Mandela's leadership long forgotten in AIDS debate

Compare these two scenarios.

Woman "A" has been in a steady relationship for a few years. One day her partner forces her to have sex against her will. She goes to the police station and lays a charge of rape. She immediately finds support from a range of organisations for her courageous determination to "break the silence". The media comment favourably. She is feted for facing the stigma and becomes a role model for rape survivors. In short, she is a hero.

Woman "B" has also been in a steady relationship. One day she goes for an AIDS test, and learns she is positive. She finds out that she contracted the virus from her partner who chose to remain silent about his status. She would never have consented to unprotected sex had she known. Betrayed and violated, she also knows that if she takes a stand, she will stand alone. If she lays a charge or sues for the violation of her physical integrity, she will be accused of "stigmatising HIV", "driving the pandemic underground" and "violating" her partner's "right to privacy". In short, unless she meekly accepts her situation, she is a villain.

In fact, under South African law, if her partner refused to reveal his status, she would only be able to force him to test for HIV if he raped her.

This is a consequence of the "progressive" line on HIV/AIDS, touted by people who actually have much in common with religious fanatics or fascists. In their blinkered focus on a free-floating single issue, they lose sight of the broader public good. Of course, they believe they are motivated by a commitment to "human rights". But they are very selective in whose "rights" they promote. They claim to "own" the moral high ground, but they hunt in a vicious pack to prevent anyone questioning their assumptions. Slacktivists is too gentle a word to describe them. They are more like an AIDS Gestapo.

That is why I am interested in a matter that is scheduled to come before a Durban court soon. In the first case of its kind in SA, a Cape Town woman is suing a Durban man for R2.56-million for infecting her with genital herpes, which like AIDS is an incurable, sexually transmitted disease. Herpes is typically dormant in the system, with intermittent, painful flare-ups, similar to a cold sore on the lip. In Britain recently, a young man was controversially sentenced to 14 months in jail for passing on genital herpes to his partner.

Although this is the first case of its kind in South Africa, the press reports of the Durban matter have passed almost unnoticed. There has been no outcry about stigmatising genital herpes or driving it "underground".

But then, this woman is middle-class and white. And her former partner is rich and white - a chief executive of a large company.

"So what?", you ask. "Why bring race into it?  Surely the sexual transmission of diseases is primarily an issue of behaviour, NOT race?"

I thought so too. I thought we had, at last, got over the racial stereotyping that characterised AIDS denialism under Thabo Mbeki, who was determined to prevent the debate focusing on the need for behaviour change. Anyone who dared venture into this territory was accused of perpetuating the racist myth that African men are "rampant sexual beasts, unable to control our urges, unable to keep our legs crossed, unable to keep it in our pants," as he once memorably told Parliament. That accusation was intended to shut down the debate. And it did.

There is no irony like a South African irony, but this one beats them all: During the Mbeki era, anyone who dared argue that AIDS was a function of sexual behaviour and NOT of race was labelled a racist!!

The election of President Zuma, whose lifestyle reinforced the stereotype Mbeki wished to eschew, inevitably meant that the denial would deepen. 

As the Durban court case illustrates, it is publicly acceptable for a white man to be called to account for infecting his partner with a sexually transmitted disease. But, not vice versa, according to the AIDS Gestapo. Who actually is being racist?  

The Gestapo approach is riddled with such contradictions. But it still comes as a surprise to find traces of Gestapo logic in the writings of an eminent and respected scientist like Dr Helen Epstein who has written by far the most compelling and rational treatise on AIDS. Her book, The Invisible Cure, explains so many things about the disease that once seemed inexplicable to me, and there has not yet been a credible rebuttal.

Her book seeks to explain why the AIDS pandemic is disproportionately centred in Southern and Eastern Africa. She comes to the conclusion that the major driver of AIDS is multiple concurrent sexual partners. She coined the term "AIDS superhighway" to describe such sexual practices, at approximately the same time that Mbeki was so determined to prevent the debate going in that direction.  

It is to Epstein's credit that she persisted, nevertheless. But it also explains why she is at such pains to prove she is not a racist. She seeks to avoid the "Mbeki stigma" by repeatedly explaining that Americans have more partners over their lifetimes than people in Africa. Serial monogamy, she explains, is far less likely to transmit AIDS than multiple concurrent partners.   

Her case is convincing. Thus it comes as a surprise to find that she was prepared to use the Mbeki trick against me (and accuse me of "reviving stereotypes of the promiscuous African") simply because I refuse to demean myself by desperately trying to prove I am not a racist when I state a case that should have nothing to do with race. I simply ignore the tired and tedious reversion to the "race card" by people who have run out of credible arguments. 

As in so many other cases, we can learn from Mandela's early example in the HIV debate.  In 1992, addressing a meeting of 50,000 people in Zwide, Eastern Cape, Mr Mandela pledged that the ANC would face the AIDS issue uncompromisingly.

He said:  "We as an organisation are going to take this matter seriously. Even the Government has not enough resources to deal with it. The misconception that our men can go around having many women, that is polygamy, must come to an end. It was all well in the olden days of our fathers but today it is dangerous." As with so many other issues, he was prepared to confront the emerging AIDS pandemic head-on.

But not for long. Interestingly, I can find no other example of Mr Mandela ever explicitly raising this issue in this way again. In fact, during his Presidency he seems to have paid scant attention to AIDS. I have often wondered whether the AIDS Gestapo managed to silence him too.

They will probably also go for Health Minister, Aaron Motsoaledi, after his comments last week, when he announced the latest AIDS data and effectively conceded that the government had failed to bring down the infection rate through current strategies. He optimistically described the statistics as an indication of "stabilisation". But the fact is, SA has fallen far short of its stated aim of halving the HIV transmission rate by 2011. The only province that has done so, is the Western Cape.

The news in Motsoaledi's announcement, however, was his breakdown of the statistics for different age categories. Comparing statistics of 2008 with 2010, he voiced particular concern at the 30% increase in prevalence amongst women aged 40 - 44; and the 33% increase in prevalence rates of women between 45 and 49 years of age.  

The Minister did not mince his words. Unfaithful husbands, he said, were to blame for the upward trend of HIV prevalence in older women.

Motsoaledi said that, although the whole country knew the ABC mantra "to abstain, or be faithful and condomise" the country needed to "revisit that message".

"Condoms are working.  The question is faithfulness," he said.

"We need to target the older age groups, the married couples," and specifically to "target the men". "We know that they have been very stubborn", he added.

Minister Motsoaledi, in his many statements, is coming to terms with the fact that our current strategy isn't working. Even Uganda, the "poster country" for what Helen Epstein describes as "pragmatism, urgency and compassion" in dealing with AIDS, is concluding that their approach has failed.

It must be a mortal blow to the AIDS Gestapo  that the Ugandan Parliament is reportedly about to pass a law requiring mandatory AIDS tests and criminalising the knowing transmission of the virus. But in South Africa, we can always rely on someone to find a way to default to the race card. And believe it or not, an acclaimed scientist is now moving towards a point of implying that the HI Virus is, in itself, racist. I am not making this up!

Dr Francois Venter (once also the victim of attacks from the AIDS Gestapo when he supported mandatory testing) has now succumbed to their logic. If you can't beat them, join them. He seems to be finding the ultimate cop-out to avoid the debate on behaviour change and reinforcing denialism.

In an newspaper article, published last week, Venter said: "There is accumulating evidence that people in our region are more vulnerable to HIV per sex act than our European, Asian or American counterparts... It would appear it matters far more where you live than who you sleep with. It is extremely plausible that something about the HIV species wandering our South African bedrooms may be more virulent, or the genes in our population more susceptible, or some environmental factor we haven't discovered makes sex manifold more risky."

What a great excuse for avoiding tackling the much tougher issue of personal responsibility! I will humbly eat my words and apologise if science proves Dr Venter to be correct. In the meantime, please excuse my scepticism.

It is fitting to end this newsletter with one of Mandela's great insights on leadership in the context of the AIDS pandemic. In 2004 he said: "They must dare to be different, and they must be prepared for the course to be difficult. They will be faced with tough decisions, and they must come up with bold and innovative responses. This is what leaders are for, and the AIDS epidemic will test their leadership skills to the limit."

As usual, he was right. 

This article by Helen Zille first appeared in SA Today, the weekly online newsletter of the leader of the Democratic Alliance.

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