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Aids: Misunderstanding Mbeki
Posted: Saturday, September 29, 2001

A July 11 editorial in The Boston Globe entitled "Mbeki's Blinders on AIDS" tells us that the "tragedy of President Thako Mbeki's speech Sunday is that it reinforces a culture of denial and confusion in South Africa." The real tragedy, which such commentaries exemplify, is an American culture of blame--blame attributed to Africans and a South African government that the editorial immodestly claims "is unwilling to make HIV prevention a national crusade."

By decrying Mbeki's government in such fashion, the Globe, like many other American press agencies who have commented on Mbeki's speech, has manufactured an enemy of Western beliefs whose opinions are nothing short of the ravings of said "cultures of denial." But are his words and those of his colleagues really just products of denial and confusion?

Mbeki's Health Minister, Manto Tshabalala-Msimang, has said, "It is inappropriate to blame everything around this epidemic on the HIV virus...clearly, the relationship between HIV and other social ills afflicting our society such as poverty and disease is complex." Mbeki himself, in his opening speech at the Durban AIDS conference, reiterated this central argument: alleviating poverty and social inequalities will play a pivotal role in conquering the African AIDS crisis.

Should poverty really be a priority in conquering African AIDS? Despite damning evidence, showcased both in the scientific literature and in the popular press, the Globe's editors say "no". "Mbeki ignores the reality [emphasis ours] that AIDS exists independent of economic circumstances," they claim. As evidence, they cite American gay men, "as affluent as the rest of US society in the 1980s, when the virus raced through their ranks." The editors credit positive outcomes among this population to the "effective
public health campaign" gay American men conducted in response to the AIDS threat.

But the firm and simple "reality" that AIDS prevalence is unrelated to economics is no reality at all. Recent CDC reports indicate that HIV incidence rates are growing fastest among poor young black and poor American women. Poverty has, in fact, been established as a key determinant for both HIV infection and the subsequent acquisition of AIDS. MORE

The ten thousand strong AIDS 'community" had been outraged by earlier comments attributed to the Head of State now hosting the first world AIDS meeting ever held in a non western country. Was Mbeki with them or against them? It was a question that grew out of a simmering controversy that began month earlier when the South African President spent a few nights conducting personal research on the Internet. It led him to the views of a handful of dissident doctors and researchers who had been challenging the conventional scientific wisdom about the origins of the AIDS virus for years.

He quickly began wondering aloud if South Africa's AIDS fighting program was on the right track. Staring down the barrel of drug costs that could bankrupt his treasury and plans for economic development, he provoked a debate about the proper strategies to pursue that is still reverberating globally.

Critics quickly elevated his stance into a heresy after he invited some of those dissidents to take part in a presidential advisory panel (which also included many mainstream researcher.) The 30 member group was charged with investigating some critical issues, including the accuracy of Aids tests, the safety of certain highly toxic anti-viral drugs like AZT which has been relatively effective in blocking transmission of the disease from mother to child, and the charged issue of what causes AIDS. Does HIV lead to Aids, as most scientists insist, or are there other causes and contributing factors? It will make its report at the end of the year.

Mbeki never openly denied an HIV-Aids link but his aggressively inquiring attitude appeared to many as if he that's what he was doing. Such questioning was viewed as a distratcion, evidence that he was in denial about an infection that the UN says is present in ten percent of the country's population, or some 4.2 million people, more than in any other comparable country.

For daring to challenge the consensus, Mbeki fell, in the words of a high level White House AIDs official I spoke with, "off the program." Soon he turned into a pariah and subject for ridicule in the world press, trashed by 60 Minutes in the US and criticized by one of South Africa's leading intellectuals Dr. Mamphela Ramphele for "irresponsibility bordering on criminality."

5000 researchers and scientists world-wide issued a "Durban Declaration" to rebuke him, insisting that that HIV causes Aids, full stop. End of story. His defensive press secretary dismissed their statement as fit for the "dustbin." Local political pressure was then brought to bear on those behind the declaration to cancel a planned press conference that could turn embarrassing. Feelings polarized. Over coffee in my hotel, an HIV positive ACT UP militant from Brooklyn New York snarled, "Mbeki should be impeached and arrested." MORE

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