“I used to work on construction sites. Now I am too weak to work,” Nkopane says.
In a vehicle idling nearby, two young men discuss the latest challenge to South Africa’s attempt to provide urgent antiretroviral (ARV) therapy to millions of HIV-infected people.
Sello Mokhalipi and Thabo Nkwe are fieldworkers for the Treatment Action Campaign (TAC), which lobbies for access to HIV drugs for all South Africans who need them. Without the medicine, the immune systems of people with HIV/AIDS become extremely weak, opening them up to illnesses that can kill them.
Mokhalipi and Nkwe approach Nkopane, who tells them he’s been taking ARVs for four years. But four months ago, nurses told him they’d run out of drugs. Without them his treatment was interrupted, which is extremely dangerous because it results in resistance to HIV medication. Since then, he says, he’s been “very sick.”
“This is the first time in four months that the nurses have given me my medicine. But I don’t know for how long. I am afraid they will tell me again, ‘Sorry, we have no drugs for you,’” Nkopane tells the activists. “I am scared of dying.”
For Mokhalipi and Nkwe, Nkopane’s story is nothing new. They spend their days crossing the Free State, and especially the sprawling Mangaung area, on the outskirts of the province’s capital, Bloemfontein. The township is home to 650,000 people, many infected with HIV. Most of Mangaung residents live in poverty, in simple brick homes or tin shacks. Most are unemployed.
“The roads here are nothing but dirt,” says Mokhalipi.
South African law requires the government to provide ARVs at certain state hospitals and clinics, including the on in Manguang. But Mokhalipi’s and Nkwe’s cell phones ring constantly with reports of people getting sick and dying because state facilities aren’t supplying the medicine.
Health activists say some provincial health ministries deny there is a problem. Free State's health officials say there is not shortage of ARVs, and that they are being distributed to everyone who needs them.
“[But] in our office we have (sworn) affidavits [by people] who have been neglected, due to the fact of not getting medication in time,” says Nkwe.