History of AIDS policy making in South Africa


conference on health & welfare in Mozambique / ANC is part (N. Nattress 2004, p 42)

Prevalence rate: 0.8%76 of women were found HIV positive in South Africa


conference on AIDS uniting the ANC and the old government’s department of health ,

an umbrella body was tasked with the developing a coordinated response to AIDS ,

“AIDS-Plan” was developed, it was very progressive at this time (N. Nattress 2004, p 43), The plan wasn’t supported by political activist & trade union. One reason might be to ease at this time, the assimilation of returning exiles, many of whom were returning from high HIV-prevalence areas.

With other words: The early transitional period had not a conductive environment for addressing AIDS.


AIDS became a “Presidential Lead project” with preferential access to funds,

a national AIDS Programme Director was appointed in December 94( at the health department not direct at the president),

Initiatives lured away from the outlined AIDS-plan and lost strength and focus

Prevalence rate: 7,6% prevalence rate based on antenatal testing


Savafina II (p. 45) a stage show fitting the musical Sarafina with anti-AIDS messages was produced (14.2 Mill R from EU), process was rushed and taken without experts, government failed to get permission to spend this money on the project, script was unsuccessful and confusing, consequences: scandal and failure


International Conference for People Living with HIV / AIDS was held in South Africa. Mbeki and the health minister acknowledged the seriousness of the epidemic

Prevalence rate: 14,3 % prevalence rate based on antenatal testing


Announcement of the development of “Virodene” as an in SA developed treatment for AIDS

In reality it was an in the cancer treatment failed medicament, which contained highly toxic industrial solvents.


Evidence becomes available on the benefits of AZT (Zidovudine) to prevent MTCT, but government will not make it available because of concerns over affordability and toxicity. The pressure group Treatment Action Campain (TAC) was started to advocate for the rights of people living with HIV/AIDS and demanded a national treatment plan

Prevalence rate: 22,9% prevalence rate based on antenatal testing


government policy making became centralised and the AIDS debate influenced by Mbeki and his ill-advised views,

Health Minister Dlamini-Zuma (was on the conference in 1990 & 1992) refused to make Zidovudine (AZT) available for MTCTP, she argued it is unaffordable

Western Cape provincial government (not ANC) ignored the national policy and started pilot projects on poor communities with MTCTP (together with MFS)

Tshabalala-Msimag (was on the conference in 1990 & 1992) became minister of health,

president Mbeki urges the council members to find out where “the truth lies” and to consult the “huge volume of literature” available in the internet (e.g.,

Tshabalala-Msimang says AZT weakens the immune-system, leads to mutations and birth defects. She also downgraded established scientific opinion as just one view among many.


AIDS policy making was characterised by the political marginalisation of established scientific information and modes of discourse. At the International AIDS conference in Durban, the South African president Thabo Mbeki said that AIDS was a disease caused by poverty, not by HIV.

In Januar 2000 the South African National AIDS Counsel (SANAC) was launched, no experts or high-profile civil society groups were invited (N. Nattress 2004, p. 50)

Shortly after Mbeki creates the “Presidential international panel of scientists of HIV in Africa” that contained conventional scientist and dissidents, who believed that AIDS was caused by poverty rather than HIV

October 2000 Mbeki announced that he was withdrawing from the public debate

Prevalence rate: 24,5% prevalence rate based on antenatal testing


April 2001 the cabinet releases the statement to the effect that HIV causes AIDS (N. Nattress 2004, p. 54)


Richard Feachen from the Global Fund evaluates SANAC as “not yet functional”, “does not meet often enough to do concrete work”

(Mail and Guardian 11-17 of April 2003)


On the Durban AIDS conference the coordinators and colleagues made a public plea for Mbeki to keep clear of the scientific debates. The answer was a harsh critic from 3 ministers saying that these people were frontline troops of the pharmaceutical industry (Nattress 2004, p. 51 / 52)

Even so Mbeki had backed out of the debates, is former dispute hat still an major effect on the AIDS policies through the coming years (Sunday Independent 9 Aug. 2003)

Prevalence rate: 26,5% prevalence rate based on antenatal testing


AIDS policy-debates focussed on feasibility, affordability and implementation of a national treatment plan

February 2003 the Minister of Health refused to sign the “framework agreement”

(Mail and Guardian 28 February – 6 March 2003, 15 –21 August 2003; Business Days 19.March 2003),

South Africa developed a “moral economy of triage” to address the AIDS issue (N. Nattress 2004. p 57),

The government wants to allocate money rather to prevention than treatment, forgetting that AIDS isn’t comparable with a warlike situation and that HAART would have an tremendous preventive impact.

The Minister of Health appoints controversial dissident as her nutritional adviser and attacks KZN for having put successful proposal to the Global Fund to support ART roll out.

President Thabo Mbeki denies in an interview with the Washington Post to have ever known anyone who has died of AIDS.


MTCTP becomes available, but isn’t used to it’s full capacity as VCT doesn’t approach enough people yet

Prevalence rate: 29,7% prevalence rate based on antenatal testing

The Minister of Health labels ARV´s as toxic after consultation with the German vitamin entrepreneur Mathias Rath.


ARV (Antiretroviral medicine) are available in pilot projects and later in hospitals around the country, but doesn’t reach enough people yet

Prevalence rate: 30.2% prevalence rate based on antenatal testing

HAART is being discussed

The Rath Fooundation claims that vitamins can cure AIDS and that TAC is a forefront of the Pharma Industry. The Heath minister Tshabala-Misinmag does not distance herself from this vitamin entrepreneur (Mercury 28.05.2005)


The head of the Moral Regeneration Movement; chairman of the South African National Aids Council; And Deputy President of the ANC Jacob Zuma, had voluntarily unprotected sex with a HIV-positive woman and publicly announced that he took a shower after the sexual intercourse to reduce his risk of getting infected (Jacob Zuma Rape trail 2006)

Health Minister Manto Tshabalala-Msimang presented South Africa at the HIV/AIDS conference in Toronto with a “salad stand” insisting that vitamins, garlic and beetroot are an alternative for ARV treatment in the fight against AIDS. 60 international experts on HIV/AIDS call for the resignation of Tshabalala Msimang.

The Mecicines Control Council impounds a shipment of Raths Healths Foundations products which contain Schedule Two substances. The shipment is released by order of the Department of Health.

November 2006: The government sends a signal out that messages about nutrition’s from Health Minister Manto Tshabalala-Msinmang are “demanding” saying it has the duty to “remove all the confusion”. Deputy Health Minister Madlala-Routledge takes a public stand for ARV treatment. (The Mercury 1.11.2006, Sunday Tribune 24.12.2006)

Prevalence rate: 29,1 % prevalence rate based on antenatal testing

New: two percent drop of HIV infections in the under 20 group


Nationwide strike in the public sector in June 2007 threatens the ARV distribution and People are left without ARV and threatened to develop ARV resistant virus strains (The Mercury 13.06.2007)

Deputy Health Minister Madlala-Routledge is removed from her post.

Fußnoten und Endnoten

76  All prevalence rates are taken from the Avert study: in June 2006

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