SOUTH AFRICAN LEADER ENTERS AIDS CONTROVERSY He queries biochemist who denies HIV link

By Louis Freedberg

San Francisco Chronicle 3 April 2000

It isn't every day that David Rasnick, a biochemist who lives in Saratoga, gets a call from a foreign president.

Truth be told, it had never happened until South African President Thabo Mbeki, Nelson Mandela's successor, called on his cell phone two months ago to discuss Rasnick's controversial stance that the human immunodeficiency virus, or HIV, does not cause AIDS.

Mbeki has not said one way or another whether he believes Rasnick's unconventional views.

But just reaching out to him has triggered an uproar in South Africa, where AIDS advocates worry that it will set back efforts to combat the disease there.

And it has also caused concern among AIDS officials in Washington, who wonder what signal it will send to the U.S. Congress, which is debating several bills to increase support for AIDS prevention efforts in Africa.

Rasnick believes that what is diagnosed as AIDS in Africa is really a new label attached to old ailments -- such as persistent coughs, diarrhea, parasitic diseases and tuberculosis -- in developing countries.

THEORY LONG AGO DISCREDITED

AIDS researchers say they are alarmed at Mbeki's interest in a theory they thought had been discredited years ago.

"It gives them a platform to espouse theories that are absolutely unsupportable,'' said Thomas Coates, director of the AIDS Research Institute at the University of California in San Francisco. "And they don't get many platforms in the world because they are considered to be on the lunatic fringe.''

Rasnick, 52, who has a doctorate in chemistry and founded two Bay Area companies that manufactured protease inhibitors, is a former president of a loose confederation known as the Group to Reasses the HIV/AIDS Hypothesis. He has made it something of a crusade to challenge the conventional wisdom that HIV causes AIDS.

"President Mbeki asked me for my personal support in his efforts to explore all things related to AIDS,'' said Rasnick. "He said he wanted to start from scratch, and wanted my thoughts on what is making Africans sick -- what we know, and what we can do about it. And he wanted to know if (anti-AIDS) drugs do more harm than good.''

To most scientists working on AIDS, the question of what triggers it was settled more than 10 years ago. In 1988, a committee of experts set up by the National Academy of Sciences concluded definitively that HIV causes AIDS. That position was corroborated by a presidential commission in the same year.

"We don't have the time and energy to get bogged down in these kinds of discussions at this point in the pandemic,'' said Sandra Thurman, President Clinton's adviser on AIDS policy.

CONFERENCE HEIGHTENS CONCERN

Another major concern is that South Africa will host the biannual International Conference on AIDS this July, the first time the meeting will be held in a developing nation. Up to 15,000 AIDS researchers, policy makers and activists are expected to attend.

Thurman worries that Mbeki's flirtation with unorthodox views could cast a shadow over the proceedings. "We don't want our deliberations to be held under the cloud of accusations and discussions about whether HIV is causing AIDS,'' she said.

Next month, Mbeki will be in Washington for his first state visit, which will give President Clinton the chance to talk to him directly about the issue. But officials are hoping that the controversy will be defused by then.

Mbeki apparently stumbled across Rasnick's work on the Internet. He then asked Rasnick to respond to a questionnaire he had sent to his health minister probing the causes and treatment of AIDS.

In preparing his response, Rasnick solicited the help of Charles Gesheckter, a professor of African history at the California State University at Chico who last November visited South Africa and met with Mbeki's health minister.

In an interview, Gesheckter argued that the incidence of AIDS in Africa has been vastly exaggerated. He cited World Health Organization statistics that indicate only 794,444 reported AIDS cases for the entire continent from 1981 to 1999 -- a stark contrast to the 2 million annual AIDS deaths now routinely cited in dramatizing the catastrophic effects of the disease there.

Both Gesheckter and Rasnick are on the board of directors of the Group to Reassess the HIV/ AIDS Hypothesis. Also on the board is Peter Duesberg, a UC Berkeley biochemist who is the best known proponent of the view that HIV doesn't cause AIDS.

OTHER STATEMENTS WORRISOME

What worries AIDS watchers is that Mbeki's discussion with Rasnick is just the latest in what they view as a series of disturbing statements and actions emanating from Pretoria.

Late last year, Mbeki told Parliament that he had come across a "large volume of scientific evidence'' that showed that AZT, the anti-AIDS drug routinely administered in the West, may be toxic, as a justification for his government's policy not to administer it to pregnant women who test HIV positive. Several studies have shown that AZT can reduce the transmission of AIDS to children by as much as 50 percent.

"As activists and doctors, we are are asking ourselves: Is this government taking the disease seriously?'' said Ashraf Grimwood, chairman of the National AIDS Convention of South Africa. He said Mbeki's flirtation with "the long dead dinosaur'' that HIV does not cause AIDS has "made a major dent on (the government's) credibility to deal with the epidemic.''

But Glaudine Mtshali, the counselor for health in the South African embassy in Washington, D.C., and a former senior official in the Department of Health in Pretoria, said Mbeki is simply opening up the debate to further strengthen what the government is doing.

"Let us hear all views; let us make up our own minds within the scarce resources we are faced with,'' she said.

MORE CONTROVERSY FROM MBEKI

So far, Mbeki shows no signs of backing off. In an opinion page article last week in Business Day, a leading South African newspaper, Mbeki spokesman Parks Mankahlana insisted that the president is committed to fighting AIDS. But with no cure, approaches such as expensive drug therapies -- which are out of the reach of most African countries -- have done little to stop its march across the continent, he said.

"HIV/AIDS is not going to succumb to the machinations of the profiteering pharmaceuticals and their propagandists,'' wrote Mankahlana, using incendiary language that presumably was cleared by Mbeki. "Like the marauders of the military industrial complex, the profit takers who are benefiting from the scourge of HIV/AIDS will disappear to the affluent beaches of the world to enjoy wealth accumulated from humankind ravaged by the dreaded disease. And we shall continue to die from AIDS.''

Mbeki has announced that he will set up an international panel to broaden the search for solutions. In the meantime, Mankahlana said, Mbeki "needs the support -- not the abuse -- of all of us."

Rasnick is one person whose support Mbeki can count on. "He is an extraordinary man, and I am at his disposal,'' he said.