Another week, another Aids debacle. This week the annual South African Aids conference was the site of a searing debate over nevirapine, a drug shown to be effective in stemming the rate of mother-to-child HIV infection.
Last week the Medicines Control Council (MCC) said it would deregister nevirapine while it undertook its own tests into its efficacy, despite the drug getting the thumbs-up from the World Health Organisation. The decision ripped through the conference, dividing it once again between the state on the one hand and the scientists on the other, their side buttressed by the growing ranks of the organised community of people living with HIV/Aids and those who support their quest for effective treatment and care. The pattern is becoming depressingly familiar in the three-year long battle between science and state to do the right thing about a disease that should be Public Enemy Number One. There is still no unity in action.
Researcher Qurraisha Abdool-Carim spelt out the dangers: South Africa has one of the highest infection rates in the world; the disease is in its killing phase as the overflowing graveyards from Soweto to Maritzburg show.
If anyone was in doubt that this country’s leader remains an Aids dissident, they should read last week’s ANC Letter Today . In an essay, A hundred flowers under the African sun, President Thabo Mbeki dwells long on the awakening intellectual spirit across the continent, on the imminent visit of novelist Ngugi wa Thiongo, before delivering his bombshell. Welcoming the MCC decision, he writes: “This announcement illustrated the challenge we face, to ensure that even on this vexed question, we honour our commitment to let a hundred flowers bloom, and a hundred schools of thought to contend, refusing to allow the never- ending search for scientific truth to be suffocated by self-serving beliefs.”
This is classic denialist twaddle — the president wants his Aids advisory panel to continue its dissident research (it hasn’t properly been dissolved yet); he still thinks anti-retrovirals are a poison. We were not surprised when the Minister of Health Manto Tshabalala-Msimang parroted the self-same conspiracy theory a few days later at the conference. The two are, after all, our liabilities in the battle against HIV/Aids. But a few days later, the Cabinet issued a sane account of its programme and response to the MCC decision; it stressed that rape survivors would still be given drug treatment and it pledged that the treatment plan (now several months late) is on the way.
Both the Department of Health’s Nono Simelela and KwaZulu-Natal MEC for Health Zweli Mkhize were energetic and inspiring participants at the conference. It is plain to see what’s happening: this is a government hopelessly divided on HIV/Aids policy. Reason versus irrationality, action versus inaction; effective treatment and care versus the African potato, all battling for pole position. When the Cabinet released its April 17 decision last year, it was meant as a watershed and a U-turn from Armageddon.
Politically, it required the president to dissolve the panel and cut ties with the silly dissidents who sit on it; to submit his individual, minority belief to the will of the collective and allow government to play its leadership role in the matter. A year later, it’s very clear he has not done so and that he won’t let the government assume its correct role at the head of the anti-Aids fight. It’s not too strong to say that the U-turn has now metamorphosed into a very scary S-bend.
No panacea
One of the fascinating characteristics of South Africa is that we are always searching for a panacea. We hold summits, conferences, write plans and raise the hopes of our people that things are about to get a lot better.
The latest addition to the plethora of panaceas, is the Brenthurst Initiative, launched by the Oppenheimer family this week.
As we have previously argued, this newspaper has no qualms about the proliferation of talk shops and ideas. We believe that the more the nation talks and the more ideas circulate the richer will be the range of policy options available to us. So we welcome the latest initiative, coming as it does from a family that, probably more than any other, benefited from the structural inequalities and injustices of our past.
There have been the expected howls of condemnation and glowing accolades from South Africa’s various ideological laagers. The problem with all these reactions is that the respective constituencies see it for what it is not: a panacea.
For a start there is very little in the way of earth-shattering research and dramatic new ideas contained in the initiative. The document merely consists of add-ons of ideas that have been in circulation for some time.
What is important about it is that the Oppenheimers are taking the lead and encouraging (white) South African business to buy into the idea of transformation as an opportunity, not a threat or a burden.
This change in attitude is very critical as suspicion of change in corporate South Africa has tended to retard the pace of transformation and project the image of a country divided over its priorities.
As President Thabo Mbeki has argued many a time, we need a “national consensus” on our priorities and the way to achieve them.
Having taken this brave leadership step, the Oppenheimers now need to show faith in their ideas by pressing for this change in attitude and concrete action by the corporations in which they wield influence.