22 March 2006

South Africa: Health Officials Promote Untested Ubhejane

Hundreds of desperate HIV positive people from all over the country are flocking to a Durban office to buy an expensive herbal treatment that they hope will cure them of AIDS.

The Health Minister, the KwaZulu-Natal health MEC and eThekwini's mayor have all encouraged people to take the product, uBhejane, while its main promoter is Professor Herbert Vilakazi, special adviser to the KwaZulu-Natal premier.

Nurses at Willowfontein Clinic in Pietermaritzburg recently told patients that they could put their names on a waiting list for uBhejane "because it is going to be rolled out like ARVs".

Zeblon Gwala, who makes uBhejane from a secret recipe, says he tells all those who want to take his product that they must choose between it and antiretroviral drugs as uBhejane cannot be taken with ARVs.

But scientists and AIDS experts caution that it is far too early to tell whether uBhejane is effective in fighting HIV.

Professor Nceba Gqaleni, Deputy Dean of the University of KwaZulu-Natal's Medical School, says his preliminary laboratory tests on uBhejane have revealed little more than that the mixture is not toxic to cells grown in test tubes.

"I want to state categorically that I have not performed any studies on humans," says Gqaleni, who is a member of the World Health Organisation's expert committee on traditional medicine for Africa.

"A clinical trial on humans still needs the approval of my institution's ethics committee as well as the Medicines Control Council. The work I am doing is attempting to see whether it will be worth conducting any work on uBhejane."

Gqaleni is angry that Vilakazi has made public part of an early report he gave to Gwala as he believes it is misleading to those who don't understand scientific studies.

Professor Salim Abdool Karim, the university's Pro Vice-Chancellor for Research, has also urged uBhejane's promoters not to make out that the university believes uBhejane is effective against HIV as this is "way too premature".

Gwala, who says he is not a traditional healer but a former truck driver, claims that the ingredients for uBhejane came to him in dreams from his healer grandfather.

He claims that he personally collects the 89 herbal ingredients from all over Africa and mixes them manually.

Patients buy the brown, bitter, smoky-tasting uBhejane liquid in unlabelled 2 litre plastic milk bottles. New patients are told to start with two bottles for R342, one with a blue lid and the other with a white lid. This lasts for two weeks and after that, they just need the blue-lid bottles, says 50 year-old Gwala.

"The one with the white lid is for improving the CD4 count and the one with the blue lid is for bringing down the viral load," explains Gwala, who dresses immaculately, drives a new 4x4 and a new Volvo and lives in an upmarket Durban suburb.

Potential buyer Vuyiswa (who asked that her surname not be used) said she and others who went to Gwala's office to buy uBhejane were told by the receptionist that they would be cured of HIV after six months.

"While I was there, a woman came in very sick and being helped by her mother. She said her CD4 was 18. She said since taking uBhejane, her stomach had been running. But they told her it was because she was still taking ARVs and that she should stop taking ARVs."

Businessman Ceaser Ngcobo has joined forces with Gwala to make the business more professional. He is busy registering uBhejane Company with himself, Gwala and Vilakazi as partners, despite claims by Vilakazi that he is merely Gwala's "advisor" and is not connected to the business.

Both Gwala and Vilakazi say they have met Health Minister Manto Tshabalala-Msimang many times since 2003 when they first made a presentation to her on uBhejane.

Gwala says it was the minister who told them to develop a protocol for uBhejane so that it could be studied at the Medical University of SA (Medunsa), now the University of Limpopo Medical School.

But Sibani Mngadi, the health minister's spokesperson, says that the Minister "has never promoted one traditional medicine over another" and the uBhejane was one of a number of traditional products that the department wanted researched.

Professor Wim du Plooy confirmed that Medunsa's ethics committee had given permission for an observational study on uBhejane, following an application from Dr Sam Mhlongo, a well know AIDS denialist and close associate of Tshabalala-Msimang and Dr Patrick Maduna, both from the university's family medicine department.

Maduna reported in 2004 that the study, which involved observing 24 people taking uBhejane over three months, had found that while uBhejane not an AIDS cure, it was not toxic, stimulated patients' appetite and enhanced their feelings of well-being.

But, says Gqaleni, "this study is not equivalent to a clinical trial and the researchers never found uBhejane to be efficacious given that you need to conduct such a study for a minimum of six months".

Gwala and Ngcobo say provincial health MEC Peggy Nkonyeni has also helped to open doors for them. Both she and Tshabalala-Msimang recently recommended to the mother of the Deputy President, who runs a Durban hospice, that she should give uBhejane to her patients.

However, Nkonyeni's spokesperson Leon Mbangwa said that the MEC "supports any businessman who benefits the people" and "any research that might help to find a solution to the AIDS epidemic, as long as that it within the law of the country".

EThekwini mayor Obed Mlaba is also supporting uBhejane, and is sponsoring its supply to patients at the Catholic Mater Consales Hospice in Inchanga.

The hospice's Sister Petra Mthethwa confirmed that the mayor was sponsoring uBhejane for patients. Mlaba was not available for comment as he was preparing for his re-inauguration.

Mthethwa said deaths at the hospice had decreased since patients started taking uBhejane, but could not provide further details.

Two patients, Khathazile Mlaba and Libelephi Magcaba, who had been at the hospice for a month reported feeling much better. However, no doctor is monitoring their progress and it was not clear whether uBhejane, TB medication or regular meals were responsible for their improvement.

While Gwala says that he keeps records of his patients, he could not supply details of those who had improved their CD4 counts (measure of immunity) and decreased their viral loads (copies of virus in their blood) since starting uBhejane.

"I do keep files but there are so many and I don't know which has these things in it," he said. One of his first patients, his younger sister, had since died of complications from an operation, he added.

Future study of uBhejane is complicated by the fact that Gwala refuses to divulge its ingredients. Even Gqaleni, who has signed a confidentiality agreement with Gwala, does not know what is in it and says "I don't know whether my ethics committe will give permission to do human trials without this information".

Last week, the Democratic Alliance laid a charge of fraud against Gwala. But Gwala, who has yet to be charged, asks why the party has singled him out when there are "many people selling their muti on the pavements".

Mngadi says that while the department is working on regulatory framework for traditional medicine "we cannot deny those who find benefit in traditional medicine from continuing to use it.

"If people are told by a traditional healer that they cannot take traditional medicine and ARVs, they must make their own decisions," said Mngadi.

Meanwhile, Gqaleni says that he is studying uBhejane because "I would be proud if something good came out of Africa to fight AIDS".

But, he warns, "this needs to be well researched and well proven because we don't want to make Africa the laughing stock of the world".

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