JOHANNESBURG, South Africa - Former South African president Nelson Mandela announced Thursday that his son, Makgatho Mandela, 54, had died that morning of illness related to AIDS, and he urged other families to speak openly about the toll of a disease that has ravaged South Africa but is still widely regarded as taboo.
Mandela, though 86 and increasingly frail, has mounted a highly public crusade against AIDS in the past several years. He called reporters to his suburban home to make the announcement just hours after Makgatho, an attorney and father of four, died at a nearby hospital.
"My son has died of AIDS," Mandela said, ending weeks of speculation that Makgatho had the disease. He compared his son's illness to his own struggles with tuberculosis and prostate cancer, and he asked all South Africans to treat AIDS as an "ordinary" disease rather than a curse for which "people will go to hell and not to heaven."
His only other son died in a car accident in 1969.
Mandela, who won the Nobel Peace Prize for his battles to end apartheid, has acknowledged doing too little to combat AIDS during his presidency from 1994 to 1999. Since then, however, he has repeatedly urged testing and treatment, and also promised to be open if any member of his family died from AIDS.
"That is the only way of making an ordinary illness ordinary instead of following those who are not well informed," he said Thursday.
More than 5 million South Africans are infected with the HIV virus - the largest number of cases in the world - at least 1,000 a day die from AIDS, according to the United Nations. Like Mandela, other regional leaders have also become increasingly forthright about the need to combat AIDS despite cultural resistance to public discussions of it.
However, the country's current president, Thabo Mbeki, has done little to promote the issue and rarely talks about AIDS. He became embroiled in controversy several years ago for suggesting that factors other than HIV cause AIDS. After being re-elected in April, he mentioned the disease only in passing during his inaugural.
A spokesman for the Mandela family, Isaac Amuah, said in a phone interview that the immediate cause of Makgatho's death was complications from a gall bladder operation. But he said that AIDS was a contributing factor, and that Mandela was determined to portray the death as resulting from AIDS in order to demystify the disease.
Mandela's announcement was immediately applauded by AIDS activists and political leaders in a country where stigma about the disease runs deep. Shame and fear remain major barriers to treating AIDS, even where drugs that can reverse the damage are available, according to doctors and researchers.
Death announcements in newspapers routinely refer to someone having suffered from "a lengthy illness" or pneumonia, instead of listing AIDS as a cause of death. Victims of AIDS are sometimes said to be cursed by witchcraft, and in some communities they are shunned.
"For senior people to be brave enough to involve their entire families is the only way to beat stigma," said Francois Venter, a Johannesburg AIDS physician.
African leaders have increasingly been outspoken in addressing AIDS and its toll on their own families. A one-time political rival of Mandela, Mangosuthu Buthelezi, has spoken publicly about the deaths of two of his children from AIDS. Zimbabwe's President Robert Mugabe revealed an AIDS death in his family. And Zambia's former president, Kenneth Kaunda, has spoken openly of the death of his son from an AIDS-related illness in 1986.
The eagerness of Mandela and others to discuss the disease in recent years has made Mbeki's silence all the more obvious, although Mandela on Thursday declined to answer a reporter's question about Mbeki's handling of AIDS.
"There's an enormous contrast," said Zackie Achmat of the Treatment Action Campaign, South Africa's most prominent AIDS activist group. Of Mbeki's low profile on the issue, Achmat added, "It adds to the stigma. ... It denies a name to the illness of people."
The government's slow response to the spread of HIV has raised widespread criticism among health experts. Until last year, the public health system did not provide antiretroviral drugs, which can reverse the deterioration caused by AIDS. Antiretroviral drugs are gradually becoming available, but most victims wait to seek treatment until they're too sick to benefit from them.
Makgatho, whose wife Zondi died of pneumonia in 2003, had been receiving antiretroviral treatment for more than a year, said Amuah, his brother-in-law. The medicine appeared to restore Makgatho to full health, but he deteriorated abruptly in the days after a gall bladder operation Nov. 30. Mandela, who learned of his son's diagnosis with AIDS last year, canceled several public events to be at his son's bedside in recent weeks.
"He had other medical problems," said Amuah. But of AIDS, he added, "It's a contributing factor. We cannot deny that."
Makgatho was one of two sons of Mandela and his first wife, Evelyn. The other son, Madiba Thembekile, died in a car crash in 1969 while his father was in prison, serving what would become 27 years for his role as a leader of the African National Congress.
Mandela had four daughters as well, one of whom died as an infant.
Makgatho kept a relatively low profile as the eldest son of an international icon. Mandela said little about his personal relationship with his son at the news conference, but in his autobiography, "A Long Walk to Freedom," Mandela speaks affectionately about discussing politics with his son and explaining the nature of racial oppression.
Also at the news conference was Makgatho's son Mandla, who described his father as strong and loving. "We were very proud to have a man such as our father to father us," he said. "He has been the pillar of our strength."
