Obstacles to the response to HIV/AIDS in South Africa: Historical legacies in perception and policy environment in 1994

Abstract

This paper presents the results of a study which overviews the policy failure regarding antiretroviral treatment (ART) in South Africa from the late 1990s to the mid-2000s. Despite being clinically proven by the international medical community to be effective in the treatment and prevention of HIV (Human Immunodeficiency Virus), ART was not implemented in post-apartheid regimes. President Mbeki denied the conventional scientific truth that HIV causes AIDS. Such a policy environment as a function of administration combined with a bureaucratic system and health care infrastructure was unfavorable for the implementation of ART. The report attempts to reveal how colonial history and apartheid experiences had an influence on shaping the perception of Mbeki as well as the conditions for policy development, which impeded the introduction of the ART program.

Keywords

HIV/AIDS antiretroviral treatment (ART)South Africa perception policy environment Mbeki

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References

Benatar

(2001) South Africa’s transition in a globalizing world: HIV/AIDS as a window and a mirror. International Affairs 77(2): 347–375.

Benatar

(2004) Health care reform and the crisis of HIV and AIDS in South Africa. The New England Journal of Medicine 351(1): 81–92.

Butler

(2005a) South Africa’s HIV/AIDS policy, 1994–2004: How can it be explained? African Affairs 104(417): 591–614.

Butler

(2005b) The negative and positive impacts of HIV/AIDS on democracy, South Africa. Journal of Contemporary African Studies 23(1): 3–26.

Cohen

(2000) South Africa’s new enemy. Science 288(5474): 2168–2170.

Commentary (2000) The Durban Declaration. Nature 406: 15–16.

Epstein

(2003) AIDS in South Africa: The invisible cure. The New York Review of Books 50(12): 44–49.

Fassin

Schneider

(2003) The politics of AIDS in South Africa: Beyond the controversies. British Medical Journal 326(7387): 495–497.

Fourie

(2006) The Political Management of HIV/AIDS in South Africa: One Burden Too Many? New York, NY: Palgrave Macmillan.

10.

Fredland

(2001) A sea change in responding to the AIDS epidemic: Leadership is awakened. International Relations 15(6): 89–101.

11.

Gauri

Lieberman

(2006) Boundary institutions and HIV/AIDS policy in Brazil and South Africa. Studies in Comparative International Development 41(3): 47–73.

12.

GCIS (Government Communications) (1998a) Mandela to address nation on AIDS (‘Partnership Against AIDS’). Available at: http://www.gov.za/search/searchdb.htm (accessed 22 March 2012).

13.

GCIS (Government Communications) (1998b) Mandela will address nation on AIDS. Available at: http://www.gov.za/search/searchdb.htm (accessed 22 March, 2012).

14.

Heywood

(2003) Current development: Preventing mother-to-child transmission in South Africa, background, strategies and outcomes of the treatment action campaign cases against the Minister of Health. South African Journal of Human Rights 19: 278–315.

15.

Independent Online (2000) Government rejects declaration on AIDS, July 3, 2000. Available at: http://www.iol.co.za/news/south-africa/government-rejects-declaration-on-aids-1.42175?ot=inmsa.ArticlePrintPageLayout.ot (accessed 28 March 2013).

16.

Johnson

(2004) The politics of AIDS policy development and implementation in post-apartheid South Africa. Africa Today 51(2): 107–128.

17.

Lindahl

Sundset

(2003) The grammar of threat and security in HIV/AIDS - An analysis of the South African Government’s discourse on HIV and AIDS between 1998–2002. Master’s Thesis, Linköping University, Sweden.

18.

Mbali

(2004) AIDS discourses and the South African state: Government denialism and post-apartheid AIDS policy-making. Transformation: Critical Perspective on Southern Africa 54: 104–122.

19.

Moran

(2004) HIV/AIDS, governance and development: The public administration factor. Public Administration and Development 24(1): 7–18.

20.

Nattrass

(2004) The Moral Economy of AIDS in South Africa. Cambridge, UK: Cambridge University Press.

21.

Nattrass

(2005) AIDS policy in post-apartheid South Africa. Yale Macmillan Center Online Draft. Available at: http://www.yale.edu/macmillan/apartheid/apartheid_part1/nattrass.pdf (accessed 5 May 2012).

22.

Nattrass

(2007) Mortal Combat: AIDS Denialism and the Struggle for Antiretrovirals in South Africa. Scottsville, KwaZulu-Natal: University of KwaZulu-Natal Press.

23.

Nattrass

(2008) AIDS and the scientific governance of medicine in post-apartheid South Africa. African Affairs 107(427): 157–176.

24.

Okaware

Opio

Musinguizi

Waibale

(2001) Fighting HIV/AIDS: Is success possible? Bulletin of the World Health Organization 79(12): 1113–1120.

25.

Parkhurst

Lush

(2004) The political environment of HIV: Lessons from a comparison of Uganda and South Africa. Social Science & Medicine 59(9): 1913–1924.

26.

Putzel

(2004) The politics of action on AIDS: A case study of Uganda. Public Administration and Development 24(1): 19–30.

27.

Schneider

(2002) On the fault-line: The politics of AIDS policy in contemporary South Africa. African Studies 61(1): 145–167.

28.

Schneider

Stein

(2001) Implementing AIDS policy in post-apartheid South Africa. Social Science and Medicine 52(5): 723–731.

29.

Schoofs

(1998) Problem pregnancy: Doctors regard AZT as an AIDS vaccine for babies, but South Africa says it’s too expensive. 15 December. Available at: http://www.villagevoice.com/1998–12–15/news/problem-pregnancy/ (accessed February 4, 2012).

30.

Shafer

Chuachoowong

Mock

Bhadrakom

Siriwasin

Young

Chotpitayasunondh

Chearskul

Roongpisuthipong

Chinayon

Karon

Mastro

Simonds

(1999) Short course Zidovudine for perinatal HIV-1 transmission in Bangkok, Thailand: A randomised clinical trial. The Lancet 353(9155): 773–780.

31.

Sheckels

(2004) The rhetoric of Thabo Mbeki on HIV/AIDS: Strategic scapegoating? Howard Journal of Communications 15(2): 69–82.

32.

Singh

(2006) Media perceptions and academic responses to South African President Thabo Mbeki. Journal of Social Science 13(3): 163–176.

33.

Skordis

Nattrass

(2002) Paying to waste lives: The affordability of reducing mother-to-child transmission of HIV in South Africa. Journal of Health Economics 21(3): 405–421.

34.

The Citizen (1998) Doctors welcome AIDS transmission trial results. The Citizen, 20 February 20.

35.

Thornton

(2008) Unimagined Community: Sex, Networks, and AIDS. Berkeley and Los Angeles, CA: University of California Press.

36.

UNAIDS (2014) GAP Report. Geneva, Switzerland: UNAIDS. Available at: http://www.unaids.org/en/resources/campaigns/2014/2014gapreport/gapreport (accessed 22 August 2014).

37.

Van der Vliet

(2001) AIDS: Losing ’ the new struggle’? Daedalus 130(1): 151–184.

38.

Van der Vliet

(2004) South Africa divided against AIDS: A crisis of leadership. In: Kauffman

Lindauer

(eds) AIDS and South Africa: The Social Expression of a Pandemic. New York, NY: Palgrave Macmillan.

39.

Washington Post (2003) Mbeki says diplomacy needed for Zimbabwe. Washington Post, 25 September. Available at: http://www.washingtonpost.com/ (accessed 22 January 2013).

40.

Whiteside

De Wall

(2004) ‘That’s resources you see!’: Political economy, ethics and the HIV/AIDS epidemic. New Political Economy 9(4): 581–594.

41.

WHO (2003) World Health Organization says failure to deliver AIDS treatment is a global health emergency. WHO Press Release. Available at: http://www.who.org/ (accessed 22 January 2013).

42.

WHO (2014) Access to antiretroviral drugs in low- and middle-income countries. Technical Report, July 2014. Available at: http://apps.who.int/iris/bitstream/10665/128150/1/9789241507547_eng.pdf?ua=1&ua=1 (accessed 22 September 2014).

43.

Willan

(2004) Briefing: Recent changes in the South African government’s HIV/AIDS policy and its implementation. African Affairs 103(410): 109–117.

44.

Youde

(2007) AIDS, South Africa, and the Politics of Knowledge. Burlington, VT: Ashgate.

45.

46.

47.

48.

http://www.who.int/hiv/topics/treatment/en/.

Obstacles to the response to HIV/AIDS in South Africa: Historical legacies in perception and policy environment in 1994–2006

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