What penalty for Mbeki blunder?

Dominic Odipo

Beyond the ANC-related headlines that have defined South Africa for us over the last few months, there appears to be an amazing tale of government neglect or incompetence that could lead to the loss of millions of lives.

This stems from a 1999 decision by then President Thabo Mbeki to ignore scientific evidence and declare available HIV-Aids drugs toxic and dangerous.

According to a study released last month by the US-based Harvard School of Public Health, more than 330,000 lives were lost in that country between 2000 and 2005 because a feasible and timely anti-retroviral drugs treatment programme was not implemented by Mbeki’s government.

The study, conducted by a Zimbabwean doctor, Pride Chigwedere, also asserts that, over the same period, about 35,000 babies were born with the Aids-causing virus because a relatively simple prevention programme was not implemented.

The study, which has been published online, states that if a simple and feasible mother-to-child transmission prophylaxis programme using an anti-Aids drug called nevirapine had been implemented, many of those children would almost certainly not have been born with HIV.

According to United Nations sources, about 19 of every 100 South Africans are infected with HIV, translating into about 5.5 million people altogether. But given policies such as these, it is safe to assume that hundreds of thousands of them could eventually succumb to the disease.

According to Chigwedere’s study, nevirapine — the Aids drug whose use Mbeki’s government restricted to just a few pilot locations —had been offered free by an international pharmaceutical company.

As if all this was not enough, the South African government went further and blocked funds from the Global Fund to Fight Aids, Tuberculosis and Malaria for more than a year.

These funds had been awarded to the South African Province of KwaZulu Natal which, incidentally, also happens to be the home province of Mbeki’s main political opponent, Jacob Zuma.

Blame

While not directly apportioning blame or responsibility, the study leaves little doubt that government action or inaction had a direct impact on the thousands, if not millions, of "person-years" lost in South Africa.

Even though there continues to be a lively international debate on the real origins of the Aids-causing virus, there is now hardly any debate about the fact that the disease can be reasonably well managed over time.

There is also hardly any further debate about which drugs are most effective in this management regime and their major side effects.

Ignorance

There is also one cardinal point on which there is and has never been any debate; If Aids is not managed somehow, it will kill the patient sooner or later as there is still no cure.

South Africa is not alone. When Aids first struck in this country in the early 1980s, the government of the day pretended that the disease was not as serious a threat to national security as some people were claiming.

When top government officials succumbed to the disease, the official notices of their passing made no reference to the real cause of death.

Officially, these officials who had passed on as a result of assorted Aids complications were reported to have died of a "long illness bravely borne".

The result of this ignorance or neglect was catastrophic. Hundreds of thousands of our people were struck down by this disease. Even though the government later changed its entire approach to the Aids pandemic, it already was, as the Irish would say, "too late to sharpen the sword when the trumpet calls for battle".

Across our western border, the government of President Yoweri Museveni took a radically different, almost revolutionary approach to the whole Aids question. The disease was quickly recognised for what it was and immediate preventive measures taken. Today, Aids is no longer big news in Uganda. It has been reduced to the status of any ordinary disease.

Scot-Free

Whatever motivated the actions or omissions of the South African government is not the real issue here. The real issues can be reduced to two questions:

If government actions or failures lead directly to so much death and suffering, should the leaders of such governments walk away scot-free?

And, two, what mechanisms can be put in place to ensure that no government, anywhere ever makes such stupendous, systemic mistakes?

The writer is a lecturer and consultant in Nairobi.

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