Fighting AIDS Denialism

A political cartoon of Mdlala-Routledge's firing.

Many parts of South African politics have played and continue to play a role in the HIV epidemic, but two major components are health activism and HIV denialism. These two aspects are closely related in that during the time of Thabo Mbeki’s presidency, health activism was in part a response to the HIV denialism proposed by the government. There was one specific incidence during Mbeki’s presidency where his denialism and rejection of health activism came back to haunt him and contributed to the end of his presidency. This was when he fired Nozizwe Madlala-Routledge, Tshabalala-Msimang’s (the health minister at the time) deputy. During the time when Tshabalala-Msimang needed a liver transplant, Madlala-Routeledge took advantage of her absence and began working closely with the TAC to support the improvement of the national strategic plan (NSP). In an interview with the New Yorker, she claimed that Tshabalala-Msimang had prevented her from speaking about AIDS and brought light onto how the government was censoring those who had different ideas on AIDS. These public statements made by Mdlala-Routledge greatly contradicted the health minister’s and the president’s views on HIV and AIDS and their denialism about HIV. It was because of these statements that Mbeki fired Madlala-Routledge and attempted to remove any opposition to his position on HIV and AIDS. Mbeki gave bogus reasons for firing Madlala-Routledge and this in combination with the TAC’s support to expose Mbeki’s unfairness made Madlala-Routledge an icon for standing up against Mbeki and Tshabalala-Msimang and standing up for AIDS. This incident took place near the ANC elections and it’s speculated that this abuse of power in combination with his waning popularity is what made him lose the election to Jacob Zuma.

It’s difficult to know how exactly this event affected the HIV epidemic and whether its help of ousting Mbeki was the turning point in the AIDS denialism and the progress in rolling out ARVs. It can only be speculated as to how long it would have taken to diminish the AIDS denialism and convince the government to expand the ART programs if Mbeki hadn’t lost to Zuma. The ANC had just made large progress in improving the NSP in and having the final draft, with the goals of having 1.5 million people on treatment by 2011, halving the new HIV cases by the same year and reducing mother to child transmission to 5%, be approved by the cabinet in 2007 .  It’s clear that the ANC and its role in health activism was moving forward and gaining some ground within the government despite Mbeki’s denialism. Rather than contributing to tarnishing Mbeki’s reputation, Mdlala-Routledge had a larger impact by becoming a symbol of someone who stood up to Mbeki and Tshabalala-Msimang. She became another face of health activism and a face for those who needed hope in order to deal with having HIV and waiting for treatment. Mdlala-Routledge was different from a face of the TAC like Mathathi and Heywood because she was in the ANC and was Tshabalala-Msimang’s deputy. She was someone whose thoughts were censored and suppressed as those who had suffered from apartheid had been.

A TAC march to parliament to demand access to treatment.

There’s no way to know which of the HIV positive people waiting for treatment at that time were coloured or black Africans that had been through apartheid and experienced a form of control and censorship, but Mdlala-Routledge’s suppression could have been a common ground that helped gain more support for her stance on AIDS as well as for the TAC. The TAC was fighting the government along with those waiting for treatment, but had much more power to make changes, where Mdlala-Routledge risked her job and lost it in order to stand up to Mbeki and fight for the right to treatment for those who needed it. She was in a much more vulnerable position like those who needed treatment and those who suffered during apartheid than the TAC was in. Mdlala-Routledge brought in some new hope by showing publicly that there were people in the government that were also against Mbeki’s denialism. Due to of all of the political aspects that affected the HIV epidemic, social unity was important because HIV was affecting so many in the population and there needed to be hope among them to continue pushing for their right of access to treatment.

Written by Amanda Masse