/ 8 March 2002

Behind Madiba’s zig-zags

Former president Nelson Mandela’s apparent zig-zags on HIV/Aids policy stem from his sensitivity to fears in President Thabo Mbeki’s camp that he is out to undermine Mbeki in the run-up to the ruling party’s national conference later this year.

This is the assessment of senior party insiders. They were commenting on a set of contradictions at Mandela’s surprise press conference on Sunday: the presence of African National Congress leaders as he called for anti-retroviral treatment for all Aids sufferers; and Mandela’s continued public support for the government’s HIV/Aids programme.

Some suggest there is a “bargained intervention”, in terms of which Mandela has offered public support of government in return for movement on drug provision.

He clearly has his eye on the ANC national executive committee (NEC) meeting next week. His move to focus the NEC on the drug treatment programme was described by some party sources as a “victory for the cause”.

By shifting the spotlight at Sunday’s conference to the treatment of all the sick, rather than mother-to-child transmission or rape prophylaxis, Mandela moved South Africa’s Aids debate into a new area.

However, he was flanked by Deputy President Jacob Zuma, ANC secretary general Kgalema Motlanthe and Minister in the Office of the Presidency Essop Pahad.

He appeared to contradict himself by questioning the safety of nevirapine and claiming it had been banned in a European country. This week, he continued to insist that the country’s HIV/Aids programme is the best in the world.

Said a source: “Madiba is a big-picture person and his instinct is that there is something morally and politically wrong with government’s approach to drug treatment.

“He believes that doctors and sick people should be the ones to decide, not politicians. He wants to move things forward, but is sensitive to the insecurities in the Mbeki camp and is constantly trying to reassure them.”

The president’s inner circle is known to think that left-leaning NGOs, the South African Communist Party and the Congress of South African Trade Unions are putting pressure on Mandela to sideline Mbeki in the run-up to the party’s elections in December.

Mandela is the one South African with the stature and popularity to challenge the president. His intervention over Mbeki’s handling of tensions in the tripartite alliance last year he raised criticisms at an NEC meeting in September left the Mbeki camp feeling threatened.

These fears resurfaced when Mandela called for a meeting with the ANC’s national working committee (NWC) on the government’s Aids policy two weeks ago, following an interview with the ‘Sunday Times’ in which he suggested there was too much debate and too little action on Aids.

Mandela emerged from that meeting saying he was satisfied with the government’s policy.

Senior ANC leaders who favour an antiretroviral roll-out commented that Mandela had been misled. One said his weakness on the scientific and administrative aspects of Aids treatment made him vulnerable. “He must be baffled by all the pseudo-science.”

However, Mandela then appears to have rethought his position in large part because of his sensitivity to media coverage, both of himself and of the ANC, sources said.

He was widely criticised for his apparent backtracking after the NWC encounter. In the same week, influential international magazine ‘Newsweek’ ran a devastating cover story on Mbeki’s Aids stance. It was followed by a lead story in the ‘Mail & Guardian’ on attempts to “mind” Mandela’s public utterances.

Sources say he approached the ANC leadership on his plans to hold another media conference on Sunday, and that it was agreed that prominent leadership figures should be at his side.

Minister of Health Manto Tshabalala-Msimang and Mbeki, who was attending the Commonwealth summit in Coolum, Australia, were not present.

Party insiders were struck by Mandela’s comment at the press conference that Zuma, also not associated with the dissident stance, would head the Aids initiative. While other officebearers were non-committal on Mandela’s proposal, Zuma told the SABC two days later that he saw nothing wrong with Mandela’s suggestion.

A day later, after meeting Tshabalala-Msimang, Mandela again expressed support for government policy.

Some in the ANC, however, remain sceptical that Mandela’s intervention will swing the national executive meeting scheduled for next week. Many of the NEC’s 60 members were “too cowardly to cross Mbeki”, one sceptic remarked, while others were confused by contradictory reports on the efficacy and toxicity of antiretrovirals.

Mandela’s adviser, Jakes Gerwel, said the former president “genuinely believed” that the government was acting “responsibly” on its anti-retroviral policy. Explaining Mandela’s call for access to antiretrovirals despite his pro-government stance, Gerwel said there was an impression that the government was denying treatment to HIV/Aids sufferers. Mandela therefore decided to shift the onus of the risk in taking the antiretrovirals to the people, he said.

NEC member and ANC MP Peter Mokaba has been circulating literature by dissident Aids scientists to party branches, it was learnt this week. The documents, which appear to have been lifted from the Internet, argue that there is no proof of the existence of HIV and that the drug AZT is not an antiretroviral.

Mokaba said those like Mandela who were calling for the use of antiretrovirals to combat HIV/Aids “mean well but do not understand that they don’t work”.

He said he would send Mandela simplified versions of the documents.