A personal, political and legal triumph

A number of people have over the years played a role in the development of the TAC and our battle for antiretrovirals. There are too many to mention. In the following pages a small group of people who played a role in one way or another and represent various constituencies, share their recollections of the past and their dreams for the future.

For me, 10 Years of ARVs represents three different, but all joyful, things – personal, political and legal.
Personally, 10 Years of ARVs has meant ten more years of life.

I fell severely ill towards the end of 1997. On median survival time, I would have been dead by mid-2000. Instead, I’m alive, fit and vigorous. At first, I had unpleasant side effects but they soon abated and my virus has been undetectable since 2000, when I had a brief viral load blip. I have turned 60 when I never thought I would make 40. ARVs have made this possible. It is something for which I am profoundly grateful every day.

ARVs for me have meant life and health in the face of certain death, and the capacity to work, contribute, enjoy friendship, love, fun and play.

Politically, 10 Years of ARVs signals one of democratic South Africa’s greatest achievements.

From a flailing and uncertain national response beset by the ghastly nightmare of denialism, we have managed to create the largest publicly-provided ARV treatment programme anywhere in the world. ARVs are not the full answer to AIDS. We have to intensify prevention efforts. Nor are they entirely easy: We need to expand access to simpler one-tablet-per-day treatment, and we must lessen stigma – both external (discrimination) and, perhaps even more importantly, its internalised dimension, for this may be stigma at its most dangerous. We should treat HIV for what it is – a chronic, manageable condition. ARVs are the golden key to this. They are the only successful treatment – and they do succeed.

One of the ways in which ARVs succeed is that they render those successfully taking them incapable of infecting others. ARVs represent a coincident triumph of treatment, prevention and lessening stigma. When I think of the ten-year national ARV programme, I think: If we South Africans can do this – if, in the face of governmentally-led scepticism, public doubt, human frailty, resource scarcity and infrastructural debility, we can provide a hugely successful treatment programme saving millions from a fatal disease – then we can do anything.

Last, for me, as a lawyer and a judge, 10 Years of ARVs represents one of the greatest achievements of South Africa’s Constitution and the rule of law it embodies.

Amidst the nightmare of presidential denialism, South Africans did not rest inert. They knew they had a Constitution. With a Bill of Rights. Which enshrined the right to speak out, to organise, to march, to protest – and, crucially, the right of access to health care. And most importantly, with the right to challenge government’s response in the courts.

Presidential denialism, which made government refuse to start a mass treatment rollout, violated the right of access to health care. The Treatment Action Campaign and its allies asked the courts to vindicate that right. And the courts did. In the bravest, and possibly most important, judgment of its 20 years, the Constitutional Court unanimously ordered President Mbeki’s government to start making ARV treatment publicly available.

10 Years of ARVs has been the culmination of a powerful surge of civic activism, personal vision and dedication, popular protest and judicial courage in our democratic constitutional state.

10 Years of ARVs remind us, joyfully, how much we will need all of these, and more, in the next ten years.

A number of people have over the years played a role in the development of the TAC and our battle for antiretrovirals. There are too many to mention. In the following pages a small group of people who played a role in one way or another and represent various constituencies, share their recollections of the past and their dreams for the future.

For me, 10 Years of ARVs represents three different, but all joyful, things – personal, political and legal.
Personally, 10 Years of ARVs has meant ten more years of life.

I fell severely ill towards the end of 1997. On median survival time, I would have been dead by mid-2000. Instead, I’m alive, fit and vigorous. At first, I had unpleasant side effects but they soon abated and my virus has been undetectable since 2000, when I had a brief viral load blip. I have turned 60 when I never thought I would make 40. ARVs have made this possible. It is something for which I am profoundly grateful every day.

ARVs for me have meant life and health in the face of certain death, and the capacity to work, contribute, enjoy friendship, love, fun and play.

Politically, 10 Years of ARVs signals one of democratic South Africa’s greatest achievements.

From a flailing and uncertain national response beset by the ghastly nightmare of denialism, we have managed to create the largest publicly-provided ARV treatment programme anywhere in the world. ARVs are not the full answer to AIDS. We have to intensify prevention efforts. Nor are they entirely easy: We need to expand access to simpler one-tablet-per-day treatment, and we must lessen stigma – both external (discrimination) and, perhaps even more importantly, its internalised dimension, for this may be stigma at its most dangerous. We should treat HIV for what it is – a chronic, manageable condition. ARVs are the golden key to this. They are the only successful treatment – and they do succeed.

One of the ways in which ARVs succeed is that they render those successfully taking them incapable of infecting others. ARVs represent a coincident triumph of treatment, prevention and lessening stigma. When I think of the ten-year national ARV programme, I think: If we South Africans can do this – if, in the face of governmentally-led scepticism, public doubt, human frailty, resource scarcity and infrastructural debility, we can provide a hugely successful treatment programme saving millions from a fatal disease – then we can do anything.

Last, for me, as a lawyer and a judge, 10 Years of ARVs represents one of the greatest achievements of South Africa’s Constitution and the rule of law it embodies.

Amidst the nightmare of presidential denialism, South Africans did not rest inert. They knew they had a Constitution. With a Bill of Rights. Which enshrined the right to speak out, to organise, to march, to protest – and, crucially, the right of access to health care. And most importantly, with the right to challenge government’s response in the courts.

Presidential denialism, which made government refuse to start a mass treatment rollout, violated the right of access to health care. The Treatment Action Campaign and its allies asked the courts to vindicate that right. And the courts did. In the bravest, and possibly most important, judgment of its 20 years, the Constitutional Court unanimously ordered President Mbeki’s government to start making ARV treatment publicly available.

10 Years of ARVs has been the culmination of a powerful surge of civic activism, personal vision and dedication, popular protest and judicial courage in our democratic constitutional state.

10 Years of ARVs remind us, joyfully, how much we will need all of these, and more, in the next ten years.