‘Personally, I don’t know anybody who has died of Aids,” President Thabo Mbeki told The Washington Post last week, prompting a flood of criticism and cartoons. It is estimated about 4,5-million South Africans are living with HIV, the highest number for any country in the world.
Mbeki and his aides should have anticipated the Aids question, because it is Mbeki’s Achilles heel, the blot on his modern ”renaissance” man visage.
At the heart of the inquiry is this: Has Mbeki changed his mind; is his government’s embrace of conventional Aids science wholehearted; and does he support the methods of prevention, treatment and care of Aids that the rest of the world now recognises as optimal?
Mbeki will trip up again and again on the Aids issue because the answer to each of the above is no, no and no again — though it shouldn’t be.
At home, the official spin is that it doesn’t matter. On April 17 last year the president officially withdrew from the debate. He would say no more; the Cabinet collective would lead the battle against Aids. It was punted as a victory of the collective spirit over the individual will.
More than a year on, and with evidence mounting in other African countries that political will and political leadership are vital in the armoury of the battle against Aids, this ostrich strategy has become a nonsense that won’t do. We cannot have a president burying his head and withdrawing from a policy and a debate that is our most serious challenge. Moreover, it is a fraught and faulty dichotomy to have a president believe one thing and his Cabinet another. Withdrawal is another name for abdication of leadership, not only here but in all of Africa.
Two pan-African conferences this year display what Mbeki can do and what he won’t, how he leads and how he has abdicated. And so myopic is his stance on Aids that it is detracting from his major foreign policy objective — the project to harness economic growth for development and for African unity.
Reel back to July, the second African Union (AU) summit in Maputo, which Mbeki attended from beginning to end like a doting father. No care was too much as he exhibited a boundless energy to instil in other leaders the importance of a peace and security council, an African stand-by force and an African Parliament.
South Africa has bankrolled a sizeable chunk of the AU budget, not only for the conference but for peace-making and keeping; and we pay a premium subscription fee to ensure that the AU stays afloat. That is political will in action and in this, Mbeki has shown himself as a leader who will move heaven and earth to make a project work and to ensure the continent’s reputation as a global development laggard is staunched.
It is a will and passion that is all-consuming: this year alone, the president has been tireless in his travels, stomping out a coup here, escorting a despot to pasture there and ceaselessly lobbying for the New Partnership for Africa’s Development.
Mbeki’s most trusted lieutenants have been harnessed to complement his energies and his drive: Minister of Foreign Affairs Nkosazana Zuma; her deputy Aziz Pahad; and Deputy Director General for Africa, Kingsley Mamabolo, make up a formidable Team SA. To watch this leadership in action in Maputo and to realise the vast scope of its vision was, for me, to bask in the glory of being South African.
Fast forward to last week’s International Conference on Aids and Sexually Transmitted Infections in Africa (Icasa) held in Nairobi. It too was an all-Africa conference.
Aids conferences are, of course, a dime a dozen, but the biannual Icasa meetings are different. For one, they are intergovernmental meetings where experience is shared and the progress in the fight against HIV and Aids on the continent is assessed.
South Africa felt, for me, present only by its absence. While Mbeki and his Team SA attend every other possible pan-African forum they didn’t attend this one. Attending and participating in the conference are not ends in themselves, but are important symbols of political will because the leadership and intelligentsia of the Aids world is present.
Mbeki has not assigned an A-team to fill his gaps on Aids — instead, there is the impotent Minister of Health, Manto Tshabalala-Msimang whose obsession with traditional nutrition and medicine earned a sideswipe from Peter Piot, executive director of UNAids. ”It’s a lot of nonsense to say potatoes are going to solve this problem,” he said at Icasa.
What did we learn at Icasa? That South Africa lags behind; that its lack of political will in this sphere is at odds with the leadership role that Mbeki has undertaken with such vigour. ”Effective responses to Aids depend on strong leadership,” says Piot in the report Accelerating Action against Aids in Africa. It is, he writes, ”the foundation of an effective response”. Take Uganda: in 1986 already, President Yoweri Museveni discerned the high rate of infection among his officer corps and saw it as a harbinger. He began to talk openly about Aids and to take control of an effective Cabinet response. From surveys indicating infection rates of more than 30% in the early Nineties, the figure today is less than 11%.
Kenyan President Mwai Kibaki has caught the bug. His Cabinet is passing a wide-ranging law to underpin its anti-Aids strategy, while Kibaki speaks openly about the role of men in combating Aids. He has also assigned a Cabinet team to accelerate action. Botswana’s President Festus Mogae’s national strategy has become a global poster-child because it draws on the public, private and academe to bolster a national strategy that is probably Africa’s current best practice.
All are examples of political will from countries poorer (excluding Botswana) than South Africa.
At home, we put the finishing touches on a national anti-retroviral treatment programme this week; the budget for HIV/Aids is increasing apace, but what is it worth without leadership from the top? Can it really be done when even those with political will have to do it by stealth. In Gauteng, an innovative and effective prevention and care programme is carried out almost in secret; even leaders who have perfectly orthodox views on Aids are forced to do the ”African potato, limitations-of-anti-retrovirals egg-dance” because they cannot be seen to take an unequivocal position.
Of course anti-retrovirals are not benign drugs, but what’s happened here is that the limitations are highlighted while the benefits have become a secondary feature.
At other international fora, South Africa’s counsel is often sought: ”How did you make your Constitution? And the Truth and Reconciliation Commission? What about the political transition?” In Nairobi last week, our counsel was not sought, our leadership was not proferred, there was no reflected glory to bask in.
The tale of two conferences show up Mbeki’s contradiction: he is both an African leader and its laggard. For most other modernist leaders of his ilk there is no obsessive dissembling of HIV and Aids; no flirting with dissidents and no awkward conflation of racism and Aids.
Those leaders come across as self-confident in their Africanness and their ability to distigmatise Aids and fight it. To read the president’s musings on Aids is to see how he views the pandemic as one that strips African dignity and pride.
Yet Aids is Africa’s big challenge.
An estimated 30-million people are infected; only 4% of those who need life-prolonging anti-retrovirals get them; by 2010 UNAids predicts that 20-million children will have lost one or both parents to Aids.
When Mbeki’s political résumé is written, his stasis, his doubting and his ambivalence on Aids will count as much in his disfavour as his tireless campaigning for a self-sufficient, equal and prosperous Africa will count in his favour. This, surely, is reason enough to change his script and his mind.