The record reveals President Thabo Mbeki ‘s true stance on Aids, writes Drew Forrest
“And thus does it happen that others who consider themselves to be our leaders take to the streets carrying their placards, to demand that, because we are germ carriers and human beings of a lower order that cannot subject their passion to reason, we must perforce adopt strange opinions to save a depraved and diseased people from perishing from a self-inflicted disease.”
President Thabo Mbeki is at it again despite his promised withdrawal from the HIV/Aids controversy that he once admitted may have caused “confusion”. This extraordinary statement was made two weeks ago, in a little-noticed speech at Fort Hare University.
Stripped of its pompous and tortured phraseology, it apparently means that those who advance a viral explanation of Aids believe black people are unclean, uncivilised and sexually promiscuous. The “leaders with placards”, presumably union leaders and Aids activists, want to force government to accept a racist view.
Whatever Mbeki’s army of apologists may say, the hard fact is that our leader is an Aids dissident. What clouds the picture is his awareness sharpened by his rough treatment at the hands of foreign journalists that dissidence is not an intellectually respectable position in the wider world. His views are, therefore, veiled by a smokescreen of “nondenial denial”, academic quibbling and obfuscation.
He is not merely saying that poverty fuels Africa’s Aids epidemic by creating fertile conditions for viral transmission. To say that overcrowding, malnourishment and illiteracy make people vulnerable to infection is entirely uncontroversial. When Minister of Labour Membathisi Mdladlana said this to journalists hungry for blood on government’s Aids stance, the vampires of the press immediately lost interest.
Mbeki’s spin doctors argue, incorrectly, that he has never denied a causal connection between HIV and Aids. What could be clearer than his blunt statement in Parliament last year that a virus cannot cause a syndrome?
But just as revealing is what he has not said. He has never unequivocally conceded that viral infection is a necessary condition for the disease. He has never clearly stated that drugs can improve the life expectancy and quality of life of infected people.
In myriad indirect ways he has communicated his dissidence to the public and his government. Aids statistics are challenged and the ravages of the epidemic de-emphasised. The virological explanation is treated as an unproved hypothesis. There is an obsessional focus on the toxicity of Aids drugs, absent, for example, in regard to equally toxic cancer medication.
Orthodox scientific opinion, here and abroad, is questioned from a non-specialist position. It is repeatedly suggested that pharmaceutical companies are promoting the virological view to swell their profits.
If Mbeki’s position is so clear, why did his ministers dance on eggs when asked in Parliament if they thought HIV caused Aids? Why, after lengthy evasion, did Minister of Education Kader Asmal snap: “You will not drive me into a corner on this issue!” Why did Mpumalanga health MEC Sibongile Manana say HIV had nothing to do with Aids, and that hospital counsellors who gave anti-retrovirals to rape victims were “trying to overthrow the government”?
Facing hostile journalists in the United States, where his Aids views dominate public perceptions, Mbeki blamed the media for misquoting him. The attempt to personalise criticism of his Aids stance by suggesting the media want to destroy him is a familiar refrain of his spin-doctors now including African National Congress churchman Cedric Mayson, South Africa’s very own Cardinal Wolsey.
Media coverage of Mbeki’s macro-economic and foreign policies has been overwhelmingly favourable. Why on earth should journalists single out Aids to destroy him?
A catalogue of his equivocation and veiled messages over two years underscores Mbeki’s central role in what judge Edwin Cameron calls “the crisis of truth-telling” on Aids in South Africa:
Mbeki tells the National Council of Provinces that AZT, widely used abroad, may be harmful to health, and asks the minister of health to establish “where the truth lies” (October 28 1999).
The ANC’s 1999 annual report insists AZT will not be made available because of “unanswered questions regarding [its] efficacy and toxicity”.
Mbeki phones United States Aids dissident David Rasnick “for advice on how to proceed with his plans to review the hypothesis that HIV causes Aids” (reported March 17 2000).
Writing to Judge Albie Sachs, he says many South Africans are sacrificing “all intellectual integrity to act as salespersons” for AZT manufacturers Glaxo-Wellcome (March 15 2000).
He appoints the Presidential Aids Panel, half of whose members are dissidents (May 4 2000).
Writing to world leaders, he compares dissident scientists to heretics who, earlier in human history, would have been burnt at the stake. (April 3 2000).
In a letter to DA leader Tony Leon, he attacks “hysterical estimates” of Africa’s Aids incidence, and describes the theory of the African origins of Aids as “insulting”. Glaxo-Wellcome is trying to boost its profit by “exploiting the justified health concerns of our people”, and the government should base its actions on truth, not necessarily on “established majority scientific opinion” (July 1 2000).
He tells Time magazine “the notion that immune deficiency is only acquired from a single virus is unsustainable” (September 4 2000).
He tells Parliament public programmes are based on the viral explanation, but adds that a virus cannot cause a syndrome (September 20 2000).
Before the municipal elections, he says South Africans are being used as “guinea pigs” and conned into using dangerous drugs. He likens the use of drugs in the DA-controlled Western Cape to “biological warfare of the apartheid era” (October 23 2000).
He says on television he would not take an Aids test because this would mean accepting a certain paradigm of Aids (April 2001).
Pressed during his US visit on whether HIV is the primary cause of Aids, he replies: “I don’t know. That’s what scientists say.” He skips a three-day United Nations Aids summit in New York (June 28 2001).
He tells the BBC’s Tim Sebastian that crime is killing more South Africans aged 16-45 than Aids, and repeats the statement that a virus cannot cause a syndrome (August 7).
Quoting five-year-old statistics, he tells the minister of health Aids is not the main killer of South Africans and recommends new priorities in health spending. He is contradicted by a Medical Research Council report released by the government only after repeated media leaks (September 2001).
Why does Mbeki unquestioningly accept the mainstream scientific view on other diseases caused by invisible pathogens tuberculosis, polio, etc but not on Aids?
The answer seems to lie in his Fort Hare utterance: it has become entangled with his hyper-defensiveness on race. A viral explanation of the rampant epidemic in central and Southern Africa, in his mind, amounts to saying black people are polluted “germ carriers” who cannot control their sexual behaviour.
His rejection of the African origins of Aids as “insulting” has the same implications. It is absolutely unclear why an epidemic should reflect on the moral character of Africans. Who else but Mbeki, and perhaps the loony right, has ever suggested this? HIV infection in West African countries is uniformly below 5%, underlining the importance of cultural factors and indicating that his racial apologetics are entirely misplaced.
Mbeki complains that Aids risks being “medicalised”. For him, aetiology and treatment of the disease are not matters for doctors and scientists they are political questions to be addressed as part of the government’s anti-racism thrust.
Hence, also, the ANC’s deprecation of the MRC report as “unprocessed”. Of course, it has been processed by its eminent scientific authors. What the ANC means is that it has not been politically processed.
The government’s conduct reflects Mbeki’s own all-consuming interest in the disease, which drives his repeated interventions. In no other country would the Cabinet intervene so persistently on the technical issues of drug toxicity and effectiveness.
The paradox is that by being not just wrong, but stubbornly wrong, he is fuelling precisely the prejudice he accuses the Aids mainstream of fostering. He is also undermining his and his government’s considerable achievements in other areas, including his important advocacy of Third World economic interests.
During his US visit, his Millennium Africa Programme message was drowned out by Aids static. The New York Times editorialised that he was in danger of eroding “all his good work with his stance on Aids”.
Because of his enormous influence in government and the ruling party, Mbeki’s views cannot be brushed off as a harmless foible. In a country where the MRC estimates one in four deaths is related to Aids, his government is actively undermining a sense of national urgency. It shows no sign of allocating the kind of resources for condom and anti-retroviral provision that could make a difference.
“The cruel games of those who do not care should not be allowed to set the national agenda,” Mbeki said in 1998, during the Virodene imbroglio. Many might level the same words at him now.