MBEKI'S AZT CLAIMS SET OFF DEBATE
AP 3 Nov. 1999
JOHANNESBURG - President Thabo Mbeki's claim that a widely used
AIDS drug is dangerous has set off an uproar,
producing bafflement and shock among
physicians and advocates who say AZT is safe.
The drug is the mainstay of efforts around the
world to prevent HIV-infected mothers from
passing the AIDS virus to their babies during
Mbeki said in Parliament last week that AZT is
toxic and was being challenged by court cases in
the United States, Britain and South Africa - a
claim the manufacturer, Glaxo Wellcome PLC, has
The issue is critical in a nation with one of the
world's worst AIDS problems, where 3.6 million
people, or 8 percent of the population, are
estimated to be HIV positive. The controversy
threatens to set back efforts to fight the
In his speech Thursday, Mbeki spoke of a "large
volume of scientific evidence alleging that,
among other things, the toxicity of this drug is
such that it is in fact a danger to health.''
Mbeki said that it would be "irresponsible'' not
to heed the "dire warnings'' of researchers
about the safety of AZT, which is one of the
world's oldest and best-known AIDS drugs.
Reputable scientists have issued no such
warnings, and it was unclear what he was
On Tuesday, the government promised to
investigate the safety of AZT. Mbeki said he has
asked the health minister, Manto
Tshabalala-Msimang, to oversee the inquiry.
Tshabalala-Msimang told the South African
Broadcasting Corp. that AZT would not be barred
from the market but she was deciding how to
investigate the matter "so that we really have
concrete information in our hands.''
The drug has been approved by regulators in
South Africa and around the world, and is
commonly used in combination with other drugs
to control the AIDS virus or prevent infection
among health care workers exposed to it. Many
studies have shown that AZT cuts in half the
risk that women will infect their babies during
AZT, also known as zidovudine, is "perfectly
acceptable'' in those three areas, said Dr. Joseph
Perriens, head of the care and support division of
the U.N. AIDS program in Geneva. It causes
slight side effects like nausea or anemia, but, he
noted, so do many medicines.
Worries about AZT's safety surfaced in the early
1990s but have long faded, Perriens said. French
researchers reported in February that two babies
who had received AZT in a study had died, but
no link between the deaths and the drug was
Perriens suggested Mbeki "inform himself better
about the toxicity of (the drug), which is not
really as serious as he thinks, and he should
probably recast the debate in terms of cost. It's
not doing his people a service.''
With an average of 1,500 South Africans
infected with HIV each day, the government has
come under increasing pressure to provide drugs
like AZT to infected pregnant mothers and rape
victims. The government has said before that it
cannot afford to do so, but this is the first time
in the public debate than an official has so
forcefully said a health danger is the reason.
Mbeki's comments are "very distressing
because it sets back the whole agenda once
again'' after previous controversies, such as a
scandal-plagued anti-AIDS musical, which
paralyzed the government AIDS program, said Dr.
Saul Johnson, a pediatrician and researcher at
Chris Hani-Baragwanath Hospital in Soweto,
where AZT has been studied as a way to
prevent mother-child transmission.
"It raises the issue of where he gets advice,''
A presidential spokeswoman was quoted over the
weekend as saying Mbeki received his
information from the Internet.
"I think if the president doesn't want to provide
AZT, he should find an excuse based on fact,''
said Dr. Salim Abdool Karim, head of AIDS
research at the Medical Research Council, which
is similar to the U.S. National Institute of Health.
"It's the standard of care in many countries,''
When asked why Mbeki would make such a
statement, he said: "I can only assume that he
has been given this information and accepted it
in good faith. I don't think the president would
deliberately try to mislead us.''