With the end of apartheid, South Africa became the epi-center of the AIDS epidemic due to an influx of migrants. Despite the rapid rise of HIV infections and AIDS deaths in Africa in the 1980s, the response to HIV in South Africa was slow. This was a result of the narrative created about the disease in the Global North that connected the spread of the virus to the behaviors of injection drug users and gay men. Another factor was that the spread of the disease in Africa looked incredibly different as more than half of people living with HIV in sub-Saharan Africa are women.
When HIV and AIDS started having a widespread impact on South African society and communities, President Mbeki followed the arguments of Peter Duesberg, who stated that HIV could not be the cause of AIDS and was opposed to Western medical approaches to solving the epidemic. In 2003, the health minister, Tshabalala-Msimang advocated for nutritional solutions to alleviating HIV in South Africa and was notoriously known as “Dr. Beetroot”. Through Mbeki’s reasoning, continuous efforts from other countries to offer help for AIDS were declined and civil society groups raised grave concerns over the need for urgent action. One of the biggest groups to raise concerns and have the greatest impact in the region was the Treatment Action Campaign.
About the Treatment Action Campaign (TAC)
The Treatment Action Campaign (TAC) was founded in 1998 as a tripartite alliance between the AIDS Law Project and COSATU, a key organization that fought apartheid in the 1980s. TAC was formed as a response to HIV in South Africa due to the lack of urgency that the government and the medical industry had in responding to the virus.
The transformative and charismatic Zackie Achmat, a previous gay rights activist who was diagnosed in 1990, initially led the organization.
TAC was a human rights-based organization focused on fighting racial discrimination and economic exploitation. This group was not only technical, but also political in their arguments as they utilized justifications for actions through moral, scientific, and economic reasoning. The TAC also developed partnerships with activist groups such as the Gay Men’s Health Crisis (GMHC) and ACT UP, which have aided training “treatment literacy” and initiated a wider peer education network.
In addition, TAC formed partnerships between elites, academics, professionals, and press, but ultimately served to strengthen the effort for the poor to become advocates for themselves. Through the framework TAC developed and their understanding of the disease, TAC used their model for social mobilization, advocacy, legal action, and education.
TAC’s First Action
TAC’s first action was to argue for the right to access medical resources – namely antiretrovirals (ARVs). TAC found inherent fault with the World Trade Organization’s 1995 TRIPS agreement, which legally protected intellectual property and patents.
In 1998, TAC demanded that the South African government introduce the program “Prevent Mother-to-Child HIV Transmission” (PMTCT). The social movement around advocacy for PMTCT was predominantly made up of poor black women living with HIV in South Africa. The issue was framed as a moral issue: that the pharmaceutical company GlaxoSmithKline (GSK), the patent holder of AZT, was profiteering off the sale of the drug. TAC demanded a price reduction and in framing it as a moral issue with reference to the South African constitution, the organization succeeded in its demand for legal action.
Key Tool to Success
A key tool for TAC’s success was its use of legal resources and advocacy. Not only did TAC make legal demands of the South African government, but they collaborated with progressive lawyers, scientists, and researchers to develop plans and alternative policy proposals. The organization went beyond simply advocating for the poor. They also based policy on the entitlement of rights to the individual. TAC has taken successful mitigation measures on five occasions; in 2001-02, for a national program for PMTCT; in 2004, for implementation of ARV roll-out; and in 2006-07, for access to ARVs for prisoners in Westville and KwaZulu Natal province, for ongoing litigation to challenge the profiteering of pharmaceutical companies and for denouncing alternative treatment to defend the Medicines Act. These cases were supported by not only the efforts of lawyers but the actions of TAC which involved marches, media campaigns, legal education, and social mobilization.
These actions were not possible only as a result of the advocacy and partnerships formed by the TAC, but also the structures in which the group functioned. Article 27 of the South African constitution, which took effect in 1997, includes the right to access medical services, reproductive health care, and emergency medical treatment. Through these efforts, TAC has helped advocate for an improved response to HIV in South Africa, a process that must continue to further combat the spread of the virus.
– Danielle Barnes