When journalist Toby Shapshak first broke the news of Tshabalala-Msimang’s death over Twitter, there were very few condolences on the public timeline.
People tend to have long memories when it comes to hundreds of thousands of lives that could have been saved had Tshabalala-Msimang and the rest of the Mbeki-acolytes rolled out antiretrovirals (ARVs) instead of being drunk on denialism.
There is the matter of her legacy; a recipe for a good braai accompaniment. No doubt the beetroots, olive oil, garlic and lemons read like a meal on speed. However, it should also be noted that a lot of the media at the time did not adequately emphasise the link between a well-balanced diet and the efficacy of ARVs.
We all had our digs at Manto. Her reported drinking problems, controversial liver transplants and alleged kleptomania; these were enough for us to burn her effigies, stoking the flames with the newspaper accounts of a health minister who called time of death on the plot. Stephen Grootes has written an evenly-keeled piece on Manto’s passing in The Daily Maverick.
Now, I would like to speak ill of the living.
Granted, government’s response to the pandemic has since improved. On World Aids Day this year, President Zuma committed to improve access to HIV/AIDS testing and treatment, effective from April 2010. By March 31st of next year, the number of accredited ARV centres will expand to include all health institutions .
Policy changes include initiating treatment for children under the age of one year who test positive not being determinant on their level of CD cells. Patients with both TB and HIV will not have to wait until their CD4 count drops to 200 or less, as they will be treated with ARVs if their count is 350 or lower.
If President Zuma and his people make good, it is a positive turn for pregnant women with HIV. They will be eligible for treatment with CD4 counts of 350 (again, a departure from the CD4 count of 200 or less) or if they display symptoms regardless of their CD4 count. Those not falling into these categories will be put on treatment at fourteen weeks of pregnancy to protect the baby, a marked departure from starting treatment during the last term.
For now, however, access to treatment remains a challenge for the marginalised.
This could not have been more affirmed than at a recent meeting of jurists, civil society representatives and people living with HIV/AIDS, where executive director of the AIDS Law Project Mark Heywood read aloud from letters he’d received from people seeking recourse. While these come from South Africans, the cases are not unique and speak to a continent-wide issue.
[transcription]
“This is about a person who lives in an informal settlement in Johannesburg called Diepsloot, who was wrongfully arrested because he didn’t have papers and was suspected, by the police, of being an illegal migrant from Zimbabwe. This is his wife writing. He is in a prison or was in a prison until quite recently. ‘On the 4th of November I went there to visit him to give him some foodstuffs and hopefully get his hospital card so I could go collect his ARV medication. The policeman I found that day was very rude and refused to let Mr M give me his hospital card nor allow me to see him. He said Mr M had not reported that he was sick, and it was not important anyway. He refused my explanation. he actually said in that prison they don’t take prisoners to hospital for medication. I had to turn back with the foodstuff and try to return some other day. On the 16th of November I went back to Sun City [colloquial name for the correctional facility in Johannesburg South], I had foodstuff and ARV medication for him. The ARV medication was refused by police and they said to me I must consult with Sister X which I never did because I don’t even know who Sister X is. Therefore Mr M never got his medication.'”
[ends]
This is despite the existence of a clear court order about the duties of prison services to provide prisoners with access to antiretroviral treatment.
“I can tell you, with my hand on my heart, the situation facing prisoners with AIDS in South African prisons is no better today than it was three years ago [when the order was passed],” Heywood said.
That was just one story.
There are others Heywood tells; of a woman refused entry as a recruit to the Durban police because she disclosed her HIV status, a mother being charged by her baby’s father for attempted murder as he believes she transmitted the virus to the child through breastfeeding.
For as long as discrimination is perpetrated, as long as human rights are negated, the virus wins. We should put that on a t-shirt.
We know the spread of HIV/AIDS to be strongly linked to gender and class inequalities.
This virus highlights the differences between public and private health care systems.
It shows us up for what we are.
Our selective sympathy would not dare to go near homosexuals, sex-workers, prisoners.
In countries like Uganda where homosexuality is criminalised, the rate of HIV infection and transmission is increasing rapidly among homosexuals because the discrimination they face has become the root cause of their inability to access treatment.
Twenty-five years into the epidemic, Heywood says, and those who are at the most at risk of infection are not at the table of HIV/AIDS prevention because they remain criminalised, marginalised and fearful to the legal responses towards their lifestyles and their work.
So who do we slam?
If there’s one thing Tshabalala-Msimang’s death should bring, apart from the vigils for the hundreds of thousands she could have saved during her tenure, it should be for the millions who can still be saved if treatment is seen as an inalienable human right.