By Bhavya Kalra

The perspectives shared in this interview are those of the participants and do not necessarily reflect those of McGill University, the Faculty of Medicine and Health Sciences, or McGill Global Health Programs.

Zackie Achmat is a lifelong socialist and activist who began his political journey during the 1976 student uprisings against apartheid. Detained and tortured as a teenager, he was later recruited into the banned ANC while imprisoned and joined its Marxist Workers' Tendency in 1985. Diagnosed with HIV in 1990, Zackie became a pioneering advocate for health and human rights. He co-founded the National Coalition for Gay and Lesbian Equality in 1994 and the Treatment Action Campaign (TAC) in 1998, playing a key role in securing access to HIV treatment. He has worked with global organisations like Médecins Sans Frontières and the WHO, and helped found movements such as Equal Education, the Social Justice Coalition, Ndifuna Ukwazi, and #UniteBehind. These initiatives fight for justice, political accountability, and social equality. Most recently, he co-founded the Global Coalition for HIV Treatment to resist devastating PEPFAR cuts. His activism is rooted in justice, dignity, and freedom.

“Hope is passive; resolve is active. That’s why I believe in resolve, not hope.”

Zackie Achmat says this with the calm certainty of someone who has lived it—not as a slogan, but as a hard-earned philosophy. He speaks as someone who has watched history repeat its cruelties and yet refuses to stop believing in humanity’s capacity to act. For him, hope without movement is sentiment; resolve, by contrast, is the discipline of those who keep going even when optimism feels like betrayal.

Zackie Achmat has spent nearly fifty years in political struggle, from anti-apartheid organizing to the founding of the Treatment Action Campaign (TAC), which transformed global access to HIV treatment. McGill Global Health Programs (GHP) looks forward to welcoming Zackie as the keynote speaker for Global Health Night 2025 on November 6th, 2025. As the first recipient of the Paul Farmer Award for Global Health Equity, he will deliver the inaugural Paul Farmer Lecture. Although the in-person event is now full, you can still register here to watch the live webcast online. During the interview, we spoke about the indivisibility of justice, the politics of despair, and why loving the world sometimes means confronting its failures without flinching.

What is a piece of your story that people often miss but that you wish shaped how they hear the rest of this conversation?

“I think perhaps the most important part of my identity, and I don’t believe in intersectionality, I believe in indivisibility, would be the fact that I’m a socialist, and everything I do and understand of the world is influenced by that,” Achmat begins.

He doesn’t separate his personal history from his politics. “Everything I know about justice,” he continues, “comes from the people who raised me.”

His worldview was formed in a household where books and politics intertwined. As a child, he read to his grandfather, an experience he calls the foundation of his lifelong education. And even though he identifies as an atheist, Achmat grew up in a Muslim household that deeply valued learning:

“The first revealed chapter of the Quran says, ‘Read in the name of your Lord.’ That is why my family encouraged study and reading.”

But his intellectual life, he tells me, was also profoundly shaped by Jack Lewis, his first lover and lifelong friend. “Jack was like my mother,” he says softly. “We worked together at an art movie house, we read together, and we bathed together, literally, discussing philosophy, history, politics, and poetry.” It was Lewis who introduced him to environmentalism, Marxist theory, and the intellectual traditions that would later inform his activism. “He explained the cattle killing, Althusser, and the history of South Africa—all in the bath,” he laughs.

He also speaks candidly about mental health. “I’ve lived with depression for more than fifty years. My mother was institutionalized several times, so there’s a genetic disposition.” Reading, he says, became both refuge and resistance. “I still read the Financial Times every day. My reading is extensive, from boring policy documents to great novels.”

“I think the fact that people don't know about my politics, my love, my understanding of culture, and everything other than HIV and sometimes queerness, is for me like, oh, come off it. I'm much more than an HIV-positive t-shirt.”

You mentioned that you love reading. If you could press one book into the hands of every first-year at McGill who wants to work in health justice, what would it be and why?

He laughs. “No, that would be the worst thing to do. I would give you a thousand books.”

But he settles on two: Bury the Chains and King Leopold’s Ghost by Adam Hochschild. “It’s about the abolition of the slave trade, the first international political movement, the role of Quakers and trade unions. It’s one of the most contemporary books about solidarity.”

For Achmat, the lessons of abolitionism still matter today, and he furthers it by saying, “If we are serious about fighting fascism, about preventing nuclear war, about the right of Palestinians to self-determination, then we must be internationalists. We must organize locally and understand what it means to be human.”

Of all the early Treatment Action Campaign moments, is there one scene that you replay because it explains why you do this work?

Achmat recalls one day vividly: May 10, 2000.

“Christopher Moraka, a poor man living in a shack, testified before Parliament. He could barely speak as he had systemic thrush”, also known as “esophageal candidiasis.”

“But he spoke about stigma and discrimination, about coming out, about poverty, and he spoke very clearly about the rights to life and health care, and then also on the fact that Pfizer was making a billion dollars profit on fluconazole. And suddenly, the room shifted. For the first time, Parliament saw expert knowledge coming from lived experience.”

That moment led the Treatment Action Campaign to openly defy patent laws and import medicines illegally, but openly. Achmat says, “And ultimately we built the most fantastic alliances. I was present when the Pfizer meeting was disrupted. Shareholders’ meeting was disrupted in New York, with activists from the Dominican Republic on the one hand, to India and Thailand on the other, from Brazil to Ukraine. And obviously the heart of international activism was in the United States with ACT UP Paris and we defeated the drug companies as a consequence.”

We are witnessing global health programs wobbling under funding cuts. If TAC was a push to make an unresponsive system move, what push do we need now?

“Trump and Musk put twenty million people in Africa on death row with the stroke of a pen,” he says, referring to the recent U.S. aid funding pauses. “Clinics have shut down. It’s not just public health; it’s the global move toward authoritarianism.” Then, he adds the line he insists must stay on record:

“Please put this in your post: the world is a shit show.”

“We are living through a time when democracy is collapsing, inequality is deepening, and empathy is eroding. It’s not only in Africa; it’s everywhere.”

But even as he names despair, he quickly returns to structural critique. “Africa pays $89 billion a year in debt repayments”, which he says is “double the entire USAID budget. If we even cut that by sixty percent, we could solve our own problems. The next HIV movement must take on debt, trade, and global capitalism itself.”

In his analysis, global health cannot remain limited to its technicalities. It must confront financial imperialism, the historical, political and colonial roots of disease, and the moral bankruptcy of systems that price life itself. To Achmat, life is not just human; rights are not just human. And he says this with a lot of conviction and love, “I've come away from speaking about human rights to speaking about fundamental rights, because our mountains have rights, and so do our rivers, and so does any animal. So, in that sense, I think it's the value of all life that should form the basis of our struggle for justice, equality, and freedom.”

Many of us in global health are angry at these injustices. How do we best channel that anger?

“Anger is personal. Rage can be used collectively,” Achmat replies. “Don’t waste your hate—it only makes you feel bad. Rage, on the other hand, can be organized into action. Action doesn’t only mean marching; it means studying, connecting with communities, and finding solidarity.”

Achmat’s discussion of rage is not about romanticizing it, but about understanding the power it holds. I tell him how many of us, especially students, immigrants, or anyone trying to do good within systems that often feel impossible to change, carry this constant frustration. Further, I tell him how, as an immigrant student, I often feel paralyzed between care and constraint, wanting to protest, but fearing the cost of speaking up. “You underestimate the power that people have,” he says quietly. “Rage can be turned into collective action.”

What should people planning to attend the McGill Global Health Night expect to hear when you deliver the inaugural lecture in November?

He laughed when I asked him that. “A cranky old man,” he said. “Irascible, irritating, and probably getting lost in his own argument.”

Then his tone softened. “But seriously, I hope to challenge people, and myself. Whether it’s our liberation struggle against apartheid, or the fight for health justice today, all struggles are incomplete. Sometimes they even regress. But each one leaves something behind; a lesson, a seed, a friendship.”

He paused before adding, “I hope we can build comradeship, and remember that we’re not just here to learn from books. We’re here to learn courage.”

As we conclude, how do you interpret the Paul Farmer quote: ‘The idea that some lives matter less is the root of all that is wrong with the world’ and what would give you hope in the next six months?

“When the white Ukrainian’s life is valued more than the dark Palestinian’s, that echoes Paul Farmer’s insight. We cannot build justice on the belief that some lives are expendable.”

It was such a simple way to expand the idea of justice—one that reached beyond people and into the living world itself. For him, equality wasn’t just about fair treatment; it was about the interconnectedness of all forms of life, and the responsibility that comes with recognizing it. Justice, in Zackie’s words, isn’t an abstract ideal but a relationship. For him, it is a way of existing that beautifully honours what sustains us, whether that’s a person, a river, or a mountain.

Towards the end of our conversation, when I asked what would surprise him, or give him hope in the next six months, he smiled faintly.

“To see my garden grow,” he said. “I don’t hope. I resolve.”

That sentence lingered with me long after the call ended. It felt like a quiet summation of everything he’s lived, as a queer activist from South Africa who has spent decades organizing, protesting, and refusing to look away. His journey is proof that resolve isn’t born from certainty, but from endurance. Change, as he sees it, is never something to wait for; it’s something to build, nurture, and care for, even when the world feels unfixable.

And maybe that’s what his words offer to all of us working in global health; a call to act not out of hope, but out of love. The kind of love that insists on showing up, again and again, even when the world breaks your heart.

In Conversation with Zackie Achmat: Five Decades of Defiance, Love, and Resolve

By Bhavya Kalra

The perspectives shared in this interview are those of the participants and do not necessarily reflect those of McGill University, the Faculty of Medicine and Health Sciences, or McGill Global Health Programs.

“Hope is passive; resolve is active. That’s why I believe in resolve, not hope.”