He may be arriving at this conclusion by a route involving some indefensible detours, but the conclusion itself is sound. The stakes are high. Most of the infected South Africans will die of AIDS, leaving behind hundreds of thousands of orphans with fewer resources and adult caretakers than if AIDS had been kept at bay. The economy is likely to weaken as people in their working years fall ill. The world held its breath as South Africa moved essentially bloodlessly from apartheid to a stable democratic government.
Cost is the obvious barrier to drug therapy.
The history of another disease, tuberculosis, is sadly instructive. A wet pill is one that a patient puts under his or her tongue in the presence of a health care worker and then spits out later to sell. If South Africans had easy access to HIV drugs, imagine their black market value in the rest of sub-Saharan Africa, where there are virtually no medications. A more immediately compelling issue is transmission of HIV from mother to child. But in a way his stance is perfectly rational.