No valley without shadows

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Ma nypeopl eonl yk nowt het i poft hei c eber goft heea r l yHI Vmov ement ’ shi s t or yi nS out hAf r i c aa nd t hei rba t t l et oa c c es sl i f es a v i ngARVs . T hi sDa v i dv er s usGol i a t hs t or yi snowc a pt ur edi nMS F ’ snew book‘ NoVa l l eyWi t houtS ha dows ’ . Nowa v a i l a bl ea sa nebookher e: bi t . l y / NoVa l l ey Wi t hout S ha dows–whi c hc a pt ur est hei nc r edi bl ea c t s ofs ol i da r i t ya ndv a s tbehi ndt hes c enesmobi l i s a t i onbet weeni nt er na t i ona l a ndS out hAf r i c a nc i v i l s oc i et ynet wor k sbet ween1998t o2006.


I n1999, MS Fs entoneofi t sv ol unt eerdoc t orDrE r i cGoema er e , t oS out hAf r i c ahopi ngt opr ov et ha t ARVsc oul dbegi v enonal a r ges c a l ewi t hapubl i chea l t ha ppr oa c ht opeopl el i v i ngi ns et t i ngswi t h l i mi t edr es our c es , s t a r t i ngwi t hpr ev ent i ngt het r a ns mi s s i onofHI Vt omot her sa ndc hi l dr en. E r i cwor k edwi t hc ount l es sT ACa ndMS Fs t a t ohel pi nt r oduc eARVsi nKha y el i t s ha , i nc ol l a bor a t i on wi t hUCTa ndt heWes t er nCa peDepa r t mentofHea l t h, a nds uppor t edT ACi nt hehi s t or i cBi gPha r ma v sMa ndel aCa s e( 2001) . Her e , E r i cna r r a t est hi ss hor tphot os el ec t i onwhi c hi nc l udesk eymoment si nt he ghtf orARVsi nt he ea r l yHI Vmov ement .



Pr et or i a , 5Ma r c h2001 I n1998, t hePha r ma c eut i c a l Ma nuf a c t ur er sAs s oc i a t i on( PMA) r epr es ent i ng39pha r ma c eut i c a l c ompa ni est ookt heS out hAf r i c a ngov er nmentt oc our tov erc l a us esi nt heMedi c i nesAc twhi c ht he gov er nments a i dwoul da l l owt oi mpor tmuc hc hea pergener i cARVdr ugs . Att ha tt i me , S out hAf r i c awa ses t i ma t edt oha v e5mi l l i onpeopl el i v i ngwi t hHI Va ndt hous a ndswer e dy i ng. I nc r edi bl y , ay ea r ’ swor t hofARVsc os tf orones i ngl epa t i entc os t$10, 000i nS out hAf r i c a , whi l e gener i cv er s i onsi nBr a z i l , I ndi aa ndT ha i l a ndwer eaf r a c t i onoft hec os t . T hec a s ewa sc a l l ed‘ Bi gPha r mav er s usNel s onMa ndel a ’ a ndwa ss us pendedf ort hr eey ea r s . I nMa r c h2001, whent hePMAr es umedt hec a s e , MS Fma r c hedwi t ht hous a ndsofa c t i v i s t sa ndpeopl e l i v i ngwi t hHI Vf r om t heT r ea t mentAc t i onCa mpa i gn( T AC) , COS AT Ua ndc i v i l s oc i et y or ga ni s a t i onsi nt hes t r eet sofPr et or i aa ga i ns tt hi sr ut hl es spr ot eer i ng.



Pr et or i a , 5Ma r c h2001 “ T hea t mos pher et ha tda ywa sv er yi mpr es s i v e . T her ewer es i c kpa t i ent swhower edes per a t ef or t r ea t ment , s a y i ng‘ wedon’ twa ntt odi e . ’ I twa s n’ tapea c ef ul ma r c h, y ouc oul ds eepeopl e ’ sa ngera nd det er mi na t i on. Whent hema r c hr ea c hedt heUSE mba s s y , I wa soneoft hes pea k er s . Ourc ont r i but i ona sdoc t or swa s t oe x pl a i nhowt r ea t i ngAi dswa spos s i bl ea nda ffor da bl ea ndwa sar i ghtnotapr i v i l ege . Behi ndt hes c enes , MS Fs t a ffwor k edwi t ht heT ACa ndahugei nt er na t i ona l net wor kofpa t entl a wy er s , HI Vdoc t or s , a c t i v i s tor ga ni s a t i ons , a nduni v er s i t ys t udent st ol a unc hahugeonl i nec a mpa i gnc a l l ed ‘ Dr opT heCa s e ’



Pr et or i a , 19Apr i l 2001 “ Ont heda yt hePMAc a s ewa sduet os t a r ti nt hePr et or i aHi ghS upr emeCour t , Za c k i eAc hma t , t hen t hel ea derof T ACs pok ea tapr es sc onf er enc eor ga ni s edbyT ACa ndMS F . I n6week s , ov er250, 000 peopl ea r oundt hewor l dha ds i gnedt he‘ Dr opT heCa s e ’ el ec t r oni cpet i t i on, ma k i ngi tt hebi gges t pet i t i oni nMS F ’ shi s t or y . Wewa nt edt os endas t r ongmes s a get ot hepha r ma c eut i c a l i ndus t r yt ha tl i f ewa sa bov epr ot . And t ha tweha dma s s i v ei nt er na t i ona l s uppor tbehi ndus . T woda y sl a t er , t hePMAa nnounc edt heywoul d dr opt hec a s ea ndpa ya l l t hec os t s . ”



Pr et or i a , 19Apr i l 2001. “ Wewer ej ubi l a nt ! T heda ya f t ert hePMAdr oppedt hei rc a s e , wehel dapr es sc onf er enc ea ndc r a c k ed opent hec ha mpa gne . Butourc el ebr a t i onwa ss hor t l i v ed. Wi t hi nda y s , t heS out hAf r i c a ngov er nmenta nnounc edt ha tARVs wer es t i l l una ffor da bl ea ndques t i onedt hes a f et yofgener i cv er s i ons . I tt ur nedoutt ha tt he gov er nmentwa si nf a c ti nc ompl et edeni a l a boutHI V. T ha boMbek i ha ds t unnedev er y onea tDur ba nAi dsc onf er enc ei nJ ul y2000t hepr ev i ousy ea rby a nnounc i ngt ha tt her ewa s n’ tc onc l us i v eev i denc et ha tHI Vc a us edAI DSi nAf r i c a . Wequi c k l yr ea l i s edt ha tourne x thugeba t t l ewa swi t ht heS out hAf r i c a ngov er nment .



Ca peT own, 27J a nua r y2002 I nl a t e2001, MS Fs t a r t edor ga ni s i ngac l a ndes t i net r i pt oBr a z i l f or T AC’ sMa t t hewDa ma ne , Noma ndl a Y a k oa ndZa c k i eAc hma t , wi t ht hea gr eementoft heBr a z i l i a ns t a t ec ompa nyPha r ma gui nosa ndt he S out hAf r i c a nMedi c i nesCont r ol sCounc i l ( MCC) . On27J a nua r y , t heyl a ndeda tCa peT owna i r por twi t h6mont hs wor t hofgener i cARVt r ea t ment , enoughf or50peopl e , i nt hei rba gs . Ay ea r ’ st r ea t mentc os tj us t$200perper s onpery ea r , c ompa r edt o t he$10, 000pr i c et a gi nS out hAf r i c a .



J oha nnes bur g, 29J a nua r y2001 “ Weha da c t ua l l y , s ec r et l ys t a r t edaf ewdoz enpa t i ent sont r ea t mentwi t ht hegener i cARVss i nc e mi d2001butt ha tda ywewa nt edt oma k ei topen. T woda y sl a t erwehel dapr es sc onf er enc ewi t h T AC, Ox f a ma ndCOS AT Ut os a ywha twe ’ ddone . I twa st hes t a r tofapubl i cdea nc ec a mpa i gna ga i ns t t hegov er nmentpos i t i on. Wewer ev er yner v ousa boutgov er nmentpot ent i a l r ea c t i on. Onc ey ous t a r t eds omeoneonARV t r ea t ment , y ouc a nnots t op. I nr es pons e , Pr es i dent i a l S pok es per s onPa r k sMa nk a hl a naa nnounc edt ha ti mpor t i nggener i c swa s i r r es pons i bl ea ndopenedt hec ount r yt obi ol ogi c a l wa r f a r e . Andt heys entaHea l t hMi ni s t r yoffic i a l t o Kha y el i t s hat os ei z eourARVs t oc k s . L uc k i l ywe ’ dhi ddenmos tofi ta wa y . ”



Kha y el i t s ha , Ca peT own, 27J ul y2002 “ I v i v i dl yr emembert he r s tt i meI metNel s onMa ndel a . I twa sa tZa c k i eAc hma t ’ shous e . Za c k i ewa s r ef us i ngt ot a k eARVt r ea t menta sl onga si twa sa v a i l a bl ef orev er y onei nS out hAf r i c aa ndMa ndel a wa spl ea di ngwi t hhi mt or ec ons i der . Wet ol dMa ndel at ha tHI Vwa st r ea t a bl ea ndt ha tt r ea t mentwa sa ffor da bl ewi t hgener i cdr ugs . Hedec i dedt oputonhi sgl ov est o ghtHI Vpubl i c l y . ”



Kha y el i t s ha , Ca peT own, 12Dec ember2002 “ Ma ndel ac a met oourr es c uewhent heANCgov er nmentt hr ea t enedt oc l os eMS F ’ sHI Vpr ogr a mmei n Kha y el i t s ha . On12Dec ember , hev i s i t edKha y el i t s haa ndt our edoneoft het hr eec l i ni c swher ewewer e offer i ngf r eeARVt r ea t ment . T hei c oni cHI VPOS I T I VET s hi r tha dbeenours i gnofpubl i cdea nc ea ga i ns tt hegov er nment . We wonder edi fMa ndel awoul dda r et owea ri t . Whenour r s tpa t i entMa t t hewDa ma neoffer edMa ndel at het s hi r t , hei ns t a nt l yt ookoffhi sown t r a di t i ona l s hi r ta nds woppedi t . Peopl ewer ec r y i ng, s hout i ng‘ v i v aMa ndel a ’ . Wi t hMa ndel aonour s i de , not hi ngc oul ds t opt hemov ement . ”



L us i k i s i k i , 1J a nua r y2002 “ ByDec ember2002, t heKha y el i t s hapr oj ec twa ss howi nggoodr es ul t s . Butc oul dMS Fr epea tt hi s model i namuc hpoor erpr ov i nc e?Ma nyofourpa t i ent si nKha y el i t s hawer e‘ t r ea t mentmi gr a nt s ’ c omi ngf r om r emot eE a s t er nCa pedi s t r i c t st ha tha dnev erev enhea r dofHI V. Whent heE a s t er nCa peHea l t hDepa r t mentbl oc k edus , wepa r t ner edwi t ht heMa ndel aF ounda t i ont o s t a r ta nHI Vpr ogr a mmei nL us i k i s i k i , oneoft hepoor es tdi s t r i c t si nt hec ount r y . T hi sphot oofal i t t l eboyl ook i ngwi t hbemus ementa thi sARVsi nar emot eL us i k i s i k i v i l l a gec a met o s y mbol i s et ha tt i me . ”



Kha y el i t s ha , 1Dec ember , Wor l dAi dsDa y2004 “ T hi smur a l pa i nt edbyt hec ommuni t yf orWor l dAi dsDa yi ss t i l l t her e , nea rt hema i nent r a nc et o Kha y el i t s ha . I tr epr es ent edahugemi l es t onea ga i ns ts t i gmabys t a t i ngc l ea r l y : t r ea t menti snowl a r gel y a v a i l a bl e . I nea r l y2000, whenMS F ’ shea dqua r t er si nBel gi um ga v ea ppr ov a l t oput180peopl eont r ea t ment ( a tac os tof$10, 000apa t i ent ) , weha dt oc hoos eonef r om ev er yf oure x t r emel ys i c kpa t i ent st oget ARVs , l i t er a l l yc ondemni ngt her es tt odea t h. F oury ea r sl a t er , wi t hgener i cARVsi nt hec ount r yweha dgr ownt o1000pa t i ent sonARVs . L ook i ngba c ki t sha r dt oi ma gi net ha tt oda y , S out hAf r i c a ’ sHI Vpr ogr a mmeha s3. 2mi l l i onon t r ea t ment



Pr et or i a , 17Oc t ober2013 “ Butourba t t l ec ont i nues . T ogett heHI Vepi demi cpr oper l yunderc ont r ol , wewi l l needgetdoubl et hi s number–6mi l l i onpeopl e–ont r ea t ment . Aswe ’ v es een, t hi ss t r uggl ec a nonl ybewonbyac i v i l s oc i et ynet wor kf orna t i ona l a ndi nt er na t i ona l a c t i v i s t s . T oda y , oneofi t spi oneerr epr es ent a t i v es , t heT ACi ss l owl ybei ngs i l enc edf r om l a c koff undi ng. T AC’ s s ur v i v a l i sourbes tgua r a nt eet onotr et ur nt ot heol dda y s , whenHI Vt r ea t mentwa st hepr i v i l egef or t her i c ha ndc onnec t ed, notar i ghtf ora l l l i v i ngi nS out hAf r i c at oda y . ”


Re a dMSF’ sne wb o o k‘ NoV a l l e yWi t ho ut Sha d o ws ’ , t hes t o r y o f MSF’ sr o l ei nt hev a s t b e hi nd t he s c e ne smo b i l i s a t i o nt o a c c e s sARV si nSo ut hAf r i c ab e t we e n1 9 9 8-2 0 0 6 . T od o wnl o a dt hee b o o kv e r s i o no f ‘ NoV a l l e yWi t ho ut Sha d o ws ’ v i s i t : b i t . l y / No V a l l e y Wi t ho ut Sha d o ws


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