By Muzondwa Banda

New African Dec. 1999

In a move that has delighted opponents of the AIDS establishment, President Mbeki has added his big voice to the concerns expressed against the "AIDS drug" AZT, saying there is "evidence" suggesting that the drug "is toxic and harmful" and that he has ordered his health minister to conduct further investigations into the safety of the drug and uncover "the truth".

Known as Zidovudine or Azidothymidine, AZT is produced by the British pharmaceutical giant GlaxoWellcome. For the last 10 years, experts who studied the effectiveness of the drug and people who have used it have continuously said the AZT was toxic and harmful.

The drug was originally developed as a cancer chemotherapy, and though it killed dividing blood cells and other cells, it was found to suppress the immune system, and thus abandoned as a cancer drug.

Years later, with the first AIDS scare stories frightening Western governments out of their cool reasoning, AZT, the cancer drug, was resurrected as an anti-AIDS drug in 1984.

Despite grave concerns by scientists that the drug's short term benefits did not compensate for its long term effects of its toxicity, AZT was "given singular support by the US and British government institutions and was to earn hundreds of millions of pounds for GlaxoWellcome", wrote Neville Hodgkinson, former science correspondent of the British weekly The Sunday Times in his 1996 book, AIDS the Failure of Contemporary Science.

But GlaxoWellcome denies the drug is toxic.

Since coming to power in June, Mbeki has been under immense pressure both at home and abroad to provide the expensive AZT free on the public health system. According to figures from the AIDS establishment, one in eight adult South Africans is infected with HIV.

Despite the pressure, Mbeki wants to use his own head. "There exists a large volume of scientific literature alleging, among other things, that the toxicity of this drug is such that it is in fact a danger to health...I have therefore asked the minister of health to go into all these matters so that we ourselves, including the country's medical authorities, are certain of where the truth lies," Mbeki told South Africa's second chamber of parliament, the National Council of the Provinces in early November.

He also revealed that the use of the drug was being challenged in courts in the US, Britain and South Africa itself.

"These are matters of great concern to the government, as it would be irresponsible not to heed the dire warnings which medical researchers have been making," said Mbeki.

GlaxoWellcome immediately issued a denial, saying Mbeki had been "gravely misinformed."

In a statement issued in Johannesburg, the company said: "For more than a decade, AZT has extended and improved the quality of life of millions of people living with HIV/AIDS around the globe."

Peter Moore, the company's medical director in South Africa, was adamant that following "extensive" research, the drug was given a stamp of approval 10 years ago, not only by South Africa's own Medicines Control Council (MCC) but also by the US Food and Drug Administration (FDA) and its British counterpart, and as well as the Centres for Disease Control (CDC) in Atlanta, USA. Moore also denied the court cases pending on the safety of AZT.

But in his book, Neville Hodgkinson revealed that documents obtained from the FDA through the the US Freedom of Information Act, showed that the main trial of AZT, upon which the drug received its license, was invalid because many of the rules for the conduct of such studies had been broken.

"The death rate among the placebo patients was far higher during the few weeks of the trial than ever seen before or since among AIDS patients, suggesting either that a disproportionate number were at death's door before the trial began, or that their deaths were accelerated because of their being deprived of conventional treatment for their infections during the course of the trial."

The deaths in the AZT trial group accelerated even further after the trial was prematurely ended, wrote Hodgkinson.

Despite these shortcomings, the drug was given a licence. The concerns expressed by people who knew about the shortcomings of the drug were thrown out the window following an intervention from the FDA which was under both political and public pressure to fast-track the drug on the market.

"In effect, AZT became an official [US] government drug, a kind of talisman for HIV," says Hodgkinson in his book. "Since then there has been totalitarianism about its marketing, which has been truly shameful and frightening," he says.

The millions of dollars that AZT has earned along with the fact that it held a flagship role in the fight against HIV, helped generate a climate of opinion in scientific, medical and political circles that was intolerant of opposing views.

Another medical researcher and writer, John Lauristen, author of Poison by Prescription: The AZT Story, has analysed the AZT studies. He concluded that "there was no scientifically credible evidence that it had benefits of any kind".

Speaking to reporters after Mbeki's speech, South African health minister, Tshabalala-Msimang, was categorical: "We have to be very cautious and very sensitive so that we do not look back 10 to 15 years down the line and find that we had exposed the vast majority of our people to a dangerous drug," she said.

Dr Joseph Perriens, head of the care and support division of UNAIDS in Geneva was quoted by the Associated Press as saying "AZT is perfectly acceptable".

We shall see if this is so from the Mbeki-ordered investigation into the drug.