The AIDS crisis and denialism
South Africa becomes the country with the most people living with HIV, while President Thabo Mbeki's government questions the science and delays treatment, at the cost of hundreds of thousands of lives.
- Estimating the Lost Benefits of Antiretroviral Drug Use in South Africa — Pride Chigwedere, George R. Seage III, Sofia Gruskin, Tun-Hou Lee and M. Essex, Journal of Acquired Immune Deficiency Syndromes (2008)
- Thabo Mbeki: The Dream Deferred — Mark Gevisser, Jonathan Ball (2007)
- Country factsheet: South Africa — UNAIDS
- A History of South Africa — Leonard Thompson and Lynn Berat, Yale University Press (2014)
HIV spread rapidly in South Africa through the 1990s, driven by migrant labour, poverty, gender inequality and the disruption of apartheid’s last years. By the early 2000s millions were infected, and AIDS was killing hundreds of thousands a year. Life expectancy fell sharply.
- Country factsheet: South Africa — UNAIDS
- A History of South Africa — Leonard Thompson and Lynn Berat, Yale University Press (2014)
President Thabo Mbeki, who succeeded Mandela in 1999, questioned whether HIV caused AIDS and whether antiretroviral drugs were safe, and his health minister, Manto Tshabalala-Msimang, promoted garlic, beetroot and lemon as remedies. The Treatment Action Campaign, led by HIV-positive activists such as Zackie Achmat, fought back with protests and in court; in 2002 the Constitutional Court ordered the government to provide drugs to prevent mother-to-child transmission. A national treatment programme began only in 2004.
- Thabo Mbeki: The Dream Deferred — Mark Gevisser, Jonathan Ball (2007)
- Estimating the Lost Benefits of Antiretroviral Drug Use in South Africa — Pride Chigwedere, George R. Seage III, Sofia Gruskin, Tun-Hou Lee and M. Essex, Journal of Acquired Immune Deficiency Syndromes (2008)
A 2008 Harvard study estimated that the delays cost more than 330,000 lives between 2000 and 2005, and led to 35,000 babies being born with HIV. After 2008 the government changed course, and South Africa built the world’s largest treatment programme. Nearly 8 million people live with HIV, and life expectancy has largely recovered.
- Estimating the Lost Benefits of Antiretroviral Drug Use in South Africa — Pride Chigwedere, George R. Seage III, Sofia Gruskin, Tun-Hou Lee and M. Essex, Journal of Acquired Immune Deficiency Syndromes (2008)
- Country factsheet: South Africa — UNAIDS
The epidemic left deep social marks. Weekend funerals became a constant of township and village life, grandmothers raised grandchildren, and stigma kept many people silent. Mandela himself broke a taboo in 2005 by announcing that his son had died of AIDS.
- Thabo Mbeki: The Dream Deferred — Mark Gevisser, Jonathan Ball (2007)
- A History of South Africa — Leonard Thompson and Lynn Berat, Yale University Press (2014)
Mbeki's flirtation with "AIDS dissidents" and his health minister's promotion of garlic and beetroot over antiretrovirals were a catastrophe; a Harvard study estimated that more than 330,000 lives were lost through delayed treatment.
- Estimating the Lost Benefits of Antiretroviral Drug Use in South Africa — Pride Chigwedere, George R. Seage III, Sofia Gruskin, Tun-Hou Lee and M. Essex, Journal of Acquired Immune Deficiency Syndromes (2008)
Mbeki raised legitimate questions about poverty as a driver of disease, the cost of patented drugs and racist stereotypes about African sexuality, even if his doubts about the science were wrong.
- Thabo Mbeki: The Dream Deferred — Mark Gevisser, Jonathan Ball (2007)
Why it matters today
Almost every South African family has lost someone to AIDS, and a generation of children grew up as orphans. The fight for treatment, led by the Treatment Action Campaign, is remembered as a triumph of activism and of the Constitution. Today South Africa runs the world's largest HIV treatment programme, but the denialist years remain a painful stain.