WHAT'S BEHIND MBEKI'S CRUSADE?
The Mail & Guardian March 31 2000
While no one disputes President Mbeki's good intentions, his investigation
of dissident views on HIV/AIDS has plunged South Africa into a national health crisis.
Scientific knowledge is only ever provisional. Whatever the rigour applied
in trying to establish it, it survives only for as long as it is not
falsified or a better explanation for something is not put forward.
So there is something to be said for the person who sets out to falsify all
or part of an accepted theory. He or she may well produce a significant
improvement or a revolution in our understanding of something. Challenging
the conventional wisdom can, indeed, be a heroic pastime in science.
There is nothing inherently wrong in trying to keep open the debate about
HIV/AIDS -- if at all the virus and the syndrome exist and are linked --
provided the debate proceeds along the rules of scientific enquiry, and is
not informed by moralising objections to gay lifestyles or Malthusean
arguments about pharmaceutical companies inventing syndromes in order to
create a market for their products.
But engaging in this kind of investigation can be highly problematic if you
are Thabo Mbeki, president of South Africa. And so it has become.
We are faced with the greatest threat to public health in this part of
Africa since smallpox and other imported European diseases decimated the
indigenous black tribes in the early years of colonialism.
Faced with this crisis, we can legitimately expect of our president that he
ensure that state policy on the issue is coherent, well-understood by the
public at large, energetic and based on the best available scientific
knowledge. He is, after all, a politician, elected to rule.
Instead, he has at times behaved like someone trying to be the Boy's Own
basement lab hero of AIDS science. He has allowed his attention to be
diverted into abstruse debates on immunology and related science. He seems
to have become the international political patron of views on HIV/AIDS
which seriously undermine the deployment in this country of best available
methods based on the best available science for treating HIV/AIDS and
related conditions. In the process, the nation's attempt to deal with this
national health crisis have been plunged into confusion. And the four
million-odd South Africans who have contracted the syndrome can be forgiven
for feeling, if not exactly abused, certainly neglected. Worse, each
attempt by Mbeki and his representative, Parks Mankahlana, over the past
fortnight to dig themselves out of this hole has only plunged them and the
rest of us deeper into it.
It is small wonder that scientists, diplomats and politicians, even in
Mbeki's own party, are asking whether Mbeki's usually astute judgment has
completely deserted him. His behaviour has also led to unhelpful
speculation about why he is so strangely exercised by the issue. Even if
the largely discredited dissident views to which he wishes to give so much
air are eventually proved to have been right, this will not compensate for
the ground that is being lost right now in our fight against what best
science sees fit to call HIV/AIDS.
We have been told of late that the "president has never said HIV does not
cause AIDS". But we know that Minister of Health Manto Tshabalala-Msimang's
proposed international panel, very much at Mbeki's instigation, is to look
into "everything about AIDS", including "whether there's this thing called
AIDS, what it is, whether HIV leads to AIDS, whether there is something
called HIV, for an example. All these questions."
Mankahlana has taken pains in the past fortnight to ensure that we all
understand the true nature of free speech, and has accused voices like ours
of attempting to stifle free thought and debate.
But this is nonsense. We and other critics of the president's approach to
HIV/AIDS would deny no one -- not even crackpots -- the right to challenge
conventional wisdom. The issue for us is that Mbeki is missing his vocation
completely if he seeks to revise scientific knowledge instead of expediting
policy in the way he was elected to do.
Tshabalala-Msimang's evident unease in interviews suggests she is rather
less well-disposed to the dissident view on HIV/AIDS than she believes
Mbeki would like her to be, or than her predecessor, Nkosazana
Dlamini-Zuma, was. Deputy President Jacob Zuma has suggested, since the
controversy erupted, that the presidency may hold back in future from
declaiming on issues of science. But he seemed less than willing to rule it
Why has Mbeki embarked on this stubborn, silent crusade? There are no
obvious reasons, no reports of African National Congress branches rising up
and demanding that the president personally push the case for the earth
being flat in the world of AIDS science. One might expect the Pan
Africanist Congress to lead any arguments that South Africa is merely a
playground for neo-colonialist pharmaceutical companies, but instead its
fiery health spokesperson, Dr Costa Gazi, is suing the government over its
denial of AZT to pregnant mothers.
The dismay over Mbeki's actions crosses the nation's traditional fracture
lines, with Mamphela Ramphele and Malegapuru Makgoba, among the most
prominent of the black scientists and doctors, as desperate for a
government turnaround as any white health worker.
No one disputes Mbeki's good intentions. He clearly understands the extent
of the AIDS epidemic, and the social and political problems it poses. If he
were not deeply concerned by the AIDS problem, it is highly unlikely he
would have become so deeply embroiled in it.
What is unclear is his judgment on this matter -- and his willingness to
confine himself to the job he was elected to do and to restrict his forays
into the intricacies of specialised subjects to the taking of best