OHANNESBURG - In a cavernous warehouse on the University of the Witswatersrand campus, nestled at the end of a long corridor, a modest band of lawyers works to ensure that AIDS ranks as high as possible on the government's list of competing priorities.
The AIDS Law Project - three attorneys and four support staff - sees the epidemic not just as a health issue, but as a litmus test of the government's commitment to the fundamental human rights enshrined in South Africa's new constitution. With minimal resources, they poke at decision makers and prod at corporate captains to defend the dignity of those who carry the AIDS virus or are dying from it.
It is frustrating work. While top-level leaders form committees and talk about building awareness, they do almost nothing to break the stigmas associated with AIDS. People living with HIV still have very little support.
''We believe if we challenge discrimination, at the end of the day that will assist effective HIV prevention,'' said Mark Heywood, director of the project. ''We want people to live longer, better, with more dignity. But there are worrying trends: Some practices of discrimination are being alleviated while others are becoming more restrictive.''
The Law Project is recognized throughout southern Africa as a clearinghouse of information on thorny legal issues such as mandatory notification of HIV test results, a policy debate now pending in several countries, including South Africa. But much of the project's work is devoted to individual cases of discrimination.
In one case, the project is suing South African Airways on behalf of an HIV-positive client who was denied a job due to the company's policy of mandatory HIV testing as a condition of employment for cabin attendants. The law project also has several civil medical malpractice suits heading to court in the coming months. One sues a doctor over the physician's failure to gain a patient's consent prior to testing, then withholding the results. In another case, blood was taken from a patient for one purpose and then screened without permission for HIV. Similarly, three other cases challenge the South African military's policy of mandatory testing prior to service.
The Law Project also plays a watchdog role on public policy issues, seeking stronger antidiscrimination language in landmark labor and health reforms. ''Parliament is just not up to scratch on these issues,'' Heywood said.
Insurance poses a special challenge. A 1988 law made it legal for companies to deny coverage to HIV-positive workers. As a result, the insurance industry now administers more tests than the medical community, Heywood said, and does so without providing for pre- and post-test counseling.
The insurance question is critical in South Africa because banks require life coverage for anyone seeking a mortgage. Heywood and his lawyers have been lobbying banks to change that policy, and have sought ways around it in negotiated deals between their clients and individual bankers.
The Law Project's highest-profile concern, however, is the killing of a Durban woman who admitted in public that she had HIV. Gugu Dlamini was fatally assaulted last November on the evening after she revealed her status. Four men were eventually arrested for the attack, but prosecutors dropped the charges in August, saying they lacked sufficient evidence to prosecute.
The Law Project has scrutinized the case throughout, and at one point pressured the provincial prosecutor in Kwa-Zulu/Natal to appoint new investigators. When the charges were dropped, Heywood circulated a scathing letter across the Internet, attacking other AIDS advocacy groups for neglecting the case.
''Put cynically,'' he wrote, ''Gugu has served her purpose. Her name has probably been used in numerous funding proposals - and that's it. Gugu was as dispensable as the thousands of other avoidable and premature deaths that take place every month, because poor marginalized black people can't afford treatments and their agonies are too easily overlooked.''
Partly because of the Law Project's work, Dlamini's case has not died completely. It was recently raised again in debate before Parliament's justice committee, and the deputy prosecutor in Kwa-Zulu/Natal, Gey van Pittius, has ordered a formal inquest for later this year, at which Heywood's team will be able to cross-examine witnesses.
''If anyone doubts that stigma is as alive and powerful as it was 15 years ago, they need only remember what happened to Gugu Dlamini, and what happens every day to millions of people living with HIV,'' said Peter Piot, executive director of UNAIDS, at an AIDS conference in Zambia last month. ''We too often forget that stigma remains our most significant challenge in AIDS.''
Part 1
