Here's why Mandela came late to the AIDS crisis in his country

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[Choir singing]

Marco Werman: A choir singing at a Mandela family funeral. It was for Nelson Mandela's son, Makgatho. The date was January 15, 2005. Days earlier, Mandela had shocked the world by announcing that his son had died of AIDS. Among many pivotal moments in Mandela's life, this one was big. Also, a big moment for South Africa, where at the time, 800 people a day were dying of AIDS. Stephanie Nolen is the author of 28: Stories of AIDS In Africa. She's also a correspondent for Canada's Globe and Mail newspaper. Stephanie, what did it mean when Nelson Mandela made that announcement, that his son died of AIDS.

Stephanie Nolen: You know, Marco, it's hard to overstate how important that moment was in the struggle against HIV in Africa. For people outside South Africa, I think obviously a lot of people were shocked because the family hadn't made that news public, although Mr. Mandela's son had been living with HIV for quite some time. So the news about his son dying was a shock, but I think the ramifications of having someone who was so esteemed, so respected and so loved say this thing that was still this incredible taboo. He called the world's media to his garden in Houghton in Johannesburg hours after his son died, and he said it so starkly, and I just remember his voice was just so raw. And he said "My son had AIDS, my son died of AIDS." And there was no other African leader who had spoken out about this, although at that point, there were about 28 million Africans living with HIV. And so it was just an earthquake in South Africa, and in fact, all across the continent.

Werman: And eleven years earlier, when Mandela took office in 1994, the HIV infection rate was already 10% of adults in South Africa, and yet, Mandela himself at the time wasn't really addressing it. Why not?

Nolen: I think the first thing to remember is that people didn't know, we didn't have any idea really of what was coming. People were infected but people hadn't started to die in the kind of absolutely horrific numbers that would come a few years later. Mr. Mandela sometimes said that he had a reticence in talking about sex, and of course, in South Africa, it's primarily a sexually transmitted infection... That he had reticence talking about sex, that it was inappropriate in his culture, for a person of his stature to talk about sex, that his time in prison had made him uncomfortable talking publicly about things like this. The explanation that his wife, Graca, gave me when I spoke to them about this was that, at the moment people were coming to him and saying this is a crisis, this is a terrible problem, this is a disease which we can't treat, because of course, we have to remember that antiretroviral drugs were not available in Africa at that point at all. they were completely out of the financial reach of the African government. So it was a death sentence. You have these millions of people infected, and they are going to die, and you can do nothing. It was easy to block those people out when sitting in front of you was someone saying "I need 14 million houses," and the next person was saying, "I need 6 million schools." And you know, those were massive problems, but they were things you could respond to, and things you had been preparing for decades to respond to.

Werman: And compounding the problem was Mandela's successor to the Presidency, Thabo Mbeki, who basically denied HIV and AIDS. How did Mandela's thinking about AIDS kind of evolve during the Thabo Mbeki years?

Nolen: Yeah. Well, that was when things went really off the rails. Mr. Mandela watched horrified as the impact of HIV became more and more apparent, and Mr. Mbeki's obstinacy on the issue became more and more apparent. And there was this terrible moment in 2004, when the senior ANC leadership met, and Mr. Mandela stood up and said okay, there's this drug, Nevirapine, that will keep HIV positive pregnant women from infecting their babies and this drug's been made available to us and we need to give it to pregnant women who have HIV. And Mr. Mbeki scorned him from the stage in a way that was almost unthinkable. He said the words "Sit down, old man." And taking their cue from him, young Mbeki supporters in the ANC ranks booed him. They mocked him and booed him and the spectacle of ANC members booing Nelson Mandela, and it was at that moment that Mr. Mandela decided that HIV was going to be one of the primary focuses of his work and his Presidency.

Werman: Incredible story. I mean, Stephanie, you spent time with people, researching your book from all parts of the economic spectrum who were living with HIV in South Africa. I'm just wondering how you think the chapter on the AIDS epidemic and Mandela's life will ultimately be written.

Nolen: I think that in a life that had very few missteps, that his lateness in the response to HIV, his failure to act when he could have had a much larger impact, is always going to be counted against him. But I think it's also somewhat a redemptive story because he did come to see, and admit very publicly where he had made a mistake. You know, some of the things he did do had such a huge impact. He went, in 2004, to South Africa's first AIDS response program in Khayelitsha, outside Cape Town. And he embraced this heroic leader of South Africa's HIV struggles, Aki Ashmit, threw his arms around him in front of the cameras, and he put on that iconic South African t-shirt that says "HIV POSITIVE" in huge letters. And he put it on in front of the cameras, and he wore it. For Nelson Mandela to do that... You know, I had people all over Africa over the coming ten years talk to me about that picture. I mean, it wasn't just in South Africa that that really meant so much to people living with the disease and also to change so many minds. It was across the continent. And so I think it's perhaps a chapter that begins as an indictment, but ultimately ends in redemption.

Werman: Stephanie Nolen, the author of 28: Stories of AIDS In Africa. Thanks for telling us all about this, Stephanie.

Nolen: It was a pleasure.