10 years of ARVs. 33 years since first unexplained cases of AIDS. 31 years since HIV was first isolated. 1 000 000s of deaths. 16 years of the Treatment Action Campaign. 20 years of democracy in South Africa. 400 000 new HIV infections annually in South Africa. 170 000 AIDSrelated deaths annually in South Africa. 88 000 TB deaths in people living with HIV every year. 2014: AIDS is not over, our work is not done.
Dear Global Donors
Fulfilling the right to health depends on common purpose between researchers, clinicians and activists On the eve of World AIDS day 2014 we write this letter as globally recognised researchers, scientists and academics who are concerned about reports of the possible closure of the Treatment Action Campaign (TAC) in South Africa as a consequence of serious funding difficulties.
We believe that health and access to health services is a human right. But we want to state unequivocally that as much as fulfillment of the right to health requires investment into new scientific breakthroughs and sound research discoveries it also requires investment and support of strong, independent, organised and relevant civil society movements.
Civil society, particularly people living with HIV, have played a pivotal role throughout the response to HIV/AIDS. In the 1980s it was the activists’ demands for treatment that increased funding for HIV research and created a sense of urgency in the medical community; in the 1990s and 2000s the loud global voice of activists helped create political commitment for the response to HIV which in turn released funds for research into many of the scientific breakthroughs we can since claim. Activists have also ensured that new science, such as that on both treatment and prevention, has been turned rapidly into delivery of care and services, and they have maintained oversight of the health systems needed to deliver this.
As a result, in the arena of HIV we have witnessed something unique – global social justice in the response to one disease. We believe the lessons of HIV need to be expanded upon: a similar alliance of activism and scientific inquiry is needed for TB, Ebola, Malaria, Cancer and the myriad of other health challenges that confront the globe.
Many activist organisations have contributed to this change but undoubtedly one of the most excellent health and human rights movements has been the TAC in South Africa.
Through its campaigns for anti-retroviral treatment the TAC helped to change the response to the HIV epidemic in South Africa- the epicenter of the global epidemic- from one that was mired in political denialism to one that wins praise for South Africa all over the world. We also salute the role that the TAC played and continues to play in treatment literacy, educating communities about HIV, their treatment and the importance of adherence. Consequently, two and a half million people are now on ARV treatment in South Africa.
However, this is no cause for complacency or for the dismantling and demobilisation of civil society. New challenges have replaced old ones; new science requires new activism and vice versa. Sustaining and expanding this intervention to all six million HIV infected people in South Africa requires that the TAC now focuses its activism on TB, on exercising oversight over the quality of public health services, ensuring accountability and a continued sense of urgency.
This is why it is alarming to hear that the TAC is facing closure apparently due to the mistaken belief that many donors and governments believe either we are nearing the end of AIDS or because they view South Africa as a middle-income country, not in need of donor support. Nothing could be further from the truth.
Allowing the TAC (and others like it in other countries of the world) to die for lack of funding will have very grave consequences. Without activist monitoring the South African AIDS response could go into reverse. Precious gains could be lost. Poor adherence, loss to follow up and medicine stock outs could go unreported. If this happens, there will be little to celebrate by the time the 21st International AIDS Conference returns to Durban in 2016- the city in which the TAC first organised a global march for access to treatment.
Outside of the scientific community many leaders we admire and respect have added their voices to save the TAC. These powerful voices include Archbishop Emeritus Desmond Mpilo Tutu, Madame Graça Machel and Stephen Lewis.
We are now adding our voices to their appeal. Please- let us in 10 years time look towards this moment as one of inspiration and renewal, not of failure.
In 2014, let us mark 10 years of anti-retrovirals in South Africa as a moment where we were reinvigorated and as a moment where we give civil society the support they need and deserve.
We close our appeal by remembering words used by Nelson Mandela 10 years ago, specifically in relation to HIV:
“The more we lack the courage and the will to act, the more we condemn to death our brothers and sisters, our children and our grandchildren. When the history of our times is written, will we be remembered as the generation that turned our backs in a moment of a global crisis or will it be recorded that we did the right thing?”
YOURS IN HEALTH
Professor Peter Piot, Director of the London School of Hygiene & Tropical Medicine, Professor of Global Health, Founding Executive Director, UNAIDS
Professor Françoise Barré-Sinoussi, Nobel Prize laureate
Professor Quarraisha Abdool Karim, Associate Scientific Director: Centre for the AIDS Programme of Research in South Africa (CAPRISA), Professor of Epidemiology: Columbia University
Professor Salim S Abdool Karim, Director: CAPRISA – Centre for the AIDS Programme of Research in South Africa
Professor Michel Alary, Centre de recherche du CHU de Quebec, Quebec, Canada; Departement de Medecine Sociale et Préventive, Universite Laval, Quebec, Canada
Dr John Ashmore, PhD, Deputy Head of Mission, Médecins Sans Frontières South Africa & Lesotho
Dr Manica Balasegaram, Executive Director Access Campaign, Médecins Sans Frontières
Professor Stefan Baral, MD MPH MBA CCFP FRCPC. Director, Key Populations Program, Center for Public Health and Human Rights, Department of Epidemiology Johns Hopkins School of Public Health
Professor Linda-Gail Bekker, MDPhD, Deputy Director, The Desmond Tutu HIV Centre, University of Cape Town
Dr Chris Beyrer, President International AIDS Society
Professor Tihana Bicanic, Senior Lecturer and Consultant in Infectious Diseases, St George’s University of London
Professor Marie-Claude Boily, MSc, PhD, Department of Infectious Diseases Epidemiology, School of Public Health, Imperial College London
Dr Brian Brink, Chief Medical Officer, Anglo American plc
Dr Pedro Cahn, MD; PhD, Director, Fundación Huesped, Buenos Aires, Argentina
Professor Francesca Conradie, President, Southern African HIV Clinicians Society
Professor Ashraf Coovadia, Adjunct Professor of Paediatrics, Head of Department – Paediatrics and Child Health Rahima Moosa Mother and Child Hospital, University of the Witwatersand
Professor Hoosen (Jerry) Coovadia, Emeritus Professor, University of KwaZulu-Natal & Director Maternal Adolescent and Child Health, University of the Witwatersrand
Professor Roel A Coutinho, MD PhD, Professor of epidemiology and control of infectious diseases, University of Utrecht, the Netherlands
Jean-François Delfraissy, MD, PhD, Director, National Agency for Aids Research, France
Dr Robert N Davidson, Department of Infectious Diseases & Tropical Medicine, Northwick Park Hospital, United Kingdom, Honorary Senior Lecturer, University of Cape Town
Dr Tom Ellman, Director of Southern Africa Medical Unit, Médecins Sans Frontières South Africa
Professor Sarah J Fidler, Reader and consultant physician in HIV, Department of Medicine, Imperial College London
Professor Gerald Friedland, Departments of Medicine and Epidemiology and Public Health, Yale School of Medicine
Professor Rajesh Gandhi, MD, Director, HIV Clinical Services and Education, Massachusetts General Hospital, Boston
Dr Eric Goemaere, MD, DTMH, MSc, Senior Regional HIV/TB support coordinator, Médecins Sans Frontières South Africa; Centre for Infectious Disease Epidemiology and Research, Honoris Causa Doctor, University of Cape Town
Professor Lawrence O Gostin, Founding O’Neill Chair in Global Health Law. Faculty Director, O’Neill Institute for National and Global Health Law, Georgetown University
Professor Glenda Gray, MBBCH FCPaed (SA) DSc (honoris causa), Professor of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand
Professor Martin Peter Grobusch, Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam
Professor Diane Havlir, Professor of medicine at the University of California, San Francisco, and the chief of the HIV/AIDS Division at San Francisco General Hospital.
Professor Mina Hosseinipour, University of North Carolina at Chapel Hill School of Medicine and UNC Project, Lilongwe Malawi
Professor Bavesh Kana, (PhD), Early Career Scientist of the Howard Hughes Medical Institute, Head of Research Unit DST/NRF Centre of Excellence for Biomedical TB Research, University of the Witwatersrand
Professor Alan Karstaedt, Chris Hani Baragwanath Hospital and University of the Witwatersrand
Dr N Kumarasamy, Chief Medical Officer, YRGCARE Medical Centre, Voluntary Health Services, Chennai, India
Professor Andrew ML Lever, FRCP FRCPath FMedSci FLSW, Professor of Infectious Diseases, Honorary Consultant Physician, University of Cambridge Department of Medicine
Professor Leslie London, Head, Public Health Medicine, Head of the Health and Human Rights Division in the School of Public Health and Family Medicine, University of Cape Town
Professor Gary Maartens, Division of Clinical Pharmacology, Department of Medicine, University of Cape Town
Professor Vincent C Marconi, MD. Division of Infectious Diseases, Emory University School of Medicine, Department of Global Health, Rollins School of Public Health, Emory University
Professor James McIntyre, Anova Health Institute, Johannesburg & School of Public Heath & Family Health, University of Cape Town
Professor Graeme Meintjes, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town
Professor Marc Mendelson, Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town
Andrew Mews, Médecins Sans Frontières Head of Mission South Africa & Lesotho
Professor Valerie Mizrahi, PhD, Director, Institute of Infectious Disease & Molecular Medicine, University of Cape Town
Professor Julio SG Montaner, MD, DSc (hon), FRCPC, FCCP, FACP, FRSC, OBC, Professor of Medicine, University of British Columbia and St. Paul’s Hospital Foundation Chair in AIDS Research, Head of Division of AIDS. UNAIDS Special Advisor on HIV Therapeutics.
Professor Yunus Moosa, Department of Infectious Diseases, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal
Professor Lynn Morris, National Institute for Communicable Diseases and University of the Witwatersrand
Dr Kogie Naidoo, Head: Centre for the AIDS Programme of Research in South Africa (CAPRISA) Treatment Research Programme
Professor Marie-Louise Newell, MB MSc PhD FMedSci. Professor of Global Health, Academic Unit of Human Development and Health, Faculty of Medicine/Faculty of Social and Human Sciences, University of Southampton
Dr Catherine Orrell, The Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town
Professor Nesri Padayatchi, Deputy Director, Centre for the AIDS Programme of Research in South Africa (CAPRISA), South Africa
Professor Helen Rees, Executive Director, Wits Reproductive Health Institute; Ad Hominem Professor in the Department of Obstetrics and Gynaecology, University of the Witwatersrand; Honorary Professor, Department of Infectious and Tropical Diseases, Clinical Research Unit, London School of Hygiene and Tropical Medicine.
Professor Theresa Rossouw, Departments of Family Medicine and Immunology, University of Pretoria.
Professor Ed Rybicki, PhD, Academic Liaison, Research Portal Project, and Institute of Infectious Disease and Molecular Medicine and Department of Molecular & Cell Biology, University of Cape Town
Professor Ian Sanne, Clinical HIV Research Unit, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand and CEO Right to Care
Professor Helen Schneider, Director, School of Public Health, University of the Western Cape
Professor Olive Shisana, Sc.D, Chief Executive Officer, Human Sciences Research Council, South Africa
Professor Leickness Chisamu Simbayi, D.Phil, Executive Director, HIV/AIDS, STIs & TB Programme, Human Sciences Research Council, South Africa
Professor Steffanie A Strathdee, PhD, Harold Simon Professor, Associate Dean of Global Health Sciences, University of California San Diego School of Medicine
Dr Cloete van Vuuren, Head of Department of Medicine: 3 Military Hospital, Affiliated Senior Lecturer: Infectious Diseases, Internal Medicine, University of the Free State
Professor Stefano Vella MD, Head of the Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Italy
Professor Francois Venter, Deputy Executive Director, Wits Reproductive Health & HIV Institute, University of the Witwatersrand
Professor Paul Volberding, Professor of Medicine and Director of Research, Global Health Sciences. University of California San Francisco
Professor Charlotte Watts, Head of the Social and Mathematical Epidemiology Group, London School of Hygiene & Tropical Medicine
Professor Anna-Lise Williamson, PhD, SARChI Chair in Vaccinology, Institute of Infectious Disease and Molecular Medicine/ Division of Medical Virology, Faculty of Health Sciences, University of Cape Town
Professor Carolyn Williamson, Head of Division of Medical Virology, University of Cape Town & National Health Laboratory Services
Dr Gustaaf Wolvaardt, MBChB, M.Med, FCP, PGCHE, Managing Director, Foundation for Professional Development, South Africa
Professor Robin Wood, Director