White, wealthy and proudly gay, Judge Edwin Cameron is hardly a typical face of the AIDS pandemic ravaging southern Africa.
But Cameron, a member of South Africa’s Supreme Court of Appeal and the only senior public servant in the country to publicly disclose he has HIV, shares one thing with millions of other Africans fighting the virus: a strong desire to live and a deep anger over halting efforts to fight the disease.
In a new book Cameron dissects Africa’s AIDS crisis, a public health emergency that the United Nations estimates could infect up to 89 million more Africans by 2025.
It is a disaster he blames in part on African “AIDS Denialism”, the prism that some leaders including South African President Thabo Mbeki have used to downplay or dismiss scientific knowledge on AIDS.
His book, “Witness to AIDS”, is an indictment of Western drug firms which he says kept AIDS medicine out of reach of most Africans for far too long and the failure of South Africa’s leaders to face up to the debacle.
“We have had leaders referring to AIDS in their families, but never in themselves,” Cameron said in an interview. “We still don’t have the heartfelt, unambiguous, insistent quality of leadership on AIDS that one would want.”
South Africa in 2003 bowed to domestic and international pressure and launched a public programme of anti-retroviral (ARV) drug treatment, a sign of hope for millions.
But implementation has been slow, thousands are still dying, and AIDS remains both politicised and stigmatised.
ONE VICTIM AMONG MILLIONS
Cameron’s career - not just his HIV status - makes him uniquely qualified to examine South Africa’s response to AIDS, increasingly depicted as a human rights issue for the estimated 5 million South Africans infected with the disease.
A human rights lawyer, Rhodes scholar at Britain’s Oxford University and one of Nelson Mandela’s first appointments to South Africa’s High Court following the end of apartheid in 1994, Cameron had for almost a decade been publicly out as a gay man, a rarity in South Africa at the time.
He was also operating with the private knowledge that in 1986 he was diagnosed with HIV.
Cameron’s personal struggle with HIV reflects the terror that surrounded the disease before life-prolonging ARV drugs were introduced in the early 1990s.
“AIDS put a short, sudden and shocking limit on my life,” he wrote in the book, which will be published in Britain, China and the United States later this year.
“In December 1986 it was for me what for tens of millions of Africans it still is today - an imminent term of death.”
Cameron remains the only prominent South African public official to go public with his HIV status, despite widespread speculation that other senior figures including MPs may also be infected.
Mandela, who has become an outspoken AIDS campaigner since stepping down as president in 1999, sought to combat the stigma this year when he publicly announced that his own son Makgatho had died from AIDS-related causes at the age of 54.
But the fear surrounding AIDS in southern Africa remains a huge obstacle to fighting the disease, with a lack of clear government leadership fuelling the sense that HIV is a shameful private burden rather than a public policy emergency.
Cameron enjoyed more than a decade of good health despite being HIV-positive, and when he did eventually fall seriously ill in 1997 he was able to afford ARVs to keep himself alive.
Millions of other South Africans were not so lucky and the government dragged its feet on introducing ARVs in the public sector - a delay activists say cost countless lives.
South Africa’s AIDS crisis has been exacerbated by the poverty of much of the population, where the legacy of apartheid has limited the spread of basic nutrition and health care.
But Cameron says the Mbeki government veered wildly off course in the early 2000s under the influence of “denialists” who saw the basic scientific building blocks of the epidemic as a racist conspiracy to promote dangerous drugs.
Mbeki questioned the link between HIV and AIDS, and left the impression his government regarded discussion of the AIDS crisis as an attempt by white Westerners to denigrate black Africans by questioning their sexual morality.
“African AIDS denialism remoralised the debate,” Cameron said. “It wrongly ascribes the medical model of HIV virology to some kind of condemnation of Africans.”
At the same time Cameron charges Western drug firms with unfairly holding up ARV prices until forced to reduce them by lawsuits and political pressure.
He is clearly angry the country has lost valuable time in fighting AIDS and may still be moving too slowly. “I believe massive errors have been made,” Cameron said.
But despite the escalating AIDS death rate and the government’s opaque attitude toward the disease, Cameron remains guardedly optimistic the tide can be turned.
ARVs, once derided by officials as unnecessary and dangerous, are increasingly available and more and more South Africans are going public as HIV-positive.
Cameron’s message, to his fellow South Africans and to the world, is that AIDS provides an opportunity for both individuals and societies to unite in fighting an epidemic
“We cannot allow our grief and our bereavement to inflict a further loss upon us: the loss of our own full humanity, our capacity to feel and respond and support,” he writes. “AIDS beckons us to the fullness and power of our own humanity.”
Revision date: June 20, 2011
Last revised: by Andrew G. Epstein, M.D.