This is an exciting yet precarious time in South Africa’s management of its HIV/Aids epidemic. Exciting because there seems to be some movement away from the infighting between government and Aids organisations that has marked the past decade; precarious because we live in a society that is already fatigued by news about the epidemic. We now have an opportunity to take stock, learn from our mistakes and turn to the future.
President Thabo Mbeki’s greatest error since his catastrophic foray into Aids denialism in the late 1990s has been to silence any real national introspection and conversation about what Aids says about this society or what we might learn from it in order to improve as a nation. We have been so busy fighting each other that we’ve stopped fighting the real enemy: the HI virus. Let us return to that agenda.
There are a number of areas where we should be acting with haste and care. We need to advance the public policy agenda — for too long we have been stuck in an artificial debate between those emphasising prevention and those favouring treatment. By now it is clear that the one does not exclude the other; we need to move on. The same goes for the ridiculous “debate” between the proponents of nutrition and supporters of medication. These disputes have detracted from where we should have been looking, namely at implementing our existing (and good) Aids policies.
We are experiencing a crisis of implementation because sections of government are allowed to get away with questioning the basic definition of what makes Aids a policy problem. If we can’t even engage with our head of state on the greatest crisis facing South Africa, how will we ever be able to implement policies effectively?
These distractions have also blinded us to profound and necessary national introspection about the true drivers of Aids in South Africa: perversely unequal and violent gender relations; liberal political correctness, which has prevented any frank discussion of critical issues such as culture, race and sex, and their impact on Aids; and a normative commitment in the high political domain to liberal political economy that has obstructed a national conversation about the socio-economic drivers of Aids. Finally, we as a society have been remarkably tolerant of supernatural moral scripts and their behavioural prescriptions regarding the epidemic.
Supernatural morality refers to religious practice and traditional beliefs that have done incredible harm in the fight against the epidemic. For example, for some reason we still allow the Catholic Church to get away with genocidal statements that condoms should not be made available; various religious societies are tolerated when they make statements that border on hate speech regarding gay men and commercial sex workers in particular; notions of “traditional” African culture are all too readily called upon to justify intergenerational sexual exploitation, virginity testing, polygamy and other activities that fan HIV.
Why do we tolerate this? Does a liberal constitution prevent rationalism and open debate, and should we stand for it? We need to secularise our national response to HIV and Aids. Supernatural scripts — “in my culture …”, “in my religion …” — are used with dangerous frequency to justify actions, to perpetuate blame and to stigmatise. Concomitant mythologies of guilt and innocence are used either to exculpate acts that perpetuate these social horrors, or to blame sexual minorities and women in particular for the spread of the epidemic. If this is allowed to continue individual South Africans will never have to take personal responsibility for their actions. After all, the beauty of supernatural moralities is that they do not depend on rational justification — they don’t have to.
If we are to have a truly fearless conversation about Aids in South Africa, we need to create an environment in which an “Aids Codesa” could prosper. To do this, we need a new master narrative around Aids that does not pussyfoot around religion and traditional culture; one that goes beyond the usual suspects, topics and holy cows.
If the government wants to demonstrate a real commitment to moving towards a national conversation rather than maintaining existing divisions, we need an indication that the policy agenda is truly open, debatable and based on rational thinking. Failure to do this would be an insult to the 1 000 who died today.
Pieter Fourie teaches politics at the University of Johannesburg and is the author of The Political Management of HIV and Aids in South Africa: One burden too many? (Palgrave Macmillan)