the decision to make anti-retrovirals available to rape survivors. But let’s face it, infection prevention strategies aren’t working. By 2007 there will be an estimated two million HIV/Aids orphans in South Africa and 10-million dead.
A national HIV/Aids treatment policy would not guarantee everybody treatment, but would serve as a statement of intent. South Africa needs a treatment policy that would ensure those living with the disease have access to drugs. It’s common knowlege that resources are scarce, but this should not be used as a licence not to treat.
Of greatest concern is the deafening silence by the medical profession. Sama expressed shock and concern about the pandemic, called for treatment for rape victims, availability of drugs to prevent vertical transmission and blanket access to anti-retrovirals for all. But it is not getting anywhere. The medical profession in general does not adopt an activist role. It recognises it is dealing with a serious problem but is intimidated by a sense of obligation to the government to ensure health care delivery continues.
The only time in the South African medical profession’s history that doctors became activists was after the death in detention of Steve Biko. A group of doctors established an organisation called the Non-aligned Medical and Dental Association, because nobody else took a stand on the conduct of the medical profession towards this one man. Now there are millions at risk, and the profession remains passive, lacking the passion to become involved in preventing this genocide.
Many people in South Africa’s townships still believe that HIV/ Aids does not exist, in spite of easy access to media. South Africa’s HIV/Aids figures are rising, which proves that awareness campaigns are not effective, no matter how many condoms are made available.
HIV/Aids did not descend on South Africa overnight. The disease revealed itself in the late 1980s. The situation became worse in the 1990s, but South Africa continued to adopt a wait-and-see attitude.
Now the figures are horrifying. South Africa is facing disaster. But in spite of the country’s capabilities there is still no local production of anti-retroviral treatment. This is not an attack on the government, but an attack on all political parties, society and businesses. We must take collective responsibility and put our humanity to test. It’s our duty to find ways to treat everyone with whatever resources we have. The South African medical profession has failed dismally in embracing its duty towards Aids patients. It must face up to the challenge of Aids by breaking its silence and stopping this madness. It must change the mindset of people and remove the stigma of HIV/Aids.
This can be achieved by declaring a state of emergency; making HIV/Aids a natural disaster and a notifiable disease; allowing parallel importation of drugs and manu-facturing drugs that can improve people’s quality of life. We have the greatest manufacturing ability on the continent. It’s time to put it to use.
Dr Kgosi Letlape is the chairperson of the South African Medical Association, which represents 15 400 doctors in South Africa