Watch: Mandela Asked This Harm Reductionist, “How Can I Be Helpful?”

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    Dr. Kgosi Letlape has been a passionate and relentless activist on the side of “the underdog,” as he puts it, for most of his life.

    An ophthalmologist in South Africa, Letlape is the former chairman of the South African Medical Association and a co-founder of the Africa Harm Reduction Alliance.

    In our filmed interview, he told Filter how South Africa’s devastating HIV epidemic has profoundly changed him, shifting him from “not just activism of talking, but of action and making things happen.”

    Dr. Letlape became a leader in the fight for access to lifesaving antiretroviral medication, in a country with the world’s largest population of people living with HIV.

    “Part of the reason injustices will prevail is when ordinary citizens are not properly informed and not mobilized.”

    Much of his work involved confronting widespread misinformation about HIV transmission. He enlisted the help of then-President Nelson Mandela to fight the massive stigma around the disease, but explained that it was people living with HIV in South Africa who had to “take to the streets” to make change.

    “We need to mobilize people,” Letlape said. “Part of the reason why injustices will prevail is when ordinary citizens are not properly informed and are not mobilized.”

    One appalling injustice is that over 42,000 South Africans die annually of smoking-related diseases. In more recent years, Dr. Letlape has turned his HIV activism into tobacco harm reduction activism.

    These two struggles to keep people alive have many similarities, he noted. Both concern vulnerable and marginalized populations, and both have been plagued by disinformation and stigma.

    “We need to speak up as physicians,” Letlape said. “We see people at the end of life who are dying from smoking-related diseases and are suffering … People who have chronic coughs and disabilities. Lives are shortened.”

    All of this is needless when safer nicotine options exist, and Letlape opposes the anti-tobacco harm reduction stance of the World Health Organization, which will hold its global tobacco control conference, COP10, in Panama in early February.

    In the video, he appeals to the WHO to “stop misinforming the public about the degrees of harm associated with noncombustible forms of nicotine.”

    Despite the preventable devastation he’s spent his life fighting against, Dr. Letlape remains an optimist. “In the long term,” he said, “truth shall reign.” 



    • Helen is Filter‘s senior editor and a multimedia journalist. She is on the methadone, vaping and nicotine train. Helen is also a filmmaker. Her two documentaries about methadone are Liquid Handcuffs and Swallow THIS. As an LCSW, she has worked with people who use drugs for over two decades. Helen is an adjunct assistant professor and teaches a course about the War on Drugs at NYU. She lives in Harlem.

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