HIV/AIDS is a contentious and sensitive topic to cover anywhere in the world.  But reporting on HIV/AIDS in the South African context poses an especially complicated ethical challenge.

Politicization of the pandemic, tensions surrounding the use of traditional and Western medicine and balancing objectivity with nation building leave South African journalists with a seemingly insurmountable task.

South Africa has the largest number of HIV infections in the world. Despite 2007 HIV prevalence data that suggests that infections within the country may be levelling off, the pandemic remains rampant; the eastern province of KwaZulu Natal, for instance, has a staggering 39 per cent HIV rate.

The Southern African region is the hardest hit by HIV in the world. According to UNAIDS, Southern Africa accounts for 35 per cent of all people living with HIV. It hosts one third of all new HIV infections and AIDS related deaths. It is within this context that South African journalists must tackle the issue of HIV/AIDS.

South Africa and HIV/AIDS

The ethics of HIV/AIDS reporting in South Africa has become more complex since the country’s first reported incidents of the pandemic in 1982. Originally considered a health topic, HIV/AIDS is now entangled with social, economic, cultural, scientific, personal and political issues.

In post-apartheid South Africa, one would be hard pressed to speak of the pandemic without provoking the kind of disagreement along racial and political lines that is symptomatic of a nation in transition.

Coverage of HIV/AIDS in South Africa has tended to be reactive, sensationalist, and ill informed.

Insufficient resources and time allocated to HIV/AIDS coverage across all South African media means that reporters tend to rely on news services like the South African Press Association (SAPA) or Health-e, a South African news agency that produces news and in-depth analysis on HIV/AIDS and public health issues, for copy.

Lack of expertise in the field means that the more complex cultural, scientific and sociological aspects of HIV/AIDS are underrepresented, leaving significant gaps in reporting and opening the door for various ethical challenges. 

“It is a difficult topic to report. It’s so complicated,” said Franz Kruger, Ombudsman for South Africa’s Mail & Guardian and author of Black, White and Grey: Ethics in South African journalism.

“I think we’re getting better at it. I think there is more care being taken, though the tabloids tend to be a bit more populous and tend to get things wrong from time to time,” said Kruger.

The death of Parks Mankahlana

The question of ethics surrounding the coverage of HIV/AIDS was not high on the agenda of the South African news media until the October 2000 death of 36-year-old presidential spokesperson, Pakamile (Parks) Mankahlana.

While the official statement made by Mankahlana’s family and the African National Congress (ANC) was that Parks had died of heart failure after a long illness, rumours of HIV/AIDS circulated immediately among the South African press. Publications, both national and international, speculated as to whether Mankahlana’s premature death was AIDS related, sparking a heated national debate on the ethics of HIV/AIDS reporting.

While some South African media reported on Mankahlana’s potential HIV positive status, crediting this information to unnamed sources within the ANC or simply reporting that other media were speculating, others remained silent on the matter, publishing only the official statements made regarding the cause of death.

This disharmony among media caused tension in a number of South African newsrooms along racial lines, said Kruger.

“The accusations from a lot of black journalists was that this would not have happened if Parks had been white and I don’t think that is quite true, I do think that race is always threaded through just about everything we do.”

The division of media over Mankahlana’s death raised ethical questions surrounding objectivity, nation building, and racism in the context of HIV/AIDS that had never been addressed by the South African media. It also demonstrated the complexities of reporting on the heavily tabooed topics of disease, death, and sex in a transitional, multicultural society.
 
Shortly after allegations of racism began, South Africa’s Business Day published an article entitled Openness is the Key, arguing that reporting on the cause of Parks’ death was in the public interest:

“The truth of Mankahlana’s death is important, not just because he was a household name but because the disease that evidently killed him casts a dark shadow over South Africa’s future. The experience of other countries is that ordinary people only start to take HIV/AIDS seriously, and adopt precautions, when role models who have the disease emerge from the closet. The fact that a decent and intelligent man like Mankahlana should remain silent on his condition is a sign that South Africans are still not confronting the HIV/AIDS crisis.”

The Star, Johannesburg’s major daily, which is generally understood as being sympathetic to the ANC, took the stance that speculation on Mankahlana’s HIV status was disrespectful to African customs and dangerous in a society where discrimination against people living with HIV/AIDS is widespread.

Mathatha Tsedu, The Star’s then deputy editor and chairman of the South African National Editors Forum, spoke out at Mankahlana’s memorial service. "I feel perturbed at being part of an institution that shows a vulture-like tendency of disrespect for life and death," he said.

President Thabo Mbeki pleaded with the media to refrain from speculating on Mankahlana’s HIV status during a memorial service in his hometown:

"When Nthabiseng (Mankahlana’s widow) says 'this is what my husband suffered from and this is what killed my husband' I would hope, truly hope, that none of us will take it upon ourselves to come to a conclusion that we know better than she."

Minister in the presidency, Essop Pahad, in his November 2000 address to the Forum of Black Journalists, also appealed to the media to refrain from publishing speculations:

“You may think that a celebrated AIDS sufferer is robbing the public of a valuable role model in not trumpeting the illness from the rooftops, but I would suggest that it is a matter of personal decision – and the personal right to privacy, entrenched in our Constitution, should be respected at all costs.”

The death of Peter Mokaba

Peter Mokaba, MP for the African National Congress, passionately spoke out against the South African press at Mankahlana’s funeral. “The media has disappointed us and I do not know how they are going to repair the damage. A comrade passes away who served them (the media) well…and they want us to bury him with diminished status,” he said.

In June of 2002, less than two years after the death of Mankahlana, Mokaba died at the age of 43 after battling pneumonia linked to ongoing respiratory problems.

The circumstances of Mokaba’s death were strikingly similar to those of Mankahlana’s but, this time, the South African press did not focus on the cause of death. While there was some speculation as to Mokaba’s HIV status, most South African media outlets chose to run the ANC’s and the Mokaba family’s official statements regarding the cause of his death.

Business Day was one of the few South African publications to comment on Mokaba’s possible HIV status, though the manner in which they did so was restrained:

“We may never know whether the pneumonia that killed Mokaba was due in any way to HIV/AIDS. Many will assume this is so … his family and colleagues have chosen at this stage to remain silent. That is their right. No one should lightly challenge that right or intrude on the grief of those who survive him.”

In both cases, the South African media was charged with the task of balancing privacy issues against the public’s right to know, resulting in very different implications for the fundamental ethical principles of journalism.

The outcry of journalists, officials and the public after Mankahlana’s death meant that the media handled Mokaba’s death very differently, choosing, for the most part, to uphold his right to privacy over the public interest.

According to Kruger, the contrasting coverage of Mankahlana’s and Mokaba’s deaths demonstrate that, while basic ethical principles tend to be fixed, their application can change dramatically, depending on the circumstances.

“There was a huge outcry after the Parks’ series of events. There were a lot of particularly black journalists who criticized the media’s handling of that and I think that had an impact on the coverage of Mokaba. To me those two deaths are particularly interesting as an example of in fact exactly this point: how we apply our principles differently from time to time.”

Ethical implications of HIV/AIDS reporting

While numerous challenges remain for South African reporters on the HIV/AIDS, there is a movement within the media to address the ethics of HIV/AIDS reporting and guide journalists who face ethical dilemmas, such as with the deaths of Mankahlana and Mokaba.

Franz Kruger has created nine principles, intended as a summary of the way accepted ethics should be applied in the context of HIV/AIDS. Kruger’s principles are set to become official policy for the South African National Editor’s Forum (SANEF).

At the foundation of these nine principles are three, more general values that can be applied in the context of HIV/AIDS. These are, truth-telling, independence and minimizing harm, adopted   from the American Society of Professional Journalists.

Truth-telling, says Kruger, is the most basic ethical principle as the media affects decisions made by both ordinary citizens and policy makers:

“Journalism’s contribution is informing people and giving a good basis for a good amount of information on which they can base various decisions on.”

Independence is a complicated principle in the South African context, as nation building tends to be high on the government agenda. Journalists who fail to tow the government line may be subjected to accusations of being unpatriotic.

“There is political pressure in the sense that the government would like journalists to be more on side of government programs and that, of course, means ANC programs. Of course the government has been very unhappy about some of the media’s coverage but has been forced to retreat quite a lot on that front,” said Kruger.

Just as it is important for South African journalists to maintain their independence from the government, says Kruger, it is also necessary to draw a firm line between reporting on HIV/AIDS and becoming advocates on the issue. “I do think that sometimes the media have got a little bit too close to NGOs and could do with a little more distance from that position,” he said.

Minimizing harm is Kruger’s final principle and is especially critical in post-Apartheid South Africa, where issues of nation building make cultural sensitivity especially important.

Particular care must be taken when reporting on traditional medicines and cures in South Africa, as the media must strike a balance between showing due respect for varying cultural beliefs and ensuring the public’s safety when it comes to traditional ‘cures’.

“I guess the line that I would draw is that where things are actively dangerous. Then I think the gloves are off and one has a duty to expose bogus cures and that kind of thing. If they’re not actively harmful then one shouldn’t be too harsh about and simply assume that western medicine knows everything,” says Kruger.

In the South African context, the issue of traditional beliefs and medicine become even more nuanced as it can be used as a political tool, says Kruger.

“It’s all interlaced with politics. The minister of health stands up and says look we should try out the African Potato and on one level that’s fine but on another level of course it’s a kind of diversionary tactic to take attention away from what she should be doing which is supplying proper medicines through the hospital system.”

While conflict and disharmony among media is inevitable in South Africa’s current political, social and economic environment, the ethics of HIV/AIDS reporting is beginning to be debated, discussed, and reinvented by the media. And as the pandemic continues to wreak havoc on the South African landscape and its people, it is becoming increasingly essential that the media is up to the task.