His Story
In Conversation
Creating a Portrait
A Campaigner:
"I am optimistic about what we can achieve if we become active citizens...If we work together we can make South Africa a better place."
Alive with HIV
Profile of an Icon
Zackie Achmat
What did Zackie Achmat do when given six months to live? He lay in bed, read and watched movies. When the months had passed and he hadn’t died he decided to get up and continue fighting. That was in 1990. Achmat’s subsequent contribution to the struggle against HIV and AIDS in South Africa is one of the most important stands in history.
Profile of an Icon
Zackie Achmat

What did Zackie Achmat do when given six months to live? He lay in bed, read and watched movies. When the months had passed and he hadn’t died he decided to get up and continue fighting. That was in 1990. Achmat’s subsequent contribution to the struggle against HIV and AIDS in South Africa is one of the most important stands in history.

He is unstoppable when moved to action, and in his role as leader of the Treatment Action Campaign (TAC), Achmat risked it all. He refused to take the lifesaving antiretroviral medication available to him, because the prohibitive price put them out of reach to most South Africans living with HIV. He became a walking indictment of the unnecessarily high cost of the medication, and a symbol for the South African people to rally around. “I was the first person to decide not to take antiretroviral drugs. Not because I didn’t believe that they didn’t work – because I believed they worked and because I believed that they should be available to everyone,” he says.

The pressure that Achmat and the TAC exerted to force the roll-out of antiretroviral drugs was immense, and the effects stunning: life expectancy in stretches of rural KwaZulu-Natal have risen from 49 years in 2003 to over 60 years in 2011. That is directly attributable to the roll-out of antiretroviral medication, which in turn took place thanks in large part to Achmat.

In addition to the tangible results of the campaign – legal and logistical – the effect of the TAC’s effort to reduce the stigma around HIV through the slogan ‘HIV Positive’, displayed on T-shirts all over the country, was enormous. It is difficult to comprehend the courage and energy required by Achmat to be the leading figure in the campaign, but he managed it, never hesitating to put himself in harm’s way. “At one stage I thought that I would die very badly, because I know how people die when they have HIV. I’m lucky. I didn’t pay with my life,” he says.

Certain of both himself and his beliefs from a young age, he told his parents and family that he was gay when he was 10 years old. A few years later, he had his first arrest at the hands of the apartheid police. When faced with the inadequate education apartheid offered to children of colour, Achmat did what he does best. He took a stand, and joined the 1976 protests against the apartheid education system.

That period in time is remembered for the police violence in Soweto on June 16, but the protests happened all over the country. In Cape Town, Achmat was in the thick of the struggle. Many children dream about burning down their schools. Achmat actually did it, but not for the reasons that usually drive such fantasies. When the boycott ended in 1977 and other school children did not want to continue the fight, Achmat made the decision for them. “I went back to school and the other kids didn’t want to boycott so I decided to set the school alight,” Achmat says.

He speaks with the eloquence of an academic or a politician, and grips his audience when talking about the motivations behind that moment. “Education is the key to human dignity and freedom. It is the key for living in the world – the social property that has been accumulated through generations,” he says. That’s why he responded with such vehemence when faced with an education system that discriminated based on race.

He has never been shy of a fight, has always risen when facing injustice. From that first protest against apartheid, he went on to join the African National Congress in the 1980s, working underground and setting up youth resistance groups. He was also active in movements promoting equality for gay and lesbian people. Achmat is full of energy, and has championed a seemingly endless array of causes. He was instrumental in securing equal rights before the law for gay and lesbian people, founding the National Coalition for Gay and Lesbian Equality.

Achmat had a history with Nelson Mandela, who he met on a number of occasions. On the meaning that Mandela has for South Africa, he is effusive. “I think Mandela’s greatest contribution to South Africa and to people of my generation was his HIV contribution,” he says. “He made people who were very angry realise that if you remain angry with someone because of what they’re doing towards you, you harm only yourself.”

Mandela himself asked Achmat to take his medicine in 2002, but Achmat refused until the government announced that it would begin the roll-out. The effects on Achmat’s emotional state were mixed. “I was happy, but I became depressed for three months because I had thought I was going to die and suddenly I had to plan for a life,” he says.

He got through that difficult period and carried on, as he always does. Today, he continues to fight for the marginalised and downtrodden, working with the Social Justice Coalition – which he co-founded in 2008 – to secure access to clean water and sanitation for residents of informal settlements. He is also involved with organisations targeting injustice and inequality in schools. In conversation he speaks with moderation, using a gentle tone to convey his message. If he is moved to anger, however, it becomes apparent how he has withstood so much, and accomplished such enormous good. Underneath his mild manner is an absolute conviction in his beliefs, and a deep intolerance for injustice.

It would have been completely understandable had Achmat decided to take a step back following the success of his fight to get affordable medication distributed across the country: his actions saved millions of lives. That was never an option. As long as he is able, Achmat will be working to improve the lives of the people who need it the most. His impact on South Africa represents one of the most significant contributions by any individual in the history of the country, and he is nowhere close to being finished. In a country whose history is full of incredible stories and remarkable individuals, that says it all.

Play video
In Conversation
Photographer and filmmaker Adrian Steirn engages with Aids activist Zackie Achmat, who co-founded the Treatment Action Campaign and championed a fight that ensured that millions of South Africans got access to affordable antiretrovirals. In this short film he discusses his motivation as a fighter against injustice and the process behind his decision to refuse antiretroviral medicine as part of his stand for HIV. Achmat shares some of his toughest moments working in the campaign, but on a lighter note also reveals a penchant for dress design.
A Portrait
A series of behind-the-scenes images reflecting the 21 Icons team at work.
The portrait frames AIDS activist Zackie Achmat with the words “Alive with HIV” in the background – a reference not only to his having lived with the disease since 1990, but also to the positive achievements of this tireless campaigner for social justice. Achmat’s decision to refuse antiretroviral drugs until the government agreed to make them accessible to all South Africans was vital in creating awareness about the issue.