Nelson Mandela attacked South Africa's HIV/Aids policies yesterday, saying he "could not stay silent" when children and young people were dying.
The pressure on Thabo Mbeki, the South African President, increased yesterday when the highest court in the country ordered his government to provide pregnantHIV-positive women with antiretroviral drugs.
Mr Mbeki's administration has been reluctant to provide drugs in the war against a virus that has infected one in nine of his citizens. Because of the ruling, Nevirapine must now be made available in all state hospitals.
The unanimous decision by the constitutional court, after a long legal battle, was a victory for Aids activists and for pregnant HIV-positive women. About 70,000 babies a year are infected with HIV before, during or after birth in South Africa.
Mr Mandela vowed to continue supporting greater access to free antiretrovirals in state hospitals, despite the ruling African National Congress's different stance. The former president said: "When people are dying – babies, young people – I can never be quiet."
He said he had not changed the views he expressed last month, when he called on people to have access to antiretrovirals if they wished. "If I have to talk about HIV-Aids – and I'm going to do so – I will repeat exactly those points that I have made." Among them was that South Africa could not afford to "conduct debates while people were dying".
But Mr Mandela also said that he supported President Mbeki for a second term, as he was doing "a marvellous job".
Mark Heywood, spokesman for Treatment Action Campaign (Tac), which with other Aids help groups challenged the government's policies, said: "What is most important is that from today or from tomorrow, children's lives can be saved at institutions which have the capacity and where doctors want to do so."
The latest Tac court victory is a crucial one, because it obliges the government to act on earlier rulings that, among other things, it has a constitutional obligation to try to save children's lives. South Africa's Bill of Rights assures socio-economic as well as legal human rights.
The ruling also means that the government can be prosecuted for contempt of court if it fails to execute the order. The Health Minister, Manto Tshabalala Msimang, has argued that the state is currently unable to implement a national roll-out of the drug to state hospitals and that it is awaiting the results of several pilot projects researching the drug's effectiveness. But Mr Heywood said: "The government can go no further with the legal process. They have to comply with the order and we hope they do."
The court order ends a series of legal battles aimed at forcing antiretroviral use by Mr Mbeki's government, whose questioning of the link between HIV and Aids has been come in for worldwide criticism.
The controversy continued this week with news of yet another policy report by the African National Congress, accepting the dissident view.
The government tried to delay a high court ruling last month, which ordered the government to make Nevirapine available, by asking the constitutional court to await the outcome of its appeal, set down to be heard in May.
But yesterday's execution order forces the government to deliver the antiretroviral in the meantime. It means that Nevirapine must be provided to all state hospitals and clinics whose doctors believe that they have the facilities and staff to test and counsel HIV-positive women, to prepare them for drug treatment.Reuse content