HIV/AIDS is a Global Threat

Prince Mangosuthu Gatsha Buthelezi (President of the Inkatha Freedom Party and former Home Affairs Minister of the Republic of South Africa), Chris Smith (former British Culture Minister) and J. Sean Curtin (Fellow, GLOCOM)

Background
According to a UN report released in March 2005, nearly 90 million Africans could be infected by HIV in the next 20 years if more is not done to combat the epidemic. It is estimated that at present somewhere in the region of 25 million Africans have HIV, which causes AIDS. Projections indicate that over the next two decades as many as 89 million new cases of the disease will strike Africa, representing 10% of the continent's population. The UN report recommends a committed and sustained campaign against HIV/AIDS with about US$200 billion invested in the project.

South Africa is considered the world's worst HIV-affected country and it is estimated that one in nine South Africans have HIV or AIDS, representing about 5.3 million infected people. The province of KwaZulu Natal, Prince Buthelezi's homeland and powerbase, is South Africa's worst hit province.

The South African government has been criticized for not doing enough to combat the spread of AIDS. Last year President Thabo Mbeki even denied knowing anyone affected by the disease, and had previously questioned the link between AIDS and HIV.

Uganda is often held up as an African example of how AIDS rates can be drastically reduced by a concerted government campaign. The Ugandan approach has been dubbed the "ABC" strategy. It emphasizes abstinence, having fewer sexual partners and the use of condoms (see note 1)

Chris Smith [who is the first British Cabinet Minister to reveal that he is HIV positive]: Those of us who are affected by HIV/AIDS in the developed world in a strange way, we are fortunate. We have access to treatment and information that can only be dreamed of by most people in South Africa. Chief Buthelezi's own family has been touched by HIV. It is touching far too many people across the whole continent in Africa and particularly South Africa...

Chief Buthelezi: My anguish at the plight of my fellow South African is I admit something which I have had to open my heart and mind to. A subject which in all candour has been taboo to talk about in my society. In this matter, I have not been free of anonymity as the disease has struck down two members of our family, our two beloved children.

There is no way to convey the pain when the natural rhythm of life is violated and parents actually outlive their offspring. One of my children Benedict who died at the age of 43 on 28th April last year and Mandisi who died who died at the age of 48 on 4th August last year. I recall that they never succumbed to the victim mentality, but displayed the courage of those who never give up hope. They did not, and I can draw comfort from the knowledge that they now live forever in the Holy City where there are no more tears of pain.

....we must treat all victims of AIDS as our own family members. That is why I also salute my former friend His Excellency Nelson Mandela. He spoke about the cause of death of his son Makgatho, who also succumbed like our children to the pandemic of AIDS more recently. 1 He and I have come a long way and I salute his courage and his generosity of sprit. He put his country before himself.

I must also say how inspire we all were by the courage of the former British Cabinet minister Mr. Chris Smith who in announcing that he was HIV positive since the 1980s said that he was inspired to do so by President Mandela's example. 2

Whist I have conceded that I have undertaken a long and painful journey, I believe that there are some things that do not change...Those like Nelson Mandela, Archbishop Desmond Tutu and myself have liken the scourge of AIDS to the age of Apartheid. We know that it took a cloak of unity to defeat racial discrimination and injustice in South Africa. Today, South Africa will have to wear the same cloak to overcome our prejudice and silence and confront the disease as one. I am confident we will achieve victory, we have done this before and we will manage it again. For a great nation like South Africa there is no is no hatchet that we cannot bury and there is no trial that we cannot overcome.

In another part of his lecture, Prince Buthelezi talked about the difficulty of discussing sexual problems openly in South Africa.

Chief Buthelezi:...Here in Britain you are use to talking openly about sexuality. Parents are encouraged to talk to their children about sex. Thorny issues such as premarital sex, abortion and homosexuality have for a long time been portrayed in British soap [operas] like Coronation Street and East Enders, have been discussed in newspapers and formed part of the national [school] curriculum. In my culture parents do not traditionally talk to children about sex. They learn these things from their older peers.

I do not mind admitting that I have come a long way in my own personal journey. If the leaders of South Africa sometimes seemed a little tardy in their response [to the AIDS epidemic] it was more out of prudence than out of malice. Sexual intercourse before marriage is taboo in our society. Our people are never realistic enough to know what the associated risks are. In the past we have felt this sexual instinct is very strong, something I am sure everyone is aware of. We therefore practiced the non-penetrative sex...African problems require African solutions and it is quite clear that if we do not look seriously at the tenets of our moral code, we will not be able to reduce the incidence of this pandemic or eliminate it...

Sean Curtin: In China and Japan, the AIDS epidemic is in its infancy. From what you have describe of the situation in South Africa and Africa as a whole, one of the major problems in tackling the issue in Asia will be a reluctance of leaders to talk about sex and in particularly sexual diseases. From your experiences in South Africa, what can you and your country do to assist Asian countries avoid the scale of the AIDS catastrophe that has befallen your country and continent? What can China and Japan learn from the South African and African experience?

Chief Buthelezi: I think I would like to take the example of Uganda 3 because there we can see concrete examples of how things are working. They have taken the bull by the horns in a process that has been driven by the leaders of the country. President Museveni 4 had enough courage to confront and deal with the matter. He energized the whole nation to do something about the AIDS problem and achieved great results. President Museveni had a very hands on approach and mobilized the entire nation.

Sean Curtin: How do you overcome the problem about a reluctance, almost an embarrassment, of leaders to talk about sex? Is there any way for leaders to address the sex issue before the problem become critical? Do you favor the sexual abstinence approach promoted by the Bush administration?

Chief Buthelezi: Yes, I would say that there is. However, in South Africa at the moment, there is a problem as there are attempts to destroy traditional leadership. I myself think it is extremely unfortunate that this movement coincides with this terrible pandemic. This is because when you look at what Ugandans did when confronted with this, they returned to their traditional moral values and looked at their moral codes. The custodians of these very things are the traditional leaders. In fact, I do believe as the President of KwaZulu-Natal that we should encourage virginity tests. Of course, I understand that some women are horrified by this idea, particularly Western women. I accept that in the West, people think it is an abuse to subject young girls to virginity tests. However, I must point out that nobody is compelled to take these tests and in fact some young people are very proud that they have taken these tests.

Notes

1 On 6 January 2005 former South African president Nelson Mandela revealed that his eldest son, Makgatho Mandela, 54, has died of Aids. Since he stepped down as President in 1999, Mandela has campaigned for greater awareness of AIDS issues. Mandela was quoted as saying, "Let us give publicity to HIV/AIDS and not hide it, because [that is] the only way to make it appear like a normal illness."

2 Chris Smith, who became Britain's first openly gay Cabinet minister in 1997, revealed he has been HIV positive since 1987. He did not tell Tony Blair about his illness when he was appointed to the Cabinet because he felt his performance would not be affected. In January 2005, he decided to go public after former South African president Nelson Mandela announced his son had died of AIDS. Smith wants to "demystify" the public perception of a "livable and treatable condition" and challenge prejudices.

3 Uganda is one of the few nations to have turned a burgeoning AIDS crisis around. At its height during the nineties the epidemic cut Ugandan life expectancy from 48 years to 38. The Ugandan approach has been dubbed the "ABC" strategy, with the emphasis firstly on abstinence, then on being faithful and thirdly on condoms. Experts say it is a strategy that has worked, producing a significant drop in the number of AIDS cases in the country.

HIV cases in Uganda dropped by 70% in the nineties. The government's message clearly stated that AIDS was deadly and that it spread through sexual activity. Because of this, HIV is now openly discussed amongst friends and family. This led to a fall of 60% of people reporting they had casual sex. Other African countries studied have similar levels of condom use as Uganda, but little reduction in the number of sexual partners. In the early 1990s, the rate of HIV infection in some urban areas was as high as 30%, but today just 6% of the total population now carries the virus.

An April 2004 study in the journal Science attributes the decrease to a successful public education campaign which led to a reduction in the number of people having casual sex, as well as the willingness amongst Ugandans to openly discuss HIV related issues. The scientists called for the Ugandan approach to AIDS prevention to be adopted in other countries.

During a July 2003 visit to Uganda, President George W. Bush praised Ugandan attempts to tackle the AIDS virus. During a meeting with Ugandan President Yoweri Museveni, the US leader said: "You have shown the world what is possible in terms of reducing infection rates."

4 President Yoweri Museveni has been Uganda's leader since 1986. He won the country's first direct presidential election 10 years later and was re-elected in 2001.

References

For more information on the global AIDS challenge see UNAIDS.

Teenage Sexual Trends Create Health Concerns
Social Trends: Series #2

The above comments were made at Chatham House (Royal Institute for International Affairs) in London on 8 March 2005.