Thabo Mbeki's HIV response and Cyril Ramaphosa's Covid-19 strategy differ like day and night.

Reporting on Covid-19 and HIV in South Africa is like night and day, Mia Malan, who has reported on both epidemics, writes.

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 It’s the day after the plane containing our repatriates from Wuhan has landed, when Cyril Ramaphosa declares a state of disaster in the country, in front of a blaring television in my lounge, it hits me: Nowhere am I able to see a single activist venting vociferously against the government. 

No Zackie Achmats, Fatima Hassans, Vuyiseka Dubulas, Edwin Camerons or Mark Heywoods standing firmly at the ready to contradict the president. No demonstrators spread-eagled across burning tar, playing dead alongside placards pleading for medicine and for the state to use evidence-based strategies to combat an epidemic. 

No health minister screeching “Traitors!” at scientists and journalists who disagree with her denial of science and her refusal to provide people with life-saving treatment.  

No pontifications about potatoes, beetroot, lemon and garlic as excellent means to protect people from a potentially fatal virus.     

Instead we have a president taking responsibility, surrounded by his sober cabinet, announcing: “It is up to us to determine how long [this epidemic] will last, how damaging it will be and how long it will take our economy and our country to recover.”

I was a young reporter when former President Thabo Mbeki and his Health Minister, Manto Tshabalala-Msimang, shocked the world when they denied the link between HIV and Aids.  

The virus, they argued, was not the cause of Aids. An Aids epidemic did not, in fact, exist, the duo insisted; it was all down to poverty. They also posited a range of conspiracy theories, including that HIV was manufactured in a lab somewhere in the West.   

It was a truly tumultuous point in the history of our then young democracy.   

If you were a dedicated health journalist during the late 1990s or early 2000s, you were basically a full-time Aids reporter. You spent your work days recording Mbeki’s and Tshabalala-Msimang’s quackish HIV statements, which you then took to credible scientists and activists to correct by way of contradictory comments.

That, of course, was, if you DID disagree with the government. 

There were some in the media who either agreed with the president and the health minister, or could not muster the courage to oppose them. It was all about politics, and power.    

The politics of Aids

HIV had become a political football, and with political leaders suggesting that a condition, which was killing hundreds of thousands, was simultaneously a hoax and something that had been manufactured by a demonic pharmaceutical industry, the issue transcended the realm of health. That meant that political and business journalists, also often editors-in-chief, joined the debate — and they chose sides that were mostly determined by politics, not science.  

It was confusion all round, with mixed messages the order of the day.

I know this to be so, because I worked for the state broadcaster at the time, and the South African Broadcasting Corporation was a fierce supporter of the Mbeki government. Like many of my colleagues, I had to fight to get my stories, that more often than not presented opinions and facts that contradicted the president, aired.  

Against the background of South Africa’s hard-fought-for young democracy at the time, disagreement with the president — and in essence taking the side of Western science — about the cause of a condition that was destroying the country, was frequently viewed as anti-democratic and even racist.  

So, journalists, scientists and activists who opposed HIV quackery were “anti-Mbeki people”, not just mere supporters of science. 

We were the enemy. 

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At the first International Aids Conference that was held on South African soil, in 2000, in Durban, the animosity was on open display amidst the grandeur of the five-star Hilton Hotel, when the health minister reprimanded two world-renowned HIV scientists whose research appeared regularly in prestigious peer-reviewed scientific journals.

Tshabalala-Msimang ordered Salim Abdool Karim, now the head of the Centre for the Aids Programme of Research, Caprisa, and Hoosen Coovadia, then from the University of Kwazulu-Natal, to a luxurious room where she chastised them in front of Health MECs and other politicians.  

Both were respected health activists who had fought for equal access to healthcare for all races during apartheid. 

“You’re disloyal! Traitors!” Abdool Karim remembers her screaming at them. “What you are doing is equal to treason to our country!”

Their sin was that they had been publicly defending HIV as the cause of Aids and advocating for access to antiretroviral treatment (labeled “poisonous” by Tshabalala-Msimang) for HIV-positive South Africans.  

But when the two scientists tried to defend themselves, Abdool Karim recalls, Tshabalala-Msimang interrupted them and yelled: “Shut up and listen!”

Salim Abdool Karim was chastised by Health Minister Manto Tshabalala-Msimang but Health Minister Zweli Mkhize is using his advice for the country’s Covid-19 response. (Madelene Cronje)

Twenty years later, after a decade of state capture, and on the brink of another epidemic — Covid-19 — Abdool Karim received a call from the current health minister, Zweli Mkhize.  

Mkhize was asking for advice, asking the scientist: “How do you think we can slow the spread” of the new coronavirus, known as SARS-Cov-2. 

Says Abdool Karim: “With the coronavirus, our experience with government is exactly the opposite [of what we endured during the Mbeki and Tshabalala-Msimang era]. The minister has been contacting us, he wants to involve us, he is seeking the opposite of what Mbeki and Tshabalala-Msimang wanted.” 

Abool Karim serves on a special Covid-19 committee. It advises the president on what actions to take. “With HIV we were so slack with taking things up, we delayed mother-to-child-prevention of HIV and access to antiretroviral treatment. But with Covid-19 we’re proactive and we’re acting early,” he says. 

The consequences — in the form of more than 300 000 unnecessary HIV-related deaths, according to a Harvard University study —  of the time the government took to respond to science, are unfortunately permanent. 

HIV journalists and the government weren’t friends

As a result of the government’s contrasting responses, reporting on HIV and Covid-19 in South Africa as a journalist, is like night and day. With the one epidemic, activists and scientists were mostly our only sources of information, and the government the ones who blocked access to data. In the case of HIV, study after study has shown how conflict — one of the strongest news values — was a central theme in stories on the subject because of activists and government being played off against each other; but it often resulted in stories being repetitive, rather than meaningful.  

With Covid-19, those same HIV activists who fought the government are now supporting and praising Cyril Ramaphosa’s early, evidence-based interventions. And the health ministry, that previously cut journalists off, has set up a media WhatsApp group through which the latest figures, as they become available, are posted directly to journalists’ phones. The system isn’t perfect — press releases have been retracted a few times because they contained the wrong figures — but the point is: there is a system that allows for a free flow of information. And when mistakes are made, the government has acknowledged them.

There’s even a data-free website and a public WhatsApp service that has so far been used by well over 2 million people, according to the health department. 

And, it seems, the ANC is, at this moment in history, using its great power for good — for state protection rather than state capture. When the ANC Youth League in Limpopo, for instance, threatened the “mother of all marches” in the province after it was announced that the quarantine site for the Wuhan repatriates was going to be in the outskirts of Polokwane, Zweli Mkhize — a powerful man in the ANC — shushed them and crushed their plans very swiftly. 

After the Wuhan plane landed he took to his Twitter handle to post a video branded with an “ANC Limpopo” logo to welcome the repatriates.   

Our own history may become our greatest teacher

The government has been calling the media its “partners” in the fight against Covid-19. To the ears of someone who reported on HIV in South Africa in the 1990s and 2000s, that has been pretty surreal. I’m sure the “partners” thing has seemed equally strange to those in the media who’ve been reporting on state capture and government corruption. 

Ok, enough Kumbaya for now: As a journalist and editor, I of course, am well aware of how rapidly this newfound “partnership” could end. But for now, it’s happening. We’re all in it together, on the same side. For now, I’m witnessing true leadership from the ANC. 

We can’t stop this virus from spreading, but we can slow down the pace at which it spreads, to help our health system to cope. 

We’re in lockdown, testing sites are increasing, there are contact tracing teams, quarantine sites-in-the-making and relatively good communication systems that will hopefully prevent panic.  

Yet, sadly, the ANC government’s criminal inaction two decades ago will likely have a bearing on South Africa’s ability to successfully combat Covid-19: We now have one of the highest HIV infection rates in the world, something that could have been prevented if we had put people on treatment earlier.  

Our latest household survey shows that four out of ten people with HIV are still not on treatment, which increases the chances that their immune systems are weak and potentially vulnerable to attacks from viruses such as SARS-CoV-2. 

Lessons don’t emerge only from other countries. With regard to Covid-19 and our response in the coming weeks and months and maybe even years, our own history just may be our greatest teacher.