AIDS & SOUTH AFRICA
A Contrary Conference in Pretoria
By Celia Farber
New York Press 25 May 2000
In 14 years of AIDS journalism, I've never seen the AIDS leadership
writhing in the kind of agony they now
find themselves in daily. The prospect of having to debate, defend or
quantify their paradigm is melting them down.
Since last fall, when the government of South Africa announced that it
would suspend AZT use while investigating its toxicity, the country that
once symbolized oppression has emerged as a crucible of enlightenment.
Over the past several months, the Western AIDS orthodoxy has been rendered
increasingly deranged by South African President Thabo Mbeki's call for a
reopening of the HIV-AIDS causation question. Before long they began
earnestly calling for the criminal prosecution of AIDS dissidents. (This
rabid wish was voiced by way of the mainstream AIDS media.)
Fantastic, I say. Just make sure it's televised because Americans will
recognize the face of at least one man being hauled off in handcuffs for
supporting open debate on AIDS, and it won't be his first visit to the
slammer: Nelson Mandela.
Just last week, Mandela came out in support of Mbeki's "controversial" AIDS
initiative, which has "AIDS
activists" and "AIDS experts" around the world in fits of apoplexy. And
this week, with Mbeki visiting Clinton, the stories all revolve around the
disturbed emotional states of "AIDS activists" who don't quite know how to
express their horror. Project Inform's Martin Delaney told the Times this
weekend that "the
fear here is that he'll dig in worse if he gets pressured."
The trigger for all this strife was a simple, historic event: After months
of deliberations and internal strife,
Mbeki and the government of South Africa convened a two-day panel in
Pretoria, May 6-7, at which 33 scientists deliberated about the evidence
for and against HIV as the single and sufficient cause of AIDS worldwide.
They also discussed the drugs used to combat it, and asked themselves
whether the drugs
have saved lives or ended lives. The AIDS orthodoxy was widely quoted as
fuming about Mbeki wasting time on dead scientific questions while they
themselves were busy saving lives. But the panel did take place, and I was
If you've absorbed the situation thus far from the mainstream press, you've
been left with the impression that the story is all about President Mbeki
betraying his country, if not losing his mind altogether? Mbeki "trawling"
the Internet late at night and "stumbling" across a few "obscure" American
scientists who say HIV doesn't cause AIDS. What's consistently absent from
reports on this subject is a statement not of
conjecture but of fact: Mbeki did not fall under the spell of two American
scientists who question HIV's role in AIDS (by which is meant Drs. David
Rasnick and Peter Duesberg). The scientific opposition to the mainstream
view of HIV and AIDS is in fact longstanding, formidable and far more
extensive than two scientists. This opposition was first galvanized around
retrovirology pioneer Peter Duesberg, who in 1987
wrote his first deconstruction of the hypothesis. Duesberg mapped the
genetic structure of retroviruses, and was widely regarded as one of the
leading retrovirologists in the world at the time of his first critique. In
subsequent years, hundreds of scientists from around the world have joined
the ranks of the
dissenters, under the auspices of the Group for the Scientific Reappraisal
of the HIV-AIDS Hypothesis, an opposition group that boasts up to 600
signatories, many of whom hold PhDs and two of whom hold Nobel Prizes.
These are the so-called AIDS dissidents, now also labeled "AIDS
denialists." On June 6, 1991, the initial
signatories drafted a letter that stands as the working definition of an
"AIDS dissident." The letter, which no major science journal would publish
for years until Science finally relented in 1996, read as follows:
It is widely believed by the general public that a retrovirus called HIV
causes the group of diseases called AIDS. Many biochemical scientists now
question this hypothesis. We propose that a thorough reappraisal of the
existing evidence for and against this hypothesis be conducted by a
suitable independent group. We further propose that critical
epidemiological studies be devised and undertaken.
Epidemiological studies? Whoever heard of anything so whacked? We all know
HIV causes AIDS. Anybody who doubts it obviously doesn't care about the
dead and dying.
Seriously, this simple statement is all that lies at the heart of the
maligned and despised AIDS dissident movement. That wish for a "thorough
reappraisal" was behind the Pretoria conference in early May. Yet judging
from media reports, you'd think that Mbeki had called for AIDS quarantines
and tattoos for all HIV-positives.
In fact, Mbeki's heresy consisted of opening up one large room at the
Sheraton hotel in Pretoria, and placing along a rectangular table 33
scientists with opposing views on what causes AIDS. About a dozen of them
argued that no proof of causation has been established between HIV and
AIDS. The others took the opposing, majority view.
There was predictable response from some quarters. "It's irresponsibility
that borders on criminality," a
South African "medical graduate" and "respected intellectual" was quoted
saying in the Sunday Herald of Glasgow. "Mbeki's position defies logic,"
said Dr. Ashraf Grimwood, the chairman of the South African National AIDS
Convention, in the same article. "The suggestion that AIDS is not caused by
totally at odds with what is happening on the ground. South Africans are
burying wives, husbands, children, relations and friends every day. People
are terrified. No-one has seen anything like it before. This country needs
to get its priorities right, or it will hardly be a country at all."
(Notice the leap of
illogic from the first to the second sentence of that statement.)
People are sick and dying in alarming numbers on the continent of Africa,
but what is it that leads us to trace this phenomenon to sexual promiscuity
and this particular retrovirus, when other complications abound? Why has
AIDS not spread outside the original risk groups in any industrialized
nation, yet where poverty is widespread, the virus (and AIDS) spreads like
wildfire? The orthodox theory is that this is due to sexual promiscuity
among Africans and a penchant for dry sex, rough sex and even sexual
rituals involving monkey blood.
"It isn't the facts that are in dispute," says African historian Charles
Geshekter of California State University at Chico, who took part in
advising Mbeki prior to the panel formation. "It's the theoretical
construct behind the facts. Yes, there is a measurable decline in African
health and increases in African mortality. What is in dispute is whether
the symptoms of such illnesses are caused by extraordinary patterns of
sexual behavior or whether the signs reflect the deterioration of life on
the continent over the past 20 years. The breakdown and decline of public
health and medical treatment across Africa is due largely if not entirely
to domestic civil war, impossible levels of indebtedness and sharp declines
in the prices paid for commodities produced by Africans. This is standard
World Bank and IMF micro- and macro-analysis. Where's the mystery?"
The statistics ubiquitously cited to demonstrate a plague of AIDS sweeping
Africa are untrustworthy in the extreme, as virtually no statistics are
kept on either rates of infection, numbers of deaths or causes of death on
the whole continent. In addition, the shoddy test used there can
cross-react with microbes endemic to the region, such as malaria.
The "Bangui definition" of AIDS was published in Science in 1986; the
diagnosis is AIDS if a patient has a persistent cough and two of three
other conditions: "prolonged fevers (a month or more), weight loss of 10
percent or greater and prolonged diarrhea." In other words, people were
diagnosed with AIDS
without being given HIV tests.
"According to the Global Burden of Disease Study (GBD), which is a
WHO-sponsored project," says
Geshekter, "Africa maintains the lowest percentage of vital statistics for
cause of death of any continent in the world." The GBD estimates that
statistics can be considered accurate on the continent for a microscopic
1.1 percent of all deaths.
One of the South African dissidents on Mbeki's Pretoria panel, Dr. Sam
Mhlongo, arrived at his own skepticism while working at a hospital in
London in the mid-1980s. There he came across a group of patients from
Uganda who, he was told, were all HIV-positive (on the ELISA test). After
retesting them using more rigorous tests, he found that every one of them
was in fact HIV-negative. "That's when I knew something was very, very
wrong," he told me.
The countries where AIDS supposedly rages in Africa are also afflicted by
dire poverty and malnutrition. But the "massive effort" to combat AIDS that
Mbeki is supposedly undermining with his skepticism amounts to widespread
condom education and distribution, and the dumping of failed, toxic drugs
population that does not, in many cases, have access to food or clean
water. AIDS advocates seem curiously unmoved by the practice of driving
around to desperately poor villages in Africa and preaching condom use to
people who don't have water. They also don't seem bothered by the fact that
poor Africans are used in shoddy drug trials, pressured to sign consent
forms they don't understand, manipulated
by AIDS terror and told they will "probably die of HIV anyway." In one
Nevarapine trial in South Africa, five pregnant women were recently killed
by the drug, a protease inhibitor; others suffered debilitating side effects.
Thabo Mbeki was a central figure in the worldwide anti-apartheid movement,
as was his father, Govan Mbeki. He led the ANC delegation that finally
negotiated the release of Mandela and other political prisoners, and
managed to negotiate a peaceful end to apartheid. "The Mbeki family is like
the royal family here in South Africa," a South African journalist told me.
Mbeki is renowned for his intellect, decency and sense of honor. He is a
rapacious reader. He was sent
abroad by the ANC as a young man to spare him from prison and ensure that
he got a good education. At the University of Sussex, where Mbeki obtained
his degree in economics, the theme of his education, according to
biographical notes, was "the notion that the students had to know enough to
be able to
question whether what they knew was, in fact, knowledge."
Mbeki was literate from a very early age, and it fell upon him to read the
letters written to the illiterate wives of the husbands who had gone off to
work in the coal, gold and diamond mines. When the miners began dying from
coughing up blood, lore had it that they died because they had been kicked
in the chest by the killer-birds of witches (impundulu). In fact, they died
of phthisis, brought on by mine dust. Is it surprising, then, that now as
president of South Africa, he looks at AIDS and questions its causes?
Twenty years of crisis. An estimated 50 billion research dollars
expended by the U.S. government. But a head of state can't invite 33
scientists into a room to discuss the actual data underlying the AIDS edifice
without triggering international outrage.
This is the Thabo Mbeki described in The Washington Post as "thin-skinned"
because when "a reporter asked if he could afford such a cautious, studied
approach to treating AIDS when activists estimate that 1,500 to 1,700 South
Africans are becoming infected with HIV daily, Mbeki retorted skeptically:
'How is that figure derived? Do you know? I don't know."'
A better question might be why "AIDS activists" are put in charge of
estimating HIV infections on a
continent that keeps no such figures. Mbeki's "I don't know" is by itself a
revolutionary statement. When discussing AIDS, rule number one is: Don't
ever admit you don't know something. Rule number two: Statistics,
especially in Africa, are always beyond dispute, spiraling toward the
skies, getting worse and worse and worse.
The night before I boarded a plane for Johannesburg, my phone rang. It was
my friend Noah Bogen, a documentary filmmaker who had for years been
telling me he wanted to do something on the HIV debate. "I'm coming with
you, Celia," he said. "I've decided I'm ready to die for something important.
I've had enough of my pointless mundane existence."
"We're not going to die, Noah," I said. "We're going to the Sheraton hotel
Two dissident scientists and three orthodox scientists are on the plane
with us. Fourteen hours later, we touch down in Johannesburg and unfurl our
aching bodies. We are greeted by the coordinator of the panel, and ushered
into a diplomatic lounge, where they take our passports, offer us drinks
and welcome us. Eventually we are divided into cars and speed off toward
Pretoria, half an hour away. On arriving
at the hotel, we learn that there will be no press access to the actual
proceedings, because the mainstream side objected fiercely to this.
A few hours later, jetlagged, I wander down to the cocktail reception,
where hardcore dissidents like
Duesberg and Harvey Bialy are conversing happily with officials from the
Centers for Disease Control and the NIH. In walks Luc Montagnier, from
whose laboratory the entire ball of wax emanated in 1983, when he isolated
the virus (or, some dissidents would say, "what passes for the virus").
I look around the room and smile at the very sight of all the orthodox
scientists eating salmon snippets from the same tray as people who don't
think HIV causes AIDS. A single air strike against this hotel at this
moment and you'd wipe out the HIV debate forever after. I greet Duesberg,
whom I've known, interviewed and admired since 1987. For years I've been
telling him that this day would come. He looks around the room. "I have to
admit," he says, "this is unbelievable."
The next morning at 8 a.m., a red carpet runs through the Sheraton, and we
take our seats to await
President Mbeki, who will address and welcome the panel. When he enters the
room, it feels great, standing up to salute somebody you actually want to
He addresses us, his voice melodic and gentle, quoting Irish poetry, asking
rhetorically if he might be a
fool. "Indeed, when eminent scientists said, 'You have spoken out of turn,'
it was difficult to think I was not a fool," he said. "You cannot respond
to a catastrophe merely by saying, I will respond in a way that is routine.
We must never freeze scientific discourse at a particular point." He
detailed the trajectory of his own skepticism, and said that the data on
HIV and AIDS in Africa had confounded him.
(Days later, Rachel Swarns of The New York Times would report that Mbeki
said in this address that he
"knew that the human immunodeficiency virus causes AIDS." He said no such
thing. I called Swarns twice for comment. At print time, she has not
Around the world, even in South Africa, the media has pilloried Mbeki,
depicting him as "unable to sleep" and searching the Internet for
conspiracy theories about AIDS. Mbeki has accused his critics of waging a
"campaign of intellectual intimidation and terrorism" against him, which he
likens to "the racist apartheid tyranny we opposed."
The real story has nothing to do with the Internet. It started with a South
African journalist and consultant named Anita Allen, who, having read Nobel
laureate/HIV dissident Kary Mullis' book Dancing Naked in the Mind Field,
began her own crash course in the dissident critique, and started calling
South African scientists and health officials to alert them. After many
weeks of polite rejections and assurances that
the scientific community of South Africa was quite sure HIV caused AIDS but
thanks anyway, Allen finally appealed to the President himself in the form
of a letter and a 100-page dossier. Three months later, an astounding thing
"It was close to midnight," Allen recalls, "and the fax machine went off. I
thought, 'Who on Earth is faxing me at this hour?'" What came through the
fax was a handwritten letter from Mbeki, saying he had read her letter
expressing concern about the HIV-AIDS question and that he wanted to meet
with her in the morning to discuss it.
Allen met with Mbeki for an hour. She brought with her a dossier of
scientific articles for him to read. "He said to me, 'What exactly do you
want me to do?' And I suggested he convene a panel. He said, 'I'm going to
be slaughtered, you know.'" "What other leader in the world would talk to
an ordinary citizen like that?" Allen wonders.
She was invited to submit a proposal on whom to invite to the panel and how
to structure it. The man placed in charge of dispatching the invitations,
Dr. Ian Roberts, was, according to Allen, hostile to the debate and simply
didn't send them out. This explains why, in the days leading up to the
conference, I was on the phone with dissidents Rasnick, Bialy and others,
trying to find out if this was really happening
or not, and they didn't know. Many of the panelists only had their flights
confirmed in the immediate days before departure.
"What's going on in there?" I continually asked whatever panelist I could
snag when they came out of the
conference room for their coffee breaks. "They have nothing, just fairy
tales about friends dying, architects dying, all these funerals," says
Christian Fiala, a dissident doctor from Austria. "There is an interesting
argument in there, that so many millions are dying and we have to act now,
and all these people trying to reopen a discussion about the causes of AIDS
is stopping this important action. But what they don't keep in mind is that
before you start to go in a certain direction, you have to know which
direction you're going in, and why. What if it's the wrong direction?"
"It took a head of state to accomplish what scientists couldn't accomplish
in 15 years," Rasnick told me. "The event itself was historic, but I would
not say that anything was resolved. Everybody just laid out their
positions, and nobody really budged from those positions... It was two days
of 'You're wrong and I'm right.'" In a separate meeting, it was decided
that Duesberg and Bialy, under the auspices of the CDC and the South
African government, will design epidemiological studies that will put the
HIV hypothesis to a test (16 years after its birth).
After the first day of the panel, there was a joke going around that Helene
Gayle, the very beautiful
African-American director of the National Center of HIV/AIDS prevention at
the CDC, had invited Duesberg to the CDC for a yearlong sabbatical.
Duesberg and Gayle were joking and being flirty, and before long nobody
knew if the joke was real or not. By the end of the conference, a version
of it had taken root, and
it was announced that a subcommittee of four - Gayle, Duesberg, Bialy and
Prof. Malegapuru Makgoba, head of South Africa's Medical Research
Council would work together to design and carry out the HIV experiments.
This was confirmed by the Health Minister at the closing press conference,
and reporters were meekly asking who would pay for the experiments.
"Peter Duesberg was more surprised than anybody on the planet to hear that
he's now collaborating with
the CDC," said Rasnick. "This is beyond anybody's wildest imagination."
Rasnick also reported that when he said that AZT has "killed a lot of
people," no one on the panel disagreed. "That was quite openly stated and
nobody disagreed with it," Rasnick said. "I would put the figure at at
least tens of thousands killed, at the doses they were giving people in the
Dr. Klaus Koehnlein, a German AIDS practitioner and dissident on the panel,
concurred. "I remember vividly the early years, and seeing those AZT
patients, and they just had no bone marrow left and that was it. They think
AZT wasn't so good and the new drugs are better, but they have no idea that
we killed a whole generation of AIDS patients with AZT. Especially in the
early high doses of 1200 and 1500 milligrams. That was just murder."
Dr. Sam Mhlongo, head of the Dept. of Family Medicine and Primary Health
Care at the Medical University of South Africa, was the only South African
on the panel who holds the dissident position. He speaks to Mbeki on a
regular basis. I ask him whether he thinks Mbeki might back down under
"There is no way this president will give in to attacks on him, because he
is convinced, like he was in the
struggle against apartheid, that there needs to be a debate. This is all
related to apartheid, because the theories and practices of apartheid were
not to be questioned. It was taken for granted. "I grew up under
apartheid," he continued. "There were funerals every week because of the
violence and the poverty of apartheid. There are many funerals still today,
and I say that there is no evidence whatsoever that these people have died
I ask him what I would see if I went to a local hospital (which I've done
in other African countries, but not in South Africa). "If you didn't see
poverty and malnutrition as the number-one cause of death in South Africa,"
he replied, "I am prepared to close my bank account and give you all my money."
I asked him how that was possible? how could there be all these media
reports about the millions dying of AIDS in Africa? It can't be a wholesale
fabrication, can it? Don't they say that AIDS affects the middle and upper
classes, not just the poor?
"Look, there are no death certificates whatsoever," he said. "We have no
references for anything. All you have is the media. Television, radio and
newspapers agreeing on this. That stuff about the upper classes is really
rubbish. I am so-called bourgeois, and I don't see any of this among the
middle class. It's the poverty-stricken, unemployed, black South Africans
who are dying, because of diseases related to
Political earthquakes sometimes begin as flukes, or oversights? like the
"opening" of the Berlin Wall, which the East German government did not
intend at all.
The panel is being followed up by a six-week Internet discussion with all
the panelists, and then
another meeting in Pretoria in early July, where conclusions will be drawn
and recommendations will be drafted for the South African government's AIDS
A strange thing happened on the last day. Apparently, Clinton called and
spoke to Mbeki just as the panel was convening, and asked if he could
dispatch four (African-American) AIDS specialists from the White House to
sit in on the panel. Mbeki agreed, and the four suddenly appeared on the
last day, but evidently didn't say much.
"It seemed like they were there to observe," said Rasnick.
"That's the United States AIDS forces coming in," quipped Duesberg.
When I collared people from the CDC in the halls and asked them for
comment, they would say diplomatically that this conference was "important"
and that many of the dissident arguments could be helpful in the "fight
It felt a little like the period around the time of the Velvet Revolution,
when former authoritarian socialists
suddenly started talking about the importance of "socialism with a human face."