Lessons from the HIV and AIDS pandemic

24 March 2020 | Story Carla Tsampiras. Photo Tumisu, Pixabay Read time 8 min.

Ralph Kretzen, who died on 26 August 1982, and Pieter Daniël (Charles) Steyn, who died on 1 January 1983, were the first two people officially recognised as dying of AIDS in South Africa.

In 1986, homophobia and stigma about HIV and AIDS still shaped public, medical and government responses. This was so ubiquitous that a provincial government blood donation service even put up posters instructing ‘moffies’ or ‘gays’ or people who had sex with “moffies” or “gays” not to give blood. (“Moffie” is a derogatory term used in South Africa for gay men.)

This was despite evidence that people were dying of AIDS regardless of sexual orientation.

Thirteen years later, in 1998, fear and stigma resulted in the brutal murder of Gugu Dlamini by a group of people from her neighbourhood. Dlamini was a South African AIDS activist determined to fight against the stigma and discrimination faced by people living with HIV and AIDS. People experienced the effects of stigma from others. They were also affected by internal stigma that prevented them seeking treatment.

 

In every pandemic people have had to make choices about how to behave.

In early March 2020, a shop assistant in my Cape Town neighbourhood relayed how people had run past her, shouting that the coronavirus had arrived, after a group of tourists sat down in an open-plan eating area near her shop. The tourists got up and left. But stigma had left a stain on all involved in the incident.

As the spread of diseases has shown over the centuries – whether smallpox in the Cape Colony in the early 18th century and late 19th century, the global influenza epidemic of 1918 or COVID-19 today – the causative agents of illness do not care for our assumptions about our alleged superiority on the planet, nor do they discriminate. They also do not recognise the structures and symbols people use to try and shore up their fears and create a sense of security.

What histories of past epidemics show is that the biggest danger during pandemics is not necessarily the causative agents, but how people respond to them. There are obviously significant differences between the COVID-19 pandemic, the AIDS epidemic, and the pandemics from beyond living memory. Still, there are sufficient similarities to remind us that pandemics act on the social fault lines, hierarchies, and inequalities that people create, globally and locally.

Anxiety and anger

In every pandemic people have had to make choices about how to behave – individually and as members of multiple communities. People’s responses have often been driven by fear, anger, anxiety, opportunities for gain, and a need to believe that “we” are safe and “others” are the problem.

Gugu Dlamini’s death shows this can lead to behaviour that is fatal. Individuals reacting from a space of fear or lack of knowledge also make it easier for governments, corporations, and other elites to manipulate those fears to delay large-scale social responses.

Irrational fears can be linked to sexual orientation, as well as race, class, gender. In the case of AIDS, fears were deployed – even between countries – to shift blame or delay responses to the AIDS epidemic. Stigma, fear, misinformation and lack of shared humanity were not challenged widely enough or quickly enough to prevent a significant number of unnecessary deaths.

Despite seismic shifts in South Africa’s political landscape heralded by the 1994 elections, unnecessary deaths continued to occur. More people died from AIDS and stigma still influenced people’s lives and deaths.

But that is not to imply that people passively accepted what was happening.

Compassion and community

Epidemics may bring out the worst, fear-based responses from people. But they also reveal some of the best, compassion-based responses.

Some hospitals refused to treat or provide palliative care to early AIDS patients and so activists, friends, families, community members and faith-based organisations took up the task. They fought administrative and legal barriers and provided some people with support, assistance, and the chance of a dignified death.

 

Epidemics may bring out the worst, fear-based responses from people. But they also reveal some of the best, compassion-based responses.

A decade later, when the efficacy of antiretrovirals became known but the government refused to supply them to people using public health care, people came together to demand treatment. From a handful of people trying to figure out a solution to a seemingly insurmountable problem, the Treatment Action Campaign became a countrywide organisation that resolutely took on governments and corporations that stood in their way.

Today South Africa has the largest antiretroviral therapy programme in the world and stigma around AIDS has lessened.

Solidarity and support

The examples of collaboration and care and collective engagement are less evident in pandemic histories than the examples of selfishness and fear and individualism. But they are still there and they provide lessons and guidance. In the first instance they require numerous people contributing in countless ways to bring about change. And they require solidarity.

No one response or one group of people is going to see humanity through this epidemic. Knowledge from multiple spheres – from the most vulnerable in our society, community organisers, activists, health sciences, humanities, social sciences, creative and performing arts, indigenous knowledge systems, and government and private sectors – needs to be brought into conversation to determine socially just responses that touch on all aspects of peoples’ lives.

Carla Tsampiras, Senior Lecturer in Medical and Health Humanities, University of Cape Town.

The Conversation
This article was published in The Conversation, a collaboration between editors and academics to provide informed news analysis and commentary. Its content is free to read and republish under Creative Commons; media who would like to republish this article should do so directly from its appearance on The Conversation, using the button in the right-hand column of the webpage. UCT academics who would like to write for The Conversation should register with them; you are also welcome to find out more from lisa.boonzaier@uct.ac.za.

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UCT’s response to COVID-19

COVID-19 is a global pandemic that caused President Cyril Ramaphosa to declare a national disaster in South Africa on 15 March 2020 and to implement a national lockdown from 26 March 2020. UCT is taking the threat of infection in our university community extremely seriously, and this page will be updated with the latest COVID-19 information. Please note that the information on this page is subject to change depending on current lockdown regulations.

Minister of Health, Dr Joe Phaahla, has in June 2022 repealed some of South Africa’s remaining COVID-19 regulations: namely, sections 16A, 16B and 16C of the Regulations Relating to the Surveillance and the Control of Notifiable Medical Conditions under the National Health Act. We are now no longer required to wear masks or limit gatherings. Venue restrictions and checks for travellers coming into South Africa have now also been removed.

In July 2022, the University of Cape Town (UCT) revised its approach to managing the COVID-19 pandemic on UCT campuses in 2022.
Read the latest document available on the UCT policies web page.

 

Campus communications

 
2022

Adjusting to our new environment 16:50, 23 June 2022
VC Open Lecture and other updates 17:04, 13 April 2022
Feedback from UCT Council meeting of 12 March 2022 09:45, 18 March 2022
Chair of Council
March 2022 graduation celebration 16:45, 8 March 2022
Report on the meeting of UCT Council of 21 February 2022 19:30, 21 February 2022
Chair of Council
COVID-19 management 2022 11:55, 14 February 2022
Return to campus arrangements 2022 11:15, 4 February 2022

UCT Community of Hope Vaccination Centre

On Wednesday, 20 July, staff from the University of Cape Town’s (UCT) Faculty of Health Sciences came together with representatives from the Western Cape Government at the UCT Community of Hope Vaccination Centre at Forest Hill Residence to acknowledge the centre’s significance in the fight against COVID-19 and to thank its staff for their contributions. The centre opened on 1 September 2021 with the aim of providing quality vaccination services to UCT staff, students and the nearby communities, as well as to create an opportunity for medical students from the Faculty of Health Sciences to gain practical public health skills. The vaccination centre ceased operations on Friday, 29 July 2022.

With the closure of the UCT Community of Hope Vaccination Centre, if you still require access to a COVID-19 vaccination site please visit the CovidComms SA website to find an alternative.

 

“After almost a year of operation, the University of Cape Town’s (UCT) Community of Hope Vaccination Centre, located at the Forest Hill residence complex in Mowbray, will close on Friday, 29 July 2022. I am extremely grateful and proud of all staff, students and everyone involved in this important project.”
– Vice-Chancellor Prof Mamokgethi Phakeng

With the closure of the UCT Community of Hope Vaccination Centre, if you still require access to a COVID-19 vaccination site please visit the CovidComms SA website to find an alternative.


Thank You UCT Community

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