Critics 'chew' furiously on Zille's HIV/drug testing 'carrots'.

January 2012, Vol. 102, No. 1 SAMJ Feisty Western Cape Premier Helen Zille saw out 2011 in a firestorm of protest over pilot and planned provincial lotteries offering potential cash prizes to anyone who tested for HIV and (negative for) drug abuse, claiming ‘persuasion’ had so far proven to be a blunt instrument. The fuse to a series of rhetorical explosions by respondents as varied as the public sector committee of the South African Medical Association (SAMA), the Treatment Action Campaign (aka Section 27), and various topical HIV pandemic authors was lit by a keynote speech Zille gave at her health department’s first-ever Wellness Summit in early November. Fuel was added to the fire by several incorrect reports of her address (including that she intended refusing ARVs to HIV-positive men who had sex without condoms or without telling their partners). However, it was incentivised testing and South Africans’ bedroom behaviour that injected what one celebrated HIV/AIDS author, Helen Epstein, described as ‘hopeful openness’ into the ongoing local AIDS prevention debate. Zille claims South Africa is in the grip of a new AIDS denialism that can only be addressed by confronting the ‘root causes’ of the HIV pandemic: the culture of multiple concurrent sexual partners and inter-generational sex that creates an ‘AIDS super-highway’. She’s also calling for HIVpositive individuals who knowingly have sex with one or more partners without disclosing their status to be criminally charged. Her administration will investigate ways of requiring people to know their status, she says. Until individuals took their responsibility as seriously as her government, which provided ‘one of the most advanced free treatment and condom distribution systems in the world’, South Africa could not beat HIV/AIDS. To address this abrogation of personal responsibility, her government was adapting cutting-edge behaviour change strategies based on work by pioneering experts from Duke and Harvard universities, who late last year led ‘brainstorming’ sessions with her key departmental heads and staff.