Book cover of History of South Africa by Thula Simpson.
Book cover of History of South Africa by Thula Simpson.

Book Extract: The first comprehensive account of SA’s history from the Second Anglo-Boer War to the Covid-19 pandemic

By Time of article published Oct 17, 2021

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Blurb

History of South Africa: from 1902 to the present, By Thula Simpson

Thula Simpson’s new book is the first comprehensive account of 20th-century South Africa to draw on documents and archives that have become accessible in the post-apartheid era, and it is the first history of the country to provide significant coverage of post-apartheid developments, up to the Free Zuma protests of July this year. History of South Africa explores the country’s tumultuous journey from the aftermath of the Second Anglo-Boer War to the Covid-19 pandemic.

Drawing on never-before-published documentary evidence – including diaries, letters, witness testimony and diplomatic reports – the book follows the South African people through the battles, elections, repression, resistance, strikes, insurrections, massacres, economic crashes and health crises that have shaped the nation’s character.

Tracking South Africa’s path from colony to Union and from apartheid to democracy, History of South Africa documents the influence of key figures including Pixley Seme, Jan Smuts, Lilian Ngoyi, HF Verwoerd, Nelson Mandela, Steve Biko, PW Botha, Thabo Mbeki, Jacob Zuma and Cyril Ramaphosa.

The book gives detailed accounts of definitive events such as the 1922 Rand Revolt, the Defiance Campaign, Sharpeville, the Soweto uprising and the Marikana massacre. Looking beyond the country’s borders, it sheds light on the role of people such as Mahatma Gandhi, Winston Churchill, Fidel Castro and Margaret Thatcher, and unpacks military conflicts such as the World Wars, the armed Struggle and the Border War.

The book explores the transition to democracy and traces the phases of ANC rule, from the Rainbow Nation to transformation, state capture to ’New Dawn’. It examines the divisive and unifying role of sport, the ups and downs of the economy, and the impact of pandemics from the Spanish flu to Aids and Covid-19.

With South Africa facing a crisis as severe as any in its history, the book shows that the challenges are neither unprecedented nor insurmountable, and that there are principles to be found in history that may lead us safely into the future.

About the author

Thula Simpson is an associate professor at the University of Pretoria. His earlier research focused on the ANC’s liberation Struggle, and his first book, Umkhonto we Sizwe: the ANC’s armed struggle, was published by Penguin in 2016.

History of South Africa is published by Penguin Random House South Africa and retails at R380

Extract

By the late 1990s, an estimated 200 babies were being born with HIV every day. Cost had remained a barrier to treatment throughout. On 9 October 1998, Nkosazana Zuma said at the launch of an R80-million state-funded AIDS awareness campaign that government could not provide AZT to pregnant women, because ‘it is not cost-effective’. As a result, pilot projects scheduled to begin that month were indefinitely postponed.

A turning point in the national debate came on 28 October 1999, when President Mbeki claimed in the National Council of Provinces that AZT was highly toxic, and that a number of legal cases were pending in South Africa, the United Kingdom and the United States against Wellcome (which had been taken over by Glaxo in 1995). He referred the public to ‘the huge volume of literature on this matter available on the Internet’. Two days later, Glaxo Wellcome’s sub-Saharan Africa head, Peter Moore, said Mbeki appeared to be ‘gravely misinformed’ as there was no legal action pending over AZT anywhere.

When cost was the ostensible issue, international drug companies were the focus of criticism – many AIDS activists had understood the Virodene affair as an aberration that was at least partly attributable to Mbeki’s desire to jump regulatory red lights in order to circumvent this larger difficulty. Mbeki’s NCOP speech changed this. The Treatment Action Campaign (TAC) had been formed in December 1998 by the anti-apartheid and gay rights activist Zackie Achmat to make AIDS treatment available to all. TAC’s Gauteng coordinator Sharon Ekamburam noted after the speech that in all previous interactions with government, the organisation had been encouraged to pressure drug companies to lower prices. She said of the address: ‘We are afraid this is a strategy by government to avoid implementing pilot programmes for preventing mother-to-child transmission.’

The Health Ministry announced in March 2000 that the government was convening an international panel of experts to investigate ‘the science of AIDS’. In a letter to world leaders a month later, Mbeki outlined his scientific objections: ‘whereas in the West HIV-AIDS is said to be largely homosexually transmitted, it is reported that in Africa … it is transmitted heterosexually’, and while relatively few people had died from AIDS in the West, millions had perished in Africa, suggesting that ‘a simple superimposition of Western experience on African reality would be absurd and illogical’. He charged that ‘[s]cientists, in the name of science, are demanding that we should co-operate with them to freeze scientific discourse on HIV-AIDS at the specific point this discourse had reached in the West in 1984’.

His intervention met with a sharp response from activists and health experts, who interpreted it as an attempt to query the commonly held scientific view that HIV caused AIDS (Mbeki’s spokesman Parks Mankahlana had responded that the president’s aim in convening the panel was not to propound any view, but to ‘unravel all the “mysteries”, including what the profit-takers cannot tell us’.) Professor Salim Abdool Karim, the head of HIV prevention and vaccine research at the Medical Research Council (MRC), replied that the question of the link between HIV and AIDS had been resolved in the 1980s, and his view was echoed by the South African Medical Association, which stated that the dissident stance on the matter had been ‘thoroughly discredited by several recent scientific studies’.

There was growing interest at the time in the drug Nevirapine, manufactured by Boehringer Ingelheim, after research in Uganda suggested that it was both cheaper and more effective than AZT. Clinical trials began at eleven South African sites in July 1999, but on 5 April 2000 the new health minister, Manto Tshabalala-Msimang, told Parliament that the drug was implicated in the deaths of five women in the trials. There was again a rapid rebuttal. Two days later, the MCC chairperson, Helen Rees, said no conclusive relation of cause and effect had been established.

An apparent retreat by the government in mid-October 2000 raised hopes that the controversy might abate. The shift involved President Mbeki informing the ANC’s NEC that he was withdrawing from the public debate on the science of HIV/AIDS because his involvement was causing confusion, and Tshabalala-Msimang announcing that HIV-positive pregnant women would be given Nevirapine at seven hospitals in KwaZulu-Natal, in an expansion of a study on the feasibility of a programme to prevent mother-to-child transmissions.

But there was little progress towards any actual roll-out of antiretroviral treatment. This led the TAC and other NGOs to take the government to court in August 2001. Judge Chris Botha ruled in their favour on 14 December, giving the government three months to make Nevirapine available to HIV-positive pregnant women at public hospitals, and to present ‘an effective comprehensive national programme’ on cutting mother-to-child transmissions.

The Sowetan breathed a sigh of relief: ‘We are sure President Thabo Mbeki can take defeat gracefully, keep out of the HIV-Aids debate, give us his blessing and let the people of South Africa get on with the job.’ The exhalation was premature, as the government served notice of its intention to appeal the judgment. Tshabalala-Msimang explained: ‘[W]e believe it gives the wrong answer to the question of who makes policy? [and] could open the way for a spate of court applications and “policy judgements” not only relating to health care, but to other service areas, such as education, housing and social services.’ But, rightly or wrongly, the Constitution was unambiguous on the matter of socio-economic rights. The appeal resulted in a landmark Constitutional Court judgment on 5 July 2002 that the state’s failure to provide Nevirapine to mothers violated the Bill of Rights.

Tshabalala-Msimang said the government accepted the ruling, but there was again no follow-up in terms of implementation. Nelson Mandela had intervened at an ANC NEC meeting in March 2002, saying the organisation risked being seen as uncaring. He was heckled in person and pilloried after his departure. He went public with his concerns in February 2003, declaring: ‘This is a war. It has killed more people than has been the case in all the previous wars and all the previous natural disasters. We must not continue to be debating, to be arguing, when people are dying.’

On 29 July 2003, the MCC informed Boehringer Ingelheim that it rejected a Ugandan study on which South Africa’s registration of Nevirapine had been based, and it requested additional information within ninety days about the drug’s safety and efficacy.

At a press briefing two days later, Tshabalala-Msimang referred to Nevirapine’s toxicity, welcoming the MCC’s announcement. She was not in the least bit disheartened by the news: she noted that the Constitutional Court had not stipulated the use of Nevirapine to control mother-to-child transmission, and she insisted that there were perfectly good remedies available. She had published an op-ed in the Sunday Times on 6 April, emphasising the importance of nutrition for those suffering from debilitating health conditions. She raised this issue in her July remarks, citing the benefits of garlic, lemon, olive oil and the African potato in the fight against AIDS and other diseases. She said she had requested the MRC to look into the African potato, which she argued had achieved astonishing results in curing disease.

The request highlighted the fact that the scientific basis of her claims was as yet unproven, and the South African Medical Journal emphasised this in a November 2003 editorial which stated there was no evidence that the foods she had mentioned had any influence on the course of HIV/AIDS.

The government had established a joint task team of the Health and Treasury Departments to explore the feasibility of rolling out antiretrovirals. The team recommended making the drugs available at public hospitals, and cabinet signed an agreement with the Global Fund to Fight AIDS, TB and Malaria on 7 August 2003 that made $41 million in donor funding available to combat AIDS. The deal mitigated the problem of affordability, but implementation again lagged, so the TAC was back in the Pretoria High Court in November 2004 to request punitive costs against the Health Department for failing to provide treatment in the public sector.

In a 2008 article, scholars from Harvard University’s School of Public Health sought to calculate the human toll of the Mbeki administration’s AIDS response. It compared the number of persons who received antiretroviral treatment between 2000 and 2005 against the total that could reasonably have been treated if the government had authorised a roll-out. It concluded that 334 300 lives were lost and 35 000 babies were born with HIV owing to the lack of access to treatment.

The Saturday Star

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