The politics of HIV/AIDS in South Africa: government action and public response

A decade ago it seemed likely that African governments would be destabilised by the impact of the HIV/AIDS epidemic. This article tests some of the presumptions in such forecasting with an examination of the South African case. It begins with an assessment of the effects on the public health system of the South African government’s efforts to cope with the illness. Efforts to implement universal treatment of people who are HIV-positive appear to have strengthened government, while the costs have been affordable. The efforts have extended the embrace of the public health system and prompted the engagement of civil society in policy formation and implementation. Survey evidence suggests that the government has gained public approval and that its health service delivery has become more socially accountable. Civil protest to engender political reforms in the treatment of AIDS patients has enhanced the role of constitutional checks on executive authority.