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TAC the first five years.
The Treatment Action Campaign “in less than five years of existence moved a nation, shifted government policy and advanced the rights of people with HIV everywhere in the world… TAC’s struggle grows out of the best traditions of the anti-apartheid movement. TAC will be a shining light for citizen action for decades to come.” - Graca Machel, on presenting TAC with the Nelson Mandela, Health and Human Rights Award in 2002
Simon Nkoli: (chanting)
Simon Nkoli: And I say to them, viva GLOW, viva.
Simon Nkoli's funeral
12 December 1998
Narrator: Simon Nkoli, a leading campaigner for gay and lesbian rights, died from AIDS related complications in 1998. Simon felt that the department of health had not done its duty in providing treatment for people living with HIV and AIDS and in his dying months, issued an angry call for action.
Zackie Achmat: We are not asking for everything, we recognise that the government has a problem with resources, but we ask you one thing. ‘Join our hands to fight the drug companies, join our hands to raise money from the private sector, join our hand in raising money from each of us who will contribute to save the lives of everyone who needs to be saved.'
Narrator: At Simon's funeral Zackie Achmat called for the formation of a Treatment Action Campaign. The first demand of the TAC was for a Mother-To-Child-Transmission-Prevention programme. We held our first demonstration on the steps of St Georges Cathedral in Cape Town.
At first relations with the Minister of Health at the time, Dr Nkosazana Zuma, were friendly. In 1999 one months treatment with antiretrovirals would cost between R4000 and R6000, when most people only earned less than R2000 a month. The minister was keen to see the prices made affordable for poor people. They started organising branches who's pathos was to start educating ourselves about HIV/AIDS, this was the origin of our focus, Treatment Literacy. It was true education about the scientific, social and political aspects of HIV and AIDS. That we could take control of the virus within us and of the pandemic as a whole.
Narrator: In 1999 Thabo Mbeki succeeded Nelson Mandela as the president of South Africa. Then the unthinkable happened. Thabo Mbeki announced the appointment of a Presidential AIDS Panel to investigate whether HIV was the cause of AIDS.
Dr Manto Tshabalala-Msimang appointed as national Minister of Health
Thabo Mbeki - President of the Republic of South Africa
Thabo Mbeki: ...some of the people in this room, to ask, what is the cause.
Narrator: In 2000 South Africa hosted the World AIDS Conference.
MC: Welcome to the 13th International World AIDS Conference.
Narrator: The amount of people living with HIVB in South Africa had increased to nearly 4.5 million in 2000. Sub-Saharan Africa had become the epicentre of the epidemic. Yet antiretroviral treatment was unaffordable for most in our region. The TAC organised a mass march for treatment access. The march mobilised global opinion in support of the call that patents and profits should not be allowed to prevent access to life saving medicines. In a crucial opening address to the conference judge Edwin Cameron placed the issue of access to treatment on the agenda.
Justice Edwin Cameron: I'm here, I am able to be talking to you, I am able to engage with you, I am able to speak to you about this important topic, because I am on antiretroviral therapy. There are people throughout Africa, 25 million people in Africa and 34 million people in our whole world, who are this moment dying. And they are dying because they don't have the privilege that I have, of purchasing my health.
Dr Peter Mugenyi: Where are the drugs? That's where they are, the drugs are where the disease is not. And where is the disease? The disease is where the drugs are not.
Narrator: During her term as Minister of Health Dr Zuma tried to introduce the Medicines Act, which allowed for wider access to cheaper generic medicines once the patent had expired. The Pharmaceutical Manufacturers Association opposed the medicines act. The TAC organised a campaign against the Pharmaceutical Manufacturer's Association, in support of the government and the Medicines Act. We mobilised trade unions, religious leaders and other NGOs to support the campaign. Faced with this opposition the PMA withdrew. The victory encouraged the growth of the TAC.
Zackie Achmat: We call on the PMA, to announce the sale of AZT to the government at R180 for a one month course for a pregnant women or rape survivor now!
Bem Plumley (Glaxo SmithKline): You asked us to announce the price of R180 for a course of AZT to treat a pregnant mum and a rape survivor, in other words what's called post exposure prophylaxis. You also asked us to reveal our manufacturing costs. Now I have to be upfront with you today and say, rioght now, right here, we can't do that.
Narrator: TAC went to Thailand and brought back a generic version of Pfizer's fluconazole, a highly effective medicine in the treatment of oral thrush. The generic version costs only 58 US cents a tablet, whilst Pfizer charged government $7 per tablet.
Narrator: In 2001 the TAC held its first national congress, where the growth of the organisation was clearly visible. The major challenge facing the TAC was to move forward with the Mother-To-Child-Transmission-Prevention Campaign, the original demand on which the TAC was founded.
Busisiwe Maqungo: My daughter died from AIDS at the age of nine months. There was no HIV Mother-To-Child-Transmission-Prevention Programme. I knew nothing about using antiretrovirals to prevent passing on the virus to my daughter.
Narrator: Research showed that a single dose of the antiretroviral Nevirapene could reduce the incidence of mother to child transmission of HIV by 50%, this simple low cost regimen reinforced the argument for a mother to child transmission prevention programme. With over 60 000 HIV positive infants born each year the need was urgent.
Launch of the PMTCT Court case
August 2001
Zackie Achmat: The Treatment Action Campaign has launched an application today in the Pretoria High Court for the government to implement mother to child transmission programmes.
Busisiwe Maqungo: I am also here supporting this Court case against our government, because I think it is necessary for the government to implement the MTCT to all the MOUs (Maternal maternal Obstetric Unit) in South Africa, not only in Cape Town. I'm supporting this not only because I also lost a child to MTCT. If there was MTCTPP I think my child would have been alive today.
Narrator: The TAC took the government to the Constitutional Court, arguing that the Constitution guaranteed the right to life, dignity and equality as well as the right to health care, and that this required government to implement a Prevention of Mother to Child Transmission Programme. The Court ruled in favour of the TAC.
Judge Arthur Chaskalson (Chief Justice of South Africa): We require the government to devise and implement, within its available resources, a comprehensive and coordinated programme, to realise progressively the rights of pregnant women and their unborn children, to have access to health services to combat mother to child transmission of HIV. The steps that have to comply with the order that we make should be taken without delay.
Nathan Geffen: I want to reiterate that the TAC is willing to work with government at every level to try and make this programme a success.
Narrator: With this victory the TAC redoubled its treatment literacy work with the support of the Treatment Action Group from New York. Treatment Literacy workshops were held countrywide. These workshops laid the foundation of a treatment literate cadre which understands the science and politics of HIV and AIDS.
Gregg Gonsalves: And you see here? All those proteins, all those parts of the virus are going are going to the outside of the cell, and they are starting to bulge out here and then it gives off a daughter virus.
Narrator: In 2002 the TAC brought together all significant role players including churches, trade unions, government officials, health care workers and others in a National Treatment Congress, which expresses our commitment to creating a broad alliance in support of treatment. The Congress proposed a national treatment plan which would spell out how a comprehensive approach to treatment would be implemented.
Zwelinzima Vavi (COSATU General Secretary): This conference will look at options to ensure that our people have access to affordable and effective treatment.
Mark Heywood: We are aiming to develop a South African national HIV/AIDS treatment plan.
Nono Simelela (Head of HIV/AIDS Unit, Dept of Health): I want to pledge the commitment, at least of the Department of Health HIV/AIDS Unit, to work in partnership. As Zackie says it has been heavy. Remember, we are out there, also working for the same goals and I wish you well, and we are here, still working towards the same goals.
Zackie Achmat: For us this has been a remarkable congress. We believe that this creates the basis for a treatment plan that we, Treatment Action Campaign, COSATU and all of civil society will put to NEDLAC and we hope it will be taken forward from there to SANAC and the government and that we will have access to antiretroviral therapy and the proper treatment of HIV in our country.
Narrator: Whilst antiretrovirals are only part of the answer to surviving HIV the vast majority of people will need them if they are to sustain health and life. The 1990s was the decade in which millions became infected with HIV. The first decade of the new century is marked by high mortality rates from AIDS related diseases. In South Africa alone over 600 people are dying daily from AIDS.
Edward Mabunda: How can I sing a love song when my sweetheart is dying, how can I sing a love song when my brother is dying, how can I sing a love song when my mother is dying. South Africa, now is the time to stand up for your rights. Treatment plan now!
Narrator: In February 2003 the TAC organised a national march at the opening of the Parliament, to demand a national treatment plan. Over 20 000 people attended. The TAC made it clear that a programme of peaceful, non-violent civil disobedience would begin unless government responded positively.
Zackie Achmat: What civil disobedience is is that we accept government, we accept the legitimacy of government, we want to change its policy. But we are prepared to sacrifice to change that policy, and the sacrifice we make is being prepared to go to jail.
TAC Civil Disobedience Campaign
Durban 2003
Narrator: Faced with continued government stonewalling we commenced a campaign of peaceful disciplined and non-violent civil disobedience. During the campaign many TAC activist succumbed to AIDS, including Sarah Hlalele, Edward Mabunda, Charlene Wilson, Keboreng Moketsi and over a hundred others.
Nelson Mandela visits TAC Chair Person
22 July 2002
Nelson Mandela: His action is based on fundamental principles which we all admire. The admiration for him is not confined only to the Western Cape or South Africa. People far beyond our boarders are aware of the principled stand that he has taken.
Treatment Action Campaign
Free your mind
Narrator: The TACs work in mobilising communities to take control of the pandemic has been recognised in a series of awards. The MTV Free Your Mind award.
Pholokgolo Ramathwala: We are honoured to accept this award on behalf of the Treatment Action Campaign, and to all people living with HIV/AIDS.
Jonathan Mann award for Health and Human Rights
Narrator: The Jonathan Mann award and the Nelson Mandela Health and Human Rights Award.
Narrator: On the 8th August 2003 cabinet announced that government was going to commence an antiretroviral treatment programme for the country and appointed a task team to formulate a plan for the rollout. This announcement is the crowning achievement of four years of struggle to place treatment on the national agenda.
Zackie Achmat: Now there is a lot of hard work that lies ahead. You see, where do we want to start? What do we want? From today on everyone of us must make sure that TAC campaigns with other organisations like New Women's Movement, like Molo Songololo, like all the organisations that we have worked with, that we campaign for a peoples healthcare service in this country. Because at the moment the healthcare service is not dealing with the needs of poor people enough.
Narrator: the most difficult task for the TAC now lies ahead, to support the role out of the treatment plan. The most important tasks are to ensure adherence to the treatment regimen and that people are empowered to react quickly to any side effects of the medication. This will require an expanded treatment literacy programme, the role out will have to be phased. Tragically many people will die whilst waiting for access to medication. The TAC feels that we have a responsibility to find treatment for all members who have fought for treatment and have been role-models of openness in their communities. This is the task of the TAC treatment project which will bring affordable access to 1 000 activists and members of the communities which support them by the end of 2004. we can only do this with your support.
Access to Information Protest
4 November 2004
Narrator: With government's commitment to implement a national treatment plan, 2004 dawned hopefully. There was a spirit of optimism. The TAC stressed that we were willing to work with the government to ensure the success of the role out.
Sipho Mthati: We are demanding from the health minister, a timetable for the implementation of the treatment plan. Western Cape and Gauteng together have got close to 10 000 people on to treatment, We would like to say to Farreed and to the western Cape government that we commend your efforts to begin to implement a treatment plan to save lives.
Lusikisiki
Eastern Cape 2004
Narrator: The role out began slowly, but as more sites opened up throughout the country thousands of people were successfully put on treatment. This was a huge victory for TAC and all South Africans. It was late, it was slow, but it was happening.
Lydia Mokoena: [My name is Lydia Mokoena. I tested in 2004 and found out in May that I'm HIV positive. I was very sick and I couldn't swallow my food. I went to KTC clinic and they referred me to Dr Peter in Site C. Dr Peter told me that I will start taking the drugs, he said that I will take 3TC, Nevirapine and AZT. After two weeks I felt better and could get up. I'm happy because I'm living as a result of these drugs, ARVs.]
TAC "200 000 by 2006"
March to Parliament February 2005
Nompumelelo Mantangana: The government had at least listened to our cries and we thank them for that. We are at war, not with the government but with the deadly killer disease HIV and AIDS.
Ministereal Health Imbizo Khayelitsha
Narrator: But it soon became clear that the Minister of Health Manto Tshabalala-Msimang was aligning herself with the President, openly supporting the activities of prominent AIDS denialist Tine van der Maas. In this meeting in Khayelitsha the minister refers to a video made by Van der Maas.
Manto Tshabalala-Msimang: You will see that the group that has been working on garlic, on lemons, they want to choose vitamins. I can tell you, I have also seen, I have promised the development of a video, where they can see for themselves.
Propaganda video produced by Tine van der Maas
Power to the people.
(clip) Tine van der Maas: Hi, this is Nelly van der Maas, my mother and my best friend.
Narrator: Van der Maas claimed that a diet of beetroot, garlic, olive oil and other supplements can reverse the condition of someone with full-blown AIDS to an HIV positive status. She claimed that antiretrovirals were toxic and encouraged people to stop taking them
(clip) Tine van der Maas:... and this one, three table spoons in the morning...
Narrator: The minister asserts that people should be given a choice of treatment of either nutrition, micro-nutrients or ARVs.
Manto Tshabalala-Msimang: If the antiretrovirals can do so and you accept them, leave other people to choose what they want. If they want to eat properly so that they can boost their immune system so be it. This is a free country, you choose what you want.
Narrator: She remained silent on the benefits of ARVs, instead emphasising their problems. Ama antiretrovirals, they have got serious effects, side effects, they do, unlike nutrition. Nutrition has no side effects. It can't be that your government is not doing good things, it cannot be.
Narrator: In reality thousands of people who had been dying of AIDS had got their lives back thanks to ARVs and healthcare workers know that antiretrovirals are saving lives, preventing children from being orphaned and allowing people to go back to work.
Narrator: The TAC has always stressed that people living with AIDS need both food and antiretrovirals, but nutritional supplements are not a treatment for AIDS or an alternative to ARVs.
Access to information Protest
4 November 2004
Narrator: The ministers continuing denialism has created a serious lake of leadership in the ARV rollout. By late 2004 only 25 000 people were on treatment. It seemed to be a matter of luck. Access to ARVs depended on whether or not you happened to live near a registered treatment site.
Sipho Mthati: Access to healthcare services should not depend on where you live. And because you live in a certain province you should not have to die.
TAC 200 000 by 2006
March to Parliament February 2005
Narrator: The TAC called for faster action, 200 000 people on treatment by 2006.
Nompumelelo Mantangana: 200 000 patients on ARVs in 2006. We have to really work hard to reach the target.
Narrator: But the government did not join hands with the TAC to meet this challenge. Instead in 2005 the minister continued to back the denialist Dr Rath. Rath is an aggressive vitamin salesman who has been lobbying against the use of ARVs, saying that they are toxic and that HIV positive people should instead take his vitamins. He saw an opportunity to exploit the suffering of people living with HIV by offering high doses of vitamin supplementation as a treatment able to reverse the cause of AIDS. Dr Rath began a vicious advertising campaign claiming that the TAC was a front for the pharmaceutical industry. TAC complained to the advertising standards authority who ordered the adverts to be stopped. TAC also took Dr Rath to court to prove that his claims were false.
Zackie Achmat: Dr Rath has not produced a single shred of evidence to show that TAC is funded by Pharmaceutical companies. Our job is to make sure that no-one profiteers from our misery.
Narrator: The tragedy of Dr Rath and Tine van der Maas is that they have been diversions from our real work; making a success of the treatment plan and working with government to all who need it.
Zackie Achmat: Our job is to get what? Medicines for people, 200 000...
Crowd: ...by 2006
Zackie Achmat: 200 000...
Crowd: ... by 2006
Narrator: By mid 2005 over 50 000 people were accessing treatment via the public sector. This would not have happened if it were not for the efforts of hundreds of thousands of people who have supported TAC's call for a national treatment plan. But over 500 000 people need treatment and AIDS is still claiming too many lives.
Nozuko Smile: [I am Nozuko Smile. I live here in Queenstown. I was diagnosed on the 4th November 2003. I learnt that I was positive. As I was positive, I went for a CD4 count. I received my count and it was 143. I haven't started ARVs, I'm still on the waiting list till now. I have been on Bactrim for 4 months with a pill count (Health Department Treatment Readiness Programme). I don't know what I am expected to do.
Narrator: When TAC comrades in Queenstown held a peaceful demonstration to demand the speeding up of the rollout to stop the deaths in their district, they were met with bureaucracy and rubber bullets.
Mziwethu Faku: The rollout is very, very, very slow and we demand that at least 20 or more people are placed on treatment per month in the Chris Hani district. To assist in team to making the ARV rollout a success in this district.
CEO Mosia (Frontier Hospital, Queenstown): What I want to request here at this moment is that the management of Frontier be allowed to get together, okay, and look at the matters at hand that are contained in this memorandum. I am sure that you are aware that we will not be able to actually respond to the issues that are actually contained here. The only thing that we can do is to say to you that we will forward the memorandum today to the province.
Linda Mafu: A very quick response. {isiXhosa} [We were here as TAC Queenstown, meeting with Mr Mosia on the 5th of May.] And he answered in exactly the same way. {isiXhosa} [He would meet with management and see how he could work with us. My conradesm we are here two months later, we are still receiving the same response, it's not on!]
Narrator: Now was the governments time to stop the flirtation with AIDS denialism and face reality. TAC stands ready to work with government, to help prepare people to go on treatment and to do the treatment support work needed to ensure good adherence to medication. We will support positive nutrition programmes and to urge government not to just talk about nutrition, but to make food available to the many people in need. We will help ensure that clinics and hospitals have the medicines that are needed. Not only for HIV but for other infections as well. We will educate people about the treatment of opportunistic infections and campaign for better TB tests and drugs, and for effective microbicides. Our job is to make sure that government meets its obligation to ensure healthcare for all South Africans.
