A lethal cocktail

The report examines how corruption, poor oversight, and political interference hinder HIV/AIDS services in South Africa despite significant increases in funding. It identifies systemic vulnerabilities in budget tracking, donor fund management, and pharmaceutical procurement, while documenting specific cases of fund misappropriation and the promotion of unproven alternative remedies. The study argues that a combination of weak institutional structures and a lack of political will creates a 'lethal cocktail' that disproportionately affects the poor and marginalised.

• South Africa has experienced a significant increase in HIV prevalence, rising from 20 per cent in 1999/00 to 30 per cent in 2005/06, while state expenditure on the pandemic increased by 1,558 per cent in the same period.
• Budgetary management and tracking mechanisms are inadequate, particularly regarding disaggregated data for donor funding, which creates risks of resource duplication between government and civil society.
• The National Department of Health (NDoH) has demonstrated poor budget management, including significant underspending and receiving qualified audit reports for four consecutive years due to non-compliance with the Division of Revenue Act.
• Political interference and 'AIDS denialism' by leadership have hindered the roll-out of antiretroviral (ARV) therapy, leading to a failure to meet government-set treatment targets.
• There is evidence of corruption and misappropriation of funds within HIV/AIDS organisations, such as the National Association of People Living with AIDS (NAPWA), which faced allegations of poor oversight and failure to pay staff despite receiving nearly R10 million in funding.
• The government has been accused of protecting and promoting unproven alternative remedies, such as uBhejane and Matthias Rath's vitamin supplements, over scientifically validated ARV treatments.
• Extreme poverty drives a secondary market for ARVs, where some patients sell their free government-supplied medication to buy food, or deliberately suppress their health to qualify for disability grants.
• The pharmaceutical supply chain is vulnerable to theft, with ARVs frequently disappearing from large hospitals and being sold to the private sector.
• Whistle-blowers in the health sector face severe professional reprisals, including dismissal, which discourages the reporting of corruption.
• A 2007 'condom scandal' involved allegations that a testing manager accepted bribes to certify defective condoms manufactured by Latex Surgical Products (Pty) Limited, potentially risking millions of lives.

APA

Schulz-Herzenberg, C. (2007). A lethal cocktail. Institute for Security Studies. https://issafrica.s3.amazonaws.com/site/uploads/Book2007LethalCocktail.PDF

Chicago

Schulz-Herzenberg, Collette. A lethal cocktail. Institute for Security Studies, 2007. https://issafrica.s3.amazonaws.com/site/uploads/Book2007LethalCocktail.PDF.

Wikipedia

{{cite report |last1=Schulz-Herzenberg |first1=Collette |title=A lethal cocktail |publisher=Institute for Security Studies |date=2007 |url=https://issafrica.s3.amazonaws.com/site/uploads/Book2007LethalCocktail.PDF |access-date=23 October 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{schulzherzenberg2007lethal, author = {Schulz-Herzenberg, Collette}, title = {{A lethal cocktail}}, institution = {Institute for Security Studies}, year = {2007}, url = {https://issafrica.s3.amazonaws.com/site/uploads/Book2007LethalCocktail.PDF}, urldate = {2026-10-23}, note = {Indexed by Climate Insights Directory} }