HIV/AIDS in South Africa: Past, Present, and Future

Welcome to this installment of The AIDS Pandemic, a podcast hosted
by Dr. David Wessner from the Department of Biology at Davidson
College. I’m Kara Earle.

Since the diagnosis of the first case of HIV in 1982, infection
rates in South Africa have skyrocketed. It is currently estimated
that one in five South Africans, or approximately 5.7 million
people, are living with HIV. In addition, there are nearly 1,000
AIDS-related deaths occurring daily. Many AIDS experts around the
world blame the South African government for their lack of
appropriate response to this nationwide epidemic. Until 2003, South
Africans using the public health system could only receive
treatment for the opportunistic infections acquired as a result of
being HIV positive, but not the antiretroviral drugs that fight the
virus itself. As a result of slow government action, the HIV
prevalence rate among pregnant women in South Africa increased from
0.8% in 1990 to 29.1% in 2006.

Since the end of Apartheid in 1993, South Africa has been governed
by a popularly elected President. Beginning in April 1994, the
African National Congress, or ANC, has consistently won a majority
of votes to become the governing party, with the President of the
ANC serving as President of South Africa. Thabo Mbeki was elected
following Nelson Mandela in June 1999, and was forced to resign by
the ANC September 24th, 2008, a mere 6 months before the end of his
second term in office. With the election of Jacob Zuma as ANC
President in December 2007, it is likely that when new national
elections are held in April of 2009, the ANC will again be the
victorious party and Zuma the new South African president. Until
then, the South African Parliament has chosen Kgalema Motlanthe to
lead the country.


Kgalema Motlanthe

As Deputy President under Nelson Mandela, Mbeki initially
acknowledged widely-held views about the spread of HIV/AIDS in
South Africa. However, shortly after his election to the
presidency, Mbeki increasingly cited poverty, not HIV, as the
primary cause of AIDS. He began to side with dissident scientists
and did not believe antiretroviral drugs could help in the
treatment of AIDS; rather, he believed the commonly used drugs were
toxic. His beliefs were shared by the South African Minister of
Health, Dr. Manto Tshabalala-Msimang, who advocated good general
nutrition and a combination of lemon juice, garlic, and alcohol as
treatment for HIV/AIDS. In 2001, the South African government,
independent of President Mbeki, declared that AIDS is in fact
caused by HIV and shortly thereafter the High Court ordered the
government to make antiretroviral drugs available publicly. Even
so, it is estimated that only 28% of South Africans who need
treatment for HIV/AIDS are actually receiving the drugs.

President Mbeki was forced to resign due to allegations that he had
interfered in a corruption case against ANC President Jacob Zuma.
Since taking office September 25, 2008, President Motlanthe has
replaced Health Minister Tshabalala-Msimang with Barbara Hogan, an
advocate for the treatment of HIV/AIDS. In combination with
increased awareness and involvement by the government in recent
years, this change is seen as a step in the right direction for the
HIV epidemic in South Africa. However, the expected next President,
Jacob Zuma, arrives with a considerable amount of controversy. In
addition to the recent corruption case brought against him, Zuma
was tried in 2006 for raping an HIV positive family friend. He was
acquitted of the charges by explaining that the victim was wearing
a short skirt and sitting provocatively. He also told the court
that he reduced the risk of HIV infection by showering afterwards.
Despite these previous comments, he seems to address the HIV/AIDS
epidemic in a reasonable manner.

It is impossible to know what changes the next six months will
bring in South Africa as a result of the sudden change in
government. In recent years, the country has shown a desire to take
on the HIV epidemic through both prevention and treatment methods,
regardless of the beliefs held by its President. It is widely
believed that a country with as much wealth as South Africa should
be able to provide antiretroviral drugs to all who need them, and
not merely the 28% who are currently receiving them. In order to
slow this epidemic, the incoming administration will need to devote
significant time and funding to the development of prevention and
treatment programs throughout South Africa.

I’m Kara Earle, thanks for listening.