The New Yorker, May 19, 2003 P. 54
LETTER FROM SOUTH AFRICA about AIDS activist Zackie Achmat, 41... Describes the scene in Khayelitsha a ramshackle township on the outskirts of Cape Town... More than five hundred thousand people live in the township; half are unemployed, and the average monthly wage is less than a hundred dollars. The dominant language is Xhosa. Although Khayelitsha resembles a squatter’s retreat, it was in fact designed by the apartheid government... Tells about a visit there to an AIDS clinic by Achmat, a former male prostitute who has become South Africa’s most prominent AIDS activist. He is the chairman of the Treatment Action Campaign, or TAC, a grassroots movement that works to secure life-saving aids medicines for poor South Africans. Achmat is the most important dissident in the country since Nelson Mandela... The Khayelitsha aids ward is the first public clinic in South Africa to have begun offering antiretroviral therapy... Although Achmat is H.I.V.-positive himself and needs antiretroviral drugs, he does not take them. In 1999, Achmat began the world’s first drug strike. "I will not take expensive treatment until all ordinary South Africans can get it on the public-health system," he announced... For nearly two years, President Thabo Mbeki has refused to grant interviews about AIDS, but his deputies made it clear to me that they and the President still believed that antiretrovirals were dangerous-and that the "H.I.V. model" was at best a theory... In 1994, Achmat founded the National Coalition for Gay and Lesbian Equality. He initiated a campaign to incorporate gay rights into the new South African constitution. Achmat won successive victories at the Constitutional Court, helping to bring about the decriminalization of sodomy... Tells about the relatively cheap South African drug Virodene, which Mbeki prefers over expensive retroviral therapy... Tells about Achmat & TAC’s supporting the Medicines Act, legislation that would make it possible for South Africa to override drug patents and provide more affordable generics, such as one for AZT... In February, 1998, thirty-nine drug companies had filed suit in Pretoria’s High Court to stop South Africa from manufacturing generics. The drug companies argued that there would be no incentive for research and development if patents were not enforced. Charlene Barshefsky, the United States Trade Representative, threatened to punish South Africa with trade sanctions. Several other Clinton Administration officials, including Vice-President Al Gore, demanded the repeal of the Medicines Act... Tells how protesters followed Gore on the campaign trail... Achmat and the other activists achieved their goal: the Clinton Administration removed South Africa from its sanctions watch list and ended its campaign against the Medicines Act... Unfortunately, Mbeki, a micromanager who juggled a wide range of intellectual pursuits, decided to research AZT. He learned of an obscure group of academics and journalists who called themselves "aids dissidents." The group made three startling claims: H.I.V. was a harmless "passenger" virus; aids was a "life-style disease" caused by poverty and malnutrition; antiretroviral drugs didn’t help patients, and often wrecked their immune systems. These views lacked scientific support... Mbeki publicly claimed that AZT was "a danger to health"... Mentions a personal fax he sent a S.A. AIDS activist and openly gay judge, Edwin Cameron, comparing the drug to Thalidomide... By attributing the AIDS epidemic to mass poverty and malnutrition, Mbeki sidestepped difficult questions about sex and responsibility. If AIDS was the "logical" outgrowth of economic deprivation, not unprotected sex, then it was easy to conclude that there was little that destitute Africans could do to save themselves. Mbeki championed African self-reliance, yet he had taken a stance on AIDS which treated his countrymen as helpless... By 2001, antiretroviral therapy that cost fifteen thousand dollars per year in the United States was available in South Africa for three thousand dollars; the government could likely have reduced the price to three hundred and fifty dollars by purchasing generic antiretrovirals from India. By that point, however, Mbeki had staked his reputation on the idea that the drugs were dangerous... Mentions that Nelson Mandela joined TAC’s cause... Mandela’s visit to Achmat’s home, in July, 2002, offered a kind of coronation. The local papers carried photographs of the two men together. They began to speak regularly by phone... Tells about TAC’s countrywide campaign of civil disobedience earlier this year... Mentions that Achmat intends to start taking retroviral drugs... (
