BBC Africa analyst
Corruption and poor oversight have undermined South Africa's fight against HIV/ Aids, a new report says .
South Africa has an estimated 1.5 million Aids orphans
The authors, the Institute of Security Studies and Transparency International, say there has been a "potentially lethal cocktail of mismanagement".
They blame South Africa's president for questioning the link between HIV and Aids and say his stance has had an impact on the whole health system.
South Africa has the highest incidence of Aids in the world.
The report, titled A Lethal Cocktail, says 30% of the population is infected.
Politicisation of the disease has created numerous channels for abuse and is undermining attempts to counter it, the report says.
The authors conclude that it has become difficult to disentangle corruption from mismanagement and system failure as the root causes of the poor response to Aids.
Much of the responsibility is laid at the door of President Thabo Mbeki, whose well-known questioning of the link between the HIV virus and Aids has resulted in activists labelling him an "Aids denialist".
The report says that his stand has had an impact throughout the health system, creating numerous channels for abuse.
The authors cite an example of a doctor dismissed for allowing a rape charity to use a disused hospital, because they were distributing anti-retroviral drugs.
The local politician accused the doctor concerned of endangering black lives and threatening to turn South Africa into a banana republic.