ETHICS, POLICY AND SOCIETY

Grant Title:Doctors, Nurses and the South African AIDS Epidemic

Funding Source and Project Period:
NLM, G13-LM008749; 2006-2011

Key HIV Center Personnel:

Principal Investigator: Ronald Bayer, Ph.D.

 Project Overview
(from abstract submitted to NLM):

This project support the writing of a history of the AIDS epidemic in South Africa based primarily on more than 80 already conducted extensive oral histories of doctors and nurses. Transcripts of the archives of taped interviews will be available to other scholars at the Columbia University Oral History Office.

The emergence of democracy in South Africa in 1994 after years of struggle against a racially oppressive regime was widely hailed. Ironically, at the very moment of political deliverance, the seeds for a. catastrophic HIV epidemic had already been sown. Confronted with the enormous task of building a new society, most were unwilling to acknowledge the nascent epidemic. Chris Hani, a long-time activist and combatant against apartheid, was one of the few who foresaw the country's dilemma. In 1990, he told his political comrades in the African National Congress, "We have a noble task ahead of us-reconstruction of our country. We cannot afford to allow the AIDS epidemic to ruin the realization of our dreams."

Just ten years later, the South African Medical Research Council documented the extent to which AIDS had begun to ravage the nation. It reported that 25% of all deaths in the country in 2000 could be attributed to AIDS; more women between 25 and 35 years of age had died than women between 60 and 69; that 65,000 children under the age of 5 had died in 2000, compared to 17,000 in 1993. In 2004 it was estimated that more than 5 million South Africans were infected with HIV. In KwaZulu Natal it is not unusual for 30 - 40% of childbearing women to be infected with HIV.

This book will trace the decade long experience of health care workers who confronted the full impact of HIV/AIDS when effective antiretroviral therapies were out of reach because of economic and political reasons; their efforts to provide care in the face of denial and stigmatization, their struggle to expand the clinical options available to their patients. It will conclude with the impact of the determination of the South African government in the fall of 2003 to begin the process of extending antiretroviral treatment to the vast numbers whose lives might be prolonged.

updated 5/16/07