Failure by Inaction: South Africa’s Early Policy on HIV/AIDS



In 1981, when the AIDS virus was first known on a global scale, the South African government, run by the National Party, was deeply engrained in a policy of apartheid; racial segregation was the norm, and social policies were unequal and semi-nonexistent.  Until 1994, when Nelson Mandela was elected as the first democratic president of South Africa, nothing on a national scale was done to address the spread of HIV/AIDS. Though his presidency meant progress in the realms of equality and protection for many South African citizens, President Mandela unfortunately did not do much to tackle the AIDS problem that was beginning to grip the country.  As noted by the Council on Foreign Relations, “Mandela instituted progressive HIV policies, including a comprehensive ‘AIDS Plan,’ but a failure of leadership and lack of national and provincial capacity undermined efforts.”  This being the one major criticism of his presidency, Mandela has said that he “acknowledges and accepts the criticism… that he failed to make HIV/AIDS a national priority during his presidency from 1994-1999.”

However, his successor’s viewpoint on the virus turned out to be the one that caused much more harm to the country.  President Thabo Mbeki, who was in office from 1999-2008, actually publicly denied the connection between HIV and AIDS.  He is also known for asserting that antiretroviral therapy (the combination of drugs commonly used to suppress HIV) was ineffective.  With much of the country (especially those most affected by the virus) living in poverty, it was hard to get access to other information than what the government asserted.  Moreover, President Mbeki’s denials combined with many traditional views on AIDS – related to witchcraft, natural healing, and false beliefs about cures in the townships – causing the people of South Africa to doubt official information, and as a result, be exceedingly uninformed about the causes, prevention methods, and treatment options of HIV/AIDS.  Without available information, those infected or at risk to be infected had nowhere to turn.  Sadly, South Africa at the time did have a medical infrastructure that would have been capable of providing antiretroviral therapy to its citizens and thus treating those infected with HIV, yet, as stated by a New York Times article at the time, Thabo Mbeki “downplayed the problem, exaggerated the toxicity of antiretroviral drugs and suggested that advocates for treating the disease are racist.”  In addition, they were not only hard to find, but the government did nothing to make the drugs affordable for the poor – often the sector of society hit hardest by AIDS.

Compounding these challenges was the fact that stigmas were crafted around those people who were infected with AIDS.  While the government did nothing to fight the spread of the disease, or to make it more manageable for its citizens, rumors and speculations – almost like the virus – spread uncontrollably.  AIDS was reconstructed as a disease of witchcraft, or one resulting from “dirty” sex.  Unfortunately, this confusion over the medical facts only served to make the virus spread quicker, and to alienate more and more of the population.  Because of the governmental inaction, those who had contracted the disease, or were at risk for contracting it, were abandoned by their government, lacked any sort of support system, and so the virus spread even quicker.

In this way, the government of South Africa failed its people by not acting.  Without providing adequate information to its citizens about AIDS (the cause, prevention possibilities, and treatment opportunities), more people contracted the virus, and more of those people died from it.   The government fell short of providing what the citizens needed from their new democracy post-apartheid – insurance that they all would be considered equally and protected.  The government had an obligation to protect its citizens, and with new medical advances, they had the capability to do this.  However, by denying scientific information that could have helped millions of people, President Thabo Mbeki hurt the accountability of the South African government to its people.  Unfortunately, taking no direct action on an issue is often unnoticed, because there are no immediate consequences or obvious motivations, and so these policies of inaction continued for so long, that community groups and NGOs felt the need to step in.  Today, 5 years after Thabo Mbeki’s presidency ended, South Africa is still the country with the largest number of people living with HIV/AIDS.


Lainey Schmidt is a junior in the College of Arts and Sciences. She can be reached at

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