Discussing the Tragedy of AIDS in South Africa

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• JEFFREY BROWN:

  In 1986, Edwin Cameron, a South African human rights lawyer, learned he was HIV positive. Eleven years later, now Judge Cameron, he went public about his condition, thrusting himself into the midst of a national debate over the AIDS crisis that has affected millions of South African lives.

  In 2000, Cameron was appoint to the Supreme Court of Appeal, the highest appeals court in South Africa. He's written his story in a new book "Witness to AIDS." The book has a forward by Nelson Mandela, who calls Justice Cameron one of South Africa's new heroes. Edwin Cameron joins me now. And, welcome to you.

• EDWIN CAMERON:

  Thank you, Jeff.

• JEFFREY BROWN:

  You were an openly gay man as a lawyer, and then as a judge. What made you decide to go public about having AIDS?

• EDWIN CAMERON:

  I've been involved in the AIDS policy formulation as a lawyer, but I'd been keeping this deathly secret, which I'd been ashamed of in the early years.

  I was infected in the 1980's as a gay man. I thought my shame was from my homosexual exposure. I discovered that in Africa, where the epidemic is overwhelmingly heterosexual, that heterosexual women feel the same sort of shame, and I decided that I had to speak out eventually to try to unite the two capacities — the public figure involved in AIDS, who was also a judge, and the private figure who was keeping the secret. So I decided to speak out in 1999.

• JEFFREY BROWN:

  You write, in fact, a great deal about the stigma attached to AIDS in Africa and South Africa. You tell the story of a man who used to work in your garden as one way of exemplifying that. Tell us that.

• EDWIN CAMERON:

  I saw him falling ill in about 2000, and I tried to reach out to him. I spoke to him. He knew that I had gone public; he knew that I could help him with access to treatment.

  And I tried to persuade him to talk to me about his condition. He came from Zimbabwe, and he left; he stopped working in my garden, he went back to Zimbabwe and he died. And I'm pretty sure that he died of AIDS, and I'm pretty sure that that's happening across Southern Africa, people for whom treatment is in reach but for whom the stigma is too much to take it.

  I think it's changing, Jeff. I think that increasingly as treatment becomes available across South African — and it is — my government is providing it in the public sector. In Botswana, there's an extensive public treatment program — I think it is changing, but I think the stigma is still very intense.

• JEFFREY BROWN:

  And is the stigma attached, do you think, to the sexual nature of the disease?

• EDWIN CAMERON:

  That's the core of it — the idea that because you have a virus that was sexually transmitted that there's some shame that attaches to it. And that is what we have got to address if we're going to make sure that those people for whom treatment is accessible are going to take it up.

• JEFFREY BROWN:

  You write in the book, AIDS is an epidemic is enmeshed with sex and death; in Africa, the epidemic is enmeshed with the politics of race and sex and death. What did you mean by that?

• EDWIN CAMERON:

  We've had difficulties in South Africa. We've grappled with a president who questioned whether HIV caused AIDS, and that stems from our racial and colonial past where white ideas, as they've seen, have been impressed on Africa, which have insulted and demeaned Africans, and our president seemed to ask the question whether the conventional biomedical model of AIDS, which sees AIDS as a sexually transmitted disease, wasn't insulting African sexual habits; that was a profound mistake. And of course the biomedical model doesn't imply a moral condemnation of Africans, but it came from our racist past and it was one of the most tragic after effects of our racist and colonial past.

• JEFFREY BROWN:

  One of the most striking things is that this epidemic came just as South Africa was entering a new era, a new era of democracy. Has it put pressure on the new institutions of the new South Africa? In what ways has it done so?

• EDWIN CAMERON:

  It has, and the good news — the bad news was that AIDS denialism delayed a rational and unambiguous response to the disease. The government has now committed itself to treatment provision in the public sector after a lot of ambivalence. The good news is that our democratic institutions came out quite exceedingly well.

  We had intense debate in — amongst civil society organizations. The media were intensely critical of the president's stance. The constitutional court delivered a unanimous judgment, setting out the medical cause of AIDS and requiring the government to provide treatment to pregnant mothers who wanted it. And the president himself was persuaded eventually to adopt a national treatment policy despite what many people thought was still his views.

  So the democratic institutions were protested profoundly, and they passed in the way that I as a South African feel very proud of.

• JEFFREY BROWN:

  So where do things stand with this treatment program now? How many people are receiving it? How is it going?

• EDWIN CAMERON:

  It's going quite well, Jeff. About 60,000 people — poor people — are receiving anti-retroviral medication through the public sector. It's not as much as they ought to be.

  We estimate that approximately 600,000 South Africans are at present falling ill with AIDS, which means that there ought to be 600,000 on treatment. So we're only getting to about 10 percent of them, but the number is steadily increasing, and that's what's optimistic about the epidemic.

• JEFFREY BROWN:

  So in going back and writing about your experience, you've written both a personal story, and, of course, a national tale. What lessons do you take from what has happened over the last, say, 10 years in South Africa with the AIDS experience?

• EDWIN CAMERON:

  The most important lessons, I think, are profoundly optimistic lessons. I'm here tonight talking with you because I've survived on treatment — I've been on treatment for eight years.

  And the fact is that there's so much fear and stigma and ignorance and dismay in Africa, and yet the fundamental factors that AIDS can now be medically managed — it's medically managed for most people, though not all, in North America and Western Europe. And that can also be the case for Africa and the lessons over the last eight years is we've turned around our approach to the management of the disease, and that we can now bring treatment to those who need it.

• JEFFREY BROWN:

  And let me end on the personal. How is your own health?

• EDWIN CAMERON:

  I'm in wonderful health. I've been undetectable for many years. My virus is being repressed by the medication. I'm on a very simple regimen, and I have huge energy and the huge privilege of being alive.

• JEFFREY BROWN:

  All right, the book is "Witness to AIDS," Justice Edwin Cameron, thank you very much.

• EDWIN CAMERON:

  Thank you.