A top United Nations Aids envoy this week said poorer nations are doing better than South Africa in the fight against Aids, and accused its health minister of preventing him from working in the country with more HIV/Aids sufferers than any other in the world.
In an Associated Press interview on Thursday, Stephen Lewis said his relations with Minister of Health Manto Tshabalala-Msimang had long been ”prickly”, but they deteriorated following a public debate at a 2004 Aids conference in Thailand over South Africa’s reluctance to give the drug nevirapine to prevent mother-to-child transmissions.
He said he has been unable to carry out his professional responsibilities in South Africa for the past year because of differences with Tshabalala-Msimang.
He also accused the government of moving slowly in providing anti-retroviral treatment to Aids sufferers, saying that much poorer countries, such as Lesotho and Malawi, have acted much quicker.
”Only the most energetic, uncompromising political leadership can turn this thing around,” he said.
”What we are seeing in Botswana, Malawi, Zambia [and] Lesotho is that when the government pulls out all the stops and moves heaven and earth to get treatment going, even in the most fragile systems you can get results,” he said in the telephone interview from Canada.
Minister under fire
Tshabalala-Msimang is under constant fire in South Africa for her views — which many people suspect echo those of President Thabo Mbeki. But in an unusual move for a top UN envoy, Lewis went public with his criticism in a forthcoming book, Race against Time.
Tshabalala-Msimang played down any rift.
”There are no ill feelings between us,” she said of Lewis at a news conference on Thursday. But she said the government could not accept Lewis’s criticism at the 2004 conference.
”At that point in time, he did something that was unacceptable,” she said.
South Africa has an estimated 6,3-million people living with HIV/Aids — the highest total in the world. More than 600 people die every day of the disease. Nearly 30% of pregnant women are infected with the virus and in the hardest-hit province, KwaZulu-Natal, it is as high as 41%.
Even though the disease is now one of the main causes of death among young adults and infants, the government’s program to provide anti-retroviral medicines to people in the advanced stages of Aids is still in relative infancy.
Mistrust
Tshabalala-Msimang has repeatedly voiced her mistrust of anti-retroviral medicines, and espoused the benefits of garlic, olive oil and lemon.
She told the press conference on Thursday that she did not know how many people were receiving the anti-retroviral therapy because the national patient information system was too weak.
She said figures from her department showed that at least 50 000 people were receiving the treatment in public-sector clinics, but this did not reflect how many people had dropped off the therapy or died of complications.
In the interview, Lewis said far poorer countries elsewhere in the continent know ”to the person” how many patients are receiving treatment.
”The slowness in treatment has less to do with questions of capacity … than the sense of energy of the government to promote the treatment regimens,” he said.
Lewis, a former Canadian ambassador to the UN, is the special representative of UN Secretary General Kofi Annan on HIV/Aids in Africa and is known as an outspoken advocate for people with Aids. — Sapa-AP