Former South African President Nelson Mandela, co-chair, International AIDS Trust, delivers speech, "Care, Support and Destigmatization" on Friday, July 12, 2002

NELSON MANDELA: Since last we came together at the Durban conference in 2000, we are told that six million more people have died as a result of HIV/AIDS. And, worst of all, that within the next 20 years, 70 million people will die unless drastic action is taken. There are many issues that I would like to touch upon in these few words. Issues of poverty and the burden of disease in developing countries, and the impact that this has on the AIDS pandemic. The importance of investment in developing countries, to spur the economic growth which will ensure a sustained response to the epidemic. The importance of the community response to HIV/AIDS, and the rooting out of denial about the cause and consequences of AIDS.

In prevention of HIV infection in the youth, we have a remarkable initiative in South Africa called loveLife, which is a bold and ambitious attempt to reduce HIV infection by promoting sexual health and healthy future for young people. The extraordinary vulnerability of women to HIV infection, and the importance of gender issues in the fight against AIDS. The importance of preventing the transmission of HIV from mother to child. AIDS should not be a disease of children. The importance of finding the vaccine, and of communities being prepared to participate in large-scale vaccine trials. The list goes on and on, but we do not have time to address all of these important subjects. Instead, we have to select a few issues which we currently regard as requiring the most urgent agenda. Nothing can be more heart-rending and in need of urgent attention than the case of AIDS orphans, who so often find themselves rejected and ostracized by communities.

Personally, nothing can shake me more than the sight of these innocent young children suffering physically, socially, and emotionally. There are nearly 14 million children who have lost one or both parents to AIDS. It is predicted that there will be more than 25 million of them by 2010. This is a tragedy of enormous consequence. I’m sure you have been told that AIDS is killing more people than were killed by all the worst wars of history and natural disasters. AIDS is a war against humanity.

When we talk about it, and the actions we take, we must be influenced by the fact that this is a war which requires mobilization of the entire population. These children will grow up without the love and care of their parents, and most of them will be deprived of their basic rights – shelter, food, health, and education. Many will be subjected to abuse, exploitation, discrimination, trafficking, and loss of inheritance. We have an obligation to provide the proper care and support for these children. No adult can stand by and watch while these children suffer. As adults, we have collective and individual responsibility. The stigma and discrimination inflicted on these children are atrocious and inexcusable. Many people suffering from AIDS are not killed by the disease itself, are killed by the stigma surrounding everybody who has HIV/AIDS.

That is why their leaders must do everything in their power to fight and to win the struggle against this stigma. Likewise, it is inexcusable to subject any person infected or affected by HIV/AIDS to such abuse and rejection. We must, therefore, tackle the stigma and discrimination associated with HIV/AIDS with even greater urgency. We must show that we care for all those affected by this terrible disease, and that we are doing something about it. Eloquence on this pandemic is good, but not sufficient. That is the first part of trying to direct the attention of the community to this pandemic. But what is more, what you do about it on the ground. Unless we are able to follow what you say by doing something practical to deal with this situation, our eloquence is less than useful.

When I was the President of South Africa, I went around the country together with the then-Minister of Social Welfare. Every city or rural area we went to, we told parents “bring the children who are suffering from terminal disease, like HIV/AIDS, cancer, tuberculosis, malaria. We also want you to bring children who are disabled, either physical or mental.” And the fact the president of the country is seen sitting at tables with children with HIV/AIDS and suffering from terminal diseases, children who are disabled, makes the parents less ashamed of their children. And it’s certain.

Parents will say, “if the President of the country and the Minister of Welfare can sit at table and enjoy a meal with our children, who suffer from terminal diseases, who are disabled, why must we be ashamed of them? We want them to come out and be seen, and to enjoy life like ordinary individuals.” Every year, I bring together between 1,500 and 2,000 children, and I go right around the country. There is hardly any province in our country that has not seen this message I bring home. And that is how we give hope to children who otherwise hardly have no future at all. It is very important for us, to go to the ground, and to tell the community how to deal with this pandemic. I know, for example, a judge who sits in one of our highest courts who has HIV/AIDS. He came to brief me about his position. His immune system was almost destroyed. He could not walk, but somehow he came to me, to fight back and win this battle. Later his immune system became stronger. He is now in the highest court of the country. If a judge can do so, you also can do so.

But you must not be ashamed of speaking out and telling the community that “I suffer from HIV/AIDS.” In jail, I contracted TB. And, outside jail, I was found to be a cancer victim. My colleagues did not stigmatize me. They gave me all their love and support. There is no reason, whatsoever, why sufferers should hide that they have been affected by this pandemic. Because when you keep quiet – and this is something, a hundred times – when you keep quiet, you are signing your own death warrant.

We need to remind ourselves why so many of these children are orphans today: because their parents were not able to get access to treatment for AIDS, most likely because they could not afford it. Or because they lived in a country which was too poor to provide their basic health care. We must know that one of the greatest assaults to human dignity is poverty, where you wake up not knowing where you’re going to get your next meal. Where you cannot have decent accommodations for yourself and for your children. Where you cannot feed them, where you cannot send them to the school. That is the greatest assault on human dignity, and that is why we should pay particular attention to the poor who are ill, whose immune system is not capable of resisting these terminal diseases.

We know – I’m sorry – I ask all leaders in the world: Is this acceptable? We know that there are treatments available which restore the immune system, which stop the opportunistic infections, especially TB, and which return AIDS sufferers for good health, for several years, at least. Is it acceptable that these dying parents have no hope of access to treatment? The simple answer is “no.” We must find ways – we must find ways and means to make life-saving treatment available to all who need it.

Regardless of whether they can pay for it, or where they live, or for any other reason, why should treatment be denied? If parents with AIDS can be given a few more years, perhaps several years or even longer, then their children will be given a few years of additional life. That will be the most precious for all of those parents and children. For those of us who are more fortunate than those dying parents, it is a timely reminder of the sanctity of human life. We should be prepared to give all that we have got, give those families that are stricken by AIDS, those extra few years.

Nothing is better for your own well-being than the feeling that “I am contributing practically towards those who are affected by this pandemic.” In my country, I approach business and ask them to send children to school – high school, university. Generally, I arrange for no less than 300 scholarships per year. I arranged for a scholarship for a young lady of 20 to go to university. Her results on the tests were excellent. She attracted a lot of praise from her lecturers. Then, suddenly, she found that she had AIDS and went to hospital. I was out of the country. And, because she could not pay the hospital charges, I came back and I immediately contacted her. And I asked her to come for lunch, knowing that she’s an AIDS sufferer. I was then told, before I could enter the gate, to meet her at the gate. The house was quiet. But after 15 minutes, I asked, where are these people? Eventually, she came with her parents. She could hardly walk, and I said just go straight to the table. And she said, I could hardly hear her talk. And for food, she just took one spoon. And very sadly, had to go from here straight to hospital. And my secretary here immediately phoned the hospital. And the doctor in charge phoned me to say that there is very little that we can do. I was devastated. And within a week, because they couldn’t do anything, they discharged her. My wife and I went to see her. Then we arranged for her to have drugs, to have good food. Then I phoned about two weeks later, and a very sharp, strong voice replied. I said, “who is speaking?” She gave me the name – same girl. I said, I can’t believe that. She was now strong.

I have raised more than 800,000 rand for her, and I send her some money every month so that she can eat properly, she can get all the drugs that she needs. I first send her 500 rand a month, but my wife almost left me in disgust. And she said, we must give her 2,000 a month.

One of the members of my staff took this money to her, and she had taken the 500 before. She said, I came across a new person, I can’t believe that it’s the same girl who was written off by the doctors. She is now recovered. There is life after HIV/AIDS.

I have three challenges to put to the world today. The first is to challenge all institutions, public and private, and all their leaders, to make a start on treatment access today, and to make rapid and real progress in achieving access to AIDS treatment for all those that need it.

Wherever they may be in the world. Regardless of whether they can afford to pay or not. We place such a huge emphasis on treatment, quite simply, because treatment will provide hope for the future.

The great tragedy of HIV infection is that most people, surely more than 90 percent, do not know that they are infected with the virus. They continue, unwittingly, to spread the infection. With the hope of treatment, people will have a reason to go for HIV counseling and testing.

But, it must be on an entirely voluntary and confidential basis. Business must stop humiliating people and testing them openly whether they have HIV or not. All that is required is to talk to people, constantly, to say, “if you don’t go for testing, if you have got AIDS and you don’t know about it, you are signing your own death warrant. The only way in which you can be saved is if you go for a test, and then accept what the doctor says to you.” I believe that this is the single most important prevention tool that we have, because it is the one that is most likely to change behavior.

My second challenge today is to all individuals: you need to establish where you stand in the fight against HIV/AIDS, and you can only do this by being aware of your HIV status. For those of you who are HIV positive, there is hope. You can live with HIV, and the rest of the world cares about you.

The sooner you establish your HIV status, the more you can do for yourself, and the more that can be done for you by others. And if voluntary counseling and testing is not available free of charge where you live, then you must demand it. It is your right to know.

My final challenge today is to the leaders of this world. There is no doubt that strong leadership is the key to an effective response in the war against AIDS. Leadership starts at the top. When the top person is committed, the response is much more effective.

This means not only political leaders, but also business leaders, union leaders, religious leaders, traditional leaders, and the leaders of NGOs. One has to make special mention of the role played by NGOs and the leadership in those organizations. These are often small organizations with meager resources that have made an impact far beyond what would have been expected from their size. One is often moved to reflect that, if only the big institutions of government and business had made a similar effort proportionately, we might very well already have turned the tide of the AIDS pandemic.

In this regard, the Bill and Melinda Gates Foundation and other big companies have done very well, by making funds available for us to treat this pandemic. Now, many people are criticizing big business and governments because they are not doing sufficiently. That is one part of it, it is true. But the other part, which many people don’t talk about, is our own shortcomings. We have not developed proper strategies to get the money out of them. President Clinton will tell you that, that as facilitator in Burundi, I asked him for money. He gave it to me on the spot.

That money got finished. I went back to the President of the United States, George Bush, and I said, “I want a million dollars.” He gave it to me.

I have gone back to almost every continent and asked for money. For my organization, in Africa alone, I collected 66 million dollars, and you know how poor Africa is.

In the Middle East, I collected 73 million dollars, and in Asia, 89 million for my organization, the ANC. Now, I was discussing this morning about the complaints against government, and I was saying, let us look at the strategy that we’re using, because if we corrected ourselves, we would be able to succeed more than we do. One of the most difficult things in life is not just to influence others, it is to change your own character.

And we are required to do that today in fighting this pandemic. We must correct our own mistakes. It is good to criticize governments when they are stingy, but you need much more than to criticize. I have criticized government openly, but I’ve gone to the same government I’ve criticized, and I’ve said, can you put money in my hand?

People, like brave and courageous men and women, let us not be afraid to criticize and speak up, but, at the same time, let’s not be afraid to go to the same people that we criticize and say we have this particular problem, can you give us money? They will respond, subject to what I was discussing this morning with some people who are criticizing governments and big institutions quite correctly.

But our own strategy must be changed. We have great appreciation for the courageous leadership given by many in all sectors of society, in different parts of the world. At the same time, I wish to repeat the appeal and challenge I have so often made, calling on all leaders in the world today to ask themselves what they have personally done to help diminish the impact of the AIDS pandemic. And whatever they have done, or have not done, to commit themselves to doing more from today. As one who has led almost the entirety of his life in a struggle to build a better world, often against odds that were thought insurmountable, I want to say to all of you who are activists in the war against AIDS, you have my greatest admiration. Keep on fighting, and you will overcome the terrible scourge of human kind.

We are all human, and the HIV/AIDS epidemic affects us all in the end. If we discard the people who are dying from AIDS, then we can no longer call ourselves people.

The time to act is now. We can make a difference. I thank you.