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July 20, 2009

South Africa still lagging on AIDS

For anyone who hoped that the era of AIDS denialism and disinformation in South Africa was over, there is a sobering report in today's New York Times. Celia Dugger writes that the South African government has failed to promote male circumcision, which researchers believe can cut the risk of HIV transmission by about half.

The reason? Maybe nothing more than politics. I wrote last year that leaders in Rwanda, Kenya and other African countries were -- bravely, I believe -- encouraging men to get circumcized at health clinics despite cultural taboos that often surround the practice. South Africa doesn't provide circumcisions or educate people about its benefits, although many South African men are requesting the procedure. The Times points out that in this country, "male circumcision has no political champion":

Thabo Masebe, a spokesman for President Jacob Zuma, said the Health Ministry must first set a policy on circumcision before Mr. Zuma, who took office in April, can take a position. Mr. Zuma is Zulu. The province of KwaZulu-Natal, the Zulu heartland, has the highest adult H.I.V. prevalence rate in the country, 39 percent, according to Unaids [the UN AIDS agency].

“The president gets involved when decisions are made,” Mr. Masebe said. “If the president spoke now, and when the time comes to make a policy, a different decision is taken, it wouldn’t sound good.”

How's that for political leadership? Rather than championing an intervention that could save lives, Zuma, whose party won two-thirds of the vote in April's general election, won't risk his neck by backing science over the beliefs of his ethnic community. Zuma has said some ridiculous things about HIV and AIDS in the past. His supporters call him "100 percent Zuluboy." But after several years in which government officials delayed lifesaving treatment from reaching hundreds of thousands of HIV-infected people, I was one of those who believed South Africa had turned a corner.

The government dramatically increased AIDS funding and built the largest ARV drug treatment program in the developing world. It tossed out reassigned the obstructive and erratic health minister, Manto Tshabalala-Msimang. But many South Africans still believe that they won't get HIV, the deadly and inevitable result of so many years of mixed messages from the top. Zuma is popular among many of the people most at risk of HIV. If he wants to distance himself even further from the ousted Thabo Mbeki, who famously questioned the science surrounding AIDS, this would be a great place to start.

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shashank

Somewhere in Africa is written by McClatchy correspondent Shashank Bengali, who's based in Kenya and has reported from more than 30 countries.

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