Head in sand, foot in mouth

By Bryan Pearson

AFP 10 Sept. 2001

President Thabo Mbeki, who questions the link between HIV and AIDS, is again under fire, this time for using outdated statistics to bolster his claim that HIV/AIDS is not South Africa's leading cause of death.

Mbeki said in a letter to Health Minister Manto Tshabalala-Msimang, a copy of which was published on Monday in Business Day newspaper, that government's spending on health services should be re-examined in the light of World Health Organisation (WHO) statistics he found on the Internet, dated 1995.

South Africa's main political opposition Democratic Alliance (DA) described Mbeki's letter as "bizarre" and said it proves he is in denial of the HIV/AIDS problem that is ravaging the country.

The WHO 1995 figures back up Mbeki's assertion that AIDS is not the leading cause of death in the country, accounting for just 2,2% of fatalities, way behind external causes such as homicide, accidents and suicides, and a host of other categories.

Business Day says, however, that a South African Medical Research Council (MRC) report to be published soon is expected to show that AIDS has indeed become the leading cause of death in the country.

The daily said the MRC report will clearly show that the pattern of AIDS deaths has shifted significantly since the mid-1990s, the period from which Mbeki's statistics come.

Mbeki in his letter warns the health minister that the figures will "provoke a howl of displeasure and a concerted propaganda campaign from those who have convinced themselves that HIV/AIDS is the single biggest cause of death" in South Africa.

The South African leader has been criticised internationally for having said in 2000 that AIDS might not be directly caused by HIV, despite the fact that South Africa has the world's largest HIV population with 4,7-million infected.

In the letter, which a presidential representative has confirmed was indeed written by the president, Mbeki instructs the minister to examine the WHO statistics and assess whether "our health policies and therefore the allocation of resources reflect the incidence of death as reflected by these figures."

He urged Tshabalala-Msimang to institute a recommendation by an AIDS panel he has set up - comprising among others experts who question the link between HIV and AIDS - that statistics "which are regularly peddled as a true representation of what is happening in our country" be thoroughly reviewed.

Toby Kasper of international humanitarian group Medecins Sans Frontieres (MSF) in Cape Town said figures to be released by the MRC will put an end to the president's assertion that AIDS is not the primary cause of death in the country.

"The data that will be coming out suggests that AIDS is not only the leading cause of death but in South Africa but may outweigh all the other causes together," he said.

He said Mbeki was basing his arguments on "outdated data" and that this was going to "lead you to incorrect conclusions."

DA deputy health representative Sandy Kalyan, meanwhile, said that figures for 1999 from assurance companies - the latest available - show that 23 000 people died violently in that year against 250 000 who died of AIDS-related illnesses.

The letter, she said, "is just another example of the president's bizarre behaviour over the whole HIV/AIDS pandemic."

"He's in complete denial of the problem."

Parliament has set aside R125-million ($14-million) in a special AIDS fund for the 2001/2002 financial year, rising to R300-million ($36-million) the following year.

But government refuses to provide anti-AIDS drugs on public health and is currently being taken to court by Treatment Action Campaign lobby group in a bid to force it to take immediate steps to prevent mother-to-infant transmission of HIV.