Antidote to Lindi Mabuza's HIV/AIDS claims 
 
Below, find:
 
a) Mabuza's denialism of the rising danger of HIV/AIDS to SA; 
b) a rebuttal/clarification of the info associated with UNAIDS; 
c) a  critique of the HSRC survey and other issues by Costa Gazi 
   (the Pan Africanist Congress health department chief); 
d) today's article by Terry Bell on Mbeki's AIDS policies in the 
   Business Report section of SA's "Independent" newspaper chain; 
e) information that Pretoria does not want people to know about trade 
   minister Alec Erwin's maneuvering at the World Trade Organisation 
   last week, very much "in concert with" Big Pharma, which left
   Medicins Sans Frontiers "dismayed at the position South Africa has 
   taken" and local activists in the Treatment Action Campaign 
   "alarmed"; and 
f) a recent email by the Treatment Action Campaign concerning the issues 
   that separate the activists from Pretoria.

Additionally, please refer to http://www.mg.co.za in a couple of days,
because the Mail and Guardian newspaper today headlined health minister
Tshabala-Msimang's dismissal of AIDS as a serious concern in an amazing
interview; it's not yet up on the website but will be soon...

A) Mabuza:
   Overcoming the legacy of apartheid
   Despite the carping, South Africa has begun to beat poverty and Aids

Lindiwe Mabuza
Thursday February 20, 2003
The Guardian
....

Take HIV/Aids. The latest survey by South Africa's human sciences
research council confirms a UNAids report that shows falling levels 
of HIV infection among young South Africans. Prevention messages about 
condom use, abstinence and faithfulness are being taken to heart, 
especially by young people.

The proportion of people in the 15 to 19 age group with no sexual
partner was 60% in 1998 and 70% in 2002. Use of a condom among the 
same group was 20% in 1998 and 49% in 2002. For 20- to 24-year-olds 
it was 8% in 1998 and 47% in 2002, while access to condoms is 
continually expanding. And the survey also nails another myth with its 
finding that fewer than 2% of South Africans believe Aids can be cured 
by sex with a virgin - a long way from the 25-30% claimed in a recent
BBC documentary.

Meanwhile, HIV incidence among the under-20s has fallen for the third
year in a row. These figures reflect the impact of our programmes, 
starting from the premise that HIV causes Aids, and combining prevention,
comprehensive treatment and care.

Of 27,000 registered medical practitioners in South Africa, only 2,000
have been trained in providing care for people with HIV/Aids. So the
department of health is running large-scale training programmes and 
campaigning to ensure that patients observe their doctor's advice.

We are also working towards lowering the cost of anti-retroviral drugs,
including those used in the treatment of HIV. In concert with the
pharmaceutical companies the government is drawing up regulations to
facilitate the import and manufacture of cheap and generic drugs.

B) Corrections/clarifications on UNAIDS report by anonymous
   The UNAIDS report (which is based on SA MoH data) does not claim 
   falling HIV rates among men AND women in that age group but among 
   women attending antenatal clinics only.

Nevertheless, taken in its own right this is good news, though I'd be 
wary to regard it as a trend ... yet. Only two time points on the graph 
at the moment.
 
Second, I think it's in the Barcelona Report where UNAIDS also noted that
at the same time, prevalence among older age groups appeared to be steady 
or rising, and they noted concern about that. Similar trends have been 
found in Zambia, btw, where there has also been evidence of falling HIV 
rates among young women, but rates high and rates among older age groups 
(plus very little condom use etc).

Third, the HSRC survey needs to be looked at very carefully. There was 
a massive refusal rate for a start and we don't seem to know what sort 
of bias (due to possible commonalities or "grouping" of reasons for 
refusal) that might have introduced. Also, the infection rate they 
derived seems to have been calculated as a % of the entire population.
 
UNAIDS HIV prevalence estimates (percentage estimates) refer only to 
15-49 year-olds (adults). So there is a danger of comparing apples and
pears on this one. But this issue of household survey based data versus
antenatal-clinic-testing-derived data is going to crop up more and more.
 
I don't think it's a bad thing because as refined as the latter method 
of estimation has become, it remains incomplete (quite incomplete and 
possibly even misleading in some settings) and maybe a more accurate 
method can be arrived at by harmonizing these various sources of data.

As for the ARV provision, enough said.

And I've heard the 2000 out of 27000 figure before though no clue where.
Seems to me to be an indictment a decade into an epidemic like this, not 
something to crow about.

C) Costa Gazi v Pretoria
   From: Costa Gazi
   To: Patrick Bond
   Sent: Friday, February 21, 2003 1:27 AM
   Subject: Re: Are these SA government claims valid?


Dear Patrick,

One must keep calm in weighing up this article's claims.

hey are mainly news to me and I note that there are no references to see
what methodology was used to make these grand claims of hitting HIV/AIDS on
the head.

I see no sign of SA beating poverty and AIDS. All I see are massively
inflating food prices and funerals galore of under-40's every weekend. The
prisons are bursting with AIDS deaths.

As for the 'carping' - what an insulting claim - of AIDS activists, that
is very true, because we are all ultra-leftists and bordering on being
terrorists.

If more teenagers are using condoms, are they having less sex or not?  No
answer.

The "virgin cure" - were illiterate people also surveyed - and how
confidentially?

The last claim about anti-retroviral drugs (ARD's) frankly a lie.
Nevirapine is provided FREE by the manufacturer for preventing
mother-to-child-transmission of HIV. This is the absolute minimal use of
such drugs and is still not in place everywhere, nor is there much
protection offered to rape survivors. Mpumalanga is a niche of denial of its
own and the President and Health Minister are OK with that. (See editorial
"Democracy Guarantees Nothing" at www.abbatrust.co.za).

As for the lack of training of doctors, the problem is easily solved by
training the clinicians who work in the public sector as the top priority.
The HIV Clinicians Group could cover this training for these 5000 public
health doctors in a short time. But first, the ARD's need to be available
free in the public sector.

Neglect of the AIDS pidemic is emphatically not a legacy of apartheid. It
was the apartheid government that started the HIV annual antenatal survey in
1990, at which time the pervalence was 0.2% ie only 2 pregnant women out of
1000 was HIV +ve. This has been steadily rising and is now hovering around
the 22%.

The following comments are relevant, about the HSRC survey, taken from the
editorial archives of the ABBA Trust   (27/12/2002)

At last!

A comprehensive survey that has looked at the prevalence of HIV in a large
cross-section of the population. This household survey by the Human Science
Research Council (HSRC) has once again highlighted the fact that we face an
unprecedented epidemic that is decimating the population and causing untold
suffering. The study also tried to assess attitudes towards HIV/AIDS and
depth of knowledge about the epidemic.

It was an expensive exercise but even so, the sample size was relatively
small. It could not be much bigger without costing a lot more money. This
has limited the firm conclusions that might be drawn from it.

The length of the report makes it difficult to summarise its findings. It
apparently challenges many conclusions that we have made from the annual
ante-natal surveys, but there is no contradiction of the need that continues
to exist for a declaration of war against the terrorism of the HIV/AIDS
epidemic. Its overall estimate that there are 4.5 million HIV +ve people is
very close to the estimates based on the ante-natal surveys (4.74 million)

The report tries to emphasise that with better statistics, the targeting
of action can be refined. There has been a tendency to look at averages for
each province without realising that there is massive variation among
different communities, socio-economic and age-sex groups within each
province and between the provinces.

There is no room for complacency in their conclusion that "only" 12% of
the population are HIV positive, instead of the usually quoted 22%. We are
still talking of millions of people, especially young people, who are
infected. It has been a shock to read that 5.6% of children aged 2-14 years
were found to be HIV +ve. The report rightly calls for further investigation
of this latter finding.

Kwazulu-Natal has for long been considered as the province with the
highest prevalence but it seems that the prevalence may have been
exaggerated by the fact that some of the annually surveyed clinics are on
truck routes and near the main highways.

It is very relevant to note that the rate in the informal urban
settlements is said to be 28%, the highest rate of all socio-economic
groups. It may well be that the insecurity and mobility of these
shack-dwellers (that is what they are) is a big risk factor. This
contradicts the suggestion in the report that poverty is not a major factor
in the spread of the virus.

There are many weaknesses of the survey. They used an HIV test that
depends on sputum and not on blood as most surveys do. Also, only 61.1% of
the initial sample was actually tested for HIV. We know nothing of the
reasons why almost 40% of the sample refused to have the test.

There was also an obsession in the report to categorise the "race" of
respondents. This has no longer remained a useful measure of  the status of
an individual. There has been a great deal of mobility of people since 1994
and the report concedes this by defining households as  "mainly" one race or
another. Scientifically speaking there is only one race  -  the human race,
and in today's South Africa, your place of residence is a far more important
epidemiological fact than your artificially defined "race".

The report has been very careful not to attribute blame to the government
for failing to react sooner to the epidemic. It diplomatically recommends
that anti-retroviral drugs should be part of the campaign against this AIDS
threat.

Unfortunately, the report did not emphasise that
mother-to-child-transmission can be almost eliminated by using more care
than just the single dose nevirapine for HIV +ve mothers, which only
protects about 50% of babies which would have got infected. In the developed
world, the transmission rate is between 0% and 2%, compared to our 15% with
the one-dose nevirapine.

All in all, Olive Shishana has produced a report which takes us several
steps further along the road of understanding what needs to be done. Her
stint in the Health Department under Nkosazana Zuma helped her to appreciate
the enormous official  resistance there is to facing up to this destructive
epidemic. But it also made her sensitive to the views of the Leader.

The Nelson Mandela Foundation commissioned this report and it is well to
remember that Madiba has also tried very cautiously to correct the misguided
views of President Thabo Mbeki. It is a great pity that Mbeki has not got
the stature of his predecessor to be able to apologise for his long-standing
mistaken views which have caused so much loss of life. This report may make
him realise that he must take the reins and lead the war against this
formidable threat to development and equity that is raging in every corner
of the land.

That is probably a forlorn hope.

D) Business Report, 21 February [comment]

Mbeki can't wish away his albatross

Terry Bell

The trade union movement and community activists remain
furious at what many have described as the government's
continued "HIV denialism".

This follows President Thabo Mbeki's flat rejection last
weekend that an agreement on HIV/Aids treatment had been
reached at the Nedlac social forum.

Mbeki and health minister Manto Tshabalala-Msimang also
caused a minor outcry in the medical profession by
mentioning tuberculosis (TB) in isolation as the country's
major killer.

"Of course TB is perhaps the major killer and there has
been an explosion of TB deaths in the past five years," said
Treatment Action Campaign (TAC) national manager
Nathan Geffen. But, he pointed out, many if not most TB
deaths were HIV related.

A Cape Town medical specialist noted: "The existence of
HIV has greatly exacerbated the problem of TB."

The issue of treatment plans became further confused
when labour department spokesperson Snuki Zikalala said
the only agreement reached was between the TAC and
Cosatu.

"No so," said Chez Milani, the general secretary of the
Federation of Unions of SA.

"There was a draft agreement reached by the entire labour
movement, community, government and business
representatives."

Trade union representatives are particularly annoyed that
the image has been created through various media reports
that whatever draft agreement exists was drawn up
between Cosatu and the TAC.

"This is wilful distortion of the Nedlac process and it
threatens the integrity of Nedlac," said Vukani Mde, Cosatu's
spokesperson.

He pointed out that "the simple truth" was that each
constituency had produced its own drafts and "these were
discussed and a compromise reached".

The impression the labour 
 and community representatives
were left with was that it was a mere formality to gain the
signatures of the government and organised business.

Business seems to have mentioned that it would be
necessary to take the draft to its scattered constituency, but
did not apparently see any problems with getting
agreement.

"From a labour viewpoint, it all seemed cut and dried," said
Mde.

That this attitude was justified can be seen in notes and
minutes of Nedlac meetings and heard on tape recordings
made of most of the meetings.

When the four constituencies first came together on the
HIV/Aids issue on October 5 last year, they agreed that
"each sector shall make written submissions regarding the
content of a treatment plan".

Each sector did just that.

The parties had been brought together at Nedlac by the
forum's director, Phillip Dexter. This followed a request
made to the forum in July last year by Cosatu, representing
all three trade union federations, and by the TAC.

The combined labour movement and the TAC felt it was
imperative that a process be started to negotiate a national
treatment plan. "People are dying every day, so it seemed a
matter of urgency," said Milani.

By September last year the Nedlac management committee
had established a senior task team to handle the
negotiations.

Health department director-general Ayanda Ntsaluba was
supported by Nono Simelele, the chief director of HIV/Aids
and TB, while Rams Ramashia of the labour department
had the support of his labour relations deputy, Les
Kettledas.

Labour was represented by Cosatu general secretary
Zwelinzima Vavi; SA Clothing and Textile Workers' Union
general secretary Ebrahim Patel, who acted as a liaison
with the other federations; and the general secretary of the
SA Transport and Allied Workers' Union, Randall Howard.

The business position was put forward by the business
representative in Nedlac, Raymond Parsons; Vic van
Vuuren of Sanlam; and Faizel Randera of the Chamber of
Mines. TAC secretary Mark Heywood and the community
sector's convener, Fadilla Legadien, made up the
community sector component.

"When the government side put in their submissions, they
considered all the cost implications," said Mde.

These were taken into account in the final draft agreed to by
all the parties.

Agreement was reached after seven meetings, in which the
different submissions were integrated into the final draft.

In November a target date for completion of the process
was set as December 1, the start of what was dubbed
International Aids month. But the process took longer than
expected and the last meeting ended late on November 29.

The TAC had remained in regular contact with its
constituencies and was able to endorse the agreement on
the spot.

Business and the government required more time to enable
their representatives to refer the final draft for formal
agreement.

"There seemed consensus that everything would be signed
by the end of December," said Mde.

However, several senior Cosatu officials privately
expressed the fear that the government might renege on the
deal, but was using the apparent agreement to ensure that
the issue of government foot-dragging on HIV/Aids was not
brought up at the ANC's December conference in
Stellenbosch.

"Now it seems we may have been justified," said one of the
December cynics.

"But this issue is a political albatross around the neck of the
president - that he cannot deny."

www.busrep.co.za


E) Medicins Sans Frontieres letter

   From: "Marta Darder" 
   Subject: [e-drug] MSF open letter to S. African  govt for a national
   treatment plan
   Reply-To: e-drug@healthnet.org
   E-drug: MSF open letter to S. African  govt for a national treatment plan

---------------------------------------------

Open Letter to the South African Government from MÉdecins Sans FrontiËres

12 February 2003

  To: Mr TM Mbeki
  President of the Republic of South Africa
  Pretoria
  Fax: 012 3238246

  cc: Mr JG Zuma; Deputy President; Fax: 012 3233114
      Mr A. Erwin; Minister of Trade and Industry; Fax: 012 3227851
      Treatment Action Campaign (TAC), South Africa info@tac.org.za


Dear Sir,

The Treatment Action Campaign (TAC) and thousands of South Africans are
mobilising on 14 February in Cape Town to demand a national HIV/AIDS
prevention and treatment plan that includes antiretroviral (ARV) therapy
for all people in South Africa who need it. MÉdecins Sans FrontiËres (MSF)
joins them to express our profound disappointment that the South African
government has failed to do so to date, and to ask you to announce by the
end of February a comprehensive HIV/AIDS treatment plan that includes ARV
treatment.

For the past four years, MSF has witnessed first-hand the daily
devastation caused by the AIDS epidemic in South Africa and the extra-
ordinary clinical benefits-and hope-that the availability of ARV 
treatment brings to the community. Our work in Khayelitsha in the Western 
Cape, where we provide ARV treatment for nearly 350 people with AIDS, 
clearly demonstrates the feasibility of ARV treatment in resource-poor 
settings; there is no longer any question that it is possible. Our new 
programme in a rural remote setting in the Eastern Cape explores the 
specific challenges of providing ARV treatment, building on our experience 
with similar programmes in other rural settings elsewhere in Africa. 
But, despite their success, such programmes cannot become a substitute 
for what is ultimately the responsibility of the South African government.

MSF supports people living with HIV/AIDS in South Africa and around the
world in their fight to have the same opportunity as people in wealthy
countries to live longer, healthier lives by having access to ARV treatment.
We have fought to support measures that will ensure that governments,
including the South African government, have every available tool to
ensure they can fulfil their right and obligation to care for the health 
of their citizens.  As you know, MSF advocates strongly to ensure that 
public health needs take priority over the protection of private 
intellectual property rights.  Along with other organisations, we were 
instrumental in securing the adoption of the historic World Trade 
Organization (WTO) Ministerial Declaration on the TRIPS Agreement and 
Public Health by all member states in Doha, and we have continued to 
advocate that it be implemented in good faith by all member states.  We 
are deeply concerned about the current state of WTO negotiations about 
paragraph 6 of the Doha Declaration and are dismayed at the position South 
Africa has taken, which would effectively create two classes of WTO members, 
one that can make full use of compulsory licensing to promote access to 
medicines, and another (the poorest countries), which will be seriously 
hampered in their efforts to do so. This represents a major backtracking 
on the Doha Declaration and we urge you to abandon this position immediately.

In South Africa in 2001, MSF began demonstrating in Khayelitsha that it is
possible to utilise low-cost quality generic ARVs to provide affordable
treatment. In April of that same year, 39 pharmaceutical companies
attempted to block the government's right to incorporate provisions in the 
Medicines and Related Substances Control Act that would allow South Africans 
access to low-cost ARVs. MSF collected 250,000 signatures from around the 
world, which were sent directly to all pharmaceutical companies implicated, 
demanding that they drop the case.  We now join TAC and thousands of other 
South Africans in urging the South African government to make use of 
provisions, such as compulsory licensing, and to promote local production 
to guarantee generic competition and access to the least expensive quality 
ARVs.

Today, five million South Africans are infected with HIV, and nearly 1,000
are dying every day of AIDS-related complications. The 600,000 South
Africans who clinically require ARV treatment now to stay alive do not
have time to wait. Their families do not have time to wait.  There can be 
no excuses for further delays.

We urge you to act now and to announce before end of February a national
HIV/AIDS treatment plan.

Sincerely,

Dr Morten Rostrup
President
MÉdecins Sans FrontiËres International Council
Tel: +41 228498400
e-mail: msf-international-gva@geneva.msf.org

Dr. Eric Goemaere
Head of Mission
MSF South Africa
PO Box 27401
Rhine Road, 8050
Cape Town, South Africa
Tel : 021 3645490
Fax : 021 3617051
e-mail: msf.sa@mweb.co.za

This letter is being co-signed by the general directors of the different
MSF sections and country co-ordinators of field projects throughout the 
world and sent to SA embassies and/or high commissioners before the march 
for a national HIV/AIDS treatment plan of February 14 in Cape Town.

For more information, contact Marta Darder, MSF South Africa,
Tel +27 21 3645490, martad@xsinet.co.za.


F) Treatment Action Campaign communique

17 February 2003

TAC March and Memoranda
  a.. Letter from Zackie Achmat about 14 February March to Parliament
  b.. Memorandum to Parliament on 14 February 2003
  c.. Memorandum to President Bush and Members of US Congress on 14 February
      2003

----------------------------------------------------------------------------
----

Dear All

On Friday 14 February 2003, between 15000 and 20000 people in South Africa
marched on our Parliament in Cape Town. Our President, Thabo Mbeki said less

on HIV/AIDS than George Bush said about peace. Although, he spent less than
three minutes on HIV/AIDS, all the marchers spent three hours listening to
music, poetry, speeches and then marched.  People from every layer of
society marched to demand access to treatment -- people living with HIV/AIDS
from every part of South Africa, trade unionists, religious leaders,
lesbian, gay, bisexual and transgender people, employers, nurses, sex
workers, doctors, teachers, principals, school, technikon and university
students called on government to sign and implement a national treatment and
prevention plan.

The memoranda below was handed over at Parliament to Ms. Xoliswa Sibeko from
President Mbeki's office, Mr. Ebrahim Ebrahim from Deputy President Jacob
Zuma's office, Mr James LV Ngculu - Chairperson of the Parliamentary
Portfolio Committee on Health and Ms Barbara Ann Hogan - Chairperson of the
Parliamentary Portfolio Committee on Finance.

A memorandum was also handed over to the US Embassy and TAC called on all
people to support the anti-war demonstrations on Saturday.

We want to thank everyone who assisted with the march, people who organised,
devoted time, travelled long distances, people across the world who wrote
letters to the South African government.

A fuller report coupled with our plans for the next 6 weeks will be
circulated soonest.

Regards

Zackie Achmat on behalf of the Treatment Action Campaign Executive.

----------------------------------------------------------------------------
----

14 February 2003


MEMORANDUM TO PARLIAMENT
President Thabo Mbeki (MP) and Deputy President Jacob Zuma (MP)
Minister of Finance: Mr. Trevor Manuel (MP); Minister of Foreign Affairs:
Dr. Nkosazana Dhlamini-Zuma (MP) Minister of Health: Dr. Manto
Tshabalala-Msimang (MP); Minister of Labour: Mr. Membathisi Mdladlana (MP);
Minister of Social Development: Dr. Zola Skweyiya (MP); Minister of Trade
and Industry: Mr. Alec Erwin (MP); All Members of Cabinet and Parliament.

C/O Chairpersons of Portfolio Committees on Health and Finance: Mr. James LV
Ngculu and Ms. Barbara Hogan

Dear President Mbeki, Deputy-President Jacob Zuma and all members of
Parliament

IMPLEMENTATION OF NATIONAL HIV/AIDS TREATMENT PLAN

We are marching today because the opening of South Africa's Parliament in
2003 should be an important day to signal to the nation and the world the
increased determination to prevent and treat HIV infection and to control an
epidemic that threatens many parts of our national life. Our march is made
by people representing millions of South Africans: We are people with HIV
from all provinces of South Africa, members of all the major trade union
federations of our country, women's organisations, NGOs, members of medical
organisations, representatives of religious faiths, academics, students, the
lesbian and gay community and many more.

We stand here to demonstrate the willingness of our society to rally behind
government in confronting the epidemic of HIV and AIDS.  In particular we
stand here to demonstrate the depth of support there would be for government
beginning to treat people with HIV/AIDS.  By government estimates, over 600
people die daily as a result of this disease. This daily presence of death,
which has touched every person on this march, will become an immense well of
anger that that will protest should there be further delays in our national
response to halting this carnage in our country.

In particular, we come to you with three demands:

  a.. First, we call on Cabinet to sign and implement the framework
agreement on a National Prevention and Treatment Plan, negotiated by
mandated representatives of government, business, labour and community at
NEDLAC. This agreement was negotiated by all the parties during October and
November 2002.  It is an expression of a socially responsible and medically
and scientifically defensible programme for addressing the HIV and AIDS
epidemic. We believe that the time for consultation is over. The time for
implementation is now. More than 75 days have passed and thousands of people
died.

  a.. Second, we call on government to urgently announce the start of a
treatment programme using antiretroviral medicines. We appreciate
government's commitment to treating opportunistic infections, for many
people who are sick with TB and pneumonia and other indicators of AIDS -
but, this is not enough. For while they may be treated and survive, their
immune systems are so weak because of HIV that they soon succumb. Many of
these deaths could be avoided with the use of antiretroviral medicine.

We consider it unacceptable that hardly any people in South Africa receive
antiretrovirals through the public sector. Government policy to withhold
these medicines is widening inequalities between the rich and the poor and
between the private and public health services. It also increases the
inequality between men and women. Our people are increasingly aware that
many of the deaths caused by withholding antiretorivals are avoidable.
Government inaction is seen as a key factor in this.  Government has
resources. Government also has the power to stop drug company profiteering.
It has failed to use the power won with the support of people
internationally to reduce the prices of anti-retrovirals and all medicines.

  a.. Last, TAC and our allies are alarmed by reports in the international
media and from observers that the South African delegates at the World Trade
Organisation have submitted to US and drug company pressure to limit the
availability of essential medicines in poorest countries. We call on the
Cabinet to ensure that the Minister of Trade and Industry stands by
government policy that will allow all essential medicines to be available to
all countries. Agreeing to US and drug company policy will deny the poorest
people in the world access to all essential medicines.

If our reasonable demands are met by government, the TAC, its allies and
supporters commit to turning all our energies to implementation in all areas
of HIV prevention and treatment. Areas for partnership are clearly set up in
the NEDLAC framework agreement.

However, whilst TAC commits to partnership, we must also say that we cannot,
with conscience, wait any longer. Numerous memoranda have been given to
government leaders over the last 4 years. Many of these have gone
unanswered. Protests, interfaith services, talks, negotiations and pressure
have met with promises, and then, equivocation.

It is in this light that TAC has made it clear that failure to respond on
these issues will lead to the commencement of a peaceful civil disobedience
campaign by TAC activists. This is not the preferred route but, in the face
of the illness, death and despair that face us daily in our communities, we
will have no choice.  The organisations gathered here today in solidarity
with the Treatment Action Campaign witness this appeal to government to meet
its promise on HIV/AIDS prevention and treatment that includes universal
access to anti-retroviral therapy.

This campaign is supported by millions of people in South Africa and the
organisations that represent them. Through international solidarity, it is
also supported by hundreds of organisations globally. We urge you to make a
choice that will reduce social conflict, give hope to our people and our
continent, as well as cherish the ideals of freedom, equality, dignity and
the right to life for all.

Attached to the letter is a list of some of the local and international
organizations that support today's march. Yours in the struggle for health
and dignity.

*******

Thabo Cele (PLWA)                      
Nomfundo Dubula (PLWA)
Pholokgolo Ramothtwala (PLWA)

Kwa-Zulu Natal              
Western Cape
Gauteng

Portia Ngcaba (PLWA)            
Thembane Shabangu (PLWA)            
Edward Mabunda (PLWA)

Eastern Cape             
Mpumalanga
North-West

Zackie Achmat (PLWA)                      
Archbishop Njongonkulu Ndungane
Willie Madisha

Treatment Action Campaign            
Church of the Province of South Africa
COSATU President

Gretchen Humpries                               
Sharon Ekambaram
Rev. Dr. Simphiwe Xaphile

FEDUSA                                           
AIDS Consortium
J.L. Zwane Presbyterian

Vuyiseka Dubula                                    
Rabbi David Hoffman
Moulana Farid Essack

Médecins Sans Frontières                  
Temple Israel, Cape Town
Positive Muslims

Mark Heywood                               
Lu-ann Hatane
Dr. Kgosi Letlape

AIDS Law Project                                    
NACOSA (WC)
SA Medical Association

SOUTH AFRICAN ORGANISATIONS

ACCESS - Alliance for Children's Entitlement to Social Security
AIDS Consortium
AIDS Law Project
All Africa Women For Peace
Anglican Church on Southern Africa
ATTN SA
Basic Income Grant Coalition
CARE
Children's Rights Centre
Combined AIDS Ministry
COSATU
Durban Lesbian and Gay Community Centre
FEDUSA
Habonim Dror
HOPSERSA
Jubilee 2000
Kagiso Anglican YCW
Methodist Church of Southern Africa
Positive Muslims
Positive Wits - HIV/AIDS Campaign
RAPCAN
SA Academy of Family Practice,
SACTWU
SA National NGO Coalition
South African Medical Association
SAMWU
SOHACA
Southern African Catholic Bishops Conference AIDS Office
South African Council of Churches
Temple Israel
The Caring Network
The Southern African HIV Clinicians Society
Themba HIV/AIDS Project
Triangle Project
WC-NACOSA
Western Province Council of Churches,
Wits HIV/AIDS Education and Support Project
Wits Perinatal HIV Research Unit
Women on Farms Project and many others
Youth Against AIDS Network

INTERNATIONAL ORGANISATIONS

ACT UP/ Atlanta, Atlanta, GA
ACT UP/ Cleveland, Cleveland, Ohio
ACT UP/ East Bay, Oakland, CA
ACT UP/ Los Angeles, Los Angeles, CA
ACT UP/ New York, New York, NY
ACT UP/ Paris, Paris, France
ACT UP/ Philadelphia, Philadelphia, PA
AIDES, Pantin, France
AIDS In Africa Committee, Jewish Reconstructionist Congregation, Evanston,
IL
AIDS Interfaith Network, Inc., New Haven, CT
AIDSETI (AIDS Empowerment and Treatment International), Washington, D.C.
Africa Action, Washington, D.C.
African Services Committee, New York, NY
All Africa Women for Peace, Pretoria, South Africa
Amahoro Association, Jersey City, NJ
American Jewish World Service, New York, NY
American Medical Student Association, Reston, Virginia
Amnesty International, London, England
Artists Against AIDS Worldwide, New York, NY
Artists for a New South Africa, Los Angeles, CA

Black AIDS Institute, Los Angeles, CA
Boston Global Action Network, Boston, MA

Canadian Treatment Action Council, Toronto, Canada
Canadian AIDS Legal Network

DanceSafe, Sacramento, CA

European AIDS Treatment Group, Germany
Exponents Inc., New York, NY

Foundation for Integrative AIDS Research, Brooklyn, NY

Gay Men's Health Crisis, New York, NY
German Institute for Medical Mission, Germany
Global AIDS Alliance, Washington, D.C.
Global Alliance for Justice Education, AIDS Working Group, International
Global Exchange, San Francisco, CA
Global Network of People Living with HIV/AIDS, Amsterdam, The Netherlands
Greek Committee for International Democratic Solidarity, Athens, Greece

Hatter Support Society for Gays and Lesbians in Hungary, Budapest, Hungary
Health GAP, San Francisco, CA
Health Rights Action Group, Kampala, Uganda
Hepatitis C Outreach Project, Portland, OR

International AIDS Empowerment, El Paso, Texas

International Community of Women Living with HIV/AIDS
International Gay and Lesbian Human Rights Commission,San Francisco, CA
International Labor Rights Fund, Washington, D.C.
INTERSECT-Worldwide, New York, NY

James S. Coleman African Studies Center, University ofCalifornia Los Angeles
Jubilee Northwest Coalition, Seattle, WA

Maryknoll AIDS Task Force, Maryknoll, NY
Michigan Coalition for Human Rights, Royal Oak, MI
Middle East Children's Alliance, Berkeley, CA
Mobilization Against AIDS International, San Francisco, CA

NextAid, Los Angeles, CA
Northeastern Law School Global AIDS Campaign, Boston, MA
Northwest Coalition for AIDS Treatment in Africa, Seattle, WA

Operation USA, Los Angeles, CA

Physicians for Human Rights, Boston, MA
Planet Poz, Albuquerque, NM
Project Inform, San Francisco, CA

Saint Michael's College Student Global AIDS Campaign, Colchester, VT
Shanti, San Francisco, CA
South Africa Development Fund, Boston, MA
Student Global AIDS Campaign, Cambridge, MA
Survive AIDS, San Francisco, CA
Sydafrika Kontakt, Denmark

TransAfrica Forum, Washington, D.C.
Test Positive Aware Network, Chicago, IL

Universities for Access to Essential Medicine, University of Minnesota

Washington State Africa Network, Seattle, WA

Yale AIDS Network, New Haven, CT

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14 February 2003
MEMORANDUM TO PRESIDENT GEORGE W. BUSH AND ALL MEMBERS OF THE UNITED STATES
CONGRESS

Dear President Bush and Members of Congress

INVEST IN HEALTH-CARE AND SIGN THE DOHA AGREEMENT UNCONDITIONALLY

The HIV/AIDS epidemic throughout our world claims thousands of deaths daily.
These deaths are premature, predictable, avoidable and the result of the HIV
virus. We are marching today because the opening of South Africa's
Parliament in 2003 should be an important day to signal to the nation and
the world the increased determination to prevent and treat HIV infection.
Our march is made by people representing millions of South Africans: We are
people with HIV from all over South Africa, members of all the trade unions
of our country, women's organisations, NGOs, medical organisations,
representatives of all faiths, academics, students, the lesbian and gay
community and many more.  We urge our government to sign a national HIV
prevention and treatment plan. We are also delivering this memorandum to
your government for two reasons:

  1.. We note your increased financial commitment to HIV prevention and
treatment.  This will be a critical adjunct to worldwide effort if the money
really becomes available for this purpose. We note with concern, regret and
anger that your government has failed in its commitments to the Global Fund
Against HIV/AIDS, Tuberculosis and Malaria.  This fund is the only hope that
people globally have that no ideologically or economically motivated
restrictions will be placed on HIV prevention and treatment programmes.
Further, we urge your government in the strongest terms to reconsider its
global priorities to invest in peace and development, as well as to
strengthen multilateral institutions.  Specifically, we demand that you
contribute $2.5billion dollars to the Global Fund this year.

  1.. The United States government remains as the only government world-wide
that undermines any meaningful agreement on access to essential medicines
for all public health issues and all countries at the World Trade
Organisation.  Your intransigence will destroy faith in multilateral trade
negotiations as people in poor countries will only see unnecessary deaths as
a consequence of negotiations that protect the profiteering of
pharmaceutical companies. We urge you to allow all poor countries to import
generic medicines for all illnesses including HIV/AIDS, TB, Malaria, cancer,
diabetes and asthma.

The Treatment Action Campaign and all our allies globally and locally insist
that we will get a formal response from your government.

Yours faithfully

Zackie Achmat               
Sipho Mthathi                
Mark Heywood

On behalf of the Treatment Action Campaign



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