 For more videos on people's struggles, please subscribe to our YouTube channel. We moved to sort of the other marker for 2021, which is also 20 years of the Doha Declaration. And again, this was, you know, a recognition by all members of the WTO that governments could overcome paying barriers on access to affordable medicines and really fuelled by big farmers suing South Africa when when your government tried to access affordable generic sort of HIV treatment. The battles for HIV treatment, I think also supported to a large extent battles for treatment in other areas, whether it was hepatitis C, whether it was cancer. But you know, I think there's something interesting that's happened. Well, not interesting, but in the last one year where you would think that, you know, the ultimate victory for those battles on overcoming intellectual property barriers for access to medicines for treatment for COVID-19 vaccines seems to be taking a lot longer than it should have. So I wonder that when you look back and reflect on those big battles of big farmer where the treatment action campaign was marching through the streets of South Africa, if it's spread across the world, we had huge successes. But did we really dent big farmers power? And where do you really see our challenges for access now? You know, we catalyzed the movements, you in India, we in South Africa, comrades in other parts of the world, the United States, that over five years put some of the most powerful companies in the world on the defensive. We had them on the back foot. They were being shamed. They were pariahs morally. We were winning legal victories against them in a number of countries. And it culminated in the Doha Declaration, as you say, November 2001, very important statement by the World Trade Organization on the powers of sovereign powers of countries when it comes to compulsory licensing, etc. I'd say two things, Kajal. One is that we had that victory, but you know, and I know that governments never use the power that activists won for them. We won them back that power. But governments are too beholden to finance, too beholden to capital, too beholden to these pharmaceutical companies, even whilst they often condemn them. It's a lip service. They're not prepared. You know, we, you mentioned we aside of the Doha Declaration, we fought to defend the piece of legislation introduced by Nelson Mandela's government. We forced the pharmaceutical companies to retreat from that case. We've never used the power of compulsory licensing in South Africa to this date. So although the one thing we've achieved equality on in some ways is access to HIV medicines around the world, that is just like an island in a bigger sea of inequality of access. So people in South Africa, if you have cancer, you die if you're poor, for the most part. If you have diabetes, if you have COVID-19, not none of that has changed. And I think as activists, we have to be self critical. I feel as if we, you know, not immediately after 2001, but probably by the late 2008, 2009, the activists movements let the pharmaceutical companies off the hook. And when we let them off the hook, they, those companies recon-solidated, they reorganized themselves. They ate up generic companies. They worked with governments to put the squeeze on India, et cetera, et cetera. And so then when we wake up with the COVID-19 epidemic, suddenly we see, well, it wasn't like a sudden revelation. We knew that nothing had changed. But suddenly the whole world can see what's going on in the production of medicine in terms of what's going on in the production of vaccines. And, you know, I'm sad that up to this point, the social response to COVID-19, the civil society response to COVID-19, that there's some overlap in activists, you know, here in South Africa, the treatment action campaign, but the lessons don't seem to have been, been learned. And the pharmaceutical companies around COVID-19 are behaving so brazenly, so astonishingly, so unashamedly in exercising their sovereign powers over countries that it's breathtaking. Yeah, absolutely. The brazenness has been quite astonishing because they've always had PR teams, right, to couch what they're doing and couch what they're putting out there. I think from the question of who controls science and the outcomes of science, I'm going to move to another part of science, and that's denialism. You know, the sort of denialism that I think South Africa really taught us about South African activists, taught us how to take on age denialism and really push science and evidence-based policymaking at the center of any approach or any addressing any public health issue. And yet again, here we are in the middle of the COVID-19 pandemic, and we are back to policymakers, our leaders, who are either unwilling or unable to follow the science. Where do you think health movements go with actually nature and evidence-based policymaking comes back? I think it's, I'll say two things. One is that I think it's a bigger problem that face social justice activists, whatever the issues that we're working on, that governments can generate science. They can generate knowledge. But for one reason or another, they choose not to use that science and that knowledge. You see it in relation to the climate crisis, you know, the amount that we know now about global warming. The world should be moving much more expeditiously on that question. And again, as you know, this will overlap with, it's already not will, it's already overlapping with disease and with pandemics and so on. You know, when it comes to COVID-19 and HIV, I don't think, you know, in South Africa, we had a president who bought into the denialism a bit like your president in India has bought into COVID denialism and Trump bought into COVID denialism. And we had a big distracting battle for five years. And that battle cost 400,000 lives because of delaying treatment. You know, this time, more governments around the world say that they are working with the science. They keep on saying, we're following the science. But what does it mean to follow the science? What it doesn't mean is that you act in the way and with the gravity and with the urgency that the science requires you to act. We don't see that. But I'd also say, Kajal, that something new we've seen with COVID-19 is that medical science is used to the exclusion of all other science, to social science in particular. So I'm very critical. I'm not a denialist for a second. I know COVID exists and is killing people and we need vaccines and so on. But the way governments have responded with these with these iron fisted lockdowns that have broken economies that have left poor people without access to foodstuffs, without access to social services, etc. Ignores everything we learned in HIV about communication, about behavior change, about social solidarity to deal with problems and so on. So I despair, frankly, it's a discussion that we have to have as activists, not just as health activists or HIV activists or treatment activists. It's a discussion we have to have as social justice activists, whatever we work on, as to how we operate in an environment where the use of science is selective and never sufficient to meet the actual challenge that science shows us is in front of us. Absolutely. I think that brings me really nicely to the last part of what I'm going to ask you to sort of comment on. And which has been always the most inspiring part of HIV epidemic and the pandemic is the role of communities and of health movements. We've seen that it is when communities take power, when they demand action, demand accountability, demand justice, that is really truly when you deal with the pandemic. And yet, you know, I think when you talked about, you know, the importance of being self critical, we haven't seen that getting replicated in other areas. And so right now in COVID-19, there's a huge struggle with people at the center of the response, how you reflect on the HIV movement, how it evolved, and the lessons both good and bad in terms of creating alliances, in terms of creating, of taking our lessons and moving it outside of the HIV sphere. And what do you think, where do you think we need to go with this? Both with COVID-19, but also in the future? Gosh, that's a big, big, big question. That's why I'm glad I'm asking it. Another whole interview for that. You know, HIV taught us, all of us, about the power that we have. This is an age in which poor people feel very disempowered and very marginalized. But the struggle around HIV, certainly the struggle we waged in South Africa, made the poorest people, the most vulnerable, the most marginalized women, black people, people living with HIV, unemployed people, realize that they had power when you mobilized that power together, using democratic rights to protest, using the courts, using science, learning science. But you can only ever build that power by turning to your communities. You know, you achieve nothing on the stage of politicians and governments if you don't have power behind you. The reason we won at times on HIV was because we weren't just NGO bureaucrats sitting in Geneva and New York, talk, talk, talk, talk, talk. We had power behind us quite, quite often. And they knew that we had power. We had power to shame. We had power to litigate. We had political power because they were also scared that, okay, what if these people use this power in an election to denounce us? And it was particularly so in South Africa because we had a new government, you know, after liberation and they felt very vulnerable and they felt that they must show that they're progressive and they care about poor people, et cetera. So there were lessons about how did we build that power. There's maybe not time to talk about it, but you know, we learned the science. We taught people about law. We taught people about healthcare systems. We taught about our own health. We practiced internal democracy around gender, around race, around equality, et cetera. It was a great movement. It was fantastic to be part of it. And I think, you know, it was the greatest human rights movement of the 21st century so far because as a result of that human rights movement, we put 25 million people across the world on antiretroviral treatment. And again, you and I remember when there was not one person in the public sector on antiretroviral treatment. But you know, to answer the second part of your question, I feel as if we lost some of that power and why we lost that power is something that we need to discuss. But I do look at activism and I'm still an activist. I'm not so much on the front line because I think younger people need to lead. And I think, you know, women need to lead and so on. And it's not for people like you and me or me in particular to, you know, to want to be activists, permanent leaders for life in activists movements. We must move on and find other ways to contribute and to build the movements that we work with. But I do feel that the new movements haven't learned those lessons. And like on the COVID thing, you talked about putting people at the center of the COVID response, which is not happening. But I feel a lot of activism at the moment around COVID. And I'll say this, I know people won't like me to say this, is lazy. It's talking above communities. It's using a language that's not resonating with the poor people who are not going to get the COVID vaccine, etc. There's been not enough going into communities to do COVID literacy, COVID vaccine literacy, COVID pharmaceutical company literacy, etc, etc. And unless you do that, we're not going to catalyze the moral outrage that we keep talking about that was so important, etc. You know, activists can scream from the rooftops, and they can be right all of the time. And we are right most of the times because we're on the side of justice. But screaming from the rooftops, power has learned how to deal with that. So unless you build a contending power, then we won't make progress. And that's, I think, really our challenge. I mean, it's a big important question that I think needs people like us and many others to get together and spend days, several days dissecting and thinking how are we going to do things differently from now on. But I still feel confident that despite the difficulties that we face in the world, we have power. Citizens still have power wherever we are, just how we build it. Absolutely. Thank you so much, Mark. Like you said, I think this is like a conversation that could go on for days or weeks or months actually dissecting. But I think it's crucial that we do that because along with the reflections, you have to think of where the foundations for the future are for the future of activism for the future of health movements. And I think it's been defined as we live and breathe. I mean, sometimes, you know, these are dystopian things that you think about novels and we're living through it. And if we don't use this opportunity to rethink what we did for the last several decades, it's laying the foundations for what's to come is going to get even trickier. Thanks so much, Mark, for taking time and on such an important day for you in South Africa. And thanks to the People's Health Dispatch for allowing me to have this conversation with Mark. These are opportunities that are few and far between and we have to make them much more common, I suppose.