Backtracking in the fight against AIDS

By Claire Bisseker

Financial Mail (South Africa) 17 March 2000

The disclosure that President Thabo Mbeki has been personally courting the opinions of San Franciscobased AIDS dissidents with a view to forming a science panel to review the causes of AIDS has plunged the local AIDS community into despair: for as long as the President doubts whether HIV causes AIDS, SA's efforts to deal with the epidemic will falter and stall.

This latest setback in SA's botched history of dealing with the epidemic follows the revelation last week that R40m of last years R109m AIDS budget went unspent and that Johannesburg Hospitals AIDS Clinic is turning patients away because of funding constraints.

Discredited Californian microbiologist Peter Duesberg, who described Mbeki's approach as a political surprise, told the FM that his close collaborator, San Franciscobased AIDS dissident David Rasnick, had been phoned by Mbeki in January for advice on how to proceed with his plans to review the hypothesis that HIV causes AIDS. Rasnick, a biochemist who believes that HIV is a harmless virus and that AIDS is caused by diseases of lifestyle (like recreational drug use) and poverty (like malnutrition), says Mbeki phoned him after he replied to faxed questions from the President on AIDS.

He asked me if I would support his efforts regarding AZT and AIDS, Rasnick told Sapa, adding that Mbeki said he planned to lobby other world leaders to join him in an international dialogue on these issues.

Respected local scientists like Medical Research Council (MRC) president William Makgoba; the MRC's director of HIV prevention and vaccine research, Prof Salim Abdool Karim; and chairman of the International AIDS Conference Prof Jerry Coovadia all of whom have backed the use of AZT to prevent mothertochild transmission have not been approached to serve on the Health Departments science panel that will review the causes of AIDS.

If this committee is being set up to look at the question of whether HIV causes AIDS, we'll become an international laughing stock, warns Karim, and it will set back our efforts to deal with the epidemic.

Makgoba dismisses Duesberg as a loony and says the scientific evidence that HIV causes AIDS is abundantly clear. Maybe (government) needs to be convinced; maybe the policy indecisiveness is because of their confusion. The only hope I have is that government has invested in the development of an AIDS vaccine, he says.

In a statement, Health Minister Manto TshabalalaMsimang says the panel's main aim is to get practical strategies for the prevention and treatment of AIDS in the African context. But then why have US scientists who deny the existence of AIDS been canvassed ahead of local experts? Besides, government already has reams of practical advice, advice it jettisons when its not to its liking. Who can forget the Virodene debacle?

Since Mbeki's attack on AZT in December, the reconstituted Medicines Control Council (MCC) has conducted two reviews of the drug at the Presidents request, both of which have been referred back to the council for more thorough analysis. The MRCs probe into AZT has found that its benefits far outweigh the risks. You can't bend scientific evidence to create what they want, says Makgoba.

Since Mbeki's speech that AZT is dangerous, we've descended into chaos and confusion, says National AIDS Council of SA chairman Dr Ashraf Grimwood. Those working in the field are dumfounded, angry and depressed by these potentially retrograde steps . Wits University Centre for Health Policy director Helen Schneider says: We are'nt going to find any magic bullets in Duesberg; it simply delays confronting the real issues and working on a coherent strategy.

One in five hospital beds in the Western Cape is occupied by a child with AIDS. They have the disease, they're filling beds and they're dying, so why are we debating the causes of AIDS? asks UCTs head of paediatric infectious diseases, Greg Hussey.

Asked if Mbeki doubted whether HIV caused AIDS, his spokesman Parks Mankahlana said: The President has doubts about the whole issue of AIDS: the fact that there's no cure, the fact that some people have contracted HIV but not contracted AIDS after more than 15 or 20 years. There are lots of things that are unknown and unclear that need to be investigated. He said Mbeki wanted to mobilise everyone to debate these questions.