/ 15 September 2000

Just say yes, Mr President


President Thabo Mbeki either gets his act together on HIV/Aids very soon or he places his presidency at risk. We South Africans are losing the battle against this disease. This is, in no small measure, the result of the refusal by Mbeki to accept the guidance of best science. That refusal is irrational and perverse. More than four million South Africans are infected with HIV. These four million-odd South Africans will die as a result. Families and communities across the country are being decimated.

More South Africans are being infected with HIV – at the rate of one a minute. Worse, the rate at which South Africans are being infected is rising. Worse still, the African National Congress – the first party to be democratically elected in our country – has allowed this rate of infection to continue to rise every year since it came to power. This represents a grave betrayal of the hopes and aspirations of millions. It is encouraging to see that members of the ANC’s health committee have now shown the intelligence and courage to challenge Mbeki’s pitiable inability to confront the crisis in our midst.

Earlier, leaders of the Congress of South African Trade Unions and the South African Communist Party were similarly forthright. Clearly, however, intellectual courage is in shorter supply among members of Mbeki’s Cabinet. We hope this changes. If not, rank-and-file ANC members and supporters, those infected with HIV and Aids and their families, and the public at large will know what to do when next these men and women ask for their vote.

This week, the country has been treated not just to Mbeki’s ambiguous utterances on HIV/Aids in an interview with Time magazine but a subsequent government statement supposed to clarify it. This latter statement singularly fails in its task. It merely confirms, as we show elsewhere in this paper, that the president aligns himself with those who reject best science on HIV/Aids.

It confirms that we have a president playing the eccentric and revelling in word games when this national crisis demands that we have a president leading us in a practical fight against the greatest-ever challenge to this country’s health and development. The statement has added yet more confusion where we need greater clarity and unity of purpose in our battle against the Aids syndrome.

To achieve that clarity and unity, we need the president simply to say: Yes, HIV causes Aids. The simple, relevant facts accepted by serious science – facts that Mbeki must confront now – are these. There has been a massive, and undeniable, increase in illnesses and deaths among South African adults and children. These illnesses are associated with a recurrent pattern of the collapse of the immune systems of those affected.

Science has isolated a virus causing acute immune deficiency. And science has detected the presence of this virus in very many of the sick and the dead.
The thrust of it is this. HIV causes Aids – in the sense that the term “cause” is invariably understood in science.

In other words, the HIV virus is a necessary and sufficient condition for Aids. The incidence, prevalence and distribution of Aids is affected by factors such as poverty, culture and biology. These factors, however, are not a, or the, cause of Aids.

Mbeki seeks to make them causes, and this is where his confusion – and, regrettably, the confusion being caused to our anti-Aids programme – has its origins. Moreover, there are instances of immune deficiency caused by treatments associated with organ transplants and chemotherapy, but these are different from Aids and are not to be confused with the massive increase in illnesses and deaths among our young adults and children.

It is a president’s task to lead. It does not befit a president to lag behind. But that is what Mbeki is doing on HIV/Aids. The person whose job it is to lead us in this campaign now makes up the most backward element of our column. In war, he would be found wanting.

We all, and the members of his party, will judge him harshly if he does not quickly collect his mind and provide clear and decisive leadership on HIV/Aids. He should be in no doubt – even if it has not been allowed to filter through to his office in the presidency – that disillusion with his leadership is increasing exponentially among many who have hitherto been admirers of him.

The rate at which this disenchantment is growing would alarm any alert politician. It is not too late for Mbeki to change the growing perception of him as an extremely intelligent man, but one whose intellect contains islands of irrationality that are impervious to reason, who has difficulty in conceding an error of judgement, and who prefers verbal play to the practical tasks at hand.

An encouraging start would be for Mbeki to say as little as this: “Deficiency in immune systems is due to more than just HIV. But we have to recognise that there has been a huge increase in the number of illnesses and deaths among our adults and children. What we know is that there is a new virus and that it is, primarily, causing this increase in deaths.” Just say it, Mr President.