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Africa: Mbeki's Aids Denial - Grace Or Folly? Part III

William Gumede

2 May 2008

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opinion

Pambazuka News continues to serialize William Gumede's chapter on Mbeki and the controversies surrounding his AIDS policies. This is from his book "Thabo Mbeki and the Battle for the Soul of the ANC." Be sure to look for parts four and five in upcoming issues.

What made Mbeki turn to the AIDS dissidents? In July 1999,Anthony Brink, an advocate and the author of the online book Debating AZT, had given him and senior health department officials copies of his book, which argued that the so-called life-giving drug was highly toxic.[33] His interest aroused, Mbeki began doing further research on his own, via the Internet.

While surfing the Net, he stumbled on virusmyth.net, a website favoured by the international dissident community. On 28 October 1999, Mbeki told the National Council of Provinces that he had examined 'a large volume of scientific literature', which showed that AZT was dangerous.[34]

The orthodox scientific community has never claimed that AZT is not toxic, but makes the point that all drugs have side effects, and that those known to be caused by AZT were far outweighed by its benefits to AIDS patients.

But Mbeki had been seduced, and before long his meanders along the inform- ation highway led him to question whether HIV caused AIDS and whether the virus was sexually transmitted.The dissidents argued that HIV was a benign 'passenger virus', and that AIDS was a lifestyle disease caused by poverty, malnutrition and narcotic abuse by homosexuals. They claimed that, far from helping the infected, ARVs caused even greater damage to their compromised immune systems.[35]

The World Health Organisation and the MCC had classified AZT safe, but Mbeki, newly installed as South Africa's president, decided that his health minister, Manto Tshabalala-Msimang, would be entrusted with determining the 'truth' about the disease and its treatment once and for all. On 2 December 1999 she met with AIDS dissident Charles Geshekter, and came away from their discussions convinced that the president was right to question views that had already gained wide international acceptance.

In his nocturnal online research, Mbeki also found the writings of American biochemist David Rasnick, a leading rebel against the conventional premise that AIDS stems from HIV. Mbeki contacted him by fax and spoke to him at length by phone, and soon the two were in regular e-mail contact. Rasnick enthusiastically agreed to support Mbeki's quest for the 'truth'. The president also made contact with another prominent AIDS dissident, Peter Duesberg, a professor of molecular and cell biology at the University of California in Berkeley.

There was a major stir when a South African newspaper published Rasnick's assertions that 'condoms don't prevent AIDS because AIDS isn't a sexually transmitted disease. In fact it isn't contagious at all. AIDS in Africa is just a new name for the diseases of poverty caused by malnutrition, poor sanitation, bad water, parasites and so on. Using condoms to prevent the diseases of poverty is the leading obscenity of our time.'[36]

Mbeki was sincere in challenging mainstream science and in his support of AIDS dissidents. He stoically believed that he was a modern-day Copernicus who would ultimately be vindicated, even if posthumously. Needless to say, the dissidents, long banished to the scientific wilderness, latched on to the new legitimacy that the president provided, and it would prove all but impossible for Mbeki to dissociate himself from them later.

His next mission was to persuade unsuspecting world leaders of the dangers of treating AIDS with conventional methods. In a brazen and bizarre letter to Bill Clinton and UN secretary general Kofi Annan dated 3 April 2000, South Africa's head of state defended an alternative approach to dealing with AIDS. In the five-page document, Mbeki passionately defended Duesberg and the other dissidents, and suggested that factors other than HIV could be the cause of AIDS in Africa. He called for a uniquely 'African solution'[37] to the problem, as AIDS seemed to affect Africans differently to those who live in the developed world. He also defended his right to consult dissident scientists, and accused unnamed foreign critics of waging a 'campaign of intellectual intimidation and terrorism' akin to 'the racist apartheid tyranny we opposed'. In an earlier period in human history, Mbeki wrote, Duesberg and his followers 'would be the heretics that would be burnt at the stake. The day may not be far off when we will, once again, see books burnt and their authors immolated by fire by those who believe that they have a duty to conduct a holy crusade against the infidels.'[38]

The letter, copies of which were delivered by hand to Clinton and Annan, concluded: 'It would constitute a criminal betrayal of our responsibility to our own people to mimic foreign approaches to treating HIV/AIDS.'[39]

The Clinton administration initially thought the letter was a hoax. Upon realising it was genuine, the contents were leaked to the Washington media. Mbeki was suitably embarrassed, and furious, convinced more than ever that Western leaders were conspiring against their African counterparts.

Bolstered by the counsel of the AIDS dissidents, Mbeki and Tshabalala-Msimang reiterated that the government would not provide ARVs through the public health system, adding the inability of existing infrastructure to implement the drug protocols to their earlier claims of toxicity and cost. Tshabalala-Msimang now argued that anti-AIDS drugs alone would have scant effect, and that the state simply did not have the money to simultaneously offer recipients clean water, sanitation, nutritional food and adequate housing.

Mbeki would charge his AIDS critics, especially those who were ANC members or belonged to the TAC, of being willing 'to sacrifice all intellectual integrity to act as salespersons of the product of one pharmaceutical company.'[40] Later, he would use this accusation again, to attack ANC MPs critical of his policies,[41] and when he opened the international conferences on AIDS in Durban in July 2000, he lambasted activists in the same manner. He blocked every effort by civil society and private organisations to set up AIDS treatment projects involving ARVs, prompting Desmond Tutu to comment: 'In South Africa we have to introduce a vibrant and lively education for the people. Churches and religious communities are already playing a role but are hamstrung by the constant worry about what government will say, when they ought to be on the same side.'[42]

Mbeki has consistently placed poverty at the heart of all South Africa's health problems, and few disagree with him, in general. But he found no broad support for his insistence that AIDS should be treated as just another disease, like malaria or TB.The scariest realisation for many people was that Mbeki genuinely believed that a number of factors, including poverty, caused rather than exacerbated AIDS, and that HIV was not to blame.

Tshabalala-Msimang drew hoots of derision when she famously announced that people with AIDS should preserve their health not with drugs, but with a diet of garlic, lemon, olive oil and the African potato.[43] In March 2003,her credibility took another dive when she appointed Roberto Giraldo,a leading AIDS dissident and one of the most vocal naysayers regarding the link between HIV and AIDS, as a consultant on nutrition.

Amid mounting evidence of AZT's effectivity and growing criticism of the government's opposition to ARV distribution, he Mbeki-ites began searching for compliant scientists who would support them.

In October 1999, Tshabalala-Msimang had rejected a report favouring the use of AZT by South Africa's MCC on the grounds that it had not been subject to a satisfactory review process. A month later, she commissioned the Cochrane Centre, an international health-care NGO that reviews clinical trials on new drugs and has branches all over the world, to research the risks of ARVs, especially AZT. Their preliminary study found strong evidence that both an intensive or shorter course of AZT was effective in decreasing the risk of mother-to-child transmission of HIV, even in breastfed babies. The most serious adverse effect the researchers identified was anaemia, but this condition tended to disappear once the full course of drugs had been concluded. Nevirapine, less expensive than AZT, was found to be both safe and effective.

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