Mbeki reaches out to a controversial AIDS researcher

By Tom Masland and Patricia King

Newsweek 17 April 2000

It was the first phone call David Rasnick ever received from a head of state. When the San Francisco biochemist's telephone rang last Jan. 21, South Africa's president, Thabo Mbeki, was on the line. Mbeki, Rasnick says, was eager to discuss Rasnick's controversial theories about AIDS: that the disease now ravaging sub-Saharan Africa is not caused by a virus, and that drug cocktails used in rich countries to defer the onset of AIDS are toxic. During the 10-minute call, Rasnick says, it was clear Mbeki is determined not to blindly follow the conventional scientific wisdom on AIDS and its treatment. "If he can stick it outˇand he has told me he willˇhe deserves a Nobel Prize," Rasnick says.

What has come over Thabo Mbeki? He is Washington's favorite African leaderˇurbane and brainy, the West's best hope for a continent mired in poverty, corruption and disease. No one doubts he is committed to fighting AIDS; Mbeki has put together a vigorous AIDS-awareness program and has also long tried to force Western drug companies into providing low-cost AIDS medicines to poor countries. But his flirtation with an obscure, discredited theory disheartens many AIDS researchersˇand flabbergasts administration officials preparing for Mbeki's state visit in late May. According to one senior U.S. official, Mbeki's contacts with the dissenters on HIV were discussed at the White House last week. Mbeki's "made a huge mistake," says this official, "but we don't know whether it was a cynical mistakeˇif there was pressure on him [to downplay HIV]ˇor a genuine error. Either way, the consequences are serious."

Mbeki has done little to clear up the mystery. His office won't even confirm or deny that the phone call to Rasnick took place. Yet Mbeki has publicly insisted on revisiting the basis of AIDS science. Some critics suggest he's motivated by intellectual prideˇthe determination not to be dictated to by the West and by South Africa's mainly white and Indian medical establishment. "The president is saying there are a number of questions regarding the prevalence of AIDS in South Africa that need to be answered," says Joel Netshitenzhe, an Mbeki spokesman.

Mbeki must be wary of getting burned on AIDS policy. As vice president, he backed development of a locally produced AIDS treatment called Virodene, which contained a dry-cleaning solvent and proved ineffective. Now he's under pressure to make costly decisions. The main sticking point is whether to commit to a program involving symptom-fighting retrovirals, of the type used by AIDS victims in the West. A large-scale program could bust his budget, but activists demand that the government provide the drug AZT free to pregnant women and rape victims. Here, the dissident AIDS theory was a useful argument for caution. In Parliament last November, Mbeki said that "there exists a large volume of scientific literature alleging... that the toxicity of this drug is such that it is a danger to health."

A new skirmish in the AIDS war erupted last week. Health Minister Manto Tshabalala-Msimang told Parliament that five South African women had died during an American clinical trial involving the AIDS drug Nevirapine, a low-cost alternative to AZT. Doctors involved in the research said the minister had misleadingly conflated two studies. Meanwhile, Mbeki questioned the motives of those who continue to urge him to set up an AZT program. In a letter obtained by the press, he said the activists seem determined to "sacrifice all intellectual integrity to act as salespersons of the product of one pharmaceutical company." Some foreign experts are threatening to boycott the 13th International AIDS Conference, planned for Durban in July, if it appears the spat will dominate the proceedings. In San Francisco, Rasnick said he views the controversy as one more proof of his theory: AIDS is a "sociological and political phenomenonˇthat's why you get all these shrill attacks." But Mbeki, whose country has more than 4 million HIV-positive people, can't afford to be glib.