In a startling closing address at the South African National Aids Conference on August 6, the provincial minister for health in Kwa-Zulu Natal, Dr Zwele Mkhize, said the South African government was committed to a comprehensive AIDS treatment plan for the country.

At the opening of the Durban conference on August 1, Health Minister Manto Tshabalala-Msimang had addressed the 4,000 delegates. Defending the government’s inaction in the face of the AIDS pandemic, she launched into a paranoid attack on “agents who are bent upon misleading the people”. During her address, Treatment Action Campaign protesters, wearing T-shirts emblazoned with the slogan “2 pills can save a life” held up placards with the names of people who had succumbed to AIDS. Deputy President Jacob Zuma, speaking after Tshabalala-Msimang, took a more placatory line stating that the government was “in the process of finalising several international agreements that will ensure access to medication to the many people infected with HIV and AIDS.”

The South African government’s sudden about-turn on the matter of a national treatment plan seems to have been precipitated by concerns about the forthcoming national elections in 2004. According to a report by Jaspreet Kindra of the Mail and Guardian, the main drivers behind the precipitous climb down were the ANC’s head of elections and Northern Cape Premier Manne Dipico, the director of a national research program on social aspects of HIV/AIDS at the Human Sciences Research Council Olive Shisana, and head of government communications Joel Netshitenzhe. Education Minister Kader Asmal and Minister of Public Enterprises, Jeff Radebe, were also named as key players in the dramatic shift.

While the ANC is prepared to admit to slow progress in dealing with poverty and unemployment, Dipico pointed out that they have neither a strategy nor answers to deal with criticism of the government’s handling of the AIDS crisis.

The surprise announcement at the South African National AIDS conference was followed by a decision at a special cabinet meeting to instruct the Department of Health to develop a detailed operational plan for the supply of anti-retroviral drugs by the end of September. The decision followed the cabinet’s endorsement of the report of the joint Health and Treasury task team, established in July 2002 to investigate the cost implications of a national AIDS treatment and prevention plan. According to the report, between 500,000 and 1.7 million lives could be saved by anti-retroviral therapy.

The cabinet decision apparently followed weeks of lobbying in the face of opposition from President Mbeki and Tshabalala-Msimang. The reportedly “despondent” health minister’s unhappiness with the cabinet instruction was clear in a number of remarks she made on Women’s Day on August 9. “I can’t say we have a rollout because the plan has not been adequately costed," stated the minister. In response to questions from reporters she repeatedly said, “I am not the one making the decisions; the cabinet decides collectively."

Opposition political parties have expressed concern about the success of the plan’s rollout under Tshabalala-Msimang. They have focused on the personal foibles of the minister herself, demanding her replacement. No consideration is given to the economic system, enthusiastically endorsed by these parties, which denies vast numbers of South Africans access to lifesaving medicines.

The seemingly endless dithering of the South African government has cost its citizenry dearly: one million deaths since the appearance of the virus, and 600 new infections per day.