HIV/Aids and Boris Johnson

In 2003, while living in London, I collared Boris Johnson in the hallway of The Spectator, and tried to persuade to publish this article. He didn’t.

Global denial is killing South Africans

Context is everything. This week has seen the US president, George Bush, visit South Africa, and the South African president, Thabo Mbeki, publish a commentary under a progressive banner in the Guardian. The impression created is of members in good standing of the international community meeting, seeking greater prosperity for their countries.

But there is a missing context for the visit and the article. That context is death, a very great many, avoidable deaths.

There is an insidious global denial and silence regarding South Africa’s dismal Aids policy, its policy of criminal neglect which is helping kill South Africans in their thousands and hundreds of thousands; abetted by the sparseness of protest among the South African people and the world community. Mr Bush’s hosts are not nearly as respectable as his visit suggests: Mr Mbeki’s cold disregard for the lives of his people is easily comparable to that of Zimbabwe’s Mr Mubabe (whom he far outclasses, though, in public relations skills).
But when Mr Mbeki or his cabinet peers travel abroad, press or politicians rarely raise a whisper about the ghosts who trail behind in obscene numbers.

What is the background to this bizarre spectacle of barely challenged, undeserved respectability?

People whose lives are threatened by Aids are treated, if they are fortunate, in two different but parallel ways. Firstly, they receive treatment for the opportunistic infections which take advantage of the Aids-weakened immune system and which are usually the immediate cause of death when it comes (this kind of treatment is available in South African hospitals). Then, depending on the state of their immune system, they may also be treated with anti-retroviral drugs (ARVs), which directly assault the virus.

Mr Mbeki and his government have now been stalling for several years on meeting their legal obligation to provide ARVs. Various reasons have been advanced for not doing so: the side-effects of the drugs (which are real, but less crippling than death); the motivations of the pharmaceutical companies (members of Mr Mbeki’s government have suggested the Aids crisis is exaggerated by these companies); and the cost of supplying the drugs, which is substantial, but now proven to be less than the cost in palliative care needed when ARVs are not deployed, even before the cost to economy and society is taken into account.

South Africa now has the world’s largest population of people living with HIV/Aids, conservatively estimated at around 4.5 million. Every day, around 600 people die untreated, according to an estimate by the pressure group the Treatment Action Campaign, an estimate the government has not disputed. The hospitals groan with the dying, the funerals accelerate, but the government ducks, dives and procrastinates – at present, holding back from releasing a report on the projected costs of ARV treatment which was completed six months (and 100,000 deaths) ago. By 2010, six million – yes, six million – people will have died if the government does not undertake with integrity a comprehensive Aids treatment and prevention programme.

These facts, quite at odds with the world’s preferred view of South Africa as a miracle of reconciliation, democracy and prosperity in Africa (of all places), do not do justice to the terrible misery they represent.
The Archbishop heading the Anglican Church in South Africa, Njongonkulu Ndungane, said (three years and 700,000 deaths ago): “We believe that history will measure this country’s slow response to the pandemic in human, not statistical terms, and that the inherent injustices will be judged as serious a crime against humanity as apartheid.”

Last November, the Guardian’s own former correspondent in the region, Chris McGreal, wrote: “Two million children will be orphaned before the end of this decade. Life expectancy will collapse to just 41 years. Millions will be driven deeper into poverty. What does Mbeki’s grand vision of Africa’s renaissance mean when he is prepared to stand idly by while six million people in his country are going to die of Aids by 2010?” But few have had the courage to be so unequivocal as Mr McGreal.

Why is there such denial about what is happening in South Africa; why so little outrage at what is happening?

Politicians everywhere are being held to far lower standards. Mr Bush and Tony Blair manipulate democracy, but have no passion for it, and their supporters shrink from recognising this. Neither has an interest in pointing out the shortcomings of the South African government. Britain, for example, is well behind the US in meeting its promises to the UN-sponsored Global Fund for Aids, Tuberculosis and Malaria. (Mr Bush has recently pledged $15-billion to fighting Aids, which will help, but as always, US money comes laden with US agendas – such as a truly demented insistence on promoting sexual abstinence.) Their spurious war on Iraq has for nearly a year diverted the world’s attention from any number of pressing worries.

The pervasive crises of democracy offer more recognisable villains. It is easy to identify the public, unabashed corruption of a Berlusconi; far less easy, and less comfortable, to recognise a human rights abuser cloaked in the vestments of social democracy.

Perhaps there is a weariness with pointing to the failings of Africa, especially when it means spoiling the myth of Africa’s great success story. It is far easier at an international summit to nod, smile and thank God you’re not one of the poor bastards who elected the villain whose hand you’re shaking, than rock the boat and risk being branded racist (oh, anything but that!) by raising hard questions.

Ignorance of the crisis also follows from a lack of accustomed signals about when we are supposed to be outraged. The South Afican government’s spin is good enough; its abuses are veiled in reasonable rhetoric and legalities; journalists, commentators and politicians, on the rare occasions the crisis is touched on, shrink from drawing the conclusion that the South African government is, just as it appears to be, callously sitting on its hands watching people die slow wasting deaths in their hundreds of thousands.

In London, I have heard hardened activists, in discussing Aids and South Africa, rush to condemn the pharmaceutical companies, the set-piece villains (and by no means innocent), but shrink from even mentioning the role of the South African government in the disaster.

The world is used to seeing African corruption as being a matter of graft. But though it exists in South Africa, this is not the corruption that most troubles the country. (Where such corruption exists, it is mostly far more visible than under its apartheid predecessor.)

No, the principal corruption is a corruption of humanity. Those currently elected to power in that country have a breathtaking disregard for the inherent value of human life.

No doubt, faced with the facts, many conduct an internal dialogue which opposes the facts of the many dying invisibly with the visible and apparently reasonable reassurances of the government, its democratic garb, and the undoubted heroes of its movement such as Nelson Mandela and Walter Sisulu. Such internal dialogues, it seems, most regularly lead to a conclusion along these lines: “No, this huge human disaster can’t be what it appears to be, the responsibility cannot be the government’s alone, these people wouldn’t do this, they are global heroes of reconciliation and democracy, they’re resisting pressure to give the US an opt-out agreement in respect of the International Criminal Court. There must be something I’m missing here. Besides, no-one else is really saying anything. (And I don’t want to appear racist.)”

What is happening in South Africa has been compared, by people struggling to convey the magnitude of the catastrophe, to war-crimes or genocide. It is neither of those things, but is no less awful or deliberate for not fitting the definitions. A crime against humanity? Certainly, perversely being conducted by those who so recently could be claim to be humanity’s heroes. Pre-meditated? It has become so.

We tend to be confused when something nasty does not fit our categories of nastiness, when useful historical analogues do not spring neatly to mind. It is a confusion we had better work hard at resolving; corrupted humanity knows its own dreadful progress.

The confusion may be readily set aside by applying to the South African government an analytical standard all too rarely deployed: if we set aside the reasonable appearances and reasonable assurances of the politicians involved, what is the actual effect of their policies and actions on the people whose votes they have accepted and for whose lives they hold a great portion of responsibility?

Once again, the effect in South Africa is death in very great numbers; multitudes of infants and young people dying at dreadfully early ages; orphans, with little hope, in staggering numbers. Now you know.

(David Le Page is a freelance journalist and member of a London-based group lobbying in support of South Africa’s Treatment Action Campaign, writing in his personal capacity.)

About David

I am an environmental writer, journalist and speaker living in Cape Town, South Africa.
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