Zackie Achmat is one of the leading figures of the South African movement fighting to get lifesaving drugs made available to everyone living with HIV and AIDS. He was an anti-apartheid activist from an early age. Although he is HIV positive, he is refusing to take antiretroviral drugs until they are made available for everyone in the South African public health system. He is chair of the Treatment Action Campaign (TAC).
This was the group which spearheaded the campaign against the giant pharmaceutical companies which had tried to stop South Africa importing cheap anti-AIDS drugs. Since the victory over that issue, the South African government has dragged its feet over making the drugs available. This is now the focus for TAC's efforts. Zackie spoke in London at a meeting organised by Globalise Resistance last week:
'THE SOUTH African government's failure to act means that 600 people die a day. AIDS is worse for poor people and black people and especially poor black people. They can't afford the drugs, they live in third rate housing, they are excluded from education and they are forced to use the grossly inadequate public healthcare service.
'The latest figures show that the private health insurance sector spent 388 billion rand on the health of 7 million people. The public health system spent 272 billion rand for the health needs of 30 million people. The government's spending priorities reinforce the structural basis of racism. In many ways this government is the best we have ever had and is the result of the triumph of the liberation movement.
'This is one of the most exciting periods to live in South Africa. The balance of social forces has shifted in our favour and we need to push forward the pro-poor, pro-feminist, pro working class agenda.
'We face an enormous task. A report drawn up for the South African government said that AIDS accounts for a quarter of all those admitted to hospital. By 2010 AIDS will lead to three to four million dead in South Africa. This year 300,000 will die.
'TAC is a small organisation of about 7,000 people. You can see the impact of AIDS among ourselves. Since the middle of March we have lost ten leading activists to AIDS. We have been forced to confront the government. The ANC has not repeated with AIDS the success it has had with TB.
'When the ANC came to power there was no decent TB programme and the cure rate was less than 40 percent. In northern KwaZulu-Natal the average journey to get treatment for TB was 28 kilometres. Within a year the average journey was 12 kilometres and within 18 months it was 800 metres.
'But the government decided it would operate within the fiscal constrains of the IMF and the World Bank, even though they do not owe a penny to either. This meant that they cut services. AIDS treatment was a victim. Instead of a real treatment and prevention strategy Thabo Mbeki, Mandela's successor, promoted a 'drug' called Virodene as treatment for people living with HIV. It was a toxic industrial solvent.
'We have increased the pressure on the government. It promised action by February. When it did not happen we started civil disobedience. On 20 March we occupied three police stations and demanded the arrest of the health minister and the trade and industry minister for culpable homicide.
'Their policies mean death for hundreds of thousands of people. They won't distribute drugs, even though they say the money is available to fund them. Should the government continue to refuse to implement a treatment and prevention plan we are going to start an extensive international campaign. Perhaps some people are worried about campaigning against the ANC government. I am a member of the ANC who thinks Mandela is a saint.
'But we cannot put our party loyalty before people's right to life. We have a wider duty to social justice and to the people who are dying. We want a huge campaign.'
Jonathan Neale from Globalise Resistance set out the background to TAC's struggle:
'THE scientific and pharmaceutical world has developed drugs that extended the life of people with AIDS by five years, eight years or ten years or more. For about two thirds of people they work well. These drugs were mostly developed by publicly funded research. Then the patents were sold to private companies.
'A year's treatment can be made in India for around $300 a year. In the US that same treatment sells for $12,000 a year. Until the 1990s it was agreed that copies ('generics') of antibiotics and anti-malarial drugs should be sold to the Third World. That agreement was broken by the World Trade Organisation in the 1990s. The TRIPS agreement says that governments must agree to bring in laws to enforce patents and copyrights.
'Even before TRIPS has been enforced, the US government has intervened to halt the import of generic drugs. The achievement of TAC was to mobilise a large movement to force the multinationals to back off from a court case that would have blocked the importation of generics.
'Companies now say they will make cheap drugs available to Africa. They make cheap drugs available to countries so long as generics are not allowed in. This is because much more is at stake than Africa. Some 41 percent of pharmaceutical sales by value are in the US and 61 percent of the profits come from the US. The companies want to defend patents to protect those markets.'