News / Africa

AIDS Revolution in South Africa, but Crises Remain

Samples of Nevirapine, an antiretroviral AIDS drug. (AP Photo/APTN)
Samples of Nevirapine, an antiretroviral AIDS drug. (AP Photo/APTN)
Darren Taylor
A president who denied that HIV caused AIDS, and so banned the use of life-saving antiretroviral (ARV) medicines in public health facilities. A health minister who declared ARVs to be “poison” and instead advocated garlic and potatoes as cures for HIV.
 
During this period in South Africa, which lasted from 1999 until a court ordered the government to give ARVs to HIV-infected people in 2004, more than 330,000 people died of AIDS-related illnesses, according to a study by Harvard University. 
 
Despite their legal obligations, President Thabo Mbeki and his health minister Manto Tshabalala-Msimang continued to resist a large-scale roll out of ARVs until they were both ousted from their positions in 2008.
 
Health activist group, the Treatment Action Campaign, said two million South Africans died “prematurely” of AIDS during President Mbeki’s tenure. It maintained that many of these deaths could have been prevented had the government facilitated wider access to ARVs. 

Former prime minister Thabo Mbeki banned the use of antiretrovirals from public health facilitiesFormer prime minister Thabo Mbeki banned the use of antiretrovirals from public health facilities
x
Former prime minister Thabo Mbeki banned the use of antiretrovirals from public health facilities
Former prime minister Thabo Mbeki banned the use of antiretrovirals from public health facilities
Phumelele Dlamini almost joined the list of fatalities. Diagnosed with HIV in 1995 after giving birth, the Soweto resident and her son had no access to ARVs for almost a decade.
 
“We were dying. I still don’t know how we survived,” she recalled. “At that stage in South Africa death from AIDS was certain. The only question you asked yourself as an HIV-infected person was, ‘How much time do I have left?’ I never thought that things would change.”  
 
But change has indeed come, and it has been radical … to the point where South Africa now has the largest public sector ARV treatment program in the world.
 
According to UNAIDS, there were 1.5 million people on state-sponsored ARVs in the country in 2011, but medical sources said this figure has since increased to 1.7 million.
 
Dlamini and her son are two of these ARV recipients.
 
“Right now, we’re living positively, and we’re taking our ARVs. I can say life is good,” she told VOA. “Drinking the ARVs is the only thing that I know that keeps people like me alive. I don’t like doing it, but it has given me life.”
 
Scientific approach
 
The appointment of Aaron Motsoaledi as health minister in May 2009 heralded a new era in South Africa’s response to its HIV epidemic. Health workers in South Africa describe the medical doctor from Limpopo province as a “man of science, not superstition” and a stark contrast to his predecessor.
 
“He speaks softly. He listens. When we activists disagree with him, he doesn’t shout and scream. He’s just a nice man,” said Dlamini, who is also an HIV counselor and is well-known in Soweto for her advocacy around the disease.
 
Dr. Kevin Rebe, a medical director who monitors South Africa’s progress in combating HIV for the Anova Health Institute, said, “Aaron Motsoaledi really does seem to have a firm grasp of what the HIV issues are...When you listen to him speak he’s coming from a very educated and researched position, which I think is quite confidence inspiring.”
 
He added that health providers now felt comfortable using science to treat HIV, unlike previously. “The science has helped us to allay fears associated with being diagnosed positive,” said Rebe. “Somebody who’s diagnosed as HIV positive today faces a very different level of stress than maybe five years ago in South Africa because the disease is publicized, treatment is publicized, people know it’s not a death sentence.”
 
Rising infections
 
But, while treatment has advanced significantly in recent years, South Africa remains the country with the highest number of people living with HIV – about 5.5 million. And, according to fieldworkers and health NGOs, infections are increasing. 

Anti-AIDS protestors march in Cape Town, South Africa (Aprili 23, 2006) (Obed Zilwa/AP Photo)Anti-AIDS protestors march in Cape Town, South Africa (Aprili 23, 2006) (Obed Zilwa/AP Photo)
x
Anti-AIDS protestors march in Cape Town, South Africa (Aprili 23, 2006) (Obed Zilwa/AP Photo)
Anti-AIDS protestors march in Cape Town, South Africa (Aprili 23, 2006) (Obed Zilwa/AP Photo)
“Our pool of people living with HIV is growing, not shrinking,” said Rebe.  
He described the picture of where South Africa stood today in terms of HIV as “problematic,” explaining, “When you roll out big ARV programs like ours, obviously people don’t die of AIDS. They live with HIV for a lot longer. So what’s actually happening in the country is that there’s just this ever growing pool of people living positive, living with HIV and AIDS, and requiring healthcare. And obviously that’s an unsustainable situation long term because eventually the pool gets too big for your taxpayer allocation to healthcare to sustain it.”
 
He said South Africa was in urgent need of better HIV prevention programs. Dlamini agreed, saying, “We can’t carry on throwing pills at the problem and praising ourselves forever for treating HIV. We now have to prevent new infections and from what I see every day on the ground, we are not.”  
 
She said although there was much more awareness about HIV and how it was spread, ignorance levels around the virus remained “shockingly high” in South Africa. 
 
“It’s still not clear what the government is doing in just making sure that people are practicing safe sex and that people understand the importance of even knowing their (HIV) status,” said Dlamini.
 
However, Motsoaledi pointed out that he and President Jacob Zuma had in 2010 launched an HIV counseling and testing campaign that had resulted in 14 million people being tested and counseled for HIV, and that condoms were available for free at government health facilities across the country. 
 
Crisis in public healthcare sector
 
Rebe said a largely dysfunctional public healthcare system was severely hampering South Africa’s attempts to successfully battle HIV. He maintained, “The healthcare system clearly is broken.”
 
Hospitals and clinics often run out of ARVs due to government failing to pay suppliers, for example. “This is happening all over South Africa. Now, if people don’t take their ARVs at the proper times they become resistant to them and that has terrible consequences. They get very ill, and some die,” said Dlamini.
 
The clinic where Rebe works at Woodstock in Cape Town has also endured an ARV shortage. “For days and days and days, we had queues outside, around the block recently,” he said. “Patients in our clinic were arriving and being told ‘Come back tomorrow for your ARVs.’ Now that’s unacceptable and it will negatively impact on peoples’ treatment success if they’re missing doses because of distribution problems.”
 
But Rebe added that drug supply chains were “generally” much better in the cities and bigger towns than in South Africa’s isolated rural regions.
He said the HIV epidemic had “completely overwhelmed” South Africa’s primary healthcare clinics. “These facilities are just full of really sick patients now because of the delays we had in initiating ARV programs in the country and because of people not accessing those programs,” he explained.  
 
The fact that South Africa was managing such a large treatment program, said Rebe, was creating “ongoing logistical challenges” that were worsened by “poor management structures” and “poor logistic operations backup.”
 
He commented, “This definitely impacts negatively on peoples’ health.”
 
Dehumanizing stigma
 
Rebe said stigma remained the biggest barrier to healthcare access for HIV-infected people in South Africa. “Communities and to some extent health providers continue to stigmatize people with HIV. Discrimination is still keeping some South Africans away (from being tested and treated for HIV).”
 
With regard to stigma, it’s the media that’s a key battleground in South Africa, said Melissa Meyer, of the HIV and AIDS Media Project at Wits University in Johannesburg.  
 
“The sense that we get from monitoring the media is that journalists are becoming better with engaging with HIV. But there are still examples of unsophisticated journalism and sometimes (careless) coverage. And we find that in that case, the biggest culprit usually is sensationalism,” said Meyer.    

A giant condom inflates over the exhibition stands at Nasrec Exhibition Center, Johannesburg, South Africa, August 2002. (AP Photo/Obed Zilwa)A giant condom inflates over the exhibition stands at Nasrec Exhibition Center, Johannesburg, South Africa, August 2002. (AP Photo/Obed Zilwa)
x
A giant condom inflates over the exhibition stands at Nasrec Exhibition Center, Johannesburg, South Africa, August 2002. (AP Photo/Obed Zilwa)
A giant condom inflates over the exhibition stands at Nasrec Exhibition Center, Johannesburg, South Africa, August 2002. (AP Photo/Obed Zilwa)
She highlighted a recent example from a tabloid newspaper which ran an article on an HIV-positive sex worker. “Her dying wish was to meet her idol, a gospel singer. The article completely neglected to mention that ART (antiretroviral therapy) rendered HIV a chronic condition and that HIV infection doesn’t necessarily equate to ‘AIDS death.’ Instead, it just ran with the idea that this sex worker was at death’s door on account of her being HIV-positive.”
 
Meyer said some newspapers continued to publish misleading and stigmatizing headlines – “often when the article itself is in fact quite accurate and sensitive. Again, there’s a recent example from a story in a local tabloid. The article itself was technically correct, but the headline read, ‘Teacher Bullies AIDS Girl.’ Calling a student an ‘AIDS Girl’ of course is extremely dehumanizing and very stigmatizing.”
 
Meyer added, “While we understand that newspapers are going to try to sell the news and so sometimes hype it up a bit, in the context of HIV it very quickly runs the risk of driving people who are living with HIV underground and away from safe sex practices.”     
 
‘Ticking time bomb’
 
While Dlamini said there was “no doubt” that South Africa was managing its AIDS epidemic “a world better” than in the past, she remained “very, very concerned” about certain aspects of it.  
 
“It’s the young people with HIV in this country that I am most worried about,” she emphasized. “We don’t see any programs in place to support and guide kids who were born (in the 1990s and early 2000s) with HIV. How do you think they feel, knowing that they could have been born HIV-free, but were not because of a government that refused to give their mothers ARVs? I can tell you through personal experience that they feel very angry and very depressed. They need help, but they are not getting it.”
 
Dlamini added that stigma was preventing many young people in South Africa from disclosing that they were infected with HIV.
 
“This is a ticking time bomb!” she exclaimed. “These kids are at the stage whereby they can go outside and have (unprotected) sex with other kids who are actually HIV-negative. That can actually spread the virus…and it’s happening as we speak.”  
 
‘Conspiracy of silence’
 
Dlamini said many rural parts of South Africa that she’d visited remained “untouched” by positive developments in the sphere of HIV in the cities.
 
She explained, “Because of ignorance and stigma, rural people are not being tested and they are infecting one another like hell. There’s still a conspiracy of silence around HIV in many parts of our country. People are still scared of the word ‘HIV.’ Some people are actually dying (of AIDS) inside their homes because they’re afraid to even go to clinics and get checked.”
 
Thus, for Dlamini, a vision of an HIV-free generation of South Africans is “just a dream” at this stage.
 
But then she hesitated, and laughed, “South Africa is a place where the impossible becomes possible. The fact that I am alive today proves that. And people thought apartheid would destroy us, but it didn’t. I don’t think AIDS will achieve what apartheid did not.”

Listen to report on HIV/AIDS in South Africa (by Darren Taylor)
Listen to report on HIV/AIDS in South Africa (by Darren Taylor)i
|| 0:00:00
...    
🔇
X

You May Like

Islamic State Survivor: A Yazidi Girl's Tale

Sarah Said Haydar, captured a year ago while fleeing Islamic State onslaught in northern Iraq, was so traumatized by militants, she sought to end her own life More

EU, US Applaud Kosovo Law on Special Court

Joint statement says lawmakers' decision to address allegations of war crimes 'demonstrated their commitment to the rule of law and to honor international agreements' More

ASEAN Ministers to Push for S. China Sea Agreements

According to documents obtained by VOA Khmer, ministers will stand up for 'freedom of navigation, unimpeded lawful maritime commerce, trade and over flight' More

This forum has been closed.
Comments
     
There are no comments in this forum. Be first and add one

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Cambodia Makes Progress Curbing Bear Tradei
X
Robert Carmichael
August 04, 2015 3:07 PM
Cambodia’s wild bears are under unprecedented pressure. Their native forests are being cut down at record rates, and China's huge demand for traditional medicine has made them targets. But experts say Cambodia's conservation efforts are setting an example that has put it well ahead of its neighbors in protecting bears. Robert Carmichael reports for VOA from Phnom Penh.
Video

Video Cambodia Makes Progress Curbing Bear Trade

Cambodia’s wild bears are under unprecedented pressure. Their native forests are being cut down at record rates, and China's huge demand for traditional medicine has made them targets. But experts say Cambodia's conservation efforts are setting an example that has put it well ahead of its neighbors in protecting bears. Robert Carmichael reports for VOA from Phnom Penh.
Video

Video Growing Number of E. Jerusalem Palestinians Seek Israeli Citizenship

Most Palestinians living in East Jerusalem have long rejected the option of full Israeli citizenship, seeing it as a betrayal to their political cause - the formation of a Palestinian state with East Jerusalem as its capital. But as that dream remains elusive, more and more Palestinians are applying for Israeli citizenship. Zlatica Hoke reports the decision is hard for many Palestinians who say they have to be pragmatic about it.
Video

Video With No Money, More Students, African Universities Struggle

Academics from around the African continent converged in Johannesburg last week for the African Universities Summit, a chance to tackle some of the major issues facing higher education in Africa today. VOA's Anita Powell reports from Johannesburg.
Video

Video Iraqi Yazidis Fear Death of Their Community

A year ago on August 3, Islamic State militants stormed the homelands of Iraq’s Yazidi minority, killing hundreds of men and enslaving thousands of women. The scenes of desperate Yazidi families crowding on the top of Sinjar mountain without food or water spurred Kurdish fighters into action, an emergency airlift and the start of the U.S. airstrike campaign against the Islamic State Sunni extremists. VOA's Sharon Benh reports from northern Iraq.
Video

Video Bangkok Warned It Soon Could Be Submerged

Italy's Venice and America's New Orleans are not the only cities gradually submerging. The nearly ten million residents of the Bangkok urban area now must confront warnings the city could become uninhabitable in a few decades. VOA Correspondent Steve Herman reports from the Thai capital.
Video

Video Inclusive Gym Gets People With Disabilities in Fitness Spirit

Individuals with special needs are 58 percent more likely to be obese than the general population. According to the U.S. Centers for Disease Control, they also have an increased likelihood of anxiety, depression and social isolation. But a sports club outside Washington wants to make a difference in these people's lives. With Carol Pearson narrating, VOA's June Soh reports.
Video

Video Wisconsin's Voter ID Law Still Mired In Controversy

Voter ID laws have sparked controversy across the US. More than 30 states enacted laws requiring citizens to show identification before they vote. Against fierce opposition, the state of Wisconsin recently enacted one the most restrictive voter ID laws in country. As Jeff Swicord reports, no one can predict its impact as the 2016 election nears.
Video

Video Astronauts Train Underwater for Deep Space Missions

Manned deep space missions are still a long way off, but space agencies are already testing procedures, equipment and human stamina for operations in extreme environment conditions. Small groups of astronauts take turns in spending days in an underwater lab, off Florida’s southern coast, simulating future missions to some remote world. VOA’s George Putic reports.
Video

Video Ebola Vaccine Hailed as Highly Effective

At last, there's a way to end the suffering from the Ebola epidemic that has ravaged West Africa for more than a year. Researchers say the vaccine is so effective, there may never be a major outbreak of Ebola again. VOA's Carol Pearson reports.
Video

Video Special Olympics Show Competitors' Skill, Determination

Special Olympics competitions will wrap up Saturday in Los Angeles, and the closing ceremony for athletes with intellectual disabilities will be held Sunday night. In a week of competition, athletes have shown what they can do through skill and determination. VOA's Mike O'Sullivan reports.
Video

Video Civil Rights Leaders Struggled to Achieve Voting Rights Act

Fifty years ago, lawmakers approved, and U.S. President Lyndon Johnson signed, the Voting Rights Act of 1965. The measure outlawed racial discrimination in voting, giving millions of blacks in many parts of the southern United States federal enforcement of the right to vote. Correspondent Chris Simkins introduces us to some civil rights leaders who were on the front lines in the struggle for voting rights.
Video

Video Shooter’s Grill: Serving Food with a Touch of the Second Amendment

Shooter's Grill, a restaurant in Rifle, Colorado, attracts visitors from all over the world as well as local patrons. The reason? Waitresses openly carry loaded firearms as they serve food, and customers are welcome to carry them, too. VOA's Enming Liu and Lin Yang paid a visit to Shooter's Grill, and heard different opinions about this unique establishment.
Video

Video Despite Controversy, Business Owner Continues Sale of Confederate Flags

At Cooter’s, a store in rural Sperryville, Virginia, about 120 kilometers west of Washington, D.C., Confederate flags are flying off the shelves. The red, white and blue battle flag, with 13 white stars representing the Confederate states, was carried by southern forces during the U.S. Civil War in the 1860s. The South had seceded from the Union over several key issues of disagreement, including slavery. VOA’s Deborah Block has the story.
Video

Video Booming London Property a ‘Haven for Dirty Money’

Billions of dollars of so-called ‘dirty money’ from the proceeds of crime - especially from Russia - are being laundered through the London property market, according to anti-corruption activists. As Henry Ridgwell reports from the British capital, the government has pledged to crack down on the practice.
Video

Video Hometown of Boy Scouts of America Founder Reacts to Gay Leader Decision

Ottawa, Illinois, is the hometown of W.D. Boyce, who founded the Boy Scouts of America in 1910. In Ottawa, where Scouting remains an important part of the legacy of the community, the end of the organization's ban on openly gay adult leaders was seen as inevitable. VOA's Kane Farabaugh reports.

VOA Blogs