The saga of the controversial multimillion-rand Presidential Aids Advisory Panel may be coming to an end, with the minister of health taking delivery of the final report of the panel’s deliberations on Thursday — nine months after the Cabinet approved the formation of a group to advise the president on the pandemic.
The minister, Manto Tshabalala-Msimang, will distribute the report to Minister of Arts, Culture, Science and Technology Ben Ngubane and Minister in the Presidency Essop Pahad. These three form a sub-committee, which will decide when to submit the report to Cabinet. The news that the final report has been completed brings to an end a period of prolonged confusion that has bordered on the farcical.
There have been rumours that the report was in part delayed by infighting about the contents and particularly the apparently irreconcilable and bitter divisions between mainstream and dissident scientists. President Thabo Mbeki came under fire last year for publicly questioning whether HIV causes Aids — one of the issues which the Aids advisory panel is supposed to pronounce on.
A draft version of the report was circulated last year to panel members for their comments. Reading this preliminary version takes one into a looking-glass world, where scientific research, data and facts are taken to mean different things by different people.
The interim report simply reinforces how polarised is belief on the issue of HIV causing Aids. Attempts to reconcile the different views produce apparently conflicting recommendations. For example, the first recommendation appears to support the dissident viewpoint by calling for “immediately doable epidemiological studies to prove or disprove once and for all that HIV causes Aids”.
However, later recommendations are based on the mainstream belief that HIV does cause Aids and include treatment guidelines on the use of anti-retroviral therapy. It is understood that the interim report was criticised by both dissident and mainstream scientists, who appear not even to agree on all the “consensus” recommendations. For example, a major point of debate has been the accuracy of the tests for HIV, in particular the Elisa test.
This strikes to the heart of the debate about whether HIV causes Aids — some dissidents believe that the tests are so flawed that they cannot even prove that HIV exists. The interim report cites Dr David Rasnick, a leading Aids dissident, supported by Professor Sam Mhlongo — a dissident from Medunsa — recommending a moratorium on HIV testing, “since the results of all the tests are unreliable and non-specific and hence give wrong information”.
Rasnick suggested that the South African government should consider stopping testing for HIV at blood banks and that “Aids would disappear instantaneously if all HIV testing were outlawed”. Dissidents have said that the consensus that the tests should be tested indicates there is uncertainty about their reliability. Mainstream scientists view the agreement to test the tests as a sop to preserve political face, or alternatively simply as checking the quality assurance of South African laboratories.
The Medical Research Council has sent 2 500 samples of sera — which have already been tested for HIV by five different South African laboratories — to the Centers for Disease Control (CDC) in Atlanta. The samples will be tested by the CDC and the results compared to those produced in South Africa.
Although the samples were sent several weeks ago, by the time the Mail & Guardian went to press neither the government nor the CDC was able to say when the results are likely to be known. There is widespread scepticism whether the final report will be able to fulfil its mandate and produce unanimous recommendations on combating HIV/Aids, given the splits between the different panel groupings. Which will again raise criticism about the need for the panel in the first place.