When Nelson Mandela last week revealed that his son Makgatho had died of HIV he was showered with praise for his leadership and bravery. The director of the UN Aids programme, Peter Piot, hailed Mandela's "unwavering and outspoken" opposition to HIV stigma and discrimination.
Mandela's candour about his son's illness will undoubtedly help to erode Aidsphobia. Compared to most other world leaders, he has been forthright concerning the need to combat the pandemic. For these reasons, we appreciate Mandela and admire him. There is, after all, very little international leadership in the fight against HIV.
Mandela's commitment and openness is therefore commendable, but this is mostly in contrast to the dishonesty and neglect of Aids by others. He has merely done what any responsible public figure should do: tell the truth and challenge HIV prejudice.
"Aids is the worst catastrophe ever to hit the world," according to the children's agency, Unicef. It causes a death toll equivalent to an Asian tsunami disaster - to which the international community has responded so well - every three weeks. As Joan Smith suggests on this page, Aids, by comparison, gets a raw deal.
Worldwide, 42 million people are infected. Already, 15 million children have been orphaned. In sub-Saharan Africa, there are 25 million HIV-positives, including nearly two million under 14. Hardly any of these people have access to treatment.
Mandela is the closest thing we have to a living saint. But the anti-apartheid liberation hero has, by his own admission, a less than heroic record on Aids. When he was South African president, from 1994 to 1999, he bowed to public sensitivities and taboos, failing to deal decisively with the HIV crisis. Mandela refused calls to lead a public education and prevention campaign. Early action would have saved lives and slowed the spread of the virus, which has now infected five million South Africans.
Is it fair to criticise the great man? Yes. From an extraordinary leader, we expect extraordinary leadership. On HIV, President Mandela let down his own people. He ignored the pleas of HIV-positive activists, many of whom were members of his African National Congress (ANC). They survived the bullets and beatings of the apartheid regime, only to be, in effect, sentenced to death by the inaction of their own ANC government.
This neglect has continued under Mandela's successor, Thabo Mbeki. He denies knowing anyone with Aids, even though his spokesman, Parks Mankahlana, died of the disease. Mbeki has also disputed the scientific evidence that HIV causes Aids, and opposed the use of anti-retroviral drugs, proven to cut the death rate. The result? An Aids holocaust. HIV is killing more South Africans than apartheid, claiming more than 600 lives a week, the equivalent of nine Sharpeville massacres every seven days. Last month, the ANC attacked Aids activists for demanding that more anti-HIV drugs are made available to the poor, accusing them of being part of a Western plot to distribute unsafe treatments. Mandela remained silent during the controversy.
Although he publicly embraced HIV-positive campaigners and chided Mbeki in 2002, the following year Mandela objected to his photo being used to promote a march in Cape Town urging a mass-treatment programme.
Is Mandela a hero of the South African battle against HIV? No. The real hero is Zackie Achmat, leader of the Aids activist Treatment Action Campaign (TAC). An ANC activist in the apartheid era, Achmat is openly gay and HIV positive. In 2000, he went to Thailand and illegally shipped back to South Africa cheap, generic versions of anti-retrovirals for distribution to people on low incomes, forcing Mbeki to end the import ban. TAC then won a court case compelling the government to provide treatment to HIV-positive pregnant women.
Two years ago, an ailing Achmat went on treatment strike. He refused life-saving drugs, insisting that he would not take them until they were made available to everyone at low cost. Risking his life, he helped to pressure the government to increase the provision of affordable drugs.
It is not too late for Mandela to make a huge difference. By speaking out and shaming the ANC government into action, he could help to ensure that South Africa's biggest post-apartheid struggle secures its goal: HIV treatment for all who need it - to halt needless, preventable deaths.Reuse content