The level of mortality among young and productive adults in Africa and in countries around the world that are affected by HIV/AIDS is unprecedented in history. It is, by any reckoning, a humanitarian crisis demanding urgent action and strong political leadership. The deprivation of life caused by HIV/AIDS, including eighteen million deaths in sub-Saharan Africa, is not equally or randomly distributed in the world. HIV/AIDS can be managed medically and can be prevented through well supported government action even where widespread poverty exists, as the governments of Brazil and Uganda, for example, have so well demonstrated.
Across the world, persons infected and affected by HIV/AIDS have lost their basic rights and freedoms in addition to their right to life. Persons living with HIV/AIDS who have been courageous enough to speak out about their disease have been subjected to violence, abuse, stigmatization, marginalization and discrimination in employment and access to services. HIV-positive persons in your country have suffered all of these human rights violations.
The constitution of South Africa is a model statement of commitment to human rights for all of Africa and the world. Your own commitment to these ideals has been demonstrated in many other fields. But that commitment is belied by a policy of denial and neglect of the profound crisis of HIV/AIDS in South Africa.
The position of the government of the Republic of South Africa has gone beyond the inaction that has unfortunately characterized government response to HIV/AIDS in so many countries. Much more deadly is your government's active undermining of a rational and effective response to the crisis through systematic denial of extremely well demonstrated science on the causation of the epidemic and refusal to take advantage of any opportunities to make HIV/AIDS treatment available to your population. While widespread poverty in South Africa is undoubtedly a significant factor in worsening the effects of HIV transmission, this does not mean that countering the epidemic must rely on what can only be long term efforts to improve the standard of living of the poor. Treatment programs for HIV/AIDS themselves can help to reduce poverty, by enabling the poor to continue working and thus maintain an income.
In April this year, South Africa won a potentially significant victory for health and human rights, when the predatory lawsuit of thirty-nine pharmaceutical companies against your government was dropped. A golden opportunity was created to mount a large-scale publicly funded program of treatment for HIV/AIDS and the opportunistic infections associated with it. It is a source of great discouragement to everyone interested in protecting the rights of persons affected by HIV/AIDS to see that, nevertheless, non-governmental organizations have had to force the South African state into court to try to win access to basic programs of prevention and treatment. The continued refusal of your government to pursue such a program - even to support the provision of the low-cost treatment for prevention of mother-to-child transmission - along with public statements that sow confusion about the scientific basis for HIV/AIDS prevention and treatment programs, are acts of injustice against your people.
When governments do little or nothing to facilitate prevention and treatment of HIV/AIDS, when treatment is feasible, they are themselves guilty of the arbitrary deprivation of life that is prohibited by article 6 of the International Covenant on Civil and Political Rights and by chapter 2 of the constitution of the Republic of South Africa. In South Africa, moreover, the focus on treatment alone caused by the government's refusal to accept the use of antiretroviral drugs has diverted attention from the equally important task of taking steps to end the violence, abuse, and discrimination suffered by those infected or at high risk of infection with HIV/AIDS.
We urge you urgently to take the following measures:
End the mother-to-child-transmission court case against the government by committing to programs to prevent vertical transmission of HIV in all government health facilities that offer antenatal care.
Authorize the appropriate actors in your government to work with the medical and public health communities and non-governmental organizations to use the considerable infrastructure of your government's health system to bring treatment, including antiretroviral drugs where necessary, to the millions of persons infected by HIV/AIDS.
Increase the government's allocation of funds to combat HIV/AIDS to a sum commensurate with the scale of the problem, rather than the less than one percent of the national and provincial budgets currently devoted to the crisis, and encourage support from international donors for programs to address the HIV/AIDS epidemic.
Support the efforts of individuals and organizations in the scientific, medical and public health sectors and in non-governmental organizations who are working to mount an effective evidence-based response to HIV/AIDS in South Africa.
Your leadership in the fight against HIV/AIDS, as in other aspects of the struggle for freedom and human rights in South Africa and in Africa as a whole, is essential to prevent an even greater catastrophe for South Africa resulting from this disease.
Sincerely,
/s/
Peter Takirambudde
Executive Director
Africa Division
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/s/
Joanne Csete
Director, HIV/AIDS and
Human Rights Program
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