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Field Report from South Africa Adapted Field Report from South Africa Adapted from the broadcast audio segment; use the audio player to listen to the story in its entirety. Burial space at Soweto's Avalon Cemetery in South Africa is filling up fast, mainly because of South Africa's staggering number of AIDS related deaths – about 850 people a day. According to UN estimates, the epidemic has pushed life expectancy down to 52 years. At 5.7 million, South Africa is home to the world's largest HIV positive population. For a nation still grappling with the aftershock of decades of apartheid this health crisis has been devastating. Barbara Hogan served as Health Minister from 2008 to 2009. “Well we thought we got liberation now we could move on. Now this deadly thing comes along. It kind of narrows us down. It's frightening… What more can I say?” While AIDS has declared war on South Africa decades ago, the government has only recently started fighting back. In 1990, South Africa's infection rate hovered at about 1%. In the early days of the emerging epidemic, a newly democratic and still divided South Africa was ill-equipped to prevent the spread of HIV says leading AIDS expert Dr. Helen Rees. “The problem is that we've got an epidemic. We had an epidemic at the same time as we came out of the apartheid. We were trying to transform our house services post-apartheid and then we had the worst epidemic that's happened in modern times. So we've been trying to juggle these things together. We are now running to catch up. The rural provinces are not doing as well the urban provinces. We need more injection of skills. We need more injection of funds just to buy the drugs.” During his nine years in office, former President Thabo Mbeki questioned the link between HIV and AIDS. He circulated a secret memo among his party's leadership charging that the thesis on the HIV/AIDS link was entrenched in centuries old white racist beliefs and concepts about Africans. For years he also suggested that anti-viral retro drugs were toxic and he consistently underfunded ARV treatment and condom distribution programs. Mbeki's former Health Minister, Dr. Manto Tshabalala-Msimang, spoke at the 2006 International AIDS conference in Toronto. “What I know is that traditional medicine also assists people and I'm not going to discard it because if a patient says to me I'm feeling better in the morning on traditional medicine I'm not the one to tell them they're not for your benefit. I'm not the one to tell the patient remember anti retro virus do not kill HIV and AIDS.” Tshabalala-Msimang's support for vegetables like garlic, beetroot, lemons and African potatoes as treatments for HIV earned her the nickname Dr. Beetroot. Her push for herbal remedies riled international AIDS advocates. Harvard researchers have estimated that the government's sluggishness in tackling the epidemic led to close to 400,000 premature deaths. South Africa's cycle of disease and death has dealt a serious blow to its work force and companies like the mining giant Anglo-American are grappling with the emotional and economic total of this epidemic. Dr. Brian Brink, Anglo-American’s Chief Medical Officer explains his earliest reaction. “It's very difficult to watch your employees getting sick and dying and going on ill-health, early retirement, in their 30s and 40s. You can't afford to lose your skills. Skills are scarce and the longer employees have been with you, the better they are at their job – the more loyal they are to the company. We don’t want to just keep losing those people as if they're dispensable. They're not.” Things got so bad at Anglo that the company began to train two people for every skilled job, just in case. “There was a lot of skepticism about HIV and the whole, ‘Does HIV cause AIDS?’ Complete distractions to actually getting on and managing the disease. When treatment became available, that was sort of at the time when we were at the peak of denial by the government and as a business we realized we couldn’t wait for this thing to get sorted out. We just had to provide the care and support to our employees that they needed,” says Brink. Inspired by Brink’s proposal, Anglo-American began an aggressive testing and treatment program. The company offered free ARVs to its workers. About 15% of workers were infected therefore the program was hardly cheap. They spent about $1500 per year, per worker, but it proved to be good business and a life saver for Anglo-American employees. The company urged all its workers from the executive suites to the deepest mines to check their HIV status. Today 80% voluntarily take an AIDS test every year. Although, there was an uptake in HIV infections in 2010 that researchers are now working to understand, the number of new infections at this mine outside Johannesburg fell every year for four straight years. Anglo-American’s treatment regime is just one example of how the private sector, non-governmental organizations and other groups filled in when the government fell short says former health minister Barbara Hogan. “There was such an industry of people doing things behind the scenes and not saying ‘Hey look at me! I'm there but just got on with the job.’ I think we're still uncovering those beehives of activity that are going on. I just think it's good for any society, for the public, for every citizen, to take responsibility for what is happening and not just sort of say ‘Well that's the state.” We didn’t do what we should have done. But even so, I think the way that South African citizens responded was remarkable.” South Africa’s current president, Jacob Zuma, has rapidly scaled up the country’s HIV programs. In April of last year, the President announced a campaign to test 15 million people for HIV by the end of 2011. The number of people accessing treatment has continued to rise and the government has set a goal to have one million more people on anti-retro viral medication by 2013. The country has also increased its focus on preventing the spread of the virus. Tens of thousands of adolescent and adult men have volunteered to be circumcised, a procedure known to reduce the chance of HIV infection. Condoms are now given away for free at clinics and nightclubs, and public education campaigns promote commitment monogamous relationships. Dr. Salim Abdool Karim, Director of the Centre for the AIDS Programme of Research in South Africa, says changing culture and changing behavior is perhaps the steepest hill to climb in the fight against AIDS. “So it's not a simple challenge of promoting condoms or telling people to be faithful. It's about engineering a new society, re-instituting the family unit and conjugal stability as the basis of our society. So in a way the challenge to HIV is massive to try and do that.” – Reported by Ray Suarez for America Abroad .
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