BioEd Online

HIV causes AIDS. That's not news to you or me, but shockingly it has taken years for the government in South Africa where about 1,000 people die of AIDS every day to acknowledge that fact and pledge to provide medicines.

In the past few weeks, the country's deputy president Phumzile Mlambo-Ngcuka has publicly promised to expand access to AIDS tests, antiretroviral drugs and prevention programmes to those who most need them.

That sounds sensible if a rather obvious thing for a politician to say but it's a far cry from what South Africans had heard until recently.

Health minister Manto Tshabalala-Msimang has extolled the virtues of beetroot, lemon juice and garlic in fighting AIDS. At the international AIDS conference in Toronto this August, her booth prominently featured those items. Six years earlier, at the same conference in Durban, President Thabo Mbeki said he didn't know anyone with AIDS and questioned its link to HIV.

It's about time the government changed its tune. As the richest country in Africa, South Africa is in a much better position to combat AIDS than its poorer neighbours. But thanks to the government's appalling neglect, it hasn't seen any decline in the rate of new infections.

Obvious problem

There are an estimated 5.4 million infected people in the country, more than in any other except India. When I visited South Africa in February, AIDS was everywhere, and I couldn't fathom how Mbeki, Tshabalala-Msimang or anyone else could look the other way.

Whatever Mbeki and Tshabalala-Msimang still believe, a few brave souls have at least made it impossible for them to say it in public without being ridiculed.

The United Nations has never taken South Africa to task, but at the Toronto conference the delightfully outspoken Stephen Lewis, the UN special envoy for HIV and AIDS in Africa, called the government's theories "more worthy of a lunatic fringe than of a concerned and compassionate state."

Three weeks after the conference ended, 81 prominent researchers, including Nobel laureate David Baltimore, called on Mbeki to fire Tshabalala-Msimang.

That hasn't happened, but it is surely a positive sign that Mlambo-Ngcuka seems to have replaced Tshabalala-Msimang as the government's AIDS chief.

Is it possible that these are just idle statements? Sure, but I'd like to believe these sentiments are sincere. A few weeks ago, the country also hosted an emergency meeting on a deadly new strain of tuberculosisanother sign that the government is beginning to realize it simply cannot continue to look away.

Only 200,000 South Africans, a quarter of the estimated 800,000 in need, receive antiretroviral drugs. Hopefully that number will now rise rapidly and South Africans will get the medicines and support they so desperately need.

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