South African minister accused of human rights abuse
BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7230.271/a (Published 29 January 2000) Cite this as: BMJ 2000;320:271All rapid responses
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Those interested in the growing filed of public health and human
rights must have been delighted by the fact that Dr. Costa Gazi, a South
African public health physician challenged the South African health policy
on zidovudine at the nation's Human Rights Commission. As many in the
field have intimated, there are crucial issues around strategy and
rhetoric as their are legal and political regimes that practitioners have
to contend with. In South Africa, politics, a history of discrimination
and inequality as well as issues around where the government chooses to
spend money are central to any campaign geared towards improving health
policies. The human rights dimension is no doubt a powerful framework for
generating attention in the zidovudine case.
The fact that the South African government, through it's civil
service bureaucracy, found Dr. Gazi guilty of bringing the Health
Minister, Dr. Tshabalala-Msimang, into disrepute does not change the basic
fallacy of the government's policy. As Dr. Gazi articulated in his
response to the Minister at the Commission's hearing, public health
science does not support this policy. The fact that South Africa has a
double standard, one for private health care allowing individuals to
obtain zidovudine and another for public health questioning the efficacy
and safety of the medicine is a clear pointer here. While the government
is supposedly investigating the safety of this medicine, thousands of
babies are being infected through mother to child HIV transmission.
As the goal of linking public health and human rights takes root in
Africa it is the action of professionals like Dr. Gazi that will count.
Government officials and policy makers alike must be held accountable for
their decisions and the impact they have on the health of individuals and
communities. Hopefully more health professionals as well as human rights
scholars can continue this trail blazing.
Competing interests: No competing interests
January 29, 2000 issue of the British Medical Journal had an article
by Pat Sidley entitled "South African minister accused of human rights
abuse". The article warrants attention and the issue calls for immediate
and continuous action.
South Africa's policy regarding mother-to-child HIV transmission
needs to be challenged by those concerned about public health and human
rights. Although Dr. Gazi's attempt to bring the issue to the countries
Human Rights Commission did not result in a change of policy, it has
definitely resulted in greater attention. With the high HIV prevalence
that characterizes the general population and prenatal clinics, it is
instructive that the Health Minister (Dr Tshabalala- Msimang) and the
president (Mr. Thabo Mbeki) rethink their current policy on availing AZT
to pregnant women.
The claim that AZT is toxic cannot be the reason for the government's
change of rationale for denying pregnant women and children AZT. There
are clear indications that government has been inconsistent on the basis
for this policy because it previously claimed that AZT was too expensive.
As Dr. Gazi has indicated, South Africa still allows the private health
sector to avail AZT. Why the double standard? Is AZT only toxic for those
who use public health resources?
I hope that Dr. Gazi's political affiliations are not used to keep
concerned parties away from the real issue- access to health care. It is
incumbent on those who care about individual and community health to
continue to challenge South Africa's policy on AZT. If silence becomes
our answer to this policy that has negative implications on human rights,
then other nations in Africa can similarly do what they like with
impunity.
Competing interests: No competing interests
Innocence, Ignorance and good Intentions
It is a sad fact that our Government is doing their best to counter
the AIDS epidemic but are suspicious of receiving advice from people who
really know a lot about the disease - such as Prof. B. Schoub the director
of our Virology Institute. Liberty politically does not necessarily mean
liberty intellectually. Prof. A.Smith of Natal University would also be a
man to use to advise the government. But, they seem to fear the advice of
anyone who is not affiliated to their own political party. Innocence and
Ignorance coupled with good Intentions will not stop the catastrophic
spread of this disease in our beloved country. Nor, will it save those
very people who have so recently received their political emancipation. If
the government would only realise that we are all concerned about all our
people and are desperately concerned about those who always are the
victims. The poor, the old and the young.
Competing interests: No competing interests