1998 – Campaign for generics saves millions of lives

Between 1998 and 2008, South Africa’s Treatment Action Campaign (TAC) mobilized people to campaign for the right to health. As a result of these campaigns, TAC succeeded in pressuring governments to reduce the price of medicines, that prevented hundreds of thousands of HIV-related deaths, and forced significant additional resources into the health system – especially for the poor.

South Africa has more HIV-positive people than any other country in the world. TAC was set up in 1998 as an advocacy group made up of people living with HIV and AIDS, predominantly poor and black. The call was for the right to treatment for HIV - and this demand soon led them to confronting both the government and the pharmaceutical industry.

The government under Thabo Mbeki refused to implement effective HIV and AIDS prevention and treatment programmes, in part because Mbeki believed the AIDS epidemic fed on stereotyped views of black sexuality and in part because of the cost of anti-retroviral (ARV) medicine. The pharmaceuticals meanwhile put pressure on the South African government to reject the imports of cheaper generic versions of ARVs and refused to license drugs at reasonable prices.

TAC used many strategies to confront the government and corporations. To challenge the illegal imports of generics, for example, TAC's leader Zackie Achmat flew in 2000 to Thailand to buy generic drugs at a fraction of their South African price. He was arrested for illegally importing drugs, but the publicity and the exposed huge price differentials shamed the pharmaceuticals and brought attention and support for TAC.

The campaign also won support internationally, putting pressure on Pfizer that as a result lowered its prices. A legal case in the Competition Commission of South Africa also found in TAC's favour, leading several drug companies to provide licenses to generic manufacturers who charged much lower prices.

To confront the government's inaction, TAC organised mass civil disobedience campaigns, held marches across the country, and launched various legal actions. Starting with a demand for a government plan to prevent mother-to child-transmission (MTCT) that they won in the courts, TAC then moved to calling for a National Treatment Plan to provide ARV for all adults. Through a combination of detailed research, leaked government information, and legal actions, TAC eventually forced the government to draw up an ARV plan in 2003.

Throughout the campaign, TAC did not just focus on the government's responsibility, but also worked with scientists, academics and health professionals, and sent activists and health workers to villages to provide their own medicine and care that HIV-positive people needed.

In 2007 the South African cabinet approved a strategic plan which committed the government to spending US$6 billion on HIV and AIDS prevention and treatment over the period 2007-2012. This plan allowed for 1.6 million people to receive ARV treatment. TAC stays engaged, both supporting and monitoring the roll-out of the programme.

Today, TAC continues to represent users of the public healthcare system in South Africa, and to campaign and litigate on issues related to the quality of and access to healthcare.