Updated 24 June 2014

Dying for treatment

This extract from Nathan Geffen's book describes the events leading up to the start of TAC's civil disobedience campaign.


This extract from the book "Debunking Delusions: The inside story of the Treatment Action Campaign" by Nathan Geffen, describes the events leading up to the start of TAC's civil disobedience campaign.

We decided to organise a massive march at the opening of Parliament on 14 February 2003 to demand that the state implement a treatment plan.

Our march poster’s salient graphical feature was a photo of Mandela in his HIV-positive T-shirt.

The march was our biggest until then and possibly since. Between 10,000 and 15,000 people took part, a magnificent cross-section of South African society. White middle-class people from Sea Point and black and coloured working-class people from across the city all joined in. All three trade union federations, Cosatu, Nactu and Fedusa, participated.

We also hired a train from Johannesburg which brought several hundred of our members from up-country. This large turnout showed how fed-up ordinary people were becoming with the state’s obstruction of treatment. We followed up the march with a statement that we would commence a civil disobedience campaign if the state did not announce a treatment plan and return to the negotiating table at Nedlac with the objective of signing the agreement. We called the proposed campaign ‘Dying for Treatment’.

Civil disobedience

I was nervous about civil disobedience. I was worried that it might backfire, that our membership would not understand why we were drawing on tactics used to fight apartheid and that public opinion, which we had fought hard to win, would turn against us. Achmat, however, was convinced it would work and he was supported by most of TAC’s leadership, including Majola, who was more in touch with what the members were thinking than most of us.

We planned our first civil disobedience action for March. It was our finest logistical effort. Somewhat paranoid about being bugged, the five or so people involved in planning it communicated on phones that I had got a friend, Gregg Gonsalves, to hire from an airport cellphone shop so they could not be linked to us.

We held meetings with our members where we discussed the purpose of the campaign. It was made clear that being arrested was likely and that anyone who wanted to participate had to be 18 or over and sign a consent form which also committed its signatories not to use violence.

Hundreds of our members signed up and a lot of the younger ones on the threshold of official adulthood bemoaned the fact that we would not let them take part. Yet except for a handful of the organisation’s leaders, no one knew the final plan until an hour or so before it was carried out. We gave our members enough information to know where to gather, but none of the details.

Launch day

On the launch day we met at gathering points in Cape Town, Durban and Sharpeville outside Johannesburg and briefed the protesters. Then hundreds of us marched to police stations to demand that the Minister of Health and the Minister of Trade and Industry, Alec Erwin, be arrested for culpable homicide. We implicated Erwin for his failure to use his ministerial powers to bring down the prices of Aids medicines.

We had also reliably heard that he was sympathetic to Mbeki’s views.

We handed over a docket, mainly prepared by Achmat, detailing the evidence against them. The plan was that we would refuse to leave until we were arrested. This took place on 20 March, one day before the commemoration of the massacre in 1961 when the Pan Africanist Congress marched to Sharpeville police station to demonstrate against the apartheid pass laws. This was not a coincidence, but it was coincidental that the American invasion of Iraq took place on the same day, reducing some of the media publicity we got. Though it was clear that the invasion was coming several days before, we were not willing to change the logistics of such a complex operation at such short notice. It was not the first time international events had overshadowed our plans.

Once I phoned the Cape Times to inform a good Aids journalist that Sibongile Mazeka, the five-year-old child of one of our members, had died of Aids without treatment. The newspaper had previously carried a beautiful story about Mazeka’s plight. ‘No ways we can do it,’ said the journalist. ‘Something too big has just happened.’

The date was 11 September 2001

In Sharpeville, TAC members dispersed not too long after handing over the docket and opening a case against the two ministers. In Cape Town, the police – who at that time got on quite well with us – did not want to lock up the demonstrators. Eventually, they symbolically arrested about 60 people and immediately released them. Things were not so cushy at CR Swart Police Station in Durban. The police refused to cooperate and instead TAC supporters were ‘tear-gassed, sprayed with a water-cannon, punched, kicked and pushed around with batons’.

Five people were hospitalised including Sifiso Nkabinde, TAC’s provincial organiser at the time. Human Rights Watch issued a statement condemning the police brutality.

So started our civil disobedience campaign. We performed a few more similar activities. On one occasion we held a sit-in at the Department of Trade and Industry offices in Cape Town, demanding to speak to Alec Erwin so that we could ask him why he was not using his ministerial powers to make generic ARVs available. We refused to move unless Erwin came. We knew from the onset this was unlikely to happen. That Erwin was in another city at the time made it even more unlikely. So 17 of us were arrested. We were charged and appeared in the Cape Town magistrates’ court several times before the charges were dropped.

On another occasion, a group of us temporarily prevented the Minister of Health from speaking at an event organised by Health Systems Trust at the Holiday Inn in Woodstock, Cape Town. We held placards accusing her of being responsible for 600 deaths a day. I remember being slightly startled by the cathartic release of anger as TAC members chanted ‘Murderer’ at the top of their voices. People in the audience joined us as we shouted, ‘Manto go to jail’.

Famous photo

An ugly fracas ensued, with Achmat, Nonkosi Khumalo and the minister exchanging insults. A famous photo was taken of Achmat sneering at the minister. He apologised later for making a personal insult about her wig, inspired apparently by a ditty composed by TAC members which suggested that Tshabalala-Msimang give her wig to Erwin (who is bald). However, none of us involved in the disruption have ever apologised for calling her a murderer.

After the disruption and after the minister had finished her speech, one of our members threw her shoe at what she mistakenly thought was Tshabalala-Msimang’s vehicle (it was apparently a decoy vehicle). It landed harmlessly in the road.

Several people reprimanded her. Another member, whose mother lay dying of TB in a nearby hospital, had to be restrained from throwing a stone. In all my years at TAC, this was the only time I ever took part in a demonstration where one of our members acted violently towards the person at whom our demonstration was aimed.

Despite civil disobedience, occasional police brutality and the sheer number of demonstrations we have organised over our decade-long history, TAC members have – remarkably – restrained their justifiable anger.

The civil disobedience campaign generated an enormous amount of publicity. We broke the law intentionally, willing to take responsibility for doing so even if this meant going to prison. In our view, the moral cause for which we were fighting, preventing thousands of avoidable deaths, outweighed our duty to abide by the law. But the campaign brought controversy as well. Some journalists who had previously reported TAC’s events positively became more circumspect.


I was grilled for what felt like hours by a presenter on a call-in radio show. He asked me why TAC had resorted to what seemed to him such undignified actions when we had successfully used the courts to get the state to implement PMTCT. The question showed a misunderstanding many people have about TAC’s litigation and the use of litigation in political campaigns generally. Court cases are costly and they often take a very long time to conclude. We could not wait so long for a treatment plan while thousands of people were dying.

Moreover, there is no guarantee of victory in court. The PMTCT case was as close to a slam dunk as a court case can get. Even if we did win, governments do not like being ordered to change their policies by courts. The state would most likely have carried out the judgment reluctantly, meeting the bare minimum of requirements to avoid contempt of court proceedings. To some extent this has been a problem with the PMTCT judgment.

(Health24, March 2010)

Order the book here.

Read other extracts from the book: Weird and wacky Aids quackery and The strange case of Matthias Rath.


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Dr Sindisiwe van Zyl qualified at the University of Pretoria before working for an HIV/AIDS NPO in Soweto for many years. She was named one of the Mail & Guardian's Top 200 Young South Africans in 2012.

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