A devastating report on the impact of AIDS in South Africa has finally been published this week, despite concerted efforts by the South African government to suppress and discredit it. The report, produced by the Medical Research Council of South Africa, makes for alarming reading. It demonstrates that 40% of all deaths in the 15-49 age group in South Africa are now AIDS related, and it predicts that, if left unchecked, the total number of AIDS related deaths in South Africa will rise to between 5-7 million by 2010. By the end of this decade, the authors argue, average life expectancy will drop in South Africa from 54 to 41, and about 780,000 people will be dying each year from Aids, the highest number in any country in the world.

The authors of the report include researchers from the University of Cape Town and The London School of Tropical Hygiene. It has been subject to rigorous review, including approval by Peter Goldblatt, the chief medical statistician for England and Wales. The authors argue it represents the most comprehensive investigation to date of the effects of AIDS in South Africa, and its findings have been widely accepted by a range of organisations, including unions, churches, and even some politicians within the ANC.

Yet, the government itself has persistently tried to prevent its publication, and now seeks to undermine the report’s credibility. While Thabo Mbeki’s views - that AIDS is only responsible for a fraction of deaths, and may not even be related to HIV - are well known, the health minister, Manto Tshabalala-Msimang, and Essop Pahad have now weighed into the debate. In an attempt to discredit and deride the report, they have described it as a "massive propaganda tool" in the hands of those who argue for wide distribution of anti-retroviral drugs, and have condemned a "sense of hysteria" over the question of deaths from Aids.

If the findings of the report are shocking, the reaction of the South African government is even more so. In the words of anti-apartheid activist and former human rights commissioner, Rhoda Kadalie, who, writing in a Johannesburg newspaper, called on Dr Tshabalala-Msimang to resign: "We have a genocide on our hands and you and your cohorts have been unwilling to listen to the experts…If the president is making it impossible to do your work effectively, why not resign with dignity in defiance of someone who is taking the country down with him?"

As the recent United Nations Development Report on HIV/AIDS and poverty makes clear, if the devastation of AIDS in developing countries, and sub-Saharan Africa in particular is to be tackled, governments will need to implement a range of far reaching measures, that include adequate treatment as well as an adequate infrastructure to support people through the appalling toll that AIDS will wreak. COSATU, the Treatment Action Campaign and the Catholic Church have also called for such measures in South Africa. It is a matter of urgency that the South African government now takes its head out of the sand and acknowledges the real threat of AIDS before the horrific scenario predicted the MRC’s report becomes a reality.

Rhoda Kadalie’s words raise a critical question: Can a legal case be made to lay a charge of genocide against those individuals responsible? Article 6 of the Rome Statute of The International Criminal Court, for example, states: “For the purpose of this Statute, "genocide" means any of the following acts committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group, as such: (a) Killing members of the group; (b) Causing serious bodily or mental harm to members of the group; (c) Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part […] .” Are there other instruments that would allow an appropriate case to be made that the failure to act on HIV/AIDS amounts to an act of genocide? Should not efforts be made to test whether a formal charge of genocide can be made? Would not such an attempt act as a stimulus – perhaps the most effective of all – to get appropriate action taken by the authorities not only in South Africa, but also in other African states?

Aids will kill 700,000 South Africans a year

The Impact of HIV/AIDS on Adult Mortality in South Africa, Medical Research Council Report

UNDP Report: HIV/AIDS: Implications for Poverty Reduction

COSATU: Joint statement on AIDS