By Anne M. Peterson

Associated Press 24 May 2000

San Francisco -- South African President Thabo Mbeki, responding to that his country isn't dealing effectively with the AIDS crisis, defended his health policies during a quiet visit to a city known for its vocal AIDS activism.

Mbeki said South African officials are currently studying the best ways to confront the AIDS epidemic: Four million South Africans, or about one in every 10 citizens, is infected with HIV.

"We want to make sure our response is effective, specific, focused and produces results,'' he said Wednesday at an event sponsored by the Commonwealth Club and the World Affairs Council.

He suggested that to effectively treat AIDS, there are several issues facing his nation -- such as poverty and nutrition -- that also must be considered.

"The debate seems to be fueled by the discussion of buying more drugs and more drugs -- not what to do to address these basic problems,'' he said.

There were no protesters inside or outside the Fairmont Hotel, where Mbeki focused mostly on the economy during the non-profit public affairs council's event. He later spoke to a small group of newspaper editors and columnists.

Mbeki has publicly entertained the theories of University of California at Berkeley virologist Peter Duesberg, who claims that HIV is not the cause of AIDS. He also has considered that AZT, a medication commonly used to slow the progress of AIDS, does more harm than good.

Along with Mbeki's willingness to accept controversial theories, the South African government has drawn the ire of activists because it has not made anti-retroviral drugs available through the public health system.

Five major drug companies have offered to cut the price of HIV and AIDS treatments. But even at reduced prices, the cost of such drugs would be so prohibitive that "it would consume the totality of the government's health budget,'' Mbeki said.

Additionally, he said, drug treatment is a comprehensive program, one that the government is not set up to provide.

"You can't just give AZT to people and say `Thank you. Good-bye. Now go do your own thing,''' he said.

Minister of Foreign Affairs Nkosazana Clarice Dlamini-Zuma said the health system in South Africa was created under apartheid to serve 4 million white people -- not the 40 million people it serves today.

"We're trying to build an infrastructure in black areas, but you cannot do that in five years,'' she said.

The South African government also has refused to endorse the use of AZT in pregnant women, despite proof that the drug cuts the chance of newborns being infected with the virus.

Again, there are other considerations, insisted Dlamini-Zuma, who was Minister of Health for five years and accompanied Mbeki on his trip. Drug treatment would mean that women couldn't nurse, thus exposing some babies to potentially contaminated water used with formula.

Already, the country has implemented a public awareness campaign, and formed partnerships with businesses and labor unions to combat the spread of HIV. Additionally, Mbeki said, there has be an effort to set aside dedicated funds in the national budget.

"I think it's inadequate to say HIV causes AIDS, use a condom, problem solved,'' he said. "We need to address a whole range of issues.''

Mbeki said his country hosted a meeting of scientists earlier this month to discuss the AIDS crisis, and the country will sponsor the international AIDS 2000 Conference in Durban in July.

Despite questions surrounding South Africa's suitability as the site for such a conference, the U.N. AIDS agency has said a boycott would divert attention from the epidemic.