Garlic days are long gone
On the eve of the International Aids conference in Durban, and 12 years after the first private ARV pilot programme was launched, Ray Joseph looks back on SA’s rocky road to managing HIV
ENDLESS “scientific” studies that tried to prove there was no link between HIV and Aids, and claims that the virus could be held at bay with a diet of fruit, vegetables and vitamins, marked South Africa’s decade of denialism under president Thabo Mbeki.
As the country’s leader pontificated, the virus claimed the lives of hundreds of thousands in a plague of biblical proportions that was sweeping through South Africa’s townships and rural areas.
From 1999, when he was elected president, to 2008, when his second term came to an abrupt end, Mbeki steadfastly denied that HIV caused Aids. He even went as far as to institute policies that denied access to antiretrovirals for seriously ill people infected with the virus.
At the height of the pandemic, lifesaving ARVs were available, but only via expensive private treatment, or for a lucky few, if they fell within the catchment areas of non-state, privately funded pilot programmes.
In newsletters penned late at night at the Presidency in Pretoria, Mbeki argued his theory that the risks of ARVs outweighed the benefits and that the drugs were “poisonous”. At the same time his minister of health, Dr Manto Tshabalala-Msimang, advocated vitamins, African potatoes, lemons, beetroot and garlic.
“Shall I repeat garlic, shall I talk about beetroot, shall I talk about lemon . . . these delay the development of HIV to Aids-defining conditions, and that’s the truth,” the minister, nicknamed Dr Beetroot, said in a debate on her department’s budget vote in 2006.
The government was ordered by the Constitutional Court to provide ARV-nevirapine (which stops HIV from multiplying) in 2002. But it only began a slow rollout two years later, in 2004. By then, the virus had emerged as one of the biggest threats to post-apartheid reconstruction and development.
During that time photographer Fanie Jason and I became obsessed with telling the story of the dead and the dying, and the stigma they faced, to give them a voice.
I’m still haunted by the image of one woman we spoke to. She was in her 30s but made prematurely old by the disease. Her body was wasted and covered in sores and her dignity gone as she struggled to control her bowels. But her neighbours refused to let her use the communal toilets because they believed she would infect them.
This is what people in townships and rural areas around South Africa were seeing on a daily basis.
The virus, in the guise of opportunistic infections like TB and pneumonia that took advantage of suppressed immune systems, was killing the young in ever-growing numbers.
A priest once said after the burial of a schoolgirl: “Before this thing young people buried the old . . . now it is the old burying the children.”
But many people survived after they were put on to ARVs and, Phoenix-like, they “came back from the dead”. Today antiretroviral therapy has transformed HIV infection from a progressive, typically fatal infection to a chronic disease that can persist for many decades. A typical young adult who acquires HIV is expected to be on therapy for up to 50 years, according to a recent article in the Lancet medical journal. Yet Mbeki is sticking to his guns. In a newsletter in March this year he reiterated his controversial views. Back in 2006 he said that, according to Statistics South Africa, tuberculosis was the country’s leading cause of deaths, while HIV and Aids were “the ninth”.
He also questioned why the spotlight was being shone on HIV/Aids while, he claimed, less was being said and done about TB.
In his March 2016 newsletter he wrote: “Did this have to do with the fact that South Africa could be a lucrative market for the sale of ARVs, as it now is?”