AIDS epidemic is no election issue

We are all the losers as political parties cynically exploit HIV/AIDS to win votes. Kerry Cullinan reports.

Election time is always the silly season of politics, when promises more extravagant than drunken New Year’€™s resolutions are brandished as vote-catchers.

Yet this election campaign ‘€“ which has been going barely a week — already shows signs of slipping beyond empty promises and entering the realm of extreme cynicism as parties jostle to manipulate the HIV/AIDS epidemic to their “advantage”.

There is something rather vulture-like in the African National Congress’€™s Smuts Ngonyama and the Democratic Alliance’€™s Tony Leon picking over the “facts” of the epidemic, as over the bare bones of AIDS sufferers.

To the DA’€™s credit, it is offering something tangible to voters: free anti-retroviral drugs to rape survivors and HIV-positive pregnant women in DA-controlled municipalities.

The Pan Africanist Congress and the Socialist Party of Azania have since also jumped on this bandwagon.

But how the DA (or the PAC or Sopa) plans to finance its expensive promises outside of the Western Cape, where it has access to provincial resources, remains a mystery. Most municipalities are cash-strapped and battling to supply even essential services, let alone expensive anti-retroviral drugs.

In Khayelitsha, the Western Cape government is spending R540 per HIV positive pregnant woman for a six-week course of AZT, plus nine months’€™ worth of milk formula at a cost of R832 per baby. (HIV can also be transmitted via breast milk.)

With a national HIV prevalence rate of 22.4% and rising, each council would have to find a lot of money to finance these drugs. Unless, of course, some of the DA’€™s wealthy members are prepared to dig into their own pockets to help finance this election promise.

The ANC government, on the other hand, is offering voters A-B-C in the face of the HIV/AIDS epidemic: Abstain from sex; Be faithful to your sexual partner; use a Condom.

As government’€™s ABC is no match for Leon’€™s AZT, Ngonyama has resorted to outrageous rhetoric to obscure his party’€™s current position of no drug treatment for people with HIV.

This week, for example, Ngonyama claimed that the DA was using the “black communities in Khayelitsha” as guinea pigs, “[conning] them into using dangerous and toxic drugs that are detrimental to their own health”.

The fact that the government-appointed Medicines Control Council (MCC) has licensed AZT as a suitable drug for both treating HIV/AIDS and preventing mothers from passing HIV to their babies seems to have escaped Ngonyama.

According to this logic, the MCC should be punished for allowing the use of “poisonous” AZT.

Another thing that the ANC’€™s Head of Presidency seems not to understand is that every drug is “toxic”, in that all have side-effects. But the “side-effect” of HIV is AIDS, which leads to death, and AZT has proven effective in slowing down the virus’€™s progression to AIDS.

Perhaps the saddest thing about this tussle around the Khayelitsha mother-to-child-transmission (MTCT) project is the fact that people from all political persuasions have been working side-by-side to make the project a success.

In fact, ANC Western Cape leader Ebrahim Rasool, ANC health committee secretary Dr Saadiq Kariem and ANC Woodstock branch chairperson Dr Fareed Abdullah (currently head of health in the Western Cape) have all been instrumental in getting the Khayelitsha project going.

While the Western Cape government has given the project its blessing and its financing, it is completely wrong of Leon to claim the Khayelitsha initiative as a DA triumph. It is a South African triumph, put together by people who care about the health of our citizens.

Some 200 babies who would have got HIV from their mothers have been spared an early death and terrible suffering, thanks to the health workers from the three Khayelitsha clinics, provincial officials, doctors from Medecins sans Frontieres (MSF) and many others involved in supporting this project.

According to MSF’€™s Dr Eric Goemaere ‘€“ a French doctor with no political interest in the Khayelitsha project — few of the over 1 300 women taking AZT have reported side effects, let alone been poisoned.

“There has been some nausea, some rashes, but that is about all,” says Goemaere.

Pumeza Bikwe, 23, felt no side-effects and neither did she feel like a guinea pig. When I interviewed her, her chubby daughter, Aneliza, has just tested HIV negative and she was delighted: “This MTCT programme has been very successful for me. I would really advise other mothers to go for it.”

Even health minister Manto Tshabalala-Msimang recognises the value of the Khayelitsha project. Lessons from Khayelitsha are going to be applied to other provinces as they set up “research sites” to provide the much cheaper anti-retroviral drug, Nevirapine, to HIV positive pregnant women.

Nevirapine has not yet been registered by the MCC for use in preventing mother-to-child transmission as AZT has ‘€“ yet we do not hear Ngonyama accusing the health minister of using black people as guinea pigs.

The subtleties of the expansion of the Nevirapine research are also lost on Ngonyama. Minister Tshabalala-Msimang says the provincial sites will focus on the “operational challenges” of offering Nevirapine to HIV positive pregnant women.

So far, four Gauteng clinics and a further four hospitals are going to be offering Nevirapine (Chris Hani-Baragwanath and Coronation already offer it). In addition, the health minister announced recently that the drug would soon be available at seven KwaZulu-Natal hospitals.

Thus, while Ngonyama may think that he is being a loyal servant of the president by bashing the Khayelitsha project, the government seems to be moving cautiously towards implementing a national programme to save babies from HIV.

Any good spin doctor would highlight government’€™s roll-out of Nevirapine as a cause for hope, rather than pulling to pieces the Khayelitsha project, which is providing the best-practice model for the Nevirapine roll-out.

Ngonyama has an ally in Mpumalanga Health MEC Sibongile Manana, who recently expelled the Greater Nelspruit Rape Intervention Project (Grip) from provincial hospitals for providing anti-retroviral drugs to rape survivors.

Grip’€™s drug programme was not costing the province a cent and had helped 72 rape survivors — yet Manana chose to effectively ban it out of loyalty to President Thabo Mbeki who, some time back, described AZT as being toxic.

Both Ngonyama and Manana parrot their problems with AZT out of apparent loyalty to the president, while Leon uses AZT as part of a political campaign to bash the president and the ANC.

Unfortunately, making drugs the focus of HIV/AIDS debate — rather than the need to teach every youngster to use condoms even before they start having sex — may also lead citizens to believe that anti-retroviral drugs offer a cure for HIV/AIDS.

In San Francisco, for example, HIV infection is on the increase for the first time in years amongst gay men who are abandoning condoms in the mistaken belief that they will be saved from AIDS by anti-retroviral drugs.

HIV/AIDS is going to ravage this country, kill more voters than any other disease and turn us into a nation of old people and babies.

The more facts are distorted to suit a party’€™s election platform, the greater the confusion and the easier it will be for the virus to spread. ‘€“ Health-e News Service.

About the author

Kerry Cullinan

Kerry Cullinan is the Managing Editor at Health-e News Service. Follow her on Twitter @kerrycullinan11