13th INTERNATIONAL AIDS CONFERENCE DURBAN: 9-14 JULY 2000 MSF/TAC Satellite Conference IMPROVED ACCESS TO HIV/AIDS DRUGS IN DEVELOPING COUNTRIES Closing Remarks by Edwin Cameron Sanibonani! Ninjani? Nami ngiyaphila. Ladies and gentlemen, I have greeted you all in the language of my Zulu-speaking compatriots. I told them that I saw them. Their response was initially passive: they acknowledged my statement. Then I asked them how they were. They told me that they are well and living. I was able to reply the same. That to me was significant. It wasn't merely a formality. It was an important part of my reality here today. I'm here, I'm able to be talking to you, I'm able to engage with you, I'm able to speak with you about this important topic, because I am on anti-retroviral treatment. Three years ago in October 1997 I fell very ill. Is there anyone here today who's feeling ill? Yes, I see you. Is there anyone who's feeling ill from AIDS? Who wants to speak about it? Well I can tell you that you taste death in your mouth when you have AIDS. Your body stops absorbing food. Your body stops producing energy for you to work and think and to enjoy life. Your body starts breaking down against its own will, and you feel terrible. When I fell ill I had good medical care. I had a good doctor. He gave me medicines to deal with the things that were making me so ill. And then he gave me the medicines that treated the underlying cause, which was this virus that was stopping my body's ability to defend itself against the things that were making me ill. That was nearly three years ago. The average survival time for someone like me a well-cared for, medically attended, well nourished male in his mid-40's after the onset of full blown AIDS is 30-36 months. I fell ill 33 months ago. So I should be dead by now. Instead of which, I'm here, "ngikhona", "ngiyaphila", I'm still living. I'm still living, when there are people here on the street outside, people in Kwa Mashu, in Dundee, in Nongoma, on the South Coast, who are feeling terribly ill, who are dying. There are people throughout Africa, 24 or 25 million people in Africa and nearly 34 million people in our whole world who are this moment dying. And they dying because they don't have the privilege that I have, of purchasing my health and life. I'm a judge. I have many privileges and benefits as a judge. I do exercise them. I don't claim not to. I have the privilege of a secure position. I can't be sacked by an employer that discriminates against me, because the Constitution says I can't be sacked, except for very rare conditions. I also have loving family who here today. And I have colleagues and friends who support me. And most importantly, on the salary of a judge I have the privilege to purchase my life. I can afford my medication it costs me $400 every month, R2550 a month. Who here is working? Who earns R2550 a month? How many of you are not working at all? Too many, too, too many people are not even working. Now why should I have the privilege of purchasing my life and health when 34 million people in the resource poor world are falling ill, feeling sick to death, and are dying? That to me ladies and gentlemen seems a moral inequity of such fundamental proportions that no one can look at it and fail to be spurred to be thought and action about it. That is something which we in Africa cannot accept. It is something that the developed world also cannot accept. A century ago in the trenches of the first World War, 18 million white Europeans died because of corporate greed, governmental ineptitude, and human folly. In Africa we face death and dying and misery and loss and mourning on the same scale. Except that this does not have to happen. Our history teachers us South Africans. I'm proud to be a South African and I'm proud to be an African. I'm white and I'm an African and I'm proud of that and our history has taught us a great deal. Our history has taught us that we don't have to accept "inevitabilities". We don't have to accept what one leading lady from the United States in the seminar I attended yesterday called "a sad reality", that these medications are not accessible to Africa and the resource-poor world. We don't accept "sad realities" in South Africa. If we accepted what others told us were sad realities, we would still have had a racist oligarchy oppressing our people. We would have had indescribable chaos and bloodshed. We have shown through our history that we will confront those "sad realities", and we will change them. Our country is not perfect. But we have a democracy anda Constitution and national aspirations that we can be proud of. You are here today because you want to be proud of our country in every respect. You want us to be proud of the way that we can make health and life available to everyone. At the seminar where I was yesterday and this morning, Dr William Makgoba who came to speak to you earlier this morning, released figures. These figures come from our own Department of Home Affairs. He gave them to the Sunday Times, and they are published today. They show that the natural order of things which is that people die late and women die after men has been reversed in our country. It has been reversed particularly in Kwa-Zulu Natal. Women are dying in their early 20's and mid- 30's. And women are dying before men. These are figures that show that something dramatically and terribly wrong is happening to our people. And what is it? We know what it is. It's not TB. It's not malaria. And it's not malnutrition. It is a virus. It's a virus called HIV. It causes AIDS. And if AIDS is not treated, it leads to terrible sickness and death. But there is a greater fact even than that. The greater fact is that those medications as you now know after this morning's discussions are available. They exist and can be cheaply produced, but the drug companies are keeping them unaffordable and inaccessible to the people who most urgently need them. We need to change the facts of our world. We need to change the facts that are going to lead to the deaths of 25 million people in Africa. And we do plan to change them. That is our role as Africans, as proud Africans, as proud South Africans. We will confront that fact and we will change it by changing the conditions that create it, through principled political action, through legal action, through principled commitment to what is right. We will challenge the future by intervening in the present. Thank you, very much.