The 1st National AIDS-Conference in South Africa

was the occasion that a TV crew from BBC London visited Blessed Gérard’s Hospice and filmed scenes from our palliative care. Hilary Andersson’s impressive report on the inequality of access to antiretroviral medication was broadcast in the BBC Newsnight programme on 5 August 2003 and surely played a role to persuade the South African Government to make a declaration of intent to roll out antiretroviral medication to the public in future.

AIDS conference
Hilary Andersson reported from the first national AIDS conference in South Africa, and asked why the Pretoria government's own policies mean that drugs which are saving lives in developed countries are being denied to the poor.


The South African Government was accused of crimes against humanity today by a leading Aids activist in the country over its response to the HIV/AIDS epidemic. 5 million people are HIV-positive in South Africa, but the government opposes universal access to anti-retroviral drugs, known as ARVs. As Hilary Andersson reports from Johannesburg, drugs that are saving lives in developed countries are being denied to the poor.

Today's sermon: "The people's hearts are leaving God. Worship the Lord with deeds, not words!"

Sibusi Dube is being buried. He was 37. The village thinks a spell was cast on him. They won't name the spell as AIDS. He leaves 7 children behind and a wife. The wave of death is under way in South Africa. Whole populations are dying. Millions are already carrying the virus. Their only hope now is treatment.

This is Zululand, a land that breeds lushness and life. For over a century migrants have coming here to work the sugar cane fields. Now they come to work in the factories.

The migrants carry the virus and the grim joke is that if you come here for work you never go back.

Hilary Andersson: "This is the town of Mandeni. It has a population of about 150.000. Now South Africa's government won't release local level HIV statistics, but we have been to hospitals around here and what they estimate that about half the population of this town is walking around carrying the virus.

Now, that information is reliable and the statistic is staggering, because what it means is this: In just over a decade's time, if nothing is done, around half the population if this town, a town the size of Redding, will be dead."

This is a hospice for the dying, a place from which few return.

Thabisile was brought here two weeks ago. She is in the final stages of AIDS. The slightest movement hurts.

The nurses think her nerv-endings have become infected. She is dying because she could not afford the drugs that would have extended her life by years.

She was found abandoned.

Thabisile Mthethwa: "I was in pain, coughing and suffering. There was no one to look after me. Sometimes my neighbours brought me food, but often they didn't. I was like that for six months."

Nkosi, her two-year-old won't leave his mother's side. No one at the hospital knows what to do with him when she dies.1 Thabisile has told them that she has a relative somewhere, but her story is not coherent.

In Mandeni's hospital2 no one gets free anti-retroviral drugs, except pregnant mothers, and that only started here three months ago. Still, it's hard to persuade even mothers here that AIDS is real. The government has questioned the connection between HIV and AIDS in the past and the people are confused.

Matron: "So, this is our pharmacy."

The drugs that are being given to the pregnant women half the chance of the mother passing the HIV virus onto the child.

Matron:"This is what the pill would look like. We just give her a piece and she takes that home."

Hilary Andersson: "That's simple."

Matron: "That's it, as simple as that"

This is an AIDS test. In three minutes the death sentence shows. The staff here say they could easily administer the life-saving drugs to everyone infected in Mandeni if only they had them. But the government won't accept this.

Dr. Ayanda Ntsaluba, Director General of Health: "There is a gap between what the hospital sometimes think they can do and what in reality happens. Because if you went to the same Mandeni, to the same hospital2, it's a different thing between doctors whether they have got the capacity to administer drugs to patients. It's another thing whether those patients have got the support mechanisms to make sure that they take those drugs regularly, they are able to be monitored properly and have got the outreach programs."

It has been fifteen months since the government officially recognised the benefits of the drugs.

Professor Alan Whiteside, Health Economist, University of Natal: ''You probably could not role out therapy to many of the people who need it at this stage. That's no excuse for not starting. We can - we have seen it happening in the private sector and I think there is evidence that you can start doing it. If the house is on fire you don't stop trying to put it out because you haven't got enough water - you don't think you haven't got enough water for the whole house. You actually start somewhere and I think that is the message that we need that we make a start."

Sibonge is 30 years old and unlike the vast majority of South Africans she is on the drugs. She has bought up to a decade of life, because she can afford to. Sibonge is well educated. She has a good job and private medical insurance. In South Africa the rich HIV-carriers live, the poor die. It's that simple.

Sibonge Ngubame: "I used to be admitted in the hospital. But since I get the ARVs like this year, I never visit the doctor. I feel much better and my results showing, that these ARVs are working very well."

Hilary Andersson: "Can you live a normal life?"

Sibonge Ngubame: "Yes, I am living a normal life. I am like - I can say I am like an HIV-negative person."

Thabisile is the same age as Sibonge and the hospice nurses have just told us she may not survive the next few weeks. Nkosi sits close.

Sixhundered people die of AIDS in South Africa every day, because Thabo Mbhekis's government hesitates to provide treatment.

Zackie Achmat, Treatment Action Campaign: "In the last four month more than 100 people have died of our own members because they don't have access to medicines, and we face death on a daily basis in ways that I wish the government could see. I really do."

Zakhie Achmed is HIV-positive. He has rallied AIDS-activists in South Africa and says his people will take to the streets again, if the government doesn't promise a nation-wide drugs programme within days.

His organisation had just been leaked to this internal government report, which shows that 1.7 million lives would be saved within seven years, if the drugs were given to everyone, or as the government eerily puts it, almost 2 million deaths would be deferred. The government has kept the reports secret since May.

Zackie Achmat: "It is feasible, it is clinically possible, it's affordable for government and it shows that we can save millions of lives in South Africa. That report undermines every irrational belief , that has been held by government, by President Mbheki, by the health ministry and so on. And we believe that government is delaying this report or the release of this report or acting on it, because there is a core of people in our government, who do not believe that HIV causes AIDS."

The government admitted to us that they could now afford a mass hand-out with the new low price of the drugs, but still, they might have other plans for the money.

Dr. Ayanda Ntsaluba: "If you asked us at Health today that we had another two billion to put into our budget, would we buy anti-retrovirals or would we do other things. We have got major parts of South Africa where people just dont have access to safe water. You can't even begin to think about anti-retrovirals in that environment, but, put that aside, we have nevertheless begun the process of engaging the issue of anti-retrovirals."

Back in the hospice the virus has claimed one more victim. The government believes that lives like his couldn't be prolonged by the drugs alone. The drugs don't work without proper nutrition and clean water.

This man leaves behind another orphan.

The children in this classroom were asked which of them had lost one or both parents. One third of them put their hands up.

Hilary Andersson: "The shocking thing is that in just over a decade's time this will be the picture across South Africa: There will be an orphan generation. One third of the country's children unable to play a full part in the county's future."

The government report admits hat with the drugs almost a million children would be spared orphanhood this decade. A million extra orphans spell massive social and economic breakdown.

South Africa is the economic powerhouse of Africa, but the factories here are losing productivity. The World Bank has just predicted that as things stand this country will lose half of it's per capita-income over the next few generations.

Professor Alan Whiteside: "If nothing is done, then South and Southern Africa faces an ecomonic development humanitarian and government's catastrophy of unparallelled magnitude. This epidemic is a darwinian event."

Thabisile has now told the nurses in the hospice that she has other children, but her mind is failing her.

Her time with Nkosi is running out.

We travelled far into the country side to see if we could find Thabisile's missing relatives.

We found her quarters here on a sugar cane farm.

It was in this room that she laid for six months, lying in her own feaces with Nkosi by her side,

here in this valley of death.

Thabisile's mother: "I could not look after her. I could not even feed her. I earn two pounds a day working in the fields. I have no money."

This is Thabisile's mother, who lives next door. She has been left with Thabisile's three other children. We asked her, if, when her daughter died, she'd take Nkosi, too. She told us, she'd manage somehow.

Thabisile is too ill to know the worst.

She does not know that Nkosi is starting to show the first signs of AIDS.

Without the drugs his fate, too, is sealed.

Hilary Andersson reporting - and we recently heard that Thabisile's son Nkosi has now gone home and is being looked after by his grandmother.

1 We had told Hilary Andersson, that we are prepared to admit Nkosi at Blessed Gérard's Children's Home, if no relative could take care of him adequately.

2 There is no hospital at Mandeni. The report talks about Sundumbili Poli-Clinic, a Primary Health Care institution in Mandeni.

This page is part of the Brotherhood of Blessed Gérard - Media review

and Newsletter No. 23 of the Brotherhood of Blessed Gérard

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This page was last updated on Monday, 01 April 2013 21:59:49