South Africa AIDS Policy Still Confused

South Africa AIDS Policy Still Confused

April 5, 2001


JOHANNESBURG (Reuters) - South Africa's AIDS policy was mired in confusion on Thursday, a day after a report ordered by President Thabo Mbeki failed to reach consensus on the causes of AIDS and how to combat the deadly disease.


The gulf between the 33 scientists and experts on the Presidential AIDS Advisory Panel was so wide it pitted those who urged the use of anti-AIDS drugs to stop mothers from transmitting the virus to the newborn against those who held the view that the very same drugs in fact caused AIDS.


  South Africa has more people living with HIV-AIDS than anywhere else in the world, with an estimated 4.7 million people carrying the disease or one in nine of the population. Seven million South Africans are forecast to be living with the disease by

 the end of the decade.


AIDS activists slammed the report as a waste of time and money and urged Mbeki to drop his controversial views on the disease to help the battle against the disease.


Mbeki has attracted worldwide scorn for questioning the causal link between HIV and AIDS, denying the use of antiretroviral drugs in the public health sector on cost and safety grounds, and by appointing leading ``AIDS dissidents'' to his advisory panel.


 The contradiction inherent in South Africa's AIDS policy became only too apparent when, in the report, the ministry of health indicated that it acted on the premise that HIV caused AIDS until further research proved otherwise.


However, Mbeki has queried that link, saying that AIDS cannot be simply explained away by a virus but has to be explained in the broader context of Africa's social and economic environment.


Mbeki's spokesman on Thursday declined to clarify what the president's views were on the disease.


 The president said at the panel's creation last year that science could not claim to ``constitute biblical absolute truths.''


Some activists said that the report showed Mbeki's views on the epidemic were still dominating the country's AIDS policy.


 ``The problem is with the president and senior ministers who are unwilling to move in opposition to his views. His beliefs are still dominant and it smacks of rank political cowardice on the part of his ministers,'' said one Johannesburg health expert.




Health officials say that Health Minister Manto Tshabalala-Msimang is a firm believer, albeit privately, of the widely accepted view that HIV causes AIDS but that she is constrained by political considerations to express her view in public because of the president's views.


Central to the ministry's AIDS policy is to educate people about the disease, change sexual behavior and treat infections associated with the disease.


The ministry has attracted criticism for denying the widespread use of key antiretroviral drugs in the public health system which it says is beyond its limited budget.


Pretoria has locked horns with the world's biggest drug firms over the supply of antiretrovirals.


 The drug firms accuse the government of failing to accept offers of discounted drugs through agreed United Nations programs or the state tendering system.


 The ministry of health says the drug firms have failed to come up with concrete price discounts.


 Relations between the drug firms and Pretoria have reached rock bottom, culminating in a landmark legal case which will resume on April 18. The hearing sees 39 of the biggest drugs firms attempting to strike down South African legislation which it fears will override their cherished patent rights.




In the 134-page report, orthodox scientists conclude that South African child mortality rates are rising at an alarming rate while dissidents question the epidemic and urge the government to stop doing AIDS tests altogether.


 ``It confirms the fact that this international advisory panel was never going to provide proper advice in the fight against HIV-AIDS in South Africa,'' said Mark Heywood of the Aids Law Project.


``Its recommendations are limited, confusing and damaging to public health in the further recommendations doubting the efficacy of HIV tests.''


Pretoria said the panel agreed on the impact ``poverty, literacy, gender relations, nutrition and sanitation'' had on the disease.


Dissidents such as Americans Peter Duesberg and David Rasnick argue that AIDS represents a breakdown of the body's immune system caused either by recreational drug use or toxic anti-AIDS drugs, and that the disease is exacerbated by poverty.


 Recommendations by the panel in the interim report include the use of music therapy and supplements such as common ginger to treat the condition.


 ``AIDS would disappear instantaneously if all HIV testing was outlawed,'' Rasnick was quoted as saying in the report.


 The government's political opponents blasted the report as a waste of time and money at a time when the country was facing a national health crisis.


  `The government continues to hide behind the excuse that there are two different views on the cause of AIDS and in doing so continues to drag its heels about tackling the AIDS pandemic,'' said the opposition Democratic Alliance.