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Rights, responsibilities and building an effective response to AIDS
Edwin Cameron, Judge of the Supreme Court of Appeal, South Africa
May 27, 2006

This presentation was made at the launch of the Zimbabwe HIV/AIDS Human Rights Charter in Harare on Saturday 27 May 2006

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It is an honour for me to be with you this morning to launch the Zimbabwe HIV/AIDS Human Rights Charter. I thank the organisers from Zimbabwe Lawyers for Human Rights for inviting me to join you and to say a few words on this important occasion.

Their invitation to me, a non-Zimbabwean South African, recognises that on this sub-continent we’re in this epidemic together: that the epidemic does not bow before borders or nationalities or to language or ethnic or racial or sexual differences, and that in AIDS, as in other matters, we need to think together and plan together and act together if we are to surmount the daunting challenges of sickness and death and discrimination it presents to us.

I am particularly honoured and pleased to be asked to speak at the launch this morning. The Charter you have drafted is a significant and enlightening document. I say this for the following reasons:

• First, the Charter unashamedly embraces human rights, and adopts a dignity-based approach to dealing with the epidemic. This is correct in principle – since human rights violations, even in pursuit of public health policy, are hard to justify. But, in addition, a human rights approach constitutes good strategic thinking, since it is only by protecting the rights of those with HIV/AIDS that we can hope to curtail the effects of the epidemic. This is because it is well documented that, in complex related ways, human rights violations against people with HIV or AIDS enhance the spread of HIV and exacerbate the epidemic. As the Chief Justice of South Africa, Justice Pius Langa, recently observed, this approach ‘must be used by all sectors of society who are actively engaged in fighting the epidemic’:
  
  
• The rights-based approach to HIV/AIDS recognises that violations of fundamental rights such as the right to non-discrimination, the right to health, the right to food and water, the right to social security, the right to privacy and the rights of women are all contributing factors that exacerbate the spread of HIV/AIDS and its consequences. It therefore aims to deal with the problem at a multi-sectoral level by ensuring that all rights are recognised and protected in all spheres of life.¹
  
  
• Second, the Charter recognises the responsibilities of government. It declares that ‘government must ensure that treatment is accessible and affordable to all’. This provision of the Charter constitutes plain speaking. And it is correct. Public provision of health care is a governmental responsibility, and no more clearly so than in a continent-wide emergency such as the HIV/AIDS epidemic. The public provision of anti-retroviral medication in particular is a vital governmental duty – one that has become especially urgent since AIDS is no longer a necessarily fatal condition, but is now chronically manageable with relatively straightforward healthcare interventions. The Charter’s focus on government’s responsibility to provide treatment is therefore well-directed.
  
  
• And in doing this the Charter also shines an unavoidable light on the question of good governance and how it affects the management of AIDS. It is obvious that without good government we cannot respond effectively to the devastation of AIDS. This lesson is emerging painfully in Zimbabwe. It requires no particular desire for controversy to note that issues of governance, economic policy and international relations are directly affecting those living with AIDS in Zimbabwe. Widespread reports reaching South Africa suggest that lifegiving supplies of anti-retroviral medication have been interrupted, that these drugs are unaffordable even to those who have jobs, and that this is a direct consequence of political instability in Zimbabwe.
  
  
• Over the last quarter-century, the AIDS epidemic has shone a remorseless light on every moral issue in every society it has touched. It has exposed hypocrisy and double-dealing and unjust privilege; it has accentuated inequality and injustice; and it has revealed misrule. All South Africans, of all political persuasions, profoundly yearn for an end to the controversy that has beset governance in Zimbabwe over much of the last decade. The destructive effects of misgovernance in the management of the AIDS epidemic acutely underscore this wish.
  
  
• Third, the Charter is important because while it emphasises government’s duties, it also rightly understands that government cannot be expected to deal with the epidemic single-handedly. Individual response to AIDS is a duty that each of us bears, inside and outside government, in each of our homes and communities and workplaces.
  
  
• In particular, effective responses – in awareness, education, prevention and in treatment access and literacy – require a vibrant, strong, unafraid civil society. That means organisations like Zimbabwe Lawyers for Human Rights, who monitor the response of government, intervene when violations of rights occur, and press vigorously for equality, dignity and treatment access.
  
  
• We in South Africa learnt this lesson very valuably, when some years ago we went through a painful period of governmental denialism about AIDS. From the end of 1999, until 2003, our government seemed unwilling to accept that HIV was the cause of AIDS. This entailed the horrendous consequence that government seemed to doubt the medically established fact that AIDS, as a virally caused condition, can be effectively treated with anti-retroviral medication. The result was that an effective national response to the illness and suffering of the epidemic became paralysed. Fortunately powerful voices in civil society, including the Treatment Action Campaign, the South African Council of Churches, and the Congress of South African Trade Unions, expressed profound and vigorous opposition to the government’s stand. This, combined with pungent media criticism, pressure from business, a Constitutional Court ruling, and our governing party’s long tradition of internally reflective debate and dissent, led to a salutary change in government’s approach. We now have a national treatment roll-out that promises every South African with AIDS access to anti-retroviral medication at public health facilities. Last week, government announced that nearly 140 000 South Africans are receiving free anti-retroviral treatment through public health facilities – a significant achievement, on which we need urgently to improve.
  
  
• The lesson from South Africa is this. An assertive, articulate, well-informed, well-organised, rights-conscious, unafraid citizenry is indispensable if we are to deal effectively with AIDS. Democracy, constitutionalism and respect for human rights are necessary in Africa. They are necessary in Southern Africa. They are necessary in South Africa. And they are necessary in Zimbabwe. They enhance our dignity and our capacities as human beings, not least because they enable us to deal better with one of our generation’s major moral challenges, AIDS.

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1. Keynote address at HIV and Access to Legal Services Conference, AIDS Law Project, University of
the Witwatersrand, Johannesburg, 17-18 February 2006.

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