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2001 a Tumultuous Year for HIV/AIDS in South Africa - 2001-12-31

It has been an eventful year in South Africa's battle against AIDS. But one event touched South Africans more than any other, it happened not in a courtroom, but a cemetery.

In June, South Africans joined together in sorrow. After months in a coma, Nkosi Johnson died at the age of 12, his tiny body finally giving in to the ravages of AIDS.

Like so many other children in South Africa, Nkosi was born with HIV, the virus that causes AIDS. He was not expected to live to see his fifth birthday, let alone his twelth. But live he did, and he became an icon in South Africa's fight against AIDS.

At least one in nine South Africans is infected with HIV. There is a powerful stigma associated with the disease. Few AIDS victims are willing to disclose their status.

But during his short life, Nkosi Johnson tried to change that. He spoke out on behalf of people living with AIDS, most famously at the 13th Annual International AIDS Conference in Durban, about a year before he died.

At Nkosi's memorial service, Reverend Brian Oosthuizen said in the minds of South Africans and people around the world, Nkosi stood for love, mercy, and peace. "Nkosi is the face of AIDS victims. Hundreds of thousands throughout our land, throughout Africa and in the world today," he said. "Nkosi, as we remember him, I am sure he would want us to remember those others, who perhaps will die at this very moment in some desolate spot, unknown, without any pomp and ceremony."

The death of Nkosi Johnson united South Africans the way few things can - especially when it comes to AIDS. The battle against AIDS in the year 2001 was marked more by controversy and division than it was by harmony.

The government found itself in court twice in connection to its AIDS policy. In the first case, the health department teamed up with AIDS activists who, in the past, had vocally criticized the government on its AIDS policy. Their opponents were 40 major international pharmaceutical companies. The drug makers had challenged the government's plan to produce and import cheaper generic versions of patented anti-AIDS drugs.

United, the activists and the government won that battle. The drug companies dropped the suit. Health Minister Manto Tshabalala-Msimang was jubilant - not only about winning the case, but about having worked with the AIDS activists to do so. "This is a victory for all of us: South Africans, in particular the developing world, and I think the pharmaceutical companies as well," she said. "I think we are really going to be starting on a clean slate, where we need to be working together in a very constructive partnership in order to address the health problems of the developing world."

But that clean slate did not last long. Seven months later, the government and the activists were back in court, this time facing off against each other.

The Treatment Action Campaign and two other AIDS advocacy groups filed a lawsuit against the national health department and eight of the nine provincial health departments. They were trying to force the government to provide a key anti-retroviral drug, Nevirapine, to HIV-positive pregnant women in public hospitals and clinics. The drug can prevent a mother from passing the virus on to her baby.

Roughly 70,000 children are born with HIV in South Africa each year. Sipho Mthathi of the Treatment Action Campaign says Nevirapine could cut that number in half. "Really, at the core of this whole issue are human rights, constitutional rights, that South Africans have all fought for and have made great sacrifices [for]," she said. "We hope that the justice system will take that into account in this case."

Nevirapine is only prescribed in selected public hospitals as part of a pilot program designed to test it. The drug is available in private hospitals, but at least 75 percent of South Africans cannot afford private medical care and therefore cannot get the drug. The pilot project reaches only 10 percent of South African women.

The activists argued in court that income, race and geography should not determine which children live and which children die. The government says Nevirapine still needs testing. It argues it will only be able to distribute the drug responsibly after the pilot project ends.

The case went to court at the end of November, each side convinced it was in the right. The goodwill created between them during the pharmaceuticals case appears to be history.

Part of VOA's Year End Series for 2001