Gaining Access to Medicine through Social Change

South Africa currently has one of the highest rates of HIV/AIDS infection in the world. A joint study by the Human Sciences Research Council and the Nelson Mandela Foundation in 2004 estimated that 15.6% of South Africans have the disease – with even higher infection rates manifesting in some parts of the country. The economic and developmental impacts of HIV/AIDS threaten to undo many of the achievements of South Africa’s much-lauded democracy.

The situation was not helped by the national government’s initial questioning of the link between HIV and AIDS, nor by its slowness to start treating those with the disease through the public health service. In other developing countries, the life expectancy of people with AIDS has demonstrably improved when anti-retroviral drugs (ARVs) have been provided through the public health service.

Prospects for progress increased substantially in late 2005. The South African government gave the country’s provinces sufficient leeway to mount creative interventions that have helped ameliorate some of the devastation that HIV/AIDS has caused. These efforts have been complemented positively by robust interventions initiated by civil society organisations – most notably, the Treatment Action Campaign.

Purpose and Impact of the Grant

The Treatment Action Campaign (TAC) captured and leveraged the groundswell of public opposition which manifested as a result of the South African government’s original policies on HIV/AIDS. TAC has mobilised a grass roots movement of people with HIV, mostly in poor communities, to advocate for better care. The organisation’s strategic blend of research, public advocacy and litigation – backed by social activism and media outreach – has made it an exemplar for social-change organisations.

In a series of highly publicised court cases, TAC has forced the government to comply with its constitutional obligations and begin providing ARVs to sick people through the public health service. TAC also won a huge public following as a result of the principled and well-publicised actions of its chairman, Zackie Achmat. Achmat, who has AIDS himself, refused to take ARVs even though he had the financial means to do so, until the drugs were available to all. By strengthening the capacity of TAC, we hope to measurably reduce the rate of increase in new HIV/AIDS infections and prolong the productive lives of those living with the disease.