The Treatment Action Campaign is a South African AIDS activist organization which was founded by the HIV-positive activist Zackie Achmat in 1998. Chris McGreal, The Guardian 12 September 2008. Accessed 20 September 2008. TAC is rooted in the experience of its founder and many of its members with direct action tactics and in the South African trade union and anti-apartheid movements. TAC has been credited with forcing the reluctant government of former South African President Thabo Mbeki to begin making antiretroviral drugs available to South Africans. Mavis Makuni, Financial Gazette, 27 September 2008. Accessed 30 September 2008.

Founding

The Treatment Action Campaign (TAC) was launched on December 10 1998, International Human Rights Day. Zackie Achmat, whom The New Yorker calls "the most important dissident in the country since Nelson Mandela", joined with a group of ten other activists to found the group after anti-apartheid gay rights activist Simon Nkoli died from AIDS even as highly active antiretroviral therapy was available to wealthy South Africans."The AIDS Rebel: South African AIDS activist Zackie Achmat", The New Yorker, 19 May 2003. Shortly thereafter, prompted by the murder of HIV-positive activist Gugu Dlamini, HIV-positive and HIV-negative members of the new group began wearing the group's now-famous T-shirts with the words "HIV Positive" printed boldly in front, a strategy inspired by the apocryphal story of the Danish king wearing the yellow star marking Jews under Nazi occupation. Achmat also became famous for his pledge to not take antiretroviral medicines until all South Africans could obtain them."S. African AIDS activist makes a striking impact; Zackie Achmat inspires L.A. audiences and celebrates a triumph won at home." Anne-Marie O'Connor, The Los Angeles Times, 24 November 2003.
Quickly outgrowing its start among a small group of Cape Town activists, TAC became a much more broadly-based group, with chapters in many regions of the nation and a largely black and poor constituency. The group campaigns for greater access to HIV treatment for all South Africans by raising public awareness and understanding about issues surrounding the availability, affordability and use of HIV treatments.

Suing the government

The TAC first confronted the South African government for not ensuring that mother-to-child-transmission (MTCT) prevention was available to pregnant mothers. It won this case on the basis of the South African constitutional guarantee of the right to health care, and the government was ordered to provide MTCT programs in public clinics. TAC also assisted the government by defending it in the case brought against the government by the pharmaceutical industry. TAC entered the case as an amicus curiae, submitting a brief in favour of the government's position. Although the withdrawal of the pharmaceutical companies from this case resulted in a government victory, the government showed no interest in providing access to the generic antiretroviral medications that its victory allowed.

Indeed, far from embracing their common victory against the patent rights of multinational companies who were not making affordable drugs available, President Thabo Mbeki began promoting the AIDS denialist view that HIV might not cause AIDS, and that AIDS medications were more toxic than helpful, inviting foreign AIDS denialists to advise his government.

Campaign for access to antiretrovirals

According to TAC's founder, two million South Africans died prematurely of AIDS during the term of former President Mbeki, Dispatch Online, South Africa, 27 September 2008. Accessed 30 September 2008. and many of these deaths could have been prevented by timely implementation of access to anti-HIV drugs.

Following their legal victories, and facing continuing refusal by the government to make antiretrovirals available, TAC began a campaign for universal access to AIDS treatment through the public health system. In a national congress in 2002, the group decided to confront the government on this issue, first enacting a thousands-strong march on Parliament in February 2003, and then beginning a civil disobedience campaign in March 2003. After assurances from people within the government that a treatment plan would be forthcoming, TAC suspended its civil disobedience campaign.

In the summer of 2003, TAC obtained and leaked an internally-circulated government report showing that treatment would be cost-effective by reducing costly hospitalizations within the public-sector health system; however, the government did not endorse the report and condemned the leak. In August 2003, at its next annual congress, TAC voted to resume civil disobedience. TAC members also voted to recommend that Achmat take his medications, which he agreed he would do. At the same time, TAC began a Treatment Project to distribute medications to its activists and to other community members.

Shortly after the Congress, and before the civil disobedience campaign resumed, the Cabinet voted to begin roll-out of antiretroviral access through public-sector health clinics. In the South African system, the Cabinet can overrule the President, and it appeared to have done so in this case.

Although the Cabinet voted to reaffirm that South African AIDS policy is based on the evidence that HIV causes AIDS, former President Thabo Mbeki continued to support the AIDS denialist position, as did his Minister of Health, Manto Tshabalala-Msimang. The Minister of Health put special emphasis on nutrition as an alternative to antiretroviral treatment. As the top health official of South Africa, she was a particular target of TAC activism. Tshabalala-Msimang was removed as Health Minister in September 2008 after President Mbeki left office, a move hailed by the Treatment Action Campaign. Claire Nullis, Associated Press, Cape Town, 26 September 2008. Accessed 30 September 2008.
Although antiretroviral access is now official policy, its implementation has been spotty. TAC continues to protest and sue the government (working with the AIDS Law Project) in order to continue to influence the speed of and approach to the rollout.

Legal challenges to Matthias Rath

A German vitamin-maker and entrepreneur named Matthias Rath publicly questioned the effectiveness of HIV medicines in advertisements in South African newspapers. Rath claims that his nutritional products can cure HIV/AIDS and that antiretroviral medications are toxic. TAC successfully pursued retractions and corrections from the newspapers, and Rath was censured by the South African media control body. TAC has sued the Minister of Health for failing to stop what it claims are Rath's illegal activities, including "conducting unauthorised experiments on people, distributing unregistered medicines and advertising unproven treatments for AIDS." In a unanimous March 3 2006 decision, the Cape of Good Hope Provincial Division court found in favour of TAC against Rath in a defamation suit. As a result of this decision, Rath may not claim that TAC is a front for the pharmaceutical industry, a "Trojan horse" or "running dog" of that industry, is funded by the pharmaceutical industry, receives funds from pharmaceutical front organisations in return for promoting antiretroviral medicines, or targets poor communities in order to promote the interests of pharmaceutical companies, since the court found no evidence that any of these allegations were true.

2006 IAS Conference and the Global Day of Action

At the XVI International AIDS Society Conference in Toronto, 13-18 August 2006, TAC had a significant presence. Many TAC staff presented in seminars and chaired sessions, most prominently TAC Secretary Sipho Mthathi and Treasurer Mark Heywood. Heywood was a panelist in a plenary session co-chaired by CNN's Sanjay Gupta entitled "Time to Deliver: The Price of Inaction". Towards the end of the session, supporters of TAC, many of whom were wearing the distinctive "HIV POSITIVE" t-shirts, took to the stage behind the panel and silently held placards containing messages such as "Fire Manto", in reference to the Health Minister, who was in attendance.

TAC members and supporters also took over the South African government's booth in the exhibitor's area. The booth contained bowls of lemons and garlic, which the Health Minister has claimed contribute to fighting HIV. TAC members passed around these items mockingly, and toyi-toyied inside the booth, attracting attention to the South African government's expenditure on the elaborate booth and lack of corresponding commitment to the national treatment plan.

During the conference's closing ceremonies, United Nations Special Envoy for HIV/AIDS in Africa Stephen Lewis pointed out the failure of South Africa's response to HIV/AIDS, calling their actions more "worthy of a lunatic fringe than of a concerned and compassionate state." Beth Duff-Brown, AP, The Washington Post, 18 August 2006. He also announced that earlier in the morning, Zackie Achmat and 44 others had been arrested for occupying provincial offices in Cape Town in protest of government's failure to treat prisoners with anti-retrovirals, and in particular the recent death of one plaintiff in the legal case against the government on this matter.

After the conclusion of the conference, TAC declared a Global Day of Action for Thursday, August 24 2006. Protests and marches were held in the U.S., Canada, Brazil, and China by TAC supporters and sympathizers. In South Africa, police used pepper spray on protesters at the Department of Correctional Services building in central Cape Town, though no one was seriously hurt. Similar protests in Gauteng, Eastern Cape, Limpopo, and KwaZulu-Natal were not met with violence. Over 2000 people took part in the demonstrations. The TAC's objective was to deliver its five demands, which include the convening of a national meeting and plan for the HIV/AIDS crisis, the dismissal of the Health Minister, the immediate treatment of prisoners, respect for the rule of law and the Constitution, and the building of a people's health service.

Support

The TAC has received support from many sectors of South African society, including Supreme Court Justice Edwin Cameron, former President Nelson Mandela, Anglican Archbishop of Cape Town Njongonkulu Ndungane, Medecins Sans Frontiers, and the Congress of South African Trade Unions (COSATU). In August 2006, U.S. President Barack Obama, then a Senator, visited TAC's Khayelitsha office and met with TAC chairperson Zackie Achmat. During his visit, Obama emphasised the importance of HIV testing and urged the South African government to "awake" from AIDS denialism."South Africa must awake from AIDS denial, Obama says", Jeff Zeleny and Laurie Goering, Chicago Tribune 21 August 2006. Accessed 20 September 2008.
TAC is supported by Ashoka, a nonprofit organisation that promotes social entrepreneurship.

Solidarity

TAC has worked with and shown solidarity with a number of organisations and movements. This includes the Social Justice Coalition, the Anti-Eviction Campaign, the AIDS Law Project and COSATU. In October 2009, TAC issued a statement of Solidarity with Abahlali baseMjondolo condemning the attacks by ANC members on Kennedy Road informal settlement.