[Ip-health] FW: [HGAPALLIES] WSJ: South Africa's TAC Plans Mass Civil Disobedience

[Kate Krauss]

----------
From: Sharonann Lynch
Date: Thu, 20 Mar 2003 20:44:08 -0500
Subject: [HGAPALLIES] WSJ: South Africa's TAC Plans Mass Civil Disobedience

South Africa's TAC Plans Mass Civil Disobedience

By MARK SCHOOFS
Staff Reporter of THE WALL STREET JOURNAL

A brash and savvy AIDS activist group is about to take a dramatic
step to push the South African government to provide AIDS drugs in
public hospitals and clinics: mass civil disobedience.

The protest action, to begin this week and last for seven days, is
believed to be the first time in Africa that AIDS patients will have
broken the law en masse to demand treatment.

The plan exposes the desperation many South African AIDS patients
feel toward their government, which so far has not offered AIDS
drugs, called antiretrovirals, even as other developing countries,
such as Brazil and Botswana, have embarked on programs to do so. The
action also spotlights one of the most effective activist
organizations to arise in democratic South Africa.

Treatment Action Campaign, or TAC , has so far kept its protest plan
secret, except to say that it will be nonviolent. In addition to
perhaps thousands of South Africans who will carry out vigils and
protests, the group expects 600 people to risk arrest, symbolizing
the number of people estimated to die of AIDS every day in South
Africa. Surveys show that more than 4.5 million South Africans --
about a tenth of the total population -- are HIV-positive, and the
vast majority of them cannot afford the antiretroviral drugs that
suppress the virus and prolong life.

TAC accuses the government of delaying and obstructing the provision
of antiretrovirals in the public sector, a charge the government
denies. The group says it has exhausted other tactics, from working
with the government to mass marches. Now, TAC leader and co-founder
Zackie Achmat says nonviolent "civil disobedience is the only means
we have of shaming the government and bringing home the sense of
urgency."

TAC gets its urgency from the fact that many of its own members have
died of AIDS, and from Mr. Achmat's vow not to take antiretroviral
drugs, which he could receive from his contacts abroad, until the
government launches a program to offer them in the public sector. The
deteriorating health of Mr. Achmat, who is HIV-positive, recently
prompted former President Nelson Mandela to urge him to take AIDS
medicine.

"If I was the sole leader of TAC , we probably wouldn't have a civil
disobedience campaign," says TAC co-chairman Mark Heywood.

A little more than four years ago, when TAC was founded, its
demonstrations were poorly attended and barely noticed by the media.
But TAC blended the strategies of the anti-apartheid movement, which
mobilized a broad range of civic groups, and American AIDS activism,
which pioneered patient involvement in medical research. Mr. Achmat,
who was jailed for his anti-apartheid activity and was also a leading
gay activist, had close ties to both these movements.

In fact, TAC shows how local activism in developing countries can
benefit from globalization. TAC's major funders are based in Germany,
Ireland and the U.S., and the group, which doesn't accept donations
from the government or pharmaceutical companies, now has an annual
budget of more than a million dollars.

Through its "treatment literacy campaign," TAC has taught thousands
of South Africans, many of whom are poor and undereducated, about the
science and treatment of AIDS. Before TAC's high-profile activities,
many South Africans didn't even know that AIDS could be treated.

The group has also dramatized the high costs of medicine. Mr. Achmat
broke the law once before by bringing numerous doses of a generic
version of Pfizer Inc.'s anti-fungal drug Diflucan into the country
in his suitcase. At a packed news conference, TAC members held up the
two identical drugs and pointed out that Pfizer's was 15 times more
expensive. Pfizer later agreed to donate its drug to South Africa's
state health-care system.

For its part, the South African government insists that TAC's
intensified pressure is misguided. A task team is in the final stages
of costing out antiretroviral treatment, and while some cabinet
ministers remain skeptical about the drugs' utility, other officials
predicted that the government will soon announce a plan to provide
the drugs. A major reason it hasn't done so yet, says Ayanda
Ntsaluba, the country's director general of health, is because the
government wants to make sure that the huge required expenditure,
which experts have said could reach 2% of the country's gross
domestic product, garners the best results and minimizes the
emergence of drug-resistant strains.

Government officials also point out that the ministry of finance has
sharply increased the AIDS budget over the past three years,
allocating what many experts say is enough money to start a treatment
program and maintain or expand the other elements of the government's
broad anti-AIDS program, which includes vaccine research, behavioral
prevention, and treatment for the opportunistic infections from which
AIDS patients suffer. So, says the government spokesperson, Joel
Netshitenzhe, "There is no need for anyone to engage in a campaign of
civil disobedience."

But "it's impossible to take it on faith when the government says to
just be patient," says TAC's Mr. Heywood.

Relations between the government and many AIDS workers have been
poisoned by one of the most bizarre chapters in the history of the
epidemic. Echoing the fringe arguments of AIDS "denialists," South
African President Thabo Mbeki began in 2000 to publicly doubt whether
HIV causes AIDS and whether AIDS drugs are too toxic.

In April, the cabinet announced that it accepts the premise that HIV
causes AIDS and that antiretroviral drugs can help those who contract
it. But the government has yet to issue a concrete plan.

Write to Mark Schoofs at mark.schoofs@wsj.com

Updated March 20, 2003