With all his life: South Africa's hero

NEW YORK - South Africa, cursed with a history of causes worth dying for, is blessed with men and women willing to die for them. To that list now add Zackie Achmat.

Achmat, 40, is South Africa's most prominent AIDS activist, and chairman of the Treatment Action Campaign. He found out that he was HIV positive in 1990, and has had AIDS since 1997. He can afford antiretroviral drugs, but in 1998 he vowed not to take them until everyone in South Africa could. That day is inching closer, largely due to the work of the campaign. For Achmat it may not arrive soon enough.

Nelson Mandela has called him a role model, visited him at his house and asked him to take his pills. "I'm an atheist, but he's my saint," Achmat said in a telephone interview from his Cape Town home. "You don't want to refuse him anything."

But he did refuse, unwilling to save his life while the drugs remained too expensive for others. Achmat's decision, which was not known to the public until last year, when journalists began to ask why he was so sick, has gripped a country disillusioned with its all-too-human leadership. Radio listeners call in to discuss whether he should take medicine. "My grandmother is asking me, 'When is Zackie going to take his pills?'" says Jonathan Berger, a researcher at Johannesburg's AIDS Law Project.

South Africa has the highest official count of AIDS-infected people in the world, with 5 million. One in five adults is infected. Each year 70,000 babies are born with HIV. The country should be engaged in a national mobilization to stave off Armageddon. Instead, South Africans are still arguing about whether HIV causes the disease and whether antiretrovirals are tonic or toxic.

President Thabo Mbeki and some of his aides have questioned HIV's role in AIDS, minimized South Africa's problem and tried to cut the AIDS budget. While constant criticism and the exploding AIDS epidemic have led Mbeki to mute his views, his government is a long way from mounting the energetic assault on AIDS that is necessary.

In this climate, the case of Zackie Achmat cuts the fog. He has been near death several times, and continues to get infections easily. He cannot travel much and has little energy to work. In addition, he says, conditions in South Africa have changed. "We are so close," he says. "The real hard work starts now."

The government is being dragged into saving its people, in no small measure because of the Treatment Action Campaign, which is by all accounts the largest and most effective AIDS group in the Third World.

The campaign can mobilize thousands of people for protests and has hundreds of activists who speak about AIDS treatment to labor and civic groups. The group helped bring Cosatu, the powerful South African labor federation, into the AIDS fight. It is an important source of information to debunk the deniers' claims.

Recently, government, business, labor and civic organizations negotiated an AIDS plan that includes treatment in South Africa's public health system, although the government has still not signed on. If it does, says Achmat, he will take his pills.

Mandela is one reason the government is changing. At first reluctant to challenge Mbeki, his protégé, and divide his party, the African National Congress, Mandela is now photographed wearing a T-shirt that says "HIV Positive," the campaign's trademark. 

The parallels between the campaign and the ANC are haunting. The campaign is one of the few organizations still wearing the ANC's mantle of activism. Its leaders are using techniques they learned in the anti-apartheid struggle. Achmat was jailed in the 1970s, and spent the 1980s living underground as an ANC activist.

The campaign is fighting an evil even more formidable and deadly than apartheid, and one that, in the absence of universal access to AIDS treatment, is just as selective in bringing most of the suffering down upon South Africa's poor. "Almost everyone I meet tells me 'Take medicine,' but also says this has made us think," Achmat says. "The country is realizing that people can actually buy life, and that this is unacceptable."