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HIV: Cutting into the voters roll, Idasa, 25 November 2004
Impact of HIV and AIDS on elections and democracy

Press release
Impact of HIV and AIDS on elections and democracy

More or less democracy for HIV/AIDS

The Governance and AIDS Programme of the Institute for Democracy in South Africa (IDASA) presented a research report, HIV/AIDS and Democratic Governance in South Africa: Illustrating the Impact on Electoral Processes, in Pretoria yesterday (25 November). The report explores, among other things, how the epidemic impacted on the April 2004 elections in South Africa. It is co-authored by Per Strand, Khabele Matlosa, Ann Strode and Kondwani Chirambo. In this extract Per Strand looks at some of the aspects around democratic governance that could affect the effective management of HIV and AIDS.

“I think [the politicians] talk about HIV and they lie about it. They are just trying to get people’s votes and they have been talking about it for years now but they have done nothing about it.”

This criticism by a woman in rural Nongoma, KwaZulu-Natal, captures an important point in our research on how the HIV/AIDS epidemic impacted on the April 2004 elections in South Africa. The woman has so far found the political response to the epidemic wanting and she does not trust the electoral process to improve on it. In a province with an estimated HIV infection rate of 37.5 percent, her disillusionment is understandable. With data from the voters’ roll we established that mortality among 30-39 year old women who were registered to vote increased between 1999 and 2003 by 179 percent in Nongoma. This is higher than the national average (129%) but lower than some other municipalities (over 300%). While we do not know the cause of death in any individual case, the over all mortality profiles we have generated are, arguably, a veritable ‘smoking gun’ for AIDS-related mortality in South Africa.

The problematic reality that is the epidemic needs to be included in any overall assessment of South Africa’s first ten years of democracy. Indeed, because of its wide implications for society as a whole, it could well be argued that it is the most acute problem that needs to be prioritised over all other developmental concerns. However we rank it on a list of priorities, the response must match the scope of the problem.

Analyses and arguments abound about what lessons to draw from the government’s overall development initiatives during the first ten years of democracy and about what should be the political vision for the next decade. On whatever grounds people are critical of the past and make plans for the future, the remedy, it is often suggested, is simply more democracy; a better future would somehow be ensured if South Africa becomes ‘more democratic’. A critical discussion based in the notion of democratic governance, however, challenges that assumption. While the public political discourse on the future for South Africa’s democracy need to debate, for instance, liberal vs. socialist democratic ideals, we must also confront and discuss problematic contradictions within various democratic paradigms and how these impact on policy. The problems with formulating an effective political response to the HIV/AIDS epidemic can demonstrate the more general point.

In the context of the epidemic we cannot afford to simply assume that democracy – in terms of, for instance, human rights, accountability and participation – automatically generates effective policy interventions that will reduce HIV prevalence and AIDS-related deaths. To take a ‘human rights approach’ to the epidemic is no panacea against its impact. Unless we discuss how different rights should be balanced and how, if it is found to be necessary, a controversial prioritisation of one right over another can be legitimised through a democratic process, a focus on human rights may hinder an effective response. Likewise, while accountability is central to the democratic contract between elected leaders and the electorate, it is a double-edged sword for advocates of a strong response. Since accountability may cause a responsible political leader who has launched a demanding policy programme to lose the next election to a populist with a simple but ineffective policy agenda, accountability can be an incentive against implementing the necessary interventions in the first place. Participation, finally, is costly. While it seeks to improve and legitimise a policy proposal, participation can stall the process and may undermine the policy as such; participation on the issue of HIV/AIDS from some in the South African civil society would generate a policy based only on abstinence.

Since we can’t simply ‘maximise’ the amount of democracy, by trying to realise all its ideals within the framework of a particular political response to the epidemic, the critical question to ask, arguably, is the following: How should central components of democracy be balanced against each other in the formulation of a strong political response to the epidemic, without undermining democracy as such? The answer is partly about content but equally much about ensuring that policy is arrived at through a process of deliberation. The South African National AIDS Council could well be the engine for that debate.

Released by the Governance and AIDS Programme of Idasa The report will be published early in 2005. Copies of the current final draft are available from Idasa. Contact Marietjie Myburg or Shaila Gupta at 012 392 0500 or shaila@idasa.org.za / marietjie@idasa.org.za If you want to share pictures, use the calendar, or start a questionnaire visit http://www.smartgroups.com/groups/rapeactionsa To leave the group, email: rapeactionsa-unsubscribe@smartgroups.com Report abuse