"South Africa is the unkindest cut of all. It is the only country in Africa, amongst all the countries I have traversed in the last five years, whose government is still obtuse, dilatory and negligent about rolling out treatment. It is the only country in Africa whose government continues to propound theories more worthy of a lunatic fringe than of a concerned and compassionate state. Between six and eight hundred people a day die of AIDS in South Africa. The government has a lot to atone for. I'm of the opinion that they can never achieve redemption."
– Stephen Lewis, United Nations Special Envoy to AIDS in Africa

South African President Thabo Mbeki on HIV/AIDS

The following is a compilation of statements about AIDS made by the president of South Africa over the last half-dozen years; it has been taken from the Treatment Action Campaign (you can visit their website from the "Links" page); it is not meant to be exhaustive, but rather to give some insight into the sentiment of his government regarding HIV/AIDS. Studying President Mbeki's stance over these critical years in the pandemic's history helps to cast light on one aspect of why it has been so difficult to succeed in the fight against AIDS in South Africa, and why the South African government has been the recipient of scathing criticism from AIDS experts and lobbyists worldwide.

 

DATE: 25 September 2003

EVENT: Washington Post Interview in New York

SOURCE: Washington Post

In an interview at the Plaza Hotel in New York, where he was attending the opening of the U.N. General Assembly, Mbeki talked expansively about Mugabe, the Bush administration's Iraq policy and South Africa's HIV/AIDS crisis.

Mbeki has been criticized for moving slowly to address the epidemic. One in 10 South Africans -- nearly 5 million people -- is infected with HIV, according to government statistics.

Mbeki said, however, that no one close to him has perished from the disease. "Personally, I don't know anybody who has died of AIDS," Mbeki said. Asked whether he knows anyone with HIV, he added quietly, "I really, honestly don't."

 

DATE: 15 July 2003

EVENT: Interview with Gavin Esler, Newsnight, BBC

SOURCE: BBC Subtitling Transcript

ESLER: Could I turn to a big problem which affects everybody in the continent and affects the conscience of everybody outside Africa, the problem of AIDS. Do you think with some 600 South Africans a day dying because of the AIDS problem, that your government has been too slow to act?

MBEKI: I don't know where you get the figure from, I don't have it. I don't know where that figure comes from. The South African Government has got, I am certain, the most comprehensive programme on the matter of AIDS and the best-funded. I think the response is very good, very comprehensive.

ESLER: Have you changed your personal views about medical research and the relationship between the HIV virus and AIDS?

MBEKI: I never raised that question. I don't know where that comes from.

ESLER: There were many reports that you doubted the two were related?

MBEKI: They were false, I have never said that. The issue we raised was that in terms of responding to AIDS we've got to have a comprehensive response. Look at the entirety of the health conditions of a person. Because for instance, you can't feed a person who has no food. Feed them with medicines and drugs and so on. You have to take care of things like that.

ESLER: Will antiretroviral therapy become available paid for publicly in South Africa?

MBEKI: It is available now.

ESLER: Your government will pay for it?

MBEKI: It is available now.

ESLER: To anybody who wants it?

MBEKI: There is mother to child transmission, those drugs are given. People who have injuries at work and people who get raped and go to the public health hospitals and so on. The matter of the general availability of antiretroviral drugs is a matter that was raised even by President Bush, do you have the health infrastructure to handle such a programme?

ESLER: Those activists who complain you are going too slowly, are they wrong?

MBEKI: They are very wrong. They started off by saying all you needed was to give drugs and we are saying no it is not. They've changed. Now they are saying you must also take care of nutrition.

 

DATE: 5 April 2002

EVENT: Beginning of Health Month

SOURCE: ANC Today, Volume 2, No. 14. 5 - 11 April 2002. http://www.anc.org.za/ancdocs/anctoday/2002/at14.htm

Because of the pursuit of particular agendas, regardless of the health challenges facing the majority of our people, who happen to be black, in our country there is a studied and sustained attempt to hide the truth about diseases of poverty.

If we allow these agendas and falsehoods to form the basis of our health policies and programmes, we will condemn ourselves to the further and criminal deterioration of the health condition of the majority of our people. We cannot and will not follow this disastrous route. We are both the victims and fully understand the legacy of centuries-old and current racism on our society and ourselves.

We will not be intimidated, terrorised, bludgeoned, manipulated, stampeded, or in any other way forced to adopt policies and programmes inimical to the health of our people. That we are poor and black does not mean that we cannot think for ourselves and determine what is good for us. Neither does it mean that we are available to be bought, whatever the price.

 

DATE: 12 October 2001

EVENT: Address at the Inaugural ZK Matthews Memorial Lecture, University of Fort Hare

SOURCE: http://www.anc.org.za/ancdocs/history/mbeki/2001/tm1012.html

To quote Carter Woodson, these [black people] have studied in...medical schools where they are likewise convinced of their inferiority by being reminded of their role as germ carriers; schools where they learn a history that pictures black people as human beings of the lower order, unable to subject passion to reason.

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 its passions to reason, we must perforce adopt strange opinions, to save a depraved and diseased people from perishing from self-inflicted disease.

Convinced that we are but natural-born, promiscuous carriers of germs, unique in the world, ["others who consider themselves to be our leaders"] they proclaim that our continent is doomed to an inevitable mortal end because of our unconquerable devotion to the sin of lust.

 

DATE: 10 Sep 2001

EVENT: Letter from Mbeki to Health Minister Manto Tshabalala-Msimang

QUOTE AND NOTE SOURCE: "Mbeki questions spending on AIDS." Business Day, 10 Sep 2001. http://www.bday.co.za/bday/content/direct/1,3523,924850-6078-0,00.html

[Questions Mbeki asks as a result of his look at these numbers in his letter to Manto:]

- what social policies have we put in place to reduce the incidence of death, bearing in mind the importance of the causes of death by rank?

- do our health policies and therefore the allocation of resources reflect the incidence of death as reflected by these figures? and,

- are the programmes of the state medical research institutes geared to respond to the profile of the incidence of death as reflected by these statistics?

There is no need for me to emphasise the point that, necessarily, the government has to respond to the objective reality of the health profile of our country and not what we or other people wish it to be or mistakenly assume it to be. It may be, of course, that the issue is more complex than I am stating it.

Needless to say, these figures will provoke a howl of displeasure and a concerted propaganda campaign among those who have convinced themselves that HIV/AIDS is the single biggest cause of death in our country.

These are the people whose prejudices led them to discover the false reality, among other things, that we are running out of space in our cemeteries as a result of unprecedented deaths caused by HIV/AIDS. In this context, I must also make a point that we have to act without delay on the proposal made by the Presidential AIDS Panel that, among other things, an investigation be made of the HIV and AIDS statistics that are regularly peddled as a true representation of what is happening in our country.

Nevertheless, whatever the intensity of the hostile propaganda that might be provoked by the WHO statistics, we cannot allow that government policy and programmes should be informed by misperceptions, however widespread and well established they may seem to be....

NOTE:
Mbeki's methodology is likely to be criticised, firstly, because the pattern of AIDS deaths shifted significantly since the mid-1990s, the period from which his statistics come.

Secondly, the WHO figures Mbeki quotes reflect, for example, tuberculosis deaths (5,3%) as separate from AIDS, although it is known that AIDS manifests itself widely in tuberculosis in Africa.

 

DATE: 24 April 2001

EVENT: eTV interview on "On The Record"

SOURCE: Cohen, Mike. "Mbeki Questions HIV Testing." The Associated Press, 24 Apr 2001.

But in a rare live broadcast on the private television station e-TV, Mbeki reignited the debate Tuesday, saying he would not take a public HIV test as it would send a message that he supported a particular scientific viewpoint.
"I go and do a test - I am confirming a particular paradigm," he said.

"I think it would be criminal if our government did not deal with the toxicity of these drugs," he said. "Let's stop politicizing this question, let's deal with the science of it."

 

DATE: 28 September 2000

EVENT: Address to African National Congress MPs at a caucus meeting in Parliament in Cape Town.

SOURCE: Mail and Guardian, 6 Oct 2000.

President Thabo Mbeki believes the United States Central Intelligence Agency (CIA) is part of a conspiracy to promote the view that HIV causes Aids. Mbeki also thinks that the CIA is working covertly alongside the big US pharmaceutical manufacturers to undermine him because, by questioning the link between HIV and Aids, he is thought to pose a risk to the profits of drug companies making anti-retroviral treatments.

He said the propaganda being made against him because of his stance on HIV/Aids was a foretaste of attempts to undermine him and South Africa that were being mounted by those determined to defend the established world economic order.

Mbeki said that if one agreed that HIV caused Aids, it followed that the condition had to be treated by drugs and those drugs were produced by the big Western drug companies. The drug companies therefore needed HIV to cause Aids, so they promoted the thesis that HIV caused Aids, he said.

DATE: 20 September 2000

EVENT: Answering questions posed in parliament

SOURCE: Harvey, Marjolein. "How can a virus cause a syndrome? asks Mbeki" iClinic, 21 Sep 2000. http://www.aegis.com/news/woza/2000/IC000906.html

"All HIV/AIDS programmes of this government are based on the thesis that HIV causes AIDS," said Mbeki, adding "There is absolutely no confusion about what to do."

But he went on to ask "Does HIV cause AIDS? Can a virus cause a syndrome? How? It can't, because a syndrome is a group of diseases resulting from acquired immune deficiency." He said that the question still unresolved by scientists is: what contribution does HIV make to the collapse of the immune system?

"Indeed, HIV contributes, but other things contribute as well," said Mbeki.

He said that what is not yet resolved and what is being investigated by the International AIDS panel is: what do HIV tests measure? "Scientists from both sides of the divide have identified this as an essential question to be resolved in order to provide comprehensive treatment," says Mbeki, adding that "We need to understand all these complexities so that our intervention can be more effective, even though many people do not want to study this question."

[Opposition leader Tony] Leon wanted to know whether the SA National AIDS Council has made any recommendations about the use of anti-retroviral drugs to prevent mother-to-child transmission of HIV (MTCT).

Mbeki replied that antiretroviral nevirapine has not been registered for MTCT anywhere in the world and that the World Health Organisation is still considering its use for this purpose.
"A National Steering Committee on MTCT has already met and will finalise its report mid-October," says Mbeki.

On the question whether he believes that HIV is a minor or major cause of AIDS, Mbeki replied that "there is a serious AIDS problem".

On the question of AIDS orphans, Mbeki replied that "orphans result from the health crisis in SA, caused by many diseases".

He pointed to 1999 WHO estimates of the causes of death in Africa, which stated that 12% of deaths are caused by HIV/AIDS, but heart diseases is still the biggest killer. "All these cause orphans," says Mbeki.

On the question why there is a delay in MTCT in other provinces when the Western Cape, the only province not controlled by the ANC, has successfully implemented free treatment, Mbeki replied that "This matter will be dealt with through the Steering Committee on MTCT".

On the call to go for an HIV test by PAC spokesperson Patricia de Lille, who went for a public HIV test recently to spur on other politicians to lead by example, Mbeki replied that "It is important to know what the state of one's health is - in my capacity as president of this country I go for regular health check-ups".

On the controversial debate whether HIV causes AIDS sparked by Mbeki's courting so-called AIDS dissidents in his presidential AIDS panel, Mbeki replied that "The way we have handled the complex scientific questions around HIV/AIDS may have been confusing, but there is nothing confusing about what government HIV/AIDS programmes are based on and are trying to do".

 

DATE: 10 September 2000

EVENT: TIME Magazine interview

SOURCE: "Gov releases parts of Time Magazine to quell Mbeki AIDS controversy." South African Press Association, 10 Sep 2000.

"Clearly there is such a thing as acquired immune deficiency. The question you have to ask is, what produces this deficiency?" he said.

"Now, if you go through the literature, ordinary standard literature available in medical schools, there will be a whole variety of things [that] can cause the immune system to collapse.

"Endemic poverty, the impact of nutrition, contaminated water, all of these things, will result in immune deficiency."

Mbeki said on the African continent, repetitive infections like malaria and sexual transmitted diseases like syphilis were also contributing factors.

"This is precisely where the problem starts. No, I am saying that you cannot attribute immune deficiency solely and exclusively to a virus";

Mbeki said there is a lack of consensus among scientists as to whether there was a link between HIV and Aids.

He said if it was believed that HIV destroyed a person's immune system, it would mean someone with tuberculosis would not be treated for that disease, which also causes immune deficiency, but for AIDS only.

"If you come to the conclusion that the only thing that destroys immune systems is HIV then your only response is to give them anti-retroviral drugs. There's no point in attending to this TB business because that's just an opportunistic disease." Mbeki said.

"The problem is that once you say immune deficiency is acquired from that virus (HIV) your response will be anti-retroviral drugs. But if you say the reason we are getting collapsed immune systems is a whole variety of reasons, including the poverty question which is very critical, then you have a more comprehensive response to the health condition of a person."

Mbeki said he believed the virus was only partly to blame for immune deficiency.

"If the scientists come back and say this virus is part of the variety of things from which people acquire immune deficiency, I have no problem with that." Mbeki said.

"But to say this is the sole cause therefore the only response to it is anti-retroviral drugs, I am saying we'll never be able to solve the AIDS problem."

 

DATE: July 2000

EVENT: Letter to Tony Leon

SOURCE: Sunday Times (SA), 9 July 2000

In this regard, you might care to consider what it is that distinguishes Africa from the United States, as a consequence of which millions in sub-Saharan Africa allegedly become HIV positive as a result of heterosexual sexual intercourse, while, to all intents and purposes, there is a zero possibility of this happening in the US.

I imagine that all manufacturers of antiretroviral drugs pay great attention to the very false figures about the incidence of rape in our country, that are regularly peddled by those who seem so determined to project a negative image of our country.

The hysterical estimates of the incidence of HIV in our country and sub-Saharan Africa made by some international organisations, coupled with the earlier wild and insulting claims about the African and Haitian origins of HIV, powerfully reinforce these dangerous and firmly-entrenched prejudices. None of this bodes well for a rational discussion of HIV-AIDS and an effective response to this matter, including the use of anti-retroviral drugs.

I trust that our discussion about AZT and rape will convince you that despite the fervent reiteration of various assertions, supported by many scientists, medical people and NGO's, about the existence of some unchallengeable and immutable truths about HIV-AIDS, as public representatives we have no right to be proponents and blind defenders of dogma.

Whatever the intensity of the campaign to oblige us to think and act differently on the HIVAIDS issue, the instinctive human desire in the face of such a barrage, to obtain social approval by succumbing to massive and orchestrated pressure, will not lead us to become proponents and blind defenders of dogma.

The cost of AIDS in human lives is too high to allow that we become blind defenders of the faith.

Once again, I would like to suggest that you inform yourself as extensively as possible about the AIDS epidemic. Again, for this purpose, I would like to recommend that you access the Internet.

On the various websites, you will find an enormous volume of literature, including CDC, WHO and UNAIDS documents, editions of various highly respected science journals as well as "dissident" articles.

I believe that it is imperative that all our public representatives should base whatever they say and do on the HIV-AIDS matter, on the truth and not necessarily on the comfort of fitting themselves into the framework of whatever might be considered to be 'established majority scientific opinion'.

 

DATE: July 2000

EVENT: Address at opening session of International AIDS Conference, Durban

SOURCE: Swindells, Steven. "Major killer is poverty not AIDS - S.Africa's Mbeki." Reuters News, 9 Jul 2000.

"The world's biggest killer and the greatest cause of ill health and suffering across the globe, including South Africa, is extreme poverty," Mbeki told a stadium audience.

"As I listened and heard the whole story about our own country, it seemed to me that we could not blame everything on a single virus," Mbeki said in a speech drawing heavily on a 1995 study by the World Health Organisation (WHO).

DATE: July 2000

EVENT: Address at opening session of International AIDS Conference, Durban.

SOURCE: Nessman, Ravi. "S. Africa Defends AIDS Policies." The Associated Press, 9 Jul 2000.

"Some in our common world consider the questions that I and the rest of our government have raised around the HIV/AIDS issue ... as akin to grave criminal and genocidal conduct," he told delegates at the opening ceremony of the 13th International AIDS Conference. "What I hear said repeatedly, stridently is 'Don't ask questions.'"

DATE: March 2000

EVENT: Mbeki responds to letters

SOURCE: SAfrica-AIDS: Mbeki digs heels in over AIDS panel: report. Agence France-Presse - Sunday, March 26, 2000. www.aegis.com

CONTEXT: His comments, it said, were contained in a written reply to the five -- Constitutional Court Judge Edwin Cameron, Anglican leader Archbishop Njongonkulu Ndungane, Methodist leader Bishop Mvume Dandala, the chairman of an upcoming international aids conference in Durban, South Africa, Professor Jerry Coovadia, and AIDS activist Merci Makhalamele.
They had written to him asking him to reconsider the government's policy of not providing anti-HIV drugs to pregnant women.

Mbeki also responded personally, the report said, to a letter from Cape Town immunologist Dr. Johnny Sachs, who questioned the wisdom of "individuals in leadership positions" querying the links between HIV and AIDS.

QUOTE:

"I am taken aback by the determination of many people in our country to sacrifice all intellectual integrity to act as salespersons of the product of one pharmaceutical company," Mbeki said, referring to Glaxo Wellcome, the British manufacturers of the anti-HIV drug AZT.
"I am also amazed at how many people, who claim to be scientists, are determined that scientific discourse and inquiry should cease, because 'most of the world' is of one mind," he added.

In his response to his critics, Mbeki defended his decision to court dissidents.
"By resort to the use of the modern magic wand at the disposal of modern propaganda machines, an entire regiment of eminent 'dissident' scientists is wiped out from the public view, leaving a solitary Peter Duesberg alone on the battlefield, insanely tilting at the windmills," he said.

Referring to his proposed panel, Mbeki said: "I hope you will agree with me that such a meeting should be inclusive of all scientific views and not only those representative of the 'consensus' to which you refer."

Minister of Health Manto Tshabala-Msimang on HIV/AIDS in South Africa

This section coming soon. In the meantime, visit www.sackmanto.co.za to learn about the Minister of Health's woeful contribute in the fight against AIDS.