AIDS Casts Long Shadow over Zuma Presidency. 06/05/09
By Susan Comrie
When Jacob Zuma is sworn in as president on May 9, he will not only inherit power and prestige, he will also inherit a country crippled by HIV and Aids.
While opposition parties are anxiously waiting for the final results, some facts and figures remain unchanged.
About six million South Africans are HIV-positive and 60 percent of those who desperately need ARV treatment still have no access to the drugs that could save their lives.
This week marks 25 years since scientists discovered the Human Immunodeficiency Virus (HIV).
At the time, the US secretary of health hailed the discovery as a major turning point in the battle against Aids and predicted it would take as little as two years for a vaccine to be available.
Twenty-five years later there is little to celebrate.
Optimists point out that at least the country's HIV infection rates have finally stabilised, but the harsh reality of statistics like these is that for the 1 000 South Africans who are infected with the virus every single day, another 1 000 die too young and with little dignity.
The ANC describes South Africa's ARV treatment programme as "amongst the best and most comprehensive in the world", and with 700 000 people on treatment, South Africa does have the largest treatment programmes.
At the moment, though, only four out of 10 people who need ARVs have access to them.
This is despite the fact that the government approved the rollout of ARVs to all HIV-positive South Africans more than five years ago.
The government's National Strategic Plan on HIV and Aids aims to provide 80 percent of HIV-positive South African with treatment by 2011.
But lately no one has been feeling very optimistic about the government's ability to deliver on that promise.
"As we're rolling that out we're coming up against massive constraints," says Lance Greyling, chief whip of the Independent Democrats.
"Even rolling out to 80 percent will be hard, because we're experiencing massive difficulties now. We don't have enough health professionals and we don't have enough funding."
Funding the Department of Health's ballooning ARV costs is a problem most political parties have been reluctant to tackle. But department director-general Thami Mseleku has made it clear that the Zuma government won't have the luxury of putting off the decision, saying earlier this year that "the numbers (of new patients) are very huge and are rising fast".
He added: "As a country, we will get to a stage where we will never be able to afford the figures required for treatment."
In the Free State that point has already come and gone - 15 000 people who were due to start treatment in November were told they would not get ARVs because the province had already used up its ARV budget.
Last year the health department asked the Treasury for an extra R1 billion to meet the rapidly increasing number of HIV-positive South Africans who immediately need treatment; it got R300 million.
"From a human rights perspective, we cannot even allow such a choice that because of constraints we are going to leave some people without treatment," says Deputy Health Minister Dr Molefi Sefularo.
"But there is an element of realism in the government's targets and we have to accept that we won't be able to reach everyone.
"People will always fall through the system."
Reckless spending by the health department has been devastating in the past and the new Zuma government will be under pressure to show that it is as tough on corruption as it claims to be.
The DA, for one, has raised questions about how the Kwazulu-Natal health department could afford to spend R824 586 on the opening function for a clinic in Greytown that cost R600 000 to build.
The new health minister, Barbara Hogan, and her deputy have promised that under their leadership there will be "fewer parties with freebies and caps" and more focus on spending where it's needed - training nurses to distribute ARVs and supporting home-based care projects. The ANC has also promised to cut new infection rates by 50 percent through an aggressive awareness campaign.
South Africa has a long history of ineffectual and misguided campaigns to raise awareness about the risks of unprotected sex and multiple partners, and both the ANC and opposition parties agree that in the future less needs to be spent on glossy magazine ads and more on face-to-face interactions in communities.
Unfortunately, awareness campaigns are often overshadowed by political leaders and prominent celebrities who provide a never-ending list of people who "forgot to play it safe".
The question is whether president-in-waiting Zuma can provide the leadership necessary to change the country's endemic attitude problem towards HIV/Aids.
Cope says Zuma's statements during his rape trial are proof that he should not be trusted to bring a change in attitude among South Africans.
"The fact that the ANC has chosen a man who does not take the issue of HIV/Aids seriously is something very devastating," says Cope spokesman Palesa Morudu.
"We need to be serious about HIV/Aids and our views on women.
"And we are not convinced that he can provide that kind of leadership."
One suggestion put forward by almost all opposition parties is for government ministers and members of parliament to undergo public HIV tests, to encourage ordinary South Africans to get tested.
"I hope more and more prominent leaders in government would step forward for voluntarily tests," says Sefularo.
"But it's a very delicate situation - there are questions of stigma and privacy.
"When I go into the townships I'm struck by the extent to which HIV is becoming more and more of an open conversation, but we need to meet their courage halfway.
"It has always been the ordinary people who have taken the lead with many epidemics, but the elite do need to narrow the gap."
This article was originally published on page 6 of Pretoria News on April 25, 2009