Rewarding Engagement? The Treatment Action Campaign and the Politics of HIV/AIDS

This 42-page study was commissioned as part of a broader research project entitled Globalisation, Marginalisation & New Social Movements in post-Apartheid South Africa, a joint project between the Centre for Civil Society and the School of Development Studies, University of KwaZulu-Natal. The paper examines the history, key characteristics, and strategies of the Treatment Action Campaign (TAC), a South African-based organisation campaigning for the treatment for people living with HIV and the reduction of new HIV infections, as a model for effective social activism. The study was conducted via interviews with TAC activists and officials, as well as allies and social movements, and the pharmaceutical company Boehinger Ingelheim. The report suggests that TAC’s strategies are useful models for mobilising for social change.

According to the report, the organisation employs a multi-strategy approach to campaigning, and its methods range from civil disobedience (on several occasions, importing medication in contravention of patent law), street demonstrations, action in the courts (the AIDS Law project at the University of the Witwatersrand works closely with TAC), and pamphlets spelling out scientific arguments. In TAC’s own understanding it maintains its visibility ‘through posters, pamphlets, meetings, street activism, and letter writing.’ TAC is not only a campaigning organisation, but also runs programmes which provide services to its members, such as providing medication and treatment literacy.

TAC’s strategies are designed to equip people living with HIV and AIDS with information, including practical advice on how to cope with HIV/AIDS and how to take treatment, as well raise consciousness on the issue. Workshops and treatment literacy programmes are designed to teach people to engage as citizens, not victims. The report also states that even where TAC is providing a service, an attempt to win policy change is also crucial to its operation.

The report talks about grassroots involvement in the organisation, the building of a cohesive civil society, and the extent to which poor and marginalised people are empowered by participation in the organisation. The authors state that TAC has become a vehicle for grassroots initiatives which suggests a willingness by people outside the activist circle to take an active role in changing their society.

In addition to these strategies, the report also examines the finances and internal organisation of TAC; the reasons why people join the organisation; its gender priorities; internal government and decision-making; TAC and the political environment; the organisation's alliances; and international support.

Whether or not TAC is defined as a social movement or a civil society association is debated heavily, though the authors conclude that regardless of how TAC is defined, the experiences of the organisation have much to teach about how social movements or civil society organisations can win battles for reform. The authors state that whether this approach can win the sort of sustained policy changes and social programmes which will enable the poor and the marginalised to claim their place as full social and political citizens remains untested. However, the report concludes that the organisation’s experience has at least held out the possibility that organisations which apply these lessons can make an impact on structures of inequality as well as its symptoms.