MIXED HIV/AIDS MESSAGES FROM GOVERNMENT
The Mail & Guardian (SA) 14 March 2000
Johannesburg -- The opportunity to institute a constructive
policy to deal with the HIV/AIDS epidemic is slipping out of reach as politicians
and scientists argue over who knows best.
Minister of Health Manto Tshabalala-Msimang confirmed two weeks
ago that her department is busy setting up a panel of approximately 30
local and international experts "to explore all aspects of the challenge of
developing prevention and treatment strategies [for HIV/AIDS] that are
appropriate to the African reality".
The announcement of names of panel members is eagerly awaited, in the context
of widespread scepticism about the government's motives in setting it up.
Tshabalala-Msimang's statement followed an earlier report, based on an interview
given by her special adviser, Dr Ian Roberts. The report, from Sapa, speculated
that the panel would be asked to evaluate the claim by California biochemist
Peter Duesberg and other AIDS dissidents that HIV is not the cause of AIDS.
The minister dodged the question of whether Duesberg had been approached to
serve on the panel, but commented that her "personal view is that those with more
extreme views are unlikely to participate because we are looking for a consensus
view". She also stated that she would welcome suggestions for panellists.
She said the panel would convene as soon as possible to agree on their terms of
reference in consultation with her department. They would be encouraged to
publish their views, which would be available on the Internet, over a period of six
to eight weeks. There would then be an attempt to "thrash out a consensus
recommendation to the department".
Some of the issues which she would
encourage the panel to review included
the treatment of HIV/AIDS and
opportunistic infections; general
prevention of the disease; prevention of
mother-to-child infections; prevention
of HIV infection following rape or
"needle-stick" injuries; and local
evidence regarding the causes and
diagnosis of AIDS and opportunistic
On whether the government would
revisit its refusal to supply anti-retroviral
drugs to pregnant women with
HIV/AIDS, Tshabalala-Msimang replied
that if the panel came to a different
conclusion, she would give it serious
consideration -- although an ingenious
solution to the funding challenges would
But she defended the government's
decision, saying that it had been taken
"in the light of the best available
evidence and the special social and
economic circumstances in our
"I still think it's the right decision", she
Asked whether the panel would be free
to come to its own conclusions,
Tshabalala-Msimang replied: "I can't
imagine that top scientists will accept
anything else." She added, however,
that it was the prerogative of the
government to make a final decision
about their recommendations.
Tshabalala-Msimang denied accusations by the Treatment Action Campaign
(TAC), following Roberts's initial announcement about the panel, that it was "a
justification for the immoral, unscientific and unlawful decision to withhold AZT or
Nevirapine from pregnant women".
"I hope that the work of the panel will demonstrate that we have no hidden
agendas", she countered.
It is difficult to see how the government could benefit from any further advice on
the issue of using anti-retroviral drugs to prevent mother-to-child transmission of
HIV. It has rejected two reports from the Medicines Control Council, and has
not yet officially reacted to a third report from the same body -- none of which it
is prepared to make public.
It also has in its possession additional reports from the Medical Research Council
and the World Health Organisation. All of these reports are believed to support
treatment using anti-retroviral drugs, but they are based upon the premise that
HIV causes AIDS.
The TAC also challenged both the minister of health and Roberts to state whether
or not they support the Duesberg claim that HIV is not the cause of AIDS, noting
that it has been discredited by the international scientific community. Roberts has
subsequently issued a statement confirming that he does not support the dissident
view but, interestingly, Tshabalala-Msimang appears to have ignored this
She is known to have met prominent AIDS dissident Charles Geshekter of
California State University, during a visit he made to South Africa in December.
According to Sapa, yet another prominent AIDS dissident, David Rasnick, claims
to have been contacted by President Thabo Mbeki in January for advice.
Mbeki's office has refused to verify or deny this claim.