How denialism nearly killed SA
N HIS opening address at 13th International Aids Conference in Durban on July 9, 2000, Thabo Mbeki said: “The world’s biggest killer and the greatest cause of ill health and suffering across the globe, including South Africa, is extreme poverty”. In his closing address at the same conference Nelson Mandela said: “Let us not equivocate: a tragedy of unprecedented proportions is unfolding in Africa. Aids today in Africa is claiming more lives than the sum total of all wars, famines and floods, and the ravages of such deadly diseases as malaria”.
Sixteen years is a long time, and reflects the sea of change from the era of HIV/Aids denialism to the pragmatic support for appropriate scientifically supported medical treatment, as will be evident at the 21st International Aids Conference which began on Monday.
As reported in the Mail and Guardian, in the year 2000, zero people were on ARVs (antiretrovirals); 70 000 HIV-infected babies were born; and there were hundreds of thousands of HIV deaths.
This year, over 3 million people are on ARVs, and fewer than 6 000 HIV-infected babies are born annually. Life expectancy has increased from 53.4 in 2004, to 62.5 in 2015. However, a survey conducted in 2012 by the Human Sciences Research Council revealed that SA was still leading the world in terms of HIV infections.
The most positive policy (perhaps the only one?) of the Zuma regime was the shift from the HIV/Aids denialism of his predecessor, acknowledging the devastating impact of this pestilence, and its corollary, support for ARVs, compared to Mbeki’s support for the beetroot and garlic quackery of his health minister, Manto Tshabalala-Msimang.
Of course, Zuma’s personal view was that taking a shower after coitus cuts “the risk of contracting HIV” – understandable from someone with no formal education, but unacceptable from someone with presidential ambitions.
The HIV/Aids denialism and pseudo-science stained (some would say with blood) the Mbeki regime, and was associated with a man of letters (who was not trained in medicine or in any allied health discipline), who scorned men and women of science; reduced scientific research to racism; and dabbled in the internet to search for, and formed unholy alliances with, HIV/AIDS dissidents.
The consequences were devastating, almost genocidal, as some have suggested: “Two independent studies have estimated that delays in making ARVs available in the public sector resulted in more than 300 000 avoidable deaths. It also resulted in an estimated 35 000 babies being born with HIV who would not otherwise have been HIV-positive”.
In 2001, Professor Malegapuru William Makgoba, then Medical Research Council president, said: “History may judge us, the present South Africans, to have collaborated in the greatest genocide of our time by the types of choices – political or scientific – we make in relation to this HIV/ Aids epidemic”.
On July 6, 2000, three days before the International Aids Conference, the Durban Declaration, signed by 5 000 international scientists, stated that “HIV causes AIDS. It is unfortunate that a few vocal people continue to deny the evidence. This position will cost countless lives”.
Parks Mankahlana ( who later died of an Aids-related ailment), Mbeki’s spokesman, responded: “If the drafters of the declaration expect to give it to the president, or the government, it will find its comfortable place among the dustbins of the office. People can’t, under the pretext of meeting in Durban to discuss questions of HIV/Aids, circulate a petition all over the world condemning the President.”
A critical concern was how members of his cabinet, and the national executive committee (NEC) of the ANC were unable to disagree with Mbeki (ironically, a similar trend has emerged under Zuma).
A case in point would be Mandela’s attempts to engage with Mbeki on the HIV crisis in SA, and Madiba’s subsequent humiliation in front of cabinet and NEC members of the ANC.
For two months in early 2002, Mandela tried to phone Mbeki, who refused to take his calls. As Mark Gevisser notes in his biography of Mbeki ( Thabo Mbeki: The Dream Deferred), Mandela subsequently complained that “he could call all the world’s leaders and the only one who would not return his call immediately was ‘my own president’”. According to Gevisser: “Most of all, he (Mandela) believed Mbeki was wrong, morally and politically” about HIV/Aids.
Mandela was concerned about SA’s international reputation, and was also “deeply distressed by his perception of the inability of serving ANC leaders to take Mbeki on, and was determined to set an example to them”. According to Mandela: “the proper thing to do is to have free and vigorous debate on every issue and to criticise everybody, including the president”.
A very frustrated Mandela publicly declared that he disagreed with the ANC government’s Aids policy, and argued: “We must not continue to be debating, to be arguing, when people are dying”.
On March 15 -17, 2002, the ANC NEC met to discuss the HIV/Aids issue. On day one Mandela was harshly reprimanded for his public criticisms of Mbeki’s views on HIV/Aids. The charge was led by Peter Mokaba and it “appeared as if he had the endorsement of the party leadership”. The meeting was chaired by Terror Lekota.
According to academic and journalist, Marvin Gumede: “As the sage elder statesman spoke, candidly stating that the government was being perceived as uncaring by stubbornly refusing to roll out the desperately needed drug, he was heckled. A startled Mandela halted, then continued, but the heckling resumed, louder and bolder and more openly than before”.
In a more recent reflection on that meeting, Dr Zweli Mkhize wrote: “A number of members launched a scathing attack on Madiba, stating that he had retired and should leave state matters and go home. Most repulsive was the suggestion that Madiba was propelled by the quest for money…
“With his chin in his hand, Mbeki sat quietly and left the session of attacks and stormy exchanges to run itself out, never once intervening to protect Madiba, who sat stonyfaced and dignified in the face of such scurrilous attacks.
“Disappointed and hurt by members of the party he had led for a long time, Madiba retreated… If the attacks were not engineered, it was even stranger that Mbeki never called anyone to order as Madiba’s dignity was sacrificed for Aids denialism”.
In a Sunday Times article in October 2008, Ngoako Ramatlhodi described in more detail Madiba’s humiliation by the NEC in 2002: “The meeting turned into a frenzy. It became a free-for-all, reminiscent of a pack of wild dogs tearing apart their prey… (The ANC members were) wild, aggressive and merciless against their former president…
“Those who attacked Madiba in that meeting did so with the silent approval of those who witnessed the orgy. They must have been genuinely afraid of Mbeki, a president who had somehow turned out to be the ANC itself. He had become larger than the movement. They were scared. I was scared.”
Pregs Govender, a former ANC MP, argued that the tradition of open debate within the ANC was being reduced to “Group think… the celebration of the individual above the collective, in its naïve and unquestioning acceptance of the leader as infallible”.
Not much has changed with the leadership of the ANC and a culture of fear still pervades the corridors of power, accompanied by “group think” and sycophancy.
Brij Maharaj is a geography professor at UKZN. He writes in his personal capacity.