IDASA’s Governance and AIDS Programme (GAP) has, in conjunction with Fair Lady magazine, held a series of “conversations” about HIV and AIDS during 2005 and 2006. This article has been compiled from articles on the conversation series published in Fairlady magazine.

by Jo Tyler

South Africa has about 600 AIDS-related deaths a day, there are 5.2 million people in the country living with HIV and about 650 000 people are sick with AIDS or are receiving antiretrovirals. Between mid-2004 and mid-2005 there were 530 000 new infections.

These were some of the startling statistics that emerged during the fourth and final debate in the Fairlady/IDASA Conversation series that took place in Cape Town on February 22.

Organised by IDASA’s Media AIDS and Governance Project, the conversations started in August last year. Fairlady and IDASA decided to run the series because, even though the pandemic first rose to prominence about 20 years ago, many South Africans still believe that HIV/AIDS is someone else’s problem.

The aim of the interactive conversation series was to explore how HIV and AIDS affects every aspect of our lives, including family and work life, the economy and the media.

The first conversation in the series – which focused on how HIV/AIDS has forced us to re-define traditional roles of men, women, children and employers – took place on 17 August 2005 at Constitution Hill in Johannesburg.

Sisonke Msimang, programme officer for HIV/AIDS with the Open Society Institute, said men need to be persuaded to get more involved in the prevention of HIV. “We need to encourage men to practise safe sex because it feels good to be with a woman knowing that you are both safe,” she said.

A recent Medical Research Council study showed that 77 percent of young people, aged 15 to 24, who are HIV positive are women. Msimang said more women than men are contracting HIV at younger ages.

Msimang said this was not only because women are biologically more vulnerable to contracting the virus than men, but also because of the power imbalances in relationships between men and women in South Africa. “If men and women functioned within partnerships of mutual care and respect we would be faced with a different scenario,” she said.

Gender Commissioner Bafana Khumalo told the audience that most people thought gender was something that concerned only women and it was time men saw themselves as part of the picture. He said: “Sometimes when we go in as gender commissioners to do training with government departments, only women are sent.”

Clem Sunter, former Anglo Gold and Uranium chief executive officer and known corporate strategist, said the apathy towards HIV/AIDS is “astounding”.

“In Europe when HIV/AIDS was first recognised as a threat, advertising agencies created very innovative public education campaigns that had a significant impact of sexual behaviour. I wonder why it is that no agency in South Africa has done the same,” he said.

The second conversation focused on the effect of HIV/AIDS on households. It was held in Cape Town on 28 September last year.

The plight of minor children – often left traumatised, destitute and vulnerable after the death of their parents from HIV- and AIDS-related illnesses – dominated the conversation.

Dr Mamphela Ramphele, author, academic, co-chair of the Global Commission on International Migration and chairperson of Circle Capital Ventures, and Dr Olive Shisana, president and chief executive officer of the Human Sciences Research Council, sketched a disturbing future scenario for AIDS orphans in southern and South Africa.

Dr Ramphele said South Africa already has about one million AIDS orphans and that by 2010 there would be at least 20 million children who would have been left without parents because of the pandemic. “What do we do with a head of household who is seven years old?” she asked.

Dr Shisana said the disease places a huge strain on people’s financial resources. To cover increased AIDS-related medical costs, households often reduced spending on education, food, housing, clothing and toiletries.

Dr Ramphele said: “We need to begin to understand the complexities of this epidemic and we also need to begin to get personally involved, each and every one of us.”

The third conversation took place in Johannesburg on 23 November 2005 and focused on the role of the media in setting the HIV and AIDS agenda.

Many of the journalists present agreed that stories needed a more “human face”, showing the stigmas real people endured. They said the big stories – for example the antiretroviral debate and the health minister’s comments about the disease – often overshadowed the personal stories.

A member of the audience commented: “The truth is that HIV is not merely a health issue, it affects all sectors of society, including the economy.”

Media, including advertising agencies, had a responsibility to get the message and the stories across to the public. Journalists were encouraged to challenge themselves and their editors who might be reluctant to publish stories about the pandemic.

On February 22, just a week short of this year’s local government elections, IDASA and Fairlady held the last conversation in Cape Town. The question posed was: “How important is political will and leadership in creating an effective response to the HIV and AIDS pandemic in South Africa?” The guest speaker was Mark Heywood, head of the AIDS Law Project at the University of the Witwatersrand.

He said South Africa still had a government that struggled to talk about HIV and this was aggravated by a minister of health “who often seems to be out of control and who uses a position of high influence to cause confusion”.

Heywood said countries like Brazil, Botswana and Lesotho are dealing with the pandemic in a far more effective manner. “Although Botswana’s programme is donor driven, Festus Mogae [the president] speaks about HIV and AIDS openly. In Lesotho the president and the king are talking about universal HIV testing. That is what we are missing.”

He acknowledged that, on paper at least, South Africa has one of the most impressive antiretroviral roll-out programmes in the world and that millions are spent on prevention campaigns, such as Lovelife, Khomonani and Soul City. He said condom distribution is widespread, voluntary counselling and testing is available at thousands of health facilities and there is access to treatment for all aspects of HIV.

But, he asked, “why, if we have such a big investment, are we not getting results”? He said: “Not only has there been an increase in the rate of HIV infection but we still have 600 AIDS-related deaths a day.”

Heywood said South Africa needs government at the highest level to take the lead and to talk scientifically about HIV and AIDS. “We need to identify key institutions where leadership is required. We need political leadership that will bring people together, but finally we also have to create political will from the people.”

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