An article in last December's Journal of Acquired Immune Deficiency Syndromes paints an even starker picture:
At the peak of the [HIV/AIDS] epidemic, the [South African] government, going against consensus scientific opinion, argued that HIV was not the cause of AIDS and that antiretroviral (ARV) drugs were not useful for patients and declined to accept freely donated nevirapine and grants from the Global Fund. . . More than 330,000 lives or approximately 2.2 million person-years were lost because a feasible and timely ARV treatment program was not implemented in South Africa. Thirty-five thousand babies were born with HIV, resulting in 1.6 million person-years lost by not implementing a mother-to-child transmission prophylaxis program using nevirapine. The total lost benefits of ARVs are at least 3.8 million person-years for the period 2000-2005.In September 2003, I visited Lusikisiki, a rural town in South Africa's Eastern Cape, where a Médecins Sans Frontières program was awaiting the government's decision as to whether it could provide antiretrovirals. Approval came a month later, and the project's final report demonstrates significant success -- for example, voluntary counseling and testing during pre-natal care visits increased from 26% in 2003 to 89% in 2006. Lessons to be drawn from that study include the importance of adherence counsellors and community support as well as service user empowerment. It's not too late to undo Mbeki's legacy, though the human cost has already been far too high.