A challenge for the medical profession over Mhlongo’s stance on Aids
crossfire
Janet Giddy
Professor Sam Mhlongo, Aids dissident, is surprised that he is the only doctor among 30 000 South African doctors who questions the belief that HIV causes Aids or that Aids exists. His explanation is that he had the benefit of a British education which taught him to think and question, while the problem with the rest of the doctors in this country is that we are all “siyavuma” people under apartheid we had to “siyavuma” (we agree) and so we never learned to question.
Mhlongo is the chief family physician and head of the family medicine and primary care department at the Medical University of Southern Africa (Medunsa). He is a returned exile who had left South Africa in 1963. After spending time in Tanzania, he qualified as a doctor at a medical school in London, where he practised as a GP, did an MScMed and had a research interest in hypertension. He came back to South Africa and took up his present position in 1999.
I am a family physician working in a primary health care clinic, which serves a poor rural population. I am also a part-time lecturer in the department of family medicine at Medunsa. The department has an excellent reputation at home and internationally and I am proud to hold a Medunsa postgraduate degree. However, I fear that the department may be tainted by Mhlongo’s widely published views on HIV/Aids. I know of doctors who have decided against studying family medicine at Medunsa because of Mhlongo.
Daily I am confronted with the desperation of people dying from Aids and their denying families. I feel like a soldier who climbs into the trenches every day and does battle in a hideous war, which we are losing. The situation has been aggravated since President Thabo Mbeki confused the issue by publicly questioning the link between HIV and Aids.
Mhlongo, who is a member of the president’s Aids advisory panel, has been in a position to influence Mbeki’s ideas and has thus contributed to undermining the fight against Aids.
In October last year I wrote to Mhlongo challenging him, as a colleague and a clinician, to look at the evidence for Aids. I had earlier tried to arrange a meeting between Mhlongo and Dr Zolile Mlisana (chairman of the South African Medical Association, or Sama) at Mlisana’s request after Mhlongo had publicly challenged the Sama president in a daily newspaper.
Mhlongo refused to meet with Mlisana, giving the following reason: “It is our policy not to meet with orthodox people unless there are more than one of us [dissidents] present.” This is ironic, given Mhlongo’s accusation in the same article that “Sama members … refuse to debate the issue with their peers”.
It was in response to my letter that Mhlongo expressed his opinion about the inability of South African “siyavuma” doctors to question. He reiterated his dissident views that Aids does not exist and that the diseases supposedly linked to Aids are diseases of poverty.
He disputed the evidence of an increased rate of tuberculosis in KwaZulu-Natal (from 100 per 100 000 in 1990 to more than 500 per 100 000 last year) or an increased death rate from the disease. The deaths at the tuberculosis hospital adjacent to my clinic have increased from one death a month in 1995 to one death a day now. His response to these facts is that under apartheid people did not know that they could access health care, so people who had TB simply died at home. Since 1994 people have learned their rights and so they are now dying in hospitals.
One may speculate on the reasons for this tenaciously held delusion. Obviously, because Mhlongo never worked as a doctor in South Africa, he has no experience of how dramatically the spectrum of clinical medicine has changed in the last 15 years.
No doubt I will be accused of academic intolerance or racism by Mhlongo. However, I believe that the Aids dissident view, and the confusion and damage it has caused to the fight against Aids, constitutes a human rights abuse which is comparable to many of those committed under apartheid.
The disaster of the impact of the dissident view confusion cannot be allowed to disappear or hide behind the bland statement by the government that its strategy is “based on the theory that HIV causes Aids”. There is a serious failure of vision and leadership at the highest level in dealing with the Aids pandemic and I would agree with Professor Malegapuru Makgoba that “…history may judge us to have collaborated in the greatest genocide of our time”. (Mail & Guardian, May 25 to 31).
I am challenging the department of family medicine as well as the Medunsa faculty to distance themselves publicly from Mhlongo and his dangerous views. I call upon the medical profession in South Africa to denounce these deluded ideas which are undermining the fight against Aids in the worst affected country in the world. Doctors need to speak out on ethical and human rights issues. The medical profession failed to denounce the district surgeons who perpetrated human rights abuses under apartheid and was justifiably criticised. Let our profession now rise to this challenge and be seen to be taking a firm stand on a critical life and death issue.
l Professor Mhlongo was asked to comment on the allegations. Here is his reply, titled “Your unexpected attack on me”:
I have just been faxed a page you wrote attacking me as a person. I must point out that this is clearly the policy of your paper, including persistent refusals to publish any material we write perceived by your paper to be anti Mail & Guardian’s pampered girls and boys, especially on the subject of Aids and HIV. In response to your request, I have no option but to refuse to respond and help you in your mission to ridicule and demean me. I know who your source and assistant is. I will choose my own method of response after reading your piece.