Yesterday Jacob Zuma, leader of the African National Congress (ANC) party, became South Africa’s fourth post-apartheid president. His was a quite extraordinary comeback, which saw him overcoming rape and corruption charges while re-energising voter turnout to over 70 percent.
But the challenges facing Zuma are formidable. He inherits a country with an 18.8 percent HIV/AIDS rate in which 1,000 AIDS deaths occur every day.
The ANC’s record on AIDS thus far has been atrocious. Zuma’s predecessor, Thabo Mbeki, famously disputed the science that HIV caused AIDS, declaring AIDS to be only “a disease of poverty”. The scientific link between HIV and AIDS was, he claimed, a conspiracy of profit-driven Western drug companies. A recent Harvard School of Public Health study has shown that this attitude, and the consequent cut in anti-retroviral treatment, cost 365,000 lives.

Zuma (right) succeeds Mbeki as President of South Africa
Absurdly short-sighted and politicised rhetoric from government officials hasn’t helped, and certainly socioeconomic factors contributing to the spread of HIV/AIDS disproportionately impact on poorer countries - poverty, and its attendant malnutrition, parasitic infection, and limited access to medical care, is a key factor in the virulence and spread of any disease. But HIV is a disease of society too, with transmission following relations of vulnerability and inequitable power relations. According to UNIFEM, young women in Africa, for whom the issue is complicated by gender inequality and blatant violations of women’s rights, are three times more likely to be HIV-positive than young men. Unless Zuma moves to tackle the issues facing women, overall efforts to address the epidemic will be futile.
Zuma himself has displayed even greater ignorance than Mbeki regarding AIDS. He famously said in court that after having sex with a woman who he knew to be HIV-positive, he protected himself by having a shower.
But at least in his in personnel appointments, if not in his personal conduct, he is effecting change. The appointment of Barbara Hogan as Health Minister, a well-respected AIDS activist, may represent a shift towards new, serious policy-making regarding the crisis. She replaces Manto Tshabalala-Msimang, who, as Health Minister under Mbeki, supported garlic, lemon juice and beetroot as remedies for AIDS.

Poverty forces many women in South Africa to turn to prostitution. YOAV LEMMER/AFP/Getty Images
Mbeki’s questioning of the international power relations which contextualise the epidemic may have been important, but the doubt he attached to a causal connection between HIV and AIDS made space for negligence and allowed the epidemic to grow. If HIV does not cause AIDS and isn’t infectious, society does not need to change its behaviour. Complex and controversial issues that impact upon HIV transmission – gender, culture, race, and sexual behaviour – need not be addressed. If HIV infection is seen as a logical result of poverty and malnutrition alone then there is very little government can, or need do, to try and combat it.
But these issues do need to be addressed. Where poverty meets gender inequality, there is an increased likelihood that poor women will be forced into commercial sex as a survival strategy. An understanding of the risk of HIV transmission is often overpowered by a need for survival and to feed one’s family. Added to this is the threat of violence that may make it extremely difficult for women to protect themselves through negotiating the use of condoms. If Zuma does not take this into account the disease will continue to spread unchecked.