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PATIENT ABUSE
Patient Abuse follows the events leading up to the formation of the Treatment Action Campaign and their struggles to access affordable quality treatment for all South Africans, by challenging the patent laws protecting the profits of multinational drug companies. Patient Abuse tells of how the Treatment Action Campaign grew from a handful of people on the steps of St Georges Cathedral to an organisation of thousands with support from activists around the globe. In April of 2001 the TAC was victorious when the PMA withdrew it's case.
Prologue: Early warnings.
AIDS Times
Star, 27 February 1992
5-m in SA may be HIV positive by the year 2000.
By 1992, accurate predictions of how the HIV/AIDS epidemic would develop, existed.
Citizen, 20 February 1992
200 000 Aids deaths by 2000: Sanlam
The Sanlam chairperson said, "To date, education is the only weapon against AIDS, what we do in the next two years will be decisive in our attempts to curb the epidemic."
Treating Aids to cost up to R10-bn ‘by 2000'
Business Day, 2 February 1992
AIDS expert quits SA unit in disgust
Unsurprisingly, the apartheid government's HIV/AIDS unit was in a crisis.
The Star, 29 June 1992
Sub-Saharan Africa has most Aids cases
By 1992 Sub-Saharan Africa had become the epicentre of the epidemic.
Citizen, 30 June 1992
HIV: 65pc of cases in Africa, says UN
Newsweek, 24 February 1992
North America 1 million
Western Europe 500, 000
Eastern Europe and former U.S.S.R. 20, 000
North Africa and Middle East 50, 000
South and South East Asia over 1 million
East Asia and Pacific 20, 000
Latin America 1 million
Sub-Saharan Africa over 6.5 million
Australia and New Zealand 30, 000
Source, World Health Organisation.
Sowetan, 3 December 1991
ANC fights to protect all the Aids victimsThe ANC makes a progressive start in the fight against HIV/AIDS.
The Argus, December 1991
ANC wants law to protect rights of those with Aids
The ANC called for non-discrimination in employment, medical aid and insurance.
Sunday Tribune, 30 August 1992
ANC, govt pact to fight AIDS
ANC participates in the National AIDS Convention of South Africa (NACOSA).
Election victory speech, May 1994
Nelson Mandela: In 1980s the African National Congress was still setting the pace, being the first major political formation in South Africa to commit itself firmly to a Bill of Rights, which we published in November 1990. These milestones give concrete expression to what South Africa can become. They speak of a constitutional, democratic, political order in which, regardless of colour, gender, religion, political opinion or sexual orientation, the law will provide for the equal protection of all citizens.
The victory of democracy in the 1994 election overshadowed even the AIDS crisis. The new ANC government faced enormous expectations and challenges.
In 1994 the democratic government adopts the National AIDS Convention of SA's National AIDS Plan for SA, covering prevention, care, support and human rights.
NACOSA South Africa united against AIDS
National AIDS plan for South Africa 1994-1995
Memorial
Lady: I'm lighting this candle in memory of my sisters son, David (...), who died last year of HIV/AIDS and was buried in Rustenberg.
AIDS Times
Sunday Times, March 1996
Too busy for all that fuss about R14m
A year after NACOSA's National AIDS Plan was adopted, the Sarafina 2 Debacle erupted.
Sowetan, March 1996
Sarafina 2 is not ‘forceful enough'
Remembering the success of Sarafina 1, Dr Zuma hoped for a quick fix for HIV/AIDS prevention.
The Star April 1996
Aids workers revise script in a damage control exercise
The Sunday Times, April 1996
Embattled Zuma gags AIDS staff
Business Day, March 1996
ANC votes to block probe into funding of Sarafina 2
Sowetan, March 1996
Mbeki in defence of Sarafina 2
No misuse of public funds and nothing else to hide.
Government reacted defensively when Sarafina 2's ineffective message costing R14 million was exposed.
Memorial
Busisiwe Maqungo: I light this candle in memory of my daughter Nomazizi, who died in 1999, January.
AIDS Times
Sunday Argus, March 1996
‘The cruel games of those who don't care should not be allowed to set the national agenda' - Thabo Mbeki
Then Deputy President, Thabo Mbeki, backs researchers who claim an industrial solvent, Virodene, can ‘cure AIDS'. It is the last time he shows interest in the medical treatment of HIV/AIDS.
Sunday Tribune, March 1996
‘I will not rest until the efficacy or otherwise of Virodene is established scientifically. If nothing else, all those infected by HIV/AIDS need to know as a matter of urgency. The cruel games of those who don't care should not be allowed to set the national agenda' - Deputy President Thabo Mbeki
The Bogus researchers obtained a hearing from Cabinet.
Sunday Argus, March 1996
Mbeki's dramatic stand on Virodene
Pressure was put on the Medicines Control Council (MCC) to approve clinical trials.
Sunday Tribune
Virodene uproar: Mbeki hits out.
Deputy President Thabo Mbeki has launched an unprecedented attack on the Medicines Control Council, (MCC), slamming its refusal to authorise clinical trails of the controversial anti-Aids drug Virodene.
When the MCC refused, Dr, Helen Rees was bought in as its new head.
Sunday Tribune, March 1996
Virodene 3 face music
The new MCC board also refused clinical trials as Virodene was clearly toxic.
Sunday Times, October 1998
Awareness is the only cure for the spread of AIDS
Government adopts ‘prevention is the only cure" policy - falsely separating prevention from treatment.
Sunday Times, October 1998
The Department of Health has decided against implementing the short-course AZT regimen
The Star, December 1998
Experts ask Zuma to rethink AZT decision
Mail & Guardian, February 1999
Tempers rising against Zuma
Dr. Zuma pulls Mother to Child Transmission Prevention (MTCTP) programmes.
PATIENT ABUSE
TAC's Struggle for Treatment Access.
Zackie Achmat: The government has been negligent when it comes to AIDS. The private sector has failed to stand, because as always its short minded interest is "Profit now, hopefully sometime later something will take this terrible thing away". Which is a head in the sand attitude. You mentioned earlier that it's an economic, political and social issue, but that was said in the declaration on Mozambique in 1987. The ANC had a conference, whilst it was still underground, with PPHC and everyone, and there was a declaration that came out there which explained everything. Everybody is now getting excited over the studies by Quarraisha and Slim Karim. They're good epidemiologists and they talk about migrant labour and so on, but we new those things way back then. So the question is we've not investigated those things, as Quarraisha and Slim are doing now. Those are things that should have been done 10 years ago.
AIDS Times
Simon Nkoli dies, November 1998
Zackie Achmat: Now we can't still loose any more time, we still have to do it.
Simon Nkoli: And I say to them, Viva Glow Viva.
Simon Nkoli's memorial
Priest: We are grateful to god for Simon. For his particular witness, and the way that he was able, certainly in Gauteng, to raise the awareness within the black community of the needs of lesbians and gays and transgendered persons.
St. Mary's Cathedral
Simon Nkoli Memorial Service
Gauteng 4 December 1998
Zackie Achmat: We ask Comrade Terror to take back the message, as Simon would have asked him to do. We are not asking for everything, we recognise that the government has a problem with resources, but we ask you one thing. Join our hands to fight the drug companies, join our hands to raise money from the private sector, join our hand in raising money from each of us who will contribute to save the lives of everyone who needs to be saved. Don't speak to us of a partnership of care and compassion, talk to us about a partnership that will save lives. Simon would have carried this message forward and we say to everyone here today cry, rage, but as comrade Terror would have said in his young days, mobilise, don't only mourn.
Simon Nkoli Memorial Service
St. Georges Cathedral, Cape Town
8 December 1998
Zackie Achmat: In this last issue of Exit there is an interview with Simon, and in that interview he says "We need action". You can read his desperation as he's dying, you can feel it in the article.
ARTICLE: Simon believes in action. Not soft focus action like support groups.
ARTICLE: He is pissed off with the Department of Health.
Zackie Achmat: He says we need action not support groups, but we need action. Now that's perhaps just a little bit of an exaggeration of Simon, we do need support groups, there are many, many people who are very lonely, we do need the action too.
ARTICLE: He is thinking about a hunger strike on the floors of the fucked up Department.
Zackie Achmat: And Simon said we want to go on a hunger strike in the offices of the Department of Health. In discussions with Peter Bussey of the National Association of People Living with HIV/AIDS, we appeal on the behalf of NAPWA for the formation of a Treatment Action Campaign.
It's first demand is for the right of pregnant mothers living with HIV to have AZT. We are asking ten people, on Thursday, to fast with us on the steps of St Georges Cathedral, from seven o'clock in the morning to seven o'clock in the evening.
AIDS TIMES
Gugu Dlamini murdered, December 1998.
Newsreader: Despite massive HIV/AIDS awareness campaigns about breaking the silence many people still choose to keep their HIV/AIDS status a secret. Gugu Dlamini was murdered after revealing her HIV/AIDS status.
Reporter: A women slain for telling the country that she was HIV positive. Gugu Dlamini was stoned to death in KwaMashu, north of Durban.
Gugu's death inspired the first ‘HIV Positive" T-shirts which became TAC's defiant symbol of openness. TAC activists modelled their HIV Positive Gugu Dlamini T-shirts for the first time at the opening of Parliament 5 February 1999. 50 000 T-shirts have since been distributed.
AIDS Times
Cape Times, February 1999
Patient's charter on cards
Government remains opposed to saving the lives of half the 60 000 babies born with HIV each ye
ar.
Dlamini-Zuma quashed hopes that the government would provide AIDS drugs to pregnant women who were HIV-positive. "It would cost about R80m, which is our whole budget for AIDS. It would be foolish to take money out of (AIDS) prevention work for this treatment.
Government refused to use a short course AZT on grounds of cost.
Cape Times, February 1999
Province to go it alone with AZT programme.
While Dr Zuma pulled MTCTP pilots around the country, the Western Cape decided to go it alone.
Cape Times, February 1999
Cape will give pregnant women AZT
The Khayelitsha MTCTP project was initiated by the ANC's Ebrahim Rasool.
World AIDS day 1999
Adeline Mangcu: The only person I am proud to say, or very ashamed to say, which ever way you put it, that got infected through me was my baby, who died in 1995. Think about this, 160 babies are born HIV positive everyday and the government is saying "No to AZT."
AIDS Times
Cape Argus, 19 February 1999.
AZT really works - Study
AIDS drug also tested in Western Cape, with results out soon.
Whilst government was saying "No to AZT", all informed medical opinion celebrated the use of AZT in MTCT prevention as a major breakthrough in the control of HIV.
Cape Argus, February 1999
AZT plan hopes to halve HIV rates in babies.
Memorial
TAC member: [She died in 1998 when she was 8 years old. Her death hurt me a lot because we used to talk and share things.]
21 March 1999
Chris Hani Baragwanath Hospital
MTCT prevention protest
Glenda Grey: Today three children will be born inside this hospital with HIV, yesterday three were, tomorrow three will, the next day three will. 4 000 children are born to HIV infected women each year in this hospital. It must stop, there is a vaccine, there's a vaccine for children. The vaccine is called AZT for children, we want AZT for children because that's the vaccine. There is a cure for children, it's called AZT.
Crowd: Viva.
Zackie Achmat: As a person living with HIV I ask everyone here to join us, to lie down, to show the government our friends have died, but we are not going to die!
25 March 1999. A TAC delegation is invited to ‘gatecrash' Dr Nkosazana Zuma's reception for the parliamentary Health Portfolio Committee at Tuynhuis. Dr Zuma embraces the TAC delegation and offers to lead a march against high cost of medicine. A follow-up meeting is scheduled.
Zackie Achmat: And then you are leading our march on the 16th.
Nkosazana Zuma: Well, 16th June, I might not be a minister. What are you marching against.
Zackie Achmat: We are marching for the reduction of prices of all drugs, but specifically AZT.
Nkosazana Zuma: I'll lead that march.
Just before the elections, on 30 April 1999, a TAC delegation meets Dr Nkosazana Zuma at Groote Schuur. A spirit of optimism prevailed about treatment of HIV. The only obstacle was the cost of the drugs.
Nkosazana Zuma: It went very well, it was a very good meeting, very therapeutic.
Greg Hussey: My name's Greg Hussey, I work at the childrens hospital in Cape Town. I'm involved with the Khayelitsha Mother to Child Transmission programme and generally involved with HIV work within the hospital and the community.
Reporter: And what was your role in the meeting?
Greg Hussey: I was just here as a supporter for the Treatment Action Campaign, to provide some technical backup for them.
Reporter: How do you think the meeting...
Greg Hussey: Very positive, but I'm not going to talk to you about it (laughs).
Zackie Achmat: He was a closet queen.
Voice: Who was a closet queen?
Zackie Achmat: Cecil John Rhodes.
Reporter: I heard that things went very well.
Zackie Achmat: Things went very well and we have agreed that, what have we agreed? We've agreed that AZT, well, affordable health and treatment is a basic human right. We've agreed that the next meeting will take place mid-June, within six weeks. And that AZT for pregnant mothers and other drug treatments are absolutely essential and it is the responsibility of business, labour, civil society, government, religious organisations to ensure that the drug companies lower their price.
The "next meeting" never happened.
Memorial
Man: I would like to light this candle for all gay and lesbian who have died of HIV and AIDS and Simon Nkoli who died of HIV and AIDS. Thank you.
AIDS Times
April 1999
Edwin Cameron: Today I've chosen to disclose before the judicial service commission that I am living with AIDS. I've spoken, out even though legally and ethically I'm entitled to remain silent, because of talk in the legal community about my health condition, which it seems best to deal with frontally. The choice to speak is available to me for very particular reasons. First, because I have a job position that is secure. Second, because I am surrounded by loved ones, friends and family and colleagues who support me and thirdly, because I have access to medical care and treatment that ensures that I remain healthy strong and productive. For millions of South Africans living with HIV and AIDS these conditions do not exist. They have no jobs or their jobs would be at risk if they spoke about their HIV.
Supreme Court of Appeal Justice Edwin Cameron becomes the first person in a high profile position to disclose their HIV status.
Top judge with Aids speaks out.
Top judge discloses he has Aids.
How top judge revealed is AIDS plight to court president.
Zackie Achmat: Tonight in Southern Africa at least 300 people will die because they cannot afford this. This is a drug called Diflucan. It is a drug that stops people who have thrush, people who have cryptococcal meningitis, people who have a range of illnesses from dying. And this little bottle will cost you R500. Drug companies are trying to twist our governments arm, to stop them from providing good health care and quality health care for all, and also accessible treatment for people who have AIDS. I have learnt, via a friend of mine, that Peter Marais, who proudly proclaims that he is hitting Dr Zuma with AZT for pregnant mothers, has asked can they start providing this drug for people with AIDS in the Cape. In conclusion I would like to say that, unless the Communist Party, who has an understanding of imperialism, leads COSATU and leads the ANC in a battle on AIDS, we will face what Engels called socialism or barbarism. We will face the question of barbarism in our society, with a vision of a landscape that is devastated. Lastly I would like to say, if the Communist Party does that I would be happy to join.
AIDS Times
Cape Times, May 1999
Aids activist seeks openness
Aids activist Zackie Achmat says he will not take costly drugs that could save his life unless they are available to all South Africans.
Zackie Achmat: The reason I won't take treatment is because the vast majority of people with HIV and AIDS in our country earn less than R600 a month, they cannot afford the treatment.
AIDS Times
June 1999
Beat It! The first ever magazine show for people living with HIV/AIDS
Mercy Makhalemele: Welcome to your first Beat It! programme.
Sipho Nhlapo: Siyanamukela ehlweleni lokuqala iBeat It! phecelezi yinqobe. {isiZulu} [Welcome to the first episode of Beat It! - just beat it.]
Mercy Makhalemele: Yinqobe yihlwelo lami nawe kuze sazi ukuziphilisa ngengciwane lengculaza. {isiZulu} [Beat It! is our guide to better living with HIV and AIDS.]
Sipho Nhlapo: Beat It! is your guide to better living with HIV/AIDS.
AIDS Times
June 1999
The ANC wins general election. Thabo Mbeki inaugurated as President.
Dr Manto Tshabalala-Msimang appointed as national Minister of Health.
5 July 1999. TAC protest US placing SA on sanctions watchlist for Medicines Act challenging patent profiteering.
Group: These are the reasons that I pledge to support the Treatment Action Campaign. I am scared and fear tomorrow, because my friends, my family members, my school mates and colleagues and even I have HIV and AIDS. I do not have enough knowledge about treatment and care, I want to learn more. I care about my life and the lives of my friends. I'm angry millions of people have HIV/AIDS and they will die for no reason, due to the fact that treatment costs are too high.
500 TAC demonstrators outside the US Consulate in Johannesburg.
May 1999
Gore told to ease up on anti-SA drugs war
Cheap medicines ‘vital'
1 August 1999. TAC interfaith service at St. George's Cathedral, Cape Town.
Zackie Achmat: The minister says to us in her message that until the stigma has gone away, we will not be able to treat people. We say "No, unless the government provides treatment, the stigma will not go away", because people will believe that it is evil spirits. So we say to comrade Dr Manto Tshabalala, we will work with you, but it is important that the message you sent us reflects the current scientific, medical and ethical questions. The last question is, in that mesasage there was a word "Prevention is the only cure." That is also an old myth, let us go out and be open, let us go out and say to everyone out there that AIDS can be treated like sugar diabetes, that AIDS can be treated like asthma, and the only reason we are dying is because we are poor. The only reason we are dying is because we are poor.
22 September 1999. TAC protests outside the Pharmaceutical Manufacturers' Association (PMA) offices in Johannesburg.
Mazibuko Jara: They are making the drugs inaccessible to us. We are here today to say, we are the people, we are living with problems, we are living with AIDS and you are the drug companies that produce these drugs. Work with us in order to deal with HIV/AIDS. Not oppose our government and take our government to court when our government wants to meet our public health needs.
Zackie Achmat: Comrades, this is the beginning, this is the beginning of struggles throughout Africa, to ensure that we get drugs. We call on the PMA to announce the sale of AZT to the government at R180 for a one month course for a pregnant women or rape survivor, now! R180 now! To publish the real production costs now and legitimate research and development costs of drugs. They spend more on Viagra than they spend on our health.
Ben Plumley (Glaxo SmithKline): You also ask us to reveal our manufacturing costs, now I have to be upfront with you today, I say, right now, right here, we can't do that.
Memorial
TAC member: I would like to light this candle on behalf of Nolutando Boklela, my homegirl and my friend.
AIDS Times
Cape Argus, 29 October 1999
Mbeki raises fears on AZT - and doubts on its benefits
President Mbeki intensifies his campaign against AZT.
Government objection to antiretrovirals shifts from cost to efficacy and toxicity.
5 February 2000. TAC supporters protest government stance on MTCT-prevention at the opening of parliament.
Sunday Tribune, March 2000
Dissent over AIDS cause
10 May 2000. TAC and the pharmaceutical industry give evidence before the Parliamentary Health Portfolio Committee.
Vicky Ehrich (Glaxo SmithKline): Nowhere in the tender to they ask for the costs of medicine. There is nowhere where we have to provide costs and yet the state buys affordably. So I am interested to know why the cost in this one particular drug is the anchor to the whole question. Because I think what we really need to be doing is sitting down and saying is just intervention affordable. The British Medical Journal has shown it to be totally affordable and cost effective and to really examine those factors, as opposed to blocking the process and demanding costs which are commercially sensitive information and I think people well know that Pharmaceutical companies are not going to expose their costs.
Zackie Achmat: We ask these drug companies to reduce their prices. Of course the drug which we really want also to be reduced is AZT and let us be clear about AZT. AZT was not invented by Glaxo Wellcom. In the early years of clinical trails, when the US government gave it to Glaxo Wellcom to develop, people with HIV could not even enter Glaxo premises because they were scared to handle us. They thought that they might catch HIV if we entered their premises.
Christopher Moraka: {IsiXhosa} [I'm HIV positive. I was diagnosed in 1996. In 1999 Pfizer made R6.5. Billion profit. We ask them to lower the price of drugs because we HIV positive people suffer the most. Other people don't feel this pain. They want to make profit, you see.]
Business Day, May 2000
Presidential AIDS panel appointed
Consensus seems unlikely as representation of views is ‘skewed' in favour of dissidents
The Presidential AIDS Advisory Panel re-opened a debate on the link between HIV and AIDS, first put forward in the 1980s by professor Peter Deusberg. It was hard to avoid the conclusion that the President was driven by fear of the cost of using antiretroviral medication. The debate was merely a smoke-screen to avoid providing treatment for people living with AIDS.
Thabo Mbeki: What happened between ‘85 and the beginning of the 90s. Whereas the situation did not change in the United States, up to today. It didn't change in Western Europe with regards to homosexual transmission, but here it changed. Changed very radically in a short period of time and increased very radically in a short period of time. Why? We started communicating with some of the people in this room, to ask "What is the cause?".
Felicia
Felicia: How did you get it do you think?
Josias Ramela (not on ARVs): I used to go in taverns, so even now I couldn't know who gave it to me.
Felicia: So it was through sex?
Josias Ramela: Because I slept with so many women in the taverns. I used to drink and do all these things.
Deon van Tonder (on ARVs): I was diagnosed with AIDS six years ago, I had full blown AIDS the end of last year and with the treatment I'm on I have just gone back to having the HI Virus.
Sometimes cost was presented as the main problem of access to antiretroviral therapy...
Manto Tshabalala-Msimang: I believe that many would agree that, everything else aside, the use of antiretroviral triple therapy is completely unaffordable in our context.
...while people with HIV continued to call for greater treatment access.
Flora Thobela: We are asking for medication, to get access to medication. We understand that it is expensive, but if it is something that can make us live longer, then the government should make it a point that we do get these medications
The real problems of infrastructure allowed the government to mask their unwillingness to address the treatment needs of people with HIV.
Felicia: Drugs like AZT have helped in America and maybe South Africa should also consider them. I know many would say that they are very expensive, your views on that, on the drugs?
Dr Nono Simelela (Director National HIV/STD Directorate): Yes they are expensive, but they should also be taken into context, they are not going to remove the virus from the system. It is just going, perhaps, to decrease the viral load, to make them feel better. But the management is not only therapeutic interventions, it's a total picture of the infrastructure you have to put in place to enable people to access those drugs in the first place. So that is why we are saying it is not only about giving one drug to one person or 20 people, it's about creating the correct environment. We still have issues of stigma, we still have issues of discrimination, so if somebody gets that drug and is in a family that does not understand or does not accept, that person will not be able to access or take that drug, if that environment is not right.
Beat It! Special Report
Funeral of Christopher Moraka, 6 August 2000
Narrator: Christopher Moraka died on the 27 July this year. His funeral took place in Nyanga on the 6 August. Those present vowed to remember him for his courageous spirit in the fight against HIV and AIDS.
Busisiwe Maqungo: Bendingathethi ukuba zidubule, xa unalo ke ithemba, awunakuzenza zonke ezo zinto, kodwa ukuba uligwala, uyakuzenza. {IsiXhosa} [If you have HIV it does not mean you should kill yourself. When you have hope. You won't do any of those things. But if you're a coward you will do these things.]
Mkhanyiseli Mpalali: U taChris, ebefana okanye ebeyintsika kuthi, kwi-branch okanye isabela senyanga nombutho i-Treatment Action Campaign, ngoba endleleni kwizinto ezininzi, u taChris besomeleza. {IsiXhosa} [Chris was a pillar to us in Nyanga Branch and the Treatment Action Campaign, because on our way forward, in many aspects, Chris strengthened us.]
Narrator: We went to visit Chris and his partner Nontsikelelo a few weeks before his death
Mercy Makhalemele: Uzizwa njani khona manje bhut'Chris? {IsiZulu} [How do you feel now brother Chris?]
Mercy Makhalemele: Kubuhlungu kuphi, kwenzakalani emzimbeni wakho? {IsiZulu} [Where is the pain or where does it hurt, what's happening in your body?]
Narrator: At the time of our visit he could not really say much and he was in need of medication for treating oral thrush.
Christopher Moraka: Akusuba xa u-HIV kumandi, akumnandanga tu. {isiXhosa} [It's not as if when you are HIV is pleasant, it's not pleasant at all, it's not a joyride.]
Christopher Moraka: Uyazazi ukuba mhh. {isiXhosa} [You know that you are going.]
Narrator: Had Christopher had access to better HIV treatment, he may have lived.
AIDS Times
Cape Times, November 2000
Deaths feed anger over AIDS policy
Zackie Achmat: We who have HIV cannot afford to die in silence whilst our disease is being denied a name. There can be no dignity in that. There can be absolutely no dignity in dying if your President will not acknowledge your disease.
Zackie Achmat: All we want you to say is... we know that in the past you said "HIV causes AIDS". All we want you to say is "Yes, it does cause AIDS". So go away now all the journalists.
Manto Tshabalala-Msimang: For all the journalists I repeat again, I have never said AIDS, HIV does not cause AIDS. I have never said so, neither has the President said so. All that we are looking for is a comprehensive response.
Zackie Achmat: If you're worried about Nevirapine then implement AZT, because the price has come down from R480 a short course to R280 a short course. And in the interim, while you are waiting, implement AZT.
Memorial
Tumi Modisa: This is Tumi Modisa from NACTU. I'm lighting this candle for my sister who died in 2000 and was buried on the 31st of December.
MSF-TAC Satellite Treatment Conference, 9 July 2000, Durban.
TAC member: Please take your seats, the court is in session.
Edwin Cameron: I'm here, I am able to be talking to you, I'm able to engage with you, I'm able to speak with you about this important topic because I'm on antiretroviral therapy. People throughout Africa, 25 million people in Africa and 34 million people in our whole world, who are this moment dying. And they are dying because they don't have the privilege that I have of purchasing my health.
Dr Peter Mugenyi (Ugandan HIV/AIDS Clinician): Where are the drugs? That's where they are, the drugs are where the disease is not. And where is the disease? The disease is where the drugs are not. This is commercial interests above commercial suffering.
Before the Durban 2000 International AIDS conference, 5 000 people join the TAC-Health Global Access Project march for treatment access.
Winnie Madikizela-Mandela: Amandla. In South Africa 4.2 million, 20% of the population have HIV. There are 1600 new infections every day and over 100 000 people are dying every year. It is predicted that one in every three 15 year olds will contract HIV/AIDS. The majority of these people are poor and black. This is a social holocaust. Let me start by asserting what appears to have become less obvious in South Africa in the last few months, AIDS exists. HIV causes AIDS.
Mark Heywood: Our march today, demanding better access to treatment, is the most broad based in the 20 year history of the HIV epidemic. We bring before you thousands of people from many different countries and perspectives. On our march today are thousands of people living with HIV and AIDS, our friends and families. We call on the South African government to immediately implement a countrywide programme to reduce the risk of mother to child transmission of HIV.
Manto Tshabalala-Msimang: I accept this petition with a great sense of humility.I want you to remember that only six years ago I myself was a political activist and therefore I admire and support what you are doing. I admire you activism, I admire you courage and I admire your persistence, and therefore I thank you for this much.
Third International AIDS Conference, Durban 2000
The Durban 2000 International AIDS Conference opened with wild extravagance that insulted poor people who have been told that there is no money for their treatment.
MC: Welcome to the 13th International World AIDS Conference. Exploring the issues, confronting challenges, seeking solutions, leading the way, breaking the silence that surrounds AIDS and HIV.
Thabo Mbeki: I came to the conclusion that as Africans we are confronted by a health crisis of enormous proportions. One of the consequences of this crisis is the deeply disturbing phenomenon of the collapse of immune systems amongst millions of our people. Such that their bodies have no natural defence against attack by many viruses and bacteria. As I listened and heard the whole story told about our own country it seemed to me that you could not blame everything on a single virus.
Jonathan Mann Memorial Lecture, XIII International AIDS Conference.
Edwin Cameron: I personally yearned for an unequivocal assertion by our President that HIV, as a viral specific condition, a specific condition that is sexually transmitted. A viral specific condition that is sexually transmitted, that if uncontained precipitates on its own, debility and death. And for which now antiretroviral therapy exists that can effectively and affordably be applied. To my grief and consternation, the Presidents speech was bereft of any of this.
Dr Hermann Reuter questions the Minister of Health at the Durban 2000 International AIDS Conference
Hermann Reuter: My name is Hermann Reuter, I am from South Africa, working in Khayelitsha, the only clinic in South Africa where the government, from a provincial budget, funds a mother to child transmission programme in which last year 800 women received AZT. I want to ask the Minister, she was speaking about building partnerships. She set out the principles that one needs for building partnerships. I think she left out that one needs a programme around which a partnership can be built. I want to ask her how she, from the Ministry of Health, is going to lead this partnership to lead a national programme on mother to child transmission. Is she going to question science, or is she going to implement the programme. Thank you.
11 July 2000. TAC press conference launches the Christopher Moraka Defiance Campaign.
Zackie Achmat: We are announcing our intention to begin a defiance campaign to bring Fluconazole and other generic medicines into the country at the earliest possible opportunity. None of us here have the intention of breaking the law and we don't believe that we will be breaking the law. What we will be doing is breaking Pfizer's patent, we will be showing that Pfizer and other companies are abusing their patent. We have no criminal intention, our only intention is to defend people's lives. Here I have in front of me a box of Fluconazole that would cost R200, but if you bought it from a South African chemist it would cost you R4 000. There is no doubt that we will bring large amounts and large quantities of this into the country to ensure that people have access to good quality and safe generics. We won't stop doing in until our government and the drug companies have bought the prices of all essential medicines down.
19 October 2000
Leon Geffen: We don't have an ethical responsibility to Pfizer or any of the other multinational countries that produce these drugs. My ethical responsibility, I have never known that medical ethics is subjugated to the laws of patents.
TAC goes to Thailand
Dr Kraisintu reveals the cost of manufacturing a capsule of fluconazole.
Krisana Kraisintu PhD (Chem) (Head of Research & Development Institute, Government Pharmaceutical Organisation (GPO): You know that the cost of manufacturing and the cost of raw material of one capsule of fluconazole is only four Bahts (sixty six cents), only four Bahts per capsule I'm talking about two hundred and eighty seven Bahts initially of the price. So if we are selling at six Bahts (one rand). Profit two Bahts (thirty three cents) per capsule; that's a lot.
Manufacturing of generic fluconazole (Biozole), in Thailand.
Rachod Thakolsri (Managing Director, Biolab Bangkok): I believe that for every country generic products are a very necessary, is a fundamental for all pharmaceutical markets. Without generics, many people would have to pay a very high cost for their healthcare, which is really not necessary. With a consistent quality control and with good management with production I believe that generic products can produce high quality products just as well as original products.
Zackie Achmat: Biozole, this will fit properly into the bottom of a suitcase.
Krisana Kraisintu: Of course you are doing things against multinational companies, especially very, very powerful multinational companies. You are talking about one to five brands in the world. So that... who you are fighting with, this is very, very important.
AIDS Times
The Star, 18 December 2000
HIV drug costs R1, 78 abroad, R124 in SA.
Cape Argus, October 2000
Activists smuggle in HIV drug
Business Day, October 2000
Cheap AIDS drug shipped in defiance
Morning Live, 13 October 2000
Newsreader: "A dangerous precedent and in defiance of the rule of law". This is how a drug company and the Minister of Health have variously described the illegal importation of the Treatment Action Campaign of the generic anti-AIDS drug, fluconazole, known as Biozole.
Newsreader 2: Zackie, this has sparked quite a bit of emotional debate, what has transpired over the past few days, but at the end of the day you are defying international patent laws, the international law states, quite clearly, that generic drugs can only be manufactured once the patent has expired and fluconazole as we know, still, will only expire next year.
Zackie Achmat: Tracey, as you are aware and Vuyo is aware, in the 31st, on about the 2nd of April, 3rd of April this year, I was a guest in your studio, and we'd come there and Pfizer, the company that owns the patent had promised a donation of Fluconazole to our government. We have not seen a single pill in our hospitals yet.
3rd Degree
Zackie Achmat: AZT, DDI, D14. Were those drugs discovered by the pharmaceutical companies that have the patent on them? Were they extensively developed by those companies? Or were they developed, as in fact I can prove and we can all prove here, that they were originated, developed and researched with public funding of universities in the United States and the National Institute for Health?
Mirryena Deeb: If one looks at the bulk of medicines bought to the...
Zackie Achmat: Sorry, we are not talking about the bulk of medicines, let's talk about those 3, specifics.
Mirryena Deeb: Let's talk about those ones. I don't know the specifically the history of each and every one of them...
Zackie Achmat: Why not? You are the CEO...
Mirryena Deeb: ...but. The issue really is that sometimes... The issue is who brings the product to the market.
e-NEWS
Helen Rees (Medicines Control Council): The problem with what the TAC has done is they have broken an absolutely fundamental piece of legislation that ensures the safety of medicines in this country, and that's unacceptable.
19 October 2000
Zackie Achmat: We are not prepared to give up these medicines, we will ensure that they are distributed clinically and properly prescribed by doctors. We will not allow you, your department or the government. I can't understand the sudden urgency when it comes to threatening companies profits when peoples lives are in danger you don't show the same urgency. So let me make that clear to you, I'm not going to have you dictate time to me.
Cameraman: Who was that Zackie?
Zackie Achmat: That was somebody from the Department of Health, trying to seize our medicines.
AIDS Times
9 December 2000
Funeral of TAC member Queenie Qiza, Gugulethu
Business Day, January 2000
SA actor brings AIDS drugs from Malaysia
13 January 2001. Actor Morné Visser arrives with another consignment of Biozole (generic Fluconazole).
Memorial
TAC member: I would like to light this candle for (...) a shop steward from SACTU and a comrade of us, who died in the Western Cape and is originally from Oudtshoorn. Thank you.
Anneke Meerkotter: We insist that we have the moral high ground and that what we are doing is not illegal. It's right what we did. We are not going to apologise for what we did, we will do it again and again and again until everyone gets access to treatment.
From a handful of people on the steps of St. George's Cathedral in December 1998, TAC has built a cadre of treatment activists.
TAC Member: I want to know why Pfizer company is the only company that is allowed to sell this Fluconazole in South Africa, because in business there is always competition.
Mandla Majola: We have done our ground work. Now we are not an unknown organisation, we are a well know organisation. And the government knows us, the government is aware about our intent. The government is feeling the pressure comrade, the drug companies are feeling the pressure comrade, everybody is feeling the pressure comrade. I'm also feeling the pressure right now.
They are determined to comprehensive HIV/AIDS treatment in the public sector and to make treatment affordable to all.
AIDS Times
21 March 2001
Funeral of TAC member Zonwabele Norman Tisana, in Paarl.
Mkhanyiseli Mpalali: We want this service to take place in parliament, so that the South African government can see how serious this is, and for the Minister of Health, Manto Tshabalala-Msimang, can see how many people are dying. It is because all the MPs appear not to care.
Sindiswa Godwana: I am a volunteer of the Treatment Action Campaign. We like our government very much and we are very much prepared to work hand in hand. We have a right to tell our government when things go wrong.
2 February 2001
Nkosi Johnson Solidarity March to Parliament
TAC calls on the government to develop a treatment plan for people with HIV/AIDS by 16 June 2001.
Zackie Achmat: We are here to ask President Mbeki, to ask Alec Irwin, to ask the Minister of Finance, to ask the Minister of Health to develop a treatment plan for people with HIV by the 16 June this year
AIDS Times
Cape Times, March 2001
Drugs battle begins
Pharmaceutical industry accused of ‘profteering'
Business Day, March 2001
Court drugs battle echoes on streets
4 March
COSATU-TAC vigil outside Pretoria High Court
COSATU commits itself body and soul to the struggle for treatment access.
Willie Madisha: I think that the first thing should be an apology, that 400 000 people who were supposed to be here are not here. And I think that should be known through and though as we go on with this particular action. And these people are not here because they have died, basically because of what the pharmaceutical companies have succeeded to do.
AIDS Times
E-news, March 2001
Newsreader: The legal battle in Pretoria's High Court has attracted attention from activists around the world because of its potential far reaching consequences for AIDS prevention. The pharmaceutical industry argues that the 1997 Medicines and Related Substances Control Amendment Act is unlawful.
Morning live, 6 March 2001
Zackie Achmat: There are three keys aspects of this law that stand
The Medicines and Related Substances Control Amendment Act of 1997 allows for:
Substituting generic medicines for off-patent branded medicines.
Zackie Achmat: The first is; the government has said it is necessary to substitute generic medicines for branded medicines, once those medicines are off-patent. Now that is done in the United States, it is done in Germany, it's done in many other countries and it's regarded as completely legal. And of course it looses the drug companies millions of Rands, but it allows people access to cheaper medicines.
Transparent pricing mechanism
Zackie Achmat: The second legal issue that they are fighting is a transparent pricing mechanism. You know the often quoted mantra of the drug companies is that they need to recoup their research and development costs, so the government has said, ‘let's have a transparent pricing mechanism, so that we understand how you arrive at your prices'. They are fighting that tooth and nail.
Importation of cheaper branded medicines from other countries (Section 15C of the Act)
Zackie Achmat: And the last issue of course, is Section 15C, which is about measures to make medicines more affordable, particularly parallel importation, which is bringing in medicines made by the same companies, sold at a much lower price, the exact same medicine from another country.
5 March 2001. 5 000 people march in support of the government in the court case.
AIDS Times
Cape Times, March 2001
Save our patients. Save our patents.
Willie Madisha: Dear President Bush. Today, the 1st March 2001 is an important day in the recent history of South Africa and for all people in developing countries. The court case in the Pretoria High Court will decide whether the South African government has the power to protect the health, dignity and lives of its people, or whether unelected faceless corporations have the right to profiteer from medicines.
Zwelinzima Vavi (General secretary COSATU): Amandla, Amandla. Those brothers from the US embassy are refusing to come here. They are treating the people living with HIV and AIDS with contempt. They are treating all of us with contempt.
Mark Heywood: As comrades know, the Treatment Action Campaign, which is made up of all the organisations here, has applied to the court to be called what is called a friend of the court. So that we can speak to the judge about the needs of the people who have HIV and so that we can give the voice of poor people in South Africa and try to add to the argument of the government.
Reporter: How do you feel about the case coming up today?
Manto Tshabalala-Msimang: We are confident that we will win the case, we are confident.
Reporter: And how do you feel about the support of thousand of people, who are going to protest as well today?
Manto Tshabalala-Msimang: I think it is because everybody realises that the government is correct. We must make sure that there is accessibility and affordability of drugs in our country. Thank you.
Mirryena Deeb: I listened to you on BBC last night, you are ahead of me. But you said something that surprised me, that you respect intellectual property rights? What happened?
Zackie Achmat: Of course we do, we don't respect greed, we don't respect greed.
AIDS Times
Morning Live, 6 March 2001
Newsreader: It may be a legal battle in Pretoria, but in the United States the battle is for American public opinion. Braving freezing temperatures New Yorkers turned out in their hundreds to show solidarity for the Medicines Act. Protesters marched on two head offices to call for the end of legal action.
Mark Milano: Glaxo SmithKline is right here on Park Avenue, so we are standing right here in solidarity, here in America, to say these companies, who are based largely in America, are killing people in Africa.
ANC stalwart Fatima Meer addresses UDW students marching for treatment access.
After hearing arguments for two days, the court was adjourned for six weeks.
Memorial
Lady: I would like to light this candle on behalf of the patients who died within the six months after they have closed the clinic in Hillbrow, 150 patients.
AIDS Times
SABC 3, 4 April 2001
Newsreader: The cabinet has received an interim report from the Presidential Advisory Panel, which confirms that HIV causes AIDS. The panel, which consists of various scientists, was set up by Thabo Mbeki after the controversy surrounding the issue of whether or not HIV causes AIDS.
18-19 March 2001
TAC National Conference, Soweto
Mark Heywood: In this room today we have one purpose, and that is to build a coalition to achieve access to quality and affordable treatment for people with HIV and AIDS and transform and improve our health service for the benefit of every person in South Africa. 169 different organisations have registered for the next two and a half days of debate and discussion, at this first National Conference of the TAC.
Promise Mthembu: We are saying antiretrovirals are not cosmetic drugs, they are drugs that save our lives. [We know you are here to make profit. You can go to the United States and England to make money from antiretrovirals, but you can't do it here in SA. Minister Erwin, apply parallel importation of generic drugs, because countries like Brazil do. We say to our government, don't be intimidated by trade laws, causing you to forget the rights of positive people. Do not take those laws at the expense of SA people.]
Willie Madisha: The TAC has succeeded to raise public awareness around the prevention of mother to child transmission. TAC's persistence and relentless struggle is beginning to bear some fruit.
AIDS Times
CNN, 20 April 2001
Newsreader: Campaigners are celebrating in South Africa after a coalition of the worlds top pharmaceutical companies withdrew a legal action to protect their drug patents. The landmark decision allows South Africa to in-act laws to broaden access to cheaper generic medicines for millions of AIDS sufferers.
Mail & Guardian, March 2000
Drug companies rocked
Business Day, 19 April 2001
Drug multinationals retreat
The retreat by the drug multinationals from their court battle with the government was believed to have been brokered by Kofi Annan, the United Nations secretary-general, a legal source said yesterday.
CNN
Mark Heywood: This case has been going on for three years, it finished in three seconds, it clearly finished simply because of public pressure and international mobilisation.
CNN, Q&A with Riz Khan
Talking point: are cheaper drugs the simple answer to the AIDS crisis?
Riz Khan: What are your expectations for getting these essential drugs to people in South Africa at a realistic price? What kind of time scale do you think is involved now?
Zackie Achmat: Well, let's look at the first thing, we have asked our government to give us a treatment plan by the 16 June. There is no question that our trade union movement, our religious organisations, everyone who has help with the campaign against the drug companies, we are now ready and focusing our weight on getting such a treatment plan. We believe that, given this year, by World AIDS Day, we would like to celebrate having a clear plan in place.
Memorial
Nontsikelelo Zwedala: I light this candle for Christopher Moraka, who was my partner and died last year.
AIDS Times
Cape Times, 20 April 2001
SA victory clears way for other countries
Cape Times, 20 April 2001
No cheap AIDS drugs for SA
Victory over pharmaceutical companies has created ‘false impression'
The minister dampens the victory spirit, stressing that antiretrovirals won't be made available.
CNN, Q&A with Riz Khan
Talking point: are cheaper drugs the simple answer to the AIDS crisis?
Zackie Achmat: The value of life in our country has been so diminished under apartheid, the value of life in our transition, because of the crime rate, has been diminished. If our government takes the moral leadership now, and deals with the issue, we will restore faith in people of the value of human life and we ask everyone in the world to help us do that. Help us, assist our government to make it a reality, not only for South Africa but for the whole of Africa and the developing world. Thanks to everyone who has helped us to make this court case a victory, because it's a victory
for all people in the world.
The TAC Pledge
I am scared and I fear tomorrow,
because my friends, my family members,
my school mates and colleagues,
and even I may have HIV/AIDS.
I do not have enough knowledge
about treatment an care.
I want to learn more.
I care about my life and the lives of my friends.
I am angry.
Millions of people have HIV/AIDS
and they will die for no reason
other than the fact that treatment costs are too high.
I will use my anger, fear,
Knowledge, emotions and care
To win affordable treatment and
Care for people with HIV/AIDS.
People with HIV/AIDS have
A right to equality, dignity and privacy.
I respect the confidentiality of
Every individual with HIV/AIDS.
Everywhere I will encourage
Openness about HIV/AIDS.
I might not be ready to tell
That I have or don't have HIV.
I will tell them when I am ready.
I pledge time, energy, courage
And other resources to build
The Treatment Action Campaign
And to struggle for access to
Affordable and quality
Health care for all.
This I pledge for myself and my future.
TAC Does not accept money from government or drug companies.
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