By Sue Pleming

Reuters 24 May 2000

Washington -- Trying once and for all to end controversy over his views on AIDS, South African President Thabo Mbeki said on Tuesday his past comments had been misinterpreted and that he had never questioned the link between HIV and AIDS.

But Mbeki was quick to stress that the world's focus should not only be on the AIDS epidemic sweeping across Africa and that the mosquito-borne disease malaria deserved equal treatment.

Reports that Mbeki questioned whether HIV causes AIDS--the view of most scientists--and his decision not to give pregnant women the antiviral drug AZT, has clouded the South African president's first state visit to the United States.

"Clearly there has been some misunderstanding of what we have said...We have never said there is no connection between HIV and AIDS. I don't know where that report came from,'' Mbeki told reporters after receiving an honorary degree at Howard University in Washington.

AIDS activists say Mbeki's government has been slow to respond to the AIDS epidemic in his country where one in 10 South Africans, or about 4.2 million people, are infected with HIV, the human immune-deficiency virus. They are also outraged by the inclusion on a presidential panel of three US researchers who contend AIDS is not always caused by HIV and that conventional drugs may be ineffective.

Mbeki, who discussed the AIDS issue with President Bill Clinton on Monday, said questions remained over the use of antiviral drugs such as AZT for pregnant women with AIDS.

Even with recently announced price reductions for drugs by five large pharmaceutical companies, prescribing AZT to all pregnant women with HIV would take up his country's entire health budget, he said. "We would not even be able to afford an aspirin,'' he said, adding that South Africa's medical infrastructure was not sufficient to monitor the use of AZT, which can be toxic.

Clinton said Monday he hoped South Africa would be helped by the decision earlier this month by five big drug makers to cut prices for AIDS drugs in Africa, and by his executive order that effectively gives African countries more leeway to pursue cheaper, generic versions of patented anti-AIDS drugs.

South African Foreign Minister Nkosazana Dlamini-Zuma, a former health minister, said she did not believe prescribing AZT was an efficient use of her government's resources. It was also not clear, she said, whether prescribing vitamins and supplementing a mother's diet would have the same effect as using AZT. "There is a lot of scientific work that still needs to be done, despite the fact that it would cost so much without a very good result in the end.''

Mbeki said one of the biggest killers in Africa was malaria, but no one wanted to talk about this issue and instead focused solely on AIDS. "I think we have to deal with this AIDS issue as effectively as possible, and so on, but I think that it would be incorrect for us as Africans to just focus on this and leave these other major issues- malaria, tuberculosis,'' he said.

The emergence of HIV/AIDS since the 1980s as an epidemic across Africa has overshadowed the fight against malaria, which affects over 400 million people each year and causes a million deaths. Most of those deaths are African children. Mbeki said he could understand that malaria was not a serious problem in the United States and so this might be difficult for people to understand.

"No one asks and no one wants to come in and say, 'What can we do to assist with dealing with malaria' because of this exclusive focus. It's an important focus but it must not mean we should close our eyes to other realities,'' Mbeki said.