By Anita Allen

1 July 2000

South Africa -- The first members of President Thabo Mbeki's Presidential AIDS Advisory Panel have started arriving here in Johannesburg, South Africa. I had lunch with Professor Charles Geshekter from the hotbed that is the University of California, US. Over a chef's salad we celebrated the road that led to our first meeting here in South Africa in Nov/Dec 1999 and shared views on all that has happened since then.

The first meeting of Mbeki's AIDS experts May 6 -7 attracted about 36 acceptances to the panel of which about 32 were present at the first meeting. Other panel members were added over the two-day meeting, notably four representatives of the Clinton Administration. Since then the panel has been expanded. Geshekter, for example, was added in the course of the Internet debate that succeeded the Sheraton meeting and closed for submissions on June 28.

From what he tells me, his exchanges have been a very valuable contribution. His background in history, an African specialist with now dozen's of extended study periods in Africa, his meetings with African politicians, administrators, scientists, health practitioners, as well as his particularly detailed experience of what's what in South Africa, all add up to a really good choice on a panel to advise the President of South Africa. About 60 panelists are expected this time, including most of the original panel members - as well as the Perth Group represented by Dr Val Turner and Eleni Papadopulos-Eleopulos who are expected this time.

They will meet for two days July 3 and 4 at the Holiday Inn Crown Plaza in Sandton, Johannesburg.

The significance of this meeting has largely escaped media commentators here. When it was first announced that President Mbeki would be assembling a panel of the world's top scientists in HIV/AIDS to advise him, it was greeted here in the media with scorn. This time round, there is almost total silence. Today's weekly Mail & Guardian, the most outspoken critic of the President's initiative, does not have a single article on AIDS. None of the letters to the Mail & Guardian editor from readers or letters from AIDS panellists to individual journalists, were printed. Its readers have not even been informed that the Presidential AIDS Advisory Panel is meeting again.

HIV/AIDS is punted in newspapers as the most devastating scourge to hit Africa. Yet those same newspapers if they publish at all on the subject, it is buried on inside pages. With the exception of Martin Willaims managing editor of the Citizen, not a single editor supported President Mbeki's decision to consult all sides in the HIV/AIDS debate.

Now, its just three days to the panel meeting, and 10 days to the 13th International AIDS Conference in Durban, sponsored by the pharmaceutical industry, and supported with funding of some R1 million from South African taxpayers through their Department of Health. Justt when they are needed every health journalist in the country is struck dumb. It is proof that they don't believe the propoganda they are being fed. The only other possibility is that because it is largely "blacks" who suffer from this scourge the largely white-owned media do not regard it as important. I like to think we have progressed beyond that here in South Africa.

Yesterday, the top radio Talk Show host, Tim Modise, had Dr Malegapuru William Makgoba, president of the Medical Research Council (MRC) and member of Mbeki's panel on his one-half-hour show on SABC's SAfm. Makgoba unblushingly reiterated that his views on HIV causing AIDS were unchanged. Nothing had happened during the Sheraton meeting, or the Internet debate to change his mind in any way. Considering some of the interchanges that he has been involved in, one of them readers saw for themselves, I can quite understand why his views have remained unchanged. Shame! As we say in South Africa, when words suddenly fail us, but we want to express regret.

Lets be clear about what is at stake here. We have in President Mbeki, a leader who has made HIV/AIDS a presidential imperative. He has rejected suggestions that in the search for solutions he should restrict himself to consulting only those who hold a majority view. In the end even those who said that an Open Debate on HIV/AIDS was unnecessary, like Makgoba, accepted invitations to sit on his panel and do just this.

From all accounts, the Internet exchanges that have followed the Sheration Hotel meeting have been lively, and illuminating. From some of the exchanges which I have read, the HIV causes AIDS paradigm is under serious attack, with very little defence being mounted.

Instead, what has happened, is that a group of scientists, led by Robert Weiss of University College, London and the Pasteur Institute, have signed the Durban Declaration. No one objects to scientists doing this, but I for one was shocked to see President Mbeki's AIDS Advisory Panellists had seen fit to sign it. They accepted an invitation to serve on the panel and embark on a process of exchanging views aimed at identifying areas of ignorance.

They accepted the all expenses paid trip per courtesy of the South African taxpayer, as distributed through the Minister of Science and Technology, and stayed at a 5-star hotel. They each received a sustainance allowance for their expenses while here, they accepted to debate in open debate and some of them did indeed speak up at the Sheraton if only incoherently. Then they accepted to debate outstanding issues on the Internet, and many of them did their level best to not take part. Now they have accepted the return all-expenses paid trip, but this time they have declared before coming to the host, President Mbeki, in front of the world, that they hold his panel initiative in contempt.

I was appalled to see that among those that signed were local panellists - Makgoba, president of the MRC, Professor Salim Abdool-Karim, Head of HIV/AIDS Research Unit at the MRC, Dr Hoosen Coovadia, Professor James McIntyre, Dr Carolyn Williamson. Some of these owe their jobs to the South African taxpayer. As such it appears that the parastatal MRC, some university academics, (and Nature if it prints July 6) have thrown down the guantlet before the President of South Africa, and everyone who is supporting his Presidential AIDS Advisory Panel, which amounts to at least the ANC Cabinet, President Clinton, and who knows who else. All together a most peculiar, and a devious and dishonourable way of doing things, I would say, wouldn't you?

The overseas panellists who signed are: Dr Helena Gayle, who represents the Centres for Disease Control, US, Luc Montagnier, Pasteur Institute, Dr Stefano Vella and Dr Stefano Bertozzi.

A reasonable person can reasonably conclude that since these people have signed this declaration before the conclusion of the Presidential AIDS Advisory Panel process, they have pre-empted the findings of that same panel. If so they ought to recuse themselves or be asked to recuse themselves from any further participation. I have every confidence that the proverbial slap across the face of the President of South Africa, and other panellists, will be the first item on the agenda on Monday morning when the panel assembles at the Holiday Inn Crown Plaza.

According to the agenda of the meeting the next item is going to be the question of aetiology of HIV. The whole vexed question of isolation, exogenous versus endogenous, infectious sexually transmitted versus harmless passenger. Of course a first prize would be consensus that HIV has not been isolated. The way I see it, we may have to settle for agreement on a series of experiments to test this and to falsify the HIV causes AIDS hypothesis.

What is also emerging is that the upcoming meeting may not be the end of a presidential "AIDS" advisory panel of some sort. President Mbeki already has an International Economic Advisory Panel, so there is no reason why a similar one could not be constituted to assist in the battle against disease and death in Africa.

That battle extends far beyond the upcoming meeting of the AIDS Advisory Panel. But one thing is for sure: HIV/AIDS science will never be "business as ususal" after Tuesday plays out at the Holiday Inn Crown Plaza in Sandton, South Africa.