State of Denial

By the year 2000, an estimated 4.2 million people in South Africa were infected with HIV; over the subsequent decade, the unchecked epidemic claimed the lives of an estimated 2.5 million South Africans. State of Denial puts a human face behind the numbers by introducing us to a cross-section of South Africans involved with the AIDS epidemic. It shows how they must fight not only the disease but the greed of the drug cartels and the incomprehensible inactivity of their own government in order to get treatment.

The film clearly blames President Thabo Mbeki and his administration for questioning the link between HIV and AIDS. Not only does his position prohibit the use of antiretroviral drugs, but it adds to the confusion about how the disease is transmitted and about how to practice "safe sex". In 2000, he even arranged a special meeting of advisors to which he invited "denialists", i.e. those who dispute that HIV causes AIDS, who used the meeting as a platform for their discredited views. There are those who contend that a reason for Mbeki's stance is that developing a program to make antiretrovirals widely available to the large numbers needing them would drain scarce funds from his plans to fight poverty in post-apartheid South Africa and leave his country beholden to international monetary and pharmaceutical interests. Yet the loss of a generation in its prime due to this disease would hurt the reconstruction of South Africa as much as anything facing the new society.

A remarkably successful movement, however, has grown up around this tragedy. The Treatment Action Campaign (TAC) opposed Mbeki's stonewalling and pressured drug companies to cut the cost of antiretroviral drugs and medications treating opportunistic infections. We meet Zackie Achmat, the HIV positive leader of the campaign, who refused to take life-saving drugs until they are available through the public health system to every South African who needs them. TAC's activism forced Pfizer to drastically cut the cost of Diflucan, which treats thrush, a common opportunistic infection among people with HIV. TAC has also gone to court and, over government objections, won the right of HIV positive pregnant women to use nevirapine to prevent passing on the disease to their children.

Ordinary South Africans are also unobtrusively volunteering to help those with AIDS. Buyile, a retired nurse, runs a home-based healthcare program in the Kutsong township of Carletonville. She travels more than 3 hours by train each day to reach her patients. There is little she can do without the proper drugs, for patients like Elizabeth, who dies during the making of the film. We are also introduced to Mary, the mother of two infected children, both of whom have been lucky enough to qualify for antiretroviral trials and are doing better. She worries, however, about what will happen to them if she does not get treatment.

Others are speaking out at great personal cost about their HIV status. In 1998, Gugu Dlamini was stoned to death by her neighbors when she announced that she had tested positive. Nonetheless, Lucky Mazibuko writes a weekly column for the mass circulation Sowetan about life with AIDS. We hear from readers how Lucky's column has opened their eyes to the reality of AIDS. The Zola Support Group provides a forum for people with HIV, especially young women, to discuss their own relationships, sexual practices and the use of condoms.

State of Denial in essence argues that AIDS may well the greatest threat to South Africa since apartheid and, by extension, to the entire continent since colonialism and the slave trade. Neither profits nor politics can be placed before it. It will require the mobilization of the whole community, including the global community, to deal with this catastrophe. State of Denial is a disturbing yet inspiring tool for involving that community in the struggle against AIDS.