South African AIDS Activist Zackie Achmat

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Zackie Achmat, head of the Treatment Action Campaign, an AIDS activist group

Why We Chose Him:
You've probably never heard of Zackie Achmat. Not unless you're a South African AIDS patient demanding your government's help to stay alive, or a global pharmaceutical corporation looking to protect an AIDS-drug patent. But the campaign led by Achmat to secure treatment for South Africa's 4.7 million HIV patients this week scored an epic victory when 39 pharmaceutical companies withdrew a lawsuit to block South Africa from importing cheaper generic copies of patented AIDS drugs. For leading the campaign that shamed the corporations into backing down, raising new hope for millions of AIDS sufferers throughout the developing world, Zackie Achmat is our Person of the Week.

Zackie Achmat is a dangerous man — to those he sees as perpetrators of injustice. Always has been. Because once he decides to challenge them, he knows no half-measures. At age 14, he tried to burn down his school during the 1976 Soweto uprising against apartheid education. And that was just the opening act of a teenage activist career that saw him leave high school well acquainted with apartheid's prison cells and with the knuckles of its security policemen. He spent the next two decades as a tireless activist in the struggle to end apartheid, and once that struggle was over he turned to making documentary films about the history of gay life in South Africa.

Fighting a government's failure

By the late 1990s, Zackie Achmat discovered a new mortal enemy. He was diagnosed HIV-positive, and found himself among the millions of similarly afflicted South Africans looking to their new government to help them stay alive. But their government failed to comprehend the scale of the crisis and was paralyzed by denial — a denial typified by President Thabo Mbeki's extended flirtation with a discredited group of "dissident" scientists who deny a link between AIDS and HIV infection.

And so it was back to protest politics for Zackie Achmat and thousands like him, who realized that their survival depended on access to the anti-retrovirals and other drugs that had kept alive tens of thousands of AIDS patients in the industrialized world. Achmat soon found himself heading up the Treatment Action Group, organizing sit-ins and marches among the government's own constituency to demand treatment through a public health system that was sending AIDS patients home to die. It was pressure from their own base that stung Mbeki and his ministers out of denial and into action, ratcheting up their AIDS education efforts.

But Achmat and his colleagues had to fight on two fronts. Patent-protected prices put most Western AIDS-treatment drugs way beyond the means of South Africa's cash-strapped government, which was a primary reason for the government's reluctance to provide mass treatment. Unmoved by the pharmaceutical corporations' argument that protected patents were the crucial incentive for companies to invest in developing new treatments, the Treatment Action Group made common cause with AIDS activists in the industrialized countries on a two-pronged program — to press pharmaceutical corporations to slash their prices, and to press governments to allow developing countries to buy cheaper generic copies of patented AIDS drugs from India, Brazil and Thailand.

Al Gore gets a taste of Achmat's medicine

And the power of the Treatment Action Group's international networking became clear late in 1999, when ACT-UP protesters began dogging then–vice president Al Gore on the campaign trail to demand that the White House withdraw the threat of sanctions against South Africa in retaliation for any importing of generic AIDS drugs. The pressure worked — President Clinton issued an executive order to that effect, which President Bush has allowed to stand. After all, what politician wants to be seen standing up for intellectual property rights (and profits) in a situation where they may keep life-saving drugs out of the hands of millions of desperately ill people? This politics of shame worked well, too, on the pharmaceutical corporations, for whom defending their patents in the face of a mounting AIDS crisis on the world's poorest continent became a public relations nightmare. Soon, the biggest of them were making agreements, brokered by the United Nations, to supply drugs at discounts of up to 95 percent, and in some cases even to waive their patents and allow poor countries to import generic drugs.

And Zackie Achmat and the Treatment Action Group kept up their pressure. Last October, Achmat took a highly publicized trip to Thailand, returning with a suitcase full of Biozole, a locally manufactured generic copy of Fluconazole — a drug used to treat opportunistic infections in AIDS patients — that he bought at a price 98 percent cheaper than the price charged in South Africa for the brand-name tablets. This illegal "import" was a symbolic act of defiance, designed to challenge the drug companies and stiffen the spine of his own government. "People were dying across the country and doctors were saying they could not afford to prescribe the right medicines," Achmat told an interviewer. "We wanted to set a moral example and put the right to health and life before profit. We don't want to be smugglers — this is the government's job to do."

A suicidal stand?

Achmat's moral example goes a lot further, sometimes to the consternation of his colleagues in the Treatment Action Group. The 38-year-old gay filmmaker is HIV-positive, and his doctors have urged him to begin taking antiretrovirals, which are affordable for someone in Achmat's economic bracket. But he refuses to take the drugs until they're available to all South African AIDS patients through the public health system. Friends and colleagues have urged him to relent, because he's too important to the campaign. He almost did last year — but balked at the last minute, unable to take advantage of the privileges that attach to his middle-class position in a society where almost all AIDS sufferers are doomed by their poverty.

Still, Zackie Achmat is not expecting to die. He's hoping the drugs will be available to all South African AIDS sufferers within three years, and he thinks he can survive that long. And, of course, that gives him a deeply personal stake in winning his campaign. One South African reporter, commending Achmat on his noble stand, drew a withering response: "I don't think it's noble, I think it's dumb," Achmat answered. "But it's a conscience issue. It's not something I advocate for anyone else."

Even before they surrendered in their courtroom battle to stop generic imports, the pharmaceutical corporations had lost their case in the court of public opinion — in no small measure due to the efforts of Achmat and his fellow campaigners. Still, the battle isn't over. Now that the drug companies have stepped aside from the dispute over importing generics, Achmat and his colleagues will have to fight to convince the South African government to commit billions of dollars to the fight to keep almost 5 million AIDS patients alive. And for Achmat, as much as any of them, the clock is ticking.