By Adele Sulcas

The Star 25 March 2000

President Thabo Mbeki has become further embroiled in the escalating controversy around HIV/AIDS, telling a constitutional court judge, the heads of two major churches and the chairperson of the world's leading international AIDS conference that he would continue to question the conventional wisdom on HIV/AIDS.

Mbeki made his stand clear in reply to a joint letter from Judge Edwin Cameron, Archbishop Njongonkulu Ndungane, the head of the Anglican church, Bishop Mvume Dandala, the head of the Methodist church and Professor Jerry Coovadia, the chairman of the Durban 2000 HIV/AIDS conference, as well as Merci Makhalamele, a prominent AIDS-activist.

They had written to him asking him to reconsider the government's policy of not providing anti-HIV drugs to pregnant women.

Mbeki also responded personally to a letter from Dr Johnny Sachs, a well-known Cape Town immunologist, who questioned the wisdom of "individuals in leadership positions" querying the links between HIV and AIDS.

Copies of Mbeki's responses, both written on March 15, were given to The Sunday Independent this week by a government source.

Mbeki's statements on the need to "reinvigorate the debate" around long-established AIDS-related science, and his telephone call in January to David Rasnick, an American dissident theorist, have caused consternation among scientists.

On several occasions recently Manto Tshabalala-Msimang, the health minister, has publicly reaffirmed that the internationally established scientific evidence on HIV-AIDS is regarded as "conclusive" and that the epidemic is "the most serious health challenge" to southern Africa.

Activists and researchers feel that a statement from the presidency is needed to clarify the government's approach to the epidemic, which already directly affects about four million South Africans who are HIV-positive.

In his response to Sachs, Mbeki insists that the debate must remain open.

Mbeki said: "I am taken aback by the determination of many people in our country to sacrifice all intellectual integrity to act as salespersons of the product of one pharmaceutical company."

This refers to Glaxo Wellcome, the British manufacturers of the anti-HIV drug AZT.

"I am also amazed at how many people, who claim to be scientists, are determined that scientific discourse and inquiry should cease, because 'most of the world' is of one mind," Mbeki said.

"The debate we need is not with me, who is not a scientist, or my office, but [with] the scientists who present 'scientific' arguments contrary to the 'scientific' view expressed by 'most of the world'.

"By resort to the use of the modern magic wand at the disposal of modern propaganda machines, an entire regiment of eminent 'dissident' scientists is wiped out from the public view, leaving a solitary Peter Duesberg alone on the battlefield, insanely tilting at the windmills."

Duesberg is the name most often associated with dissidents who believe HIV does not cause AIDS.

The letter to the Cameron group quotes five studies that cast doubts on the safety or efficacy of AZT, including a French study, reported on by The Sunday Independent last year, in which eight children of 1 754 mother-child pairs experienced a condition called mitochondrial dysfunction.

"It is clear from your letter that you believe that we should ignore or merely note these findings because of the current 'consensus amongst responsible and authoritative scientific leaders' as well as 'the available evidence'," Mbeki writes.

"Undoubtedly, such 'consensus' and 'available evidence' also existed on the use of Thalidomide.

"Faced with the findings indicated in this letter, I am afraid that my own conscience would not allow that I respond only to the 'consensus' with which you are in agreement."

Referring to the health department's recent decision to form an international expert panel "to discuss all HIV-AIDS matters that are in dispute", Mbeki writes: "I hope you will agree with me that such a meeting should be inclusive of all scientific views and not only those representative of the 'consensus' to which you refer."

He ends by saying: "I fully recognise that I have much to learn and must be ready to admit and correct whatever mistakes I might make as a result of not heeding the advice that 'a little learning is a dangerous thing'."

Jon Cohen of the American journal Science, who wrote an evaluation of the dissidents' claims in Science in December 1994, said the questions Mbeki was raising have long been considered "dead" debates.

"These questions are old, they're stale. Science is provisional, things keep changing, AIDS moves quickly. Medicine is also about making conclusions and not simply debating things forever," Cohen said.