Taking a stand for democracy

In his poem "Over There, World War II", the outstanding African American poet, Langston Hughes, spoke about the hopes and aspirations of the African American soldiers who served in the US armed forces during the Second World War. Foreseeing the end of the war and the victory of the Allied Forces, he wrote:

"Dear Fellow Americans
I write this letter
Hoping times will be better
When this war
Is through.
I'm a Tan-skinned Yank
Driving a tank.
I ask, WILL V-DAY
BE ME-DAY, TOO?

I wear a U.S. uniform.
I've done the enemy much harm,
I've driven back
The Germans and the Japs,
From Burma to the Rhine.
On every battle line,
I've dropped defeat
Into the Fascists' laps.

I've seen my buddy lying
Where he fell.
I've watched him dying
I promised him that I would try
To make our land a land
Where his son could be a man -
And there'd be no Jim Crow birds
Left in our sky.

So this is what I want to know:
When we see Victory's glow,
Will you still let old Jim Crow
Hold me back?
When all those foreign folks who've waited -
Italians, Chinese, Danes - are liberated.
Will I still be ill-fated
Because I'm black?

When I take off my uniform,
Will I be safe from harm -
Or will you do to me
As the Germans did the Jews?
When I've helped this world to save,
Shall I still be colour's slave?
Or will Victory change
Your antiquated views?

Or will you stand up like a man
At home and take your stand
For Democracy?
That's all I ask of you.
When we lay the guns away
To celebrate
Our Victory Day
WILL V-DAY BE ME-DAY, TOO?
That's what I want to know."

The countries of Africa, including our own, owe their liberation and independence from colonial and racist rule to the struggles of the African masses. As these masses engaged the foreign and racist masters, as did those who fought against fascism, they were asserting their right to determine their destiny.

They fought to free themselves from the humiliating and degrading racist "Jim Crow" laws and practices put in place by the oppressors to keep them in subservience. They hoped that times would be better when their struggles for liberation and independence were through, as did the African American soldiers when they dropped defeat into the fascists' laps.

Unfortunately, soon after liberation from foreign domination was achieved, many of our countries fell victim to military dictatorships. When the soldiers used their guns to seize political power, they took away the right of the masses to determine their destiny. They put in place "Jim Crow" decrees of a special type, also intended to keep the people in subservience.

In his long poem, "History is the home address", our own poet, Mongane Wally Serote, addressed some pointed questions to Africa's soldiers:

"where were you when the coup happened
where were you when the whipped cracked
when the shot rang through the sky

African soldier,
with your uniform
with your stern face, mr gun commando,
what did you command this morning
did you hear
when the shot rang
when the plane fell and killed Machel
where, soldier?
African soldiers, intelligence men,
African intelligence women, where were you?
Where were you and your gun and your report?

where were you and your gun and the training we paid for
where
where were you when the African revolution began

where were you, African soldiers,
on whose side are you?
did the beer and the brandy and the whisky
work on you that night
and that morning?
your sins are so big,
boy, what will you do?"

Using his own words and speaking from a different continent in a different setting, the African poet in Africa, Mongane Serote, asked the same questions that the African poet in America, Langston Hughes, asked.

Together they asked the question of their people - where will you be when the powers that be deny us our rights! And what will you do! On whose side are you! Will you stand up and take your stand for democracy! Will you act to guarantee the people the right to determine their destiny!

And so we must say that the "letter" that Langston Hughes wrote to his "Fellow Americans" is a letter that we, the Fellow Africans, should read as a letter addressed to us as well. As the continent of Africa, we have no choice but to respond to the simple but passionate plea that an African in America made in defence of the humanity of his fellow Africans in America.

We are close to the close of the year 2004. I believe that we can honestly say that during this year, our continent has responded to the challenge thrown at our feet by Langston Hughes. We have acted in a manner that has saved us from the big sins of the African soldiers, of which Mongane Serote spoke.

We have in practice made the statement that we are determined that the African masses should reclaim their right to determine their destiny. We have done what we should and must do to ensure that the people fully enjoy the fruits of their liberation from colonial and racial domination.

The African masses have sought to answer the question posed by Langston Hughes - will V-Day be Me-Day too! They have striven to answer the question - will Independence or Freedom Day be our Day of Liberation as well! Perhaps Africa's soldiers have also done what they needed to do to answer the question posed by Mongane Serote - on whose side are you?

This year, millions of Africans participated in electoral processes freely to choose their governments, freely to determine their future. They have acted to give expression to the goal that each and everyone of our liberation struggles sought to achieve, that the people shall govern!

More than 45 years ago, in 1957, independent Ghana was born out of the colonial Gold Coast. This historic African victory marked the beginning of the process of the total liquidation of colonialism and white minority domination on our continent. Nevertheless, regardless of the hopes of the peoples of Africa including our own, it took another 37 years before this was achieved, when we achieved our liberation in 1994.

The African liberation process slowed down because the region of Southern Africa represented the strongest manifestation of colonial rule in Africa. Apart from Algeria and Kenya to some extent, it was here that Africa would face its most difficult challenges in the struggle to realise its total liberation.

In the end it took two decades totally to liberate Southern Africa, if we start with the seizure of power by progressive soldiers in Portugal in 1974, leading to the liberation of Angola and Mozambique in 1975, to the emancipation of South Africa in 1994, which was preceded by the independence of Zimbabwe in 1980 and Namibia in 1990.

To achieve these results, other countries and peoples in our region made many sacrifices, including the loss of life. Tanzania, Zambia, Malawi, Swaziland, Botswana and Lesotho all had to pay a price for the support they gave to ensure the achievement of the objective to liberate Southern Africa and thus contribute to the final liquidation of the colonial system in Africa.

Inevitably, given the sacrifices that were made throughout our region to drop defeat into the oppressors' laps, the question had to be answered practically - would Independence or Freedom Day also be the people's Day of Liberation! Would our hard fought victory guarantee the right of the masses of Southern Africa freely to determine their destiny!

At the beginning of this month, December, the international broadcasting network, BBC News, asked the question, "Is democracy taking root in Africa?" It opined:

"It had been a year of elections in Africa with polls in South Africa, Algeria, Rwanda, Malawi, Mauritania, Tunisia, Cameroon, Namibia. In just the past couple of weeks, Niger, Mozambique and Ghana have also gone to the polls. (The BBC did not mention the elections in Botswana, Equatorial Guinea, Cameroon, Tunisia and Comoros). The results have been largely predictable, and a few hitches aside, voting has been comparatively peaceful. So is this a sign that Africans are embracing the concept of democratic rule? Or are they being fooled - with the system being manipulated behind-the-scenes to ensure the ruling party is re-elected?"

This year, 2004, democratic elections in the SADC region took place in South Africa, Malawi, Botswana, Namibia and Mozambique, the last being held this month. In all these instances nobody has contested the reality that, "a few hitches aside", these have been truly democratic elections, whose results genuinely express the will of the peoples of our countries.

Even the BBC has found no evidence of "manipulation behind the scenes to ensure the ruling party is re-elected."

To confirm this, we can take just one example to represent our region, Mozambique, and the comments made by the Observers who followed the Mozambique elections.

The EISA Election Observer Mission said that "as of today (4 December 2004) (the Mission) is largely satisfied that the process of voting and counting so far meets the standards enshrined in the Principles for Election Management, Monitoring and Observation in the SADC Region."

The Observer Mission of the African Union said: "On the whole, the elections of 1-2 December 2004 were conducted fairly and in a mature and transparent manner. The people were offered the opportunity to express their choices freely. The AU Observer Mission wishes to seize this opportunity to congratulate the NEC (IEC) for well organised and executed elections; the political parties for mature contestation and the people of Mozambique for their responsible participation in the electoral process."

The US Carter Centre delegation led by former President Jimmy Carter said: "The Carter Centre congratulates the people and leaders of Mozambique for the conduct of the presidential and legislative elections. To date, with a few exceptions, our assessment of Mozambique's elections is positive. We are especially pleased about the peaceful atmosphere that prevailed on election day and the calm and orderly manner in which the poll was conducted in most places."

The EU Observer Mission said: "During election days, voting and counting at polling stations were conducted in an organised way and polling staff was very committed and well trained. Voters demonstrated a high degree of civic behaviour and voted peacefully and orderly. No incidents were observed during the election days. The secrecy of the vote was respected and the ballot boxes properly sealed."

Next year, 2005, elections within the SADC region will be held in the Democratic Republic of Congo, Mauritius, Tanzania and Zimbabwe. We are certain that these elections will confirm the excellent track record our region achieved this year, concluding with no "manipulation behind the scenes to ensure the ruling party is re-elected."

As happened this year, next year our region will demonstrate its commitment to meet its obligations contained in the SADC Election Guidelines, the AU Guidelines and the NEPAD Peer Review Guidelines on Good Governance. But above all, it will once again prove its determination to give full expression to the goal for which the entirety of our region fought a difficult struggle - that, the people shall govern!

Despite the challenges it faces, we can nevertheless say that Africa has concluded the year 2004 on a high note. It has positioned itself the better to confront the various problems that continue to afflict the continent.

It has helped to release the creative energies of the masses of the African people, expanding their possibility to become their own liberators from war, dictatorship, instability and poverty, in the same way that they were their own liberators from colonialism and apartheid. Indeed, Africa's time has come! Ke nako!

Health

Nevirapine, drugs & African guinea pigs

Some years ago, our national licensing authority, the Medicines Control Council, MCC, provisionally licensed the drug Nevirapine for mother-to-child-prevention of HIV transmission (MTCT). The licence was provisional because the manufacturer had not supplied all the necessary information required to license drugs.

Some time after this, the same manufacturer failed to supply the US drug licensing authority, the Food and Drug Administration, FDA, with the same information requested by the MCC. When the FDA asked them to supply this information, the manufacturers withdrew their application and have not resubmitted it ever since.

In this regard, AP has reported that because of the known problems about the Uganda "study", "NIH at first sought to postpone the FDA review of nevirapine, then top NIH and FDA officials arranged for the drug maker to pull its U.S. application rather than risk a public rejection that might scare African countries looking for U.S. guidance on the drug."

This tells the deeply disturbing and frightening story that "top" U.S. government officials were ready to hide from "African countries looking for U.S. guidance on the drug", the adverse effects of nevirapine they knew very well, and which they were certain would oblige the FDA to reject the licence application of the drug maker.

In other words they entered into a conspiracy with a pharmaceutical company to tell lies to promote the sales of nevirapine in Africa, with absolutely no consideration of the health impact of those lies on the lives of millions of Africans.

Sensitive to all these developments, our national Health Department decided to introduce the now provisionally-licensed nevirapine in 18 trial sites throughout our country, both to make the drug available to our people and to try to answer the many unanswered questions about the drug.

This necessary investigative work, targeted at ensuring that our public health system did not further compromise the health of our people, especially the poor who depend exclusively on the public health system, had to come to a stop, because essentially the Constitutional Court ruled that there should be a general "roll-out" in terms of the availability of nevirapine.

Having carried out further investigations concerning this drug, this year the MCC directed that nevirapine should no longer be used as mono-therapy for purposes of MTCT.

As was to be expected, various individuals and NGOs in our country dedicated to the marketing of anti-retroviral drugs, immediately spoke out against the decision of the MCC, which was based on the obligation of the Council to protect the health and lives of our people from harmful drugs.

And then earlier this month, the news agency Associated Press (AP) revealed that indeed the MCC decision was fully justified. The agency reported that the clinical "study" carried out in Uganda to validate nevirapine as a correct intervention to address MTCT, was scientifically faulty and could not be used to authorise the use of nevirapine for MTCT.

"Among other things it said, Dr. Betsy Smith's report, finished in January 2003, said the Uganda trial suffered from "incomplete or inadequate safety reporting" and records on patients were "of poor quality and below expected standards of clinical research."

"She strongly urged NIH not to make sweeping conclusions about nevirapine based on the Uganda research. "Safety conclusions from this trial should be very conservative," she wrote."

The news agency also reported:

"The government's chief AIDS researcher removed some negative safety conclusions from a subordinate's report on a U.S.-funded drug experiment, then ordered the research to resume over objections from his staff, memos show.

"As justification, Dr. Edmund Tramont, chief of the National Institutes of Health's (NIH) AIDS Division, cited his four decades of medical experience and argued that Africans with an AIDS crisis deserved some leniency in meeting U.S. safety standards, according to interviews and documents obtained by the Associated Press.

"Tramont's staff, including his top deputy, had urged more scrutiny of the Uganda research site to ensure it overcame record-keeping problems, violations of federal patient safety safeguards and other issues. These problems had forced a 15-month halt to the research into using a single dose of nevirapine to prevent African babies from getting AIDS from their mothers.

"AP reported on Monday that NIH knew about the problems in early 2002 but did not tell the White House before President Bush launched a plan that summer to spread nevirapine throughout Africa.

"Now, officials have new concerns that the lone dose of nevirapine may cause long-term resistance to AIDS drugs in the hundreds of thousands of African patients who received it, foreclosing future treatment options."

AP also reported that "Westat, a medical auditing firm hired by NIH to visit and audit the Uganda site" found in March 2002 that, "It appeared likely, in fact, that many adverse events and perhaps a significant number of serious adverse events for both mother and infant may not have been collected or reported in a timely manner.

"Westat reported there were 14 deaths not reported in the study database as of early 2002 and that the top two researchers in Uganda acknowledged thousands of bad reactions that weren't disclosed."

During the same month it reported the highly unethical conduct concerning the alteration of the report on the Uganda "study", Associated Press reported on the death of a woman in the US who had been prescribed an anti-retroviral regimen that included nevirapine. It said:

"In July 2003, the Tennessee woman (Ms Hafford) was hospitalized and on a respirator, and top government scientists were monitoring reports of her worsening condition. NIH officials suspected the drug regimen was the cause as it contained nevirapine. Since at least 2000, the government has warned that nevirapine could cause lethal liver damage or rashes when taken in multiple doses over time.

"Ouch! Not much [we] can do about [dumb] docs," Dr. Edmund Tramont, chief of NIH's AIDS Division, wrote in an e-mail after his staff reported that physicians continued giving Hafford nevirapine and Combivir despite signs of liver failure."

In this case, evidently, Dr Tramont blamed "dumb doctors". In the earlier case relating to the Uganda "study" and the felt need to dispense nevirapine in Africa, regardless of the grave health concerns expressed by his team of scientists, according to AP he had pleaded political imperatives.

AP reported that, "Tramont wrote in 2003 e-mails that he reopened the clinics (in Uganda despite the objections of his scientific team) because he didn't want NIH "perceived as bureaucratic but rather thoughtful and reasonable" and that it was important to encourage Africans' fight against AIDS "especially when the president (George W.Bush) is about to visit them."

Having been kept completely in the dark about what the U.S. government medical scientists knew about nevirapine and MTCT, understandably and honestly President Bush announced that "This major commitment of my government, (relating to the expenditure of large sums of money to fight HIV and AIDS especially in Africa and the Caribbean), to prevent mother-to-child HIV transmission, is the first of this scale by any government, anywhere." Nevirapine would be the drug given to Africans on the continent and the Diaspora to meet this unprecedented commitment!

Clearly, what was important for Dr Tramont was not the health of the African people, but the success of President Bush's visit to our continent, during which he would market nevirapine to convince all of us that he is concerned about our health, not knowing that the US state medical research authorities had kept him ignorant about the serious concerns relating to the use of nevirapine.

In other words, Dr Tramont was happy that the peoples of Africa should be used as guinea pigs, given a drug he knew very well should not be prescribed.

Understandably outraged at this contemptuous attitude towards the lives of Africans, which is informed by the conviction that they are worth nothing, compared to perceptions about US state institutions and the image of an innocent President Bush, the prominent African American US leader, Rev Jesse Jackson issued the following statement:

"I read with outrage and disbelief that Dr. Edmund Tramont, chief of the National Institutes of Health's AIDS Division, had removed some negative safety conclusions from a subordinate's report on a U.S.-funded drug experiment for Africa and then ordered the research to resume over objections from his staff.

"According to news reports, Dr. Tramont doctored the final document to under report thousands of severe reactions, including deaths and long-term resistance, to Nevirapine. This was not a thoughtful and reasonable decision, but a crime against humanity. Furthermore, upon learning of the potential lethal side effect of Nevirapine, President Bush and his administration did nothing to stop the shipment and usage of the drug in Africa. They must be held accountable for their inaction.

"Africa, a continent with the world's largest HIV/AIDS population, claiming about 25 million of the estimated 38 million people infected with HIV/AIDS, is once again being marginalized. For the millions of Africans who pined their faith and hope on U.S. moral leadership in the fight against this pandemic, disappointment and devastation are understatements in expressing their feelings.

"Moreover, for the National Institute of Health (NIH) to know about the problems in early 2002 but failed to inform the White House before President Bush launched a plan that the same year sought to increase the distribution of nevirapine throughout Africa, is an outrage. The President should demand nothing less than a thorough investigation of the matter. The fact that Dr. Tramont rushed to secretly alter the report findings and then dismissed the objections of professional safety monitors hired by NIH, when President Bush was about to visit Africa, seems to be a political decision.

"I call upon both houses in Congress to open a thorough investigation of this catastrophe and hold the NIH and the Bush administration responsible for spreading this deadly drug. With more than 5,000 Africans dying a day from HIV/AIDS, the U.S. should double its efforts in fighting this pandemic, instead of adding to the agony.

"Research standards and drug quality that are unacceptable in the US and other western countries must never be pushed onto Africa. We should stop discounting the lives of Africans. We are all God's children, created equally. And where there is suffering, it is our moral obligation to do all we can to save humanity.

"Keep Hope Alive!"

The Republican Finance Committee Senate Chairperson, Senator Charles Grassley was similarly outraged by the conduct of Dr Tramont of the NIH. He has therefore asked the US Justice Department to investigate this conduct.

AP reported that "In a letter released Monday, Grassley said he was compelled to do so by 'the serious nature of these allegations and the grave implications if the allegations have merit' "

AP also reported that the NIH had hired an auditor, who "first helped disclose the problems" with the nevirapine saga. The auditor, Michael Hensley, had said that "NIH officials were in a rush to declare that things were OK."

Most interestingly, and specifically with regard to our own country and people, Mr Hensley told AP: "It seemed to me we were drawing conclusions too quickly across the board, especially the implementation of nevirapine in South Africa."

As will inevitably happen, in time the truth will come out! This includes the truth about the origins of the enormous pressure that was put on our government to make nevirapine generally available throughout the public health system.

As the foregoing shows, many people and institutions especially in the United States are deeply worried about what Senator Grassley described as the "grave implications" of the AP disclosures about the nevirapine affair. We too agree that these disclosures have grave implications.

But obviously, the TAC does not agree. It is determined to continue to pursue its mission to promote the widest possible use of anti-retroviral drugs in our country, at all costs. In this regard, despite the fact that it is a mere NGO, and not a body of suitably qualified scientists, it is quite ready even to deny the reality of established scientific truths.

Consequently, despite and in the face of everything we have reported in this article, it issued a statement which said, among other things: "The criticisms levelled by the parties involved in the NIH news story, that broke two days ago, do not provide evidence questioning the safety or efficacy of short-course nevirapine. It is false, as has been reported in some places and by the Department of Health, that short-course nevirapine has been associated with thousands of adverse events. There is to date not a single life-threatening adverse event associated with this regimen which is widely used in the developing world."

Desperate to ensure that the truth does not undermine its drug marketing campaign, the TAC said, "The TAC is angry and considering legal advice on the Department of Health's continued misinformation campaign on nevirapine."

Intent to sustain public pressure for the expansion of the market for anti-retroviral drugs in general, and nevirapine in particular, the TAC also said:

"Reporting in South Africa over the last 24 hours regarding this (NIH) news story has been sloppy, with many journalists failing to understand the content or context of what is being debated. This has the potential to undermine public confidence in nevirapine unnecessarily. Science reporting in South Africa is generally poor and the TAC will endeavour in the future to work with journalists and other organisations to improve the quality of science reporting."

And so, to guarantee and improve the sale of anti-retroviral drugs, this being the central mission of the treatment campaign of the Treatment Action Campaign, the TAC boldly proclaims that it is a Science Institute that is capable of improving the quality of scientific reporting in our country, and undoubtedly especially "scientific reporting" about nevirapine and other anti-retroviral drugs!

It counts our courts as its ally, which, presumably because of past experience, it is confident would adjudicate the scientific and health controversy that has arisen concerning nevirapine, in its favour. Perhaps our judges will have to decide whether they are a scientific review panel or an institution that has oversight over the faithful implementation of our Constitution and our laws.

But to make doubly sure that it achieves its objective of marketing anti-retroviral drugs at all costs, the TAC also pledges to position itself as the central adjudicator of what should appear in our mass media as quality science reporting! And the quality science reporting it seeks should be such that it does not unnecessarily "undermine public confidence in nevirapine". Naturally!

Michael Hensley said it seemed to him that despite the known adverse effects of the drug, the NIH was very keen to expedite "the implementation of nevirapine in South Africa." Jesse Jackson wrote that "We should stop discounting the lives of Africans".

Strangely for an organisation that presents itself as African, passionately concerned about the health and the lives of Africans, the TAC seems quite happy to "discount the lives of Africans", and to ensure "the implementation of nevirapine in South Africa", regardless of "the significant number of serious adverse events for both mother and infant (that) may not have been collected or reported in a timely manner during the course of the Uganda "study".

Whose interests does the TAC serve?

Media Focus

What the media says

Like many others, we have, in the past, expressed serious concern at the quality of some of the journalism in our country, seemingly to no avail.

The December 10, 2004 edition of the Financial Mail contains fiction presented as fact that illustrates precisely what we have been complaining about.

In her "Editor's Note" the Editor says that at its next National Conference in 2007, the ANC will choose a "party leader" to succeed ANC President Mbeki. She also anoints Comrade Nkosazana Dlamini-Zuma as President Mbeki's "favourite" to succeed him.

In an Editorial entitled "ZANU-PF still fiddling while Zimbabwe burns", the journal says that President Mbeki met MDC President Morgan Tsvangirai last month "for the first time". It also says that President Mbeki "thought it more important to fly off to mediate in the Ivory Coast than to take action in the crisis closer to home", referring to Zimbabwe.

All these are inventions dressed up as facts.

Absolutely nobody knows whether the 2007 ANC National Conference will decide to replace President Mbeki with somebody else as the President of the ANC. The ANC Constitution has no term-limitation affecting any official position. So far there has been no discussion in the ANC at any level suggesting that Thabo Mbeki should not be re-elected ANC President in 2007.

We know it as a matter of fact that President Mbeki has not communicated any information to the Editor of the FM, or anybody else for that matter, concerning any member of the ANC, if any, who might be his "favourite" to occupy any position within the ANC.

President Mbeki has met Mr Tsvangirai in Zimbabwe a number of times. The last time was last December, President Mbeki's last visit to Zimbabwe, an encounter that was widely reported by the media.

President Mbeki went to the Cote d'Ivoire at the request of the Chairperson of the African Union, President Obasanjo, and not because "he thought it more important" to visit the Cote d'Ivoire rather than Zimbabwe.

Perhaps because they lack the wisdom of the FM, other international organisations such as the UN, the EU, the World Bank, the IMF and ECOWAS, also thought, like the AU, that it was important that President Mbeki should assist in the effort to end the highly dangerous Ivorian crisis.

For this reason all these organisations delegated high-level representatives to accompany President Mbeki throughout the five days he was in the Cote d'Ivoire.

President Mbeki maintains continuous contact with the situation in Zimbabwe, consistent with the express wishes of the major protagonists in that country. Nothing required that he should be in Zimbabwe during the period December 2 to 6, when he was in the Cote d'Ivoire.

The FM has every right to its opinions and the pursuit of its political agenda. However, regardless of its devotion to the success of its political cause, it has no right deliberately to mislead its readers by presenting fabrications as facts.

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