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South Africa: The ANC government and the AIDS crisis
By Barry Mason
5 July 2000
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South Africa currently has four million HIV/AIDS cases and
the figure is projected to rise to 7.5 million by the year 2010.
Yet the ANC government of President Thabo Mbeki has no effective
programme to tackle the developing catastrophe. The government's
National Council of AIDS does not even have representation from
members of local AIDS community groups, health professionals,
activists or voluntary bodies.
In 1997 South Africa attempted to obtain cheaper versions of
the AZT drug treatment which is available in most western countries.
It was blocked by the world pharmaceutical industry, which took
up a law suite against alleged breach of intellectual property
rights. Even at the lower prices which some companies have now
agreed to charge, the South African government says that it is
unable to fund the drugs, even for HIV-positive mothers or for
rape victims.
Rather than take up any challenge to the pharmaceutical corporations'
drive for profit, President Mbeki has recently taken a different
tack. He implied that AIDS in Africa was a different phenomenon
from AIDS in the West. Furthermore he publicly questioned scientific
evidence linking the HIV virus with the AIDS disease. In April,
Mbeki wrote to world leaders contrasting the spread of the disease
in Africa through heterosexual contact to that in the West, where
it first emerged in gay communities in America. Calling for an
African solution to an African problem, he said his
government would not "condemn our own people to death by
giving up the search for specific and targeted responses to the
specifically African incidence of HIV-AIDS.
Mbeki has also sprung to the defence of so-called AIDS
dissidents such as Peter Duesberg, professor of biochemistry
and molecular biology at the University of California. Duesberg
was one of a minority of scientists who questioned the link between
HIV and AIDS in the 1980s. Implying that the majority of scientists
were blocking a continued discussion, Mbeki suggested that the
dissidents were being witch-hunted and claimed that there was
"an orchestrated campaign of condemnation" against them.
There have been many occasions in the history of science when
individual scientists have been pilloried for their unorthodox
views by the majority of their peers. There is, however, no evidence
that this is the case with the HIV/AIDS investigations, and none
of the so-called dissidents appear to have had their papers barred
from publication or to have been sacked from their jobs. So what
is the controversy about?
The HIV-AIDS link
The body of scientific evidence established since AIDS was
initially recognised in the early 1980s definitively links the
disease's occurrence with the presence of the HIV virus. AIDS
is the result of a disease process.
Geographical clusters of the first recognised cases suggested
it was an infectious disease with a common cause. The fact that
it is transmitted through sexual contact, blood to blood contact,
or from mother to child pointed to an infectious process.
Research showed that the common factor between the various
groupsgay men, drug users and haemophiliacsthat exhibited
AIDS was the presence of the HIV virus. The common precursor to
AIDS infection in the differing groups and regions of the world
has been the detection of the HIV virus in the bloodstream.
The most convincing evidence of the link between HIV and AIDS
is that the drugs that attack the HIV virus exhibit most effect
in slowing the AIDS disease process. The main consequence of the
HIV virus is to destroy cells that form part of the human immune
system. These cells are known as CD4+ T cells (a form of white
blood cell) that normally help to overcome an invading infection.
The destruction of these cells by HIV leaves the body unable to
fight infections and cancers. There is a direct causal relationship
between the level of HIV virus and hence the destruction of these
cells and the onset of the AIDS condition.
It is because so much more is now understood about the relationship
between HIV and AIDS that the alternative theories of the 1980s
have been largely rejected. As Professor Francoise Barre-Sinoussi
of the Pasteur Institute in Paris who discovered the HIV virus
put it: HIV was discovered in 1983, 17 years ago. We have
accumulated so much evidence of the link with AIDS; it is nonsense
to try to separate the virus and the disease."
Mbeki's intervention
There has been widespread concern amongst South African scientists
about Mbeki's April letter. Professor Malegapuru Makgoba, head
of the South African Medical Research Council, attacked the role
of the AIDS dissidents calling them failures in their own
countries and said that he was concerned South Africa was
becoming fertile ground for pseudo-science.
In his efforts to create an African solution to
the AIDS epidemic Mbeki established a panel, which met in Pretoria
behind closed doors over the weekend of May 6 and 7 this year.
According to press reports, the debate became heated at
times. The panel included Duesberg and other AIDS dissidents,
as well as mainstream scientists. All that resulted from the conference
was the establishment of a committee of four scientists, two mainstream
and two dissident, who will continue the discussion on the Internet.
The scientists will meet again in July in Durban.
It is not the first time that Mbeki has been involved in AIDS
controversies. In 1997, Mbeki, then deputy president, along with
Nkosazana Zuma (then Health Minister) enthusiastically endorsed
an anti-AIDS drug developed by three Pretoria scientists. At a
cabinet meeting in January that year the three scientistscryogenics
researcher Olga Visser and cardiothoracic surgeons Professor Dirk
du Plessis and Dr. Kallie Landaurepromoted their new drug,
Virodene, and asked for 3.7 million rand ($544,000) to continue
their research.
One of the major constituents of the drug was a dry-cleaning
solvent, which is normally toxic to humans. The South African
Medicine's Control Council (MCC) refused to sanction trials of
Virodene, raising concerns over the methodology and ethics of
the drug. In response, Zuma pushed for the dismissal of two top
MCC officials who were only vindicated and reinstated at the end
of last year.
In an article published in March 1998, South Africa's Mail
& Guardian commented: The Virodene researchers had
so little respect for the humanity of the subjects of their trial11
seriously ill AIDS patientsthat they did not even bother
to submit themselves to a committee. Subsequent attempts by the
researchers to construct trials have not passed the ethical standards
required.
In 1998, it was revealed that Joshua Nxomalo (a personal friend
of Thabo Mbeki and a former ANC military cadre) had played a leading
role in arranging the meeting between Virodene drug researchers
and senior government officials, including Mbeki. He was also
one of a group of black investors who had bought into the rights
for Virodene.
Recently, Channel 4 News in Britain revealed that it had obtained
Virodene company documents showing the firm projected annual profits
of £100 million, and that the ANC would have received a
6 percent share had the project gone ahead.
Whether Mbeki's current intervention is just a cynical attempt
to divert attention from his government's responsibility in dealing
with HIV/AIDS, or whether his "African solution" is
solely aimed at developing the profits of a favoured company,
is not yet clear. Whatever the reason, it can only hold back progress
in tackling the epidemic at the cost of many more lives.
See Also:
CIA says Africa's AIDS epidemic
is a "national security" issue
[21 June 2000]
One in eight South
Africans HIV-positive
[11 December 1999]
HIV/AIDS
[WSWS Full Coverage]
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