Monday, May 15, 2000

AIDS in South Africa; A President Misapprehends a Killer

THE tone and substance of the letter was so peculiar that some officials in Washington thought it was a hoax. In a five-page letter to President Clinton last month, South Africa's president, Thabo Mbeki, argued that his country had to chart its own course in dealing with AIDS, including consulting those who challenged prevailing views on the causes and treatments of the disease. A ''campaign of intellectual intimidation and terrorism'' akin to ''medieval book-burning'' was keeping such voices from being heard, Mr. Mbeki wrote.

The letter was no hoax, and it touched off an uproar, in part because South Africa's democratic politics and advanced industry make it the natural leader in the fight against a disease that has devastated Africa. This status was acknowledged in the nation's selection to sponsor this year's international AIDS conference. Yet here was Nelson Mandela's anointed successor questioning many years of scientific research. Never mind that Mr. Mandela hardly mentioned the disease during his presidency. In the weeks since, many South Africans have engaged in a kind of psychoanalysis of the 57-year-old president they elected last year. Why did this cultured man, educated as an economist at Sussex University in England, take such a position? What does he gain from it?

Mr. Mbeki is the only African leader to have questioned the consensus theory on AIDS. He has, moreover, an embattled history with the disease, having first become embroiled in the scientific debate three years ago, when Mr. Mandela's cabinet backed research into Virodene, a supposed cure developed locally that turned out to be carcinogenic. Attacked by scientists, the health minister in Mr. Mandela's government, which Mr. Mbeki was virtually running, refused to back down, and it later turned out that stock in the company set up to make Virodene had been given to the ruling African National Congress. Virodene was discredited long before Mr. Mbeki began publicly questioning the causes of AIDS, so there seems little reason to believe that led to his present position. But it helped create the ill-will that exists between the scientific establishment and the A.N.C.

Last year, Mr. Mbeki stunned experts by questioning the safety of the standard anti-AIDS drug AZT, which the government has declined to distribute to pregnant women despite studies indicating that it could greatly reduce the transmission of the virus to newborns. Still, AIDS activists are shocked by Mr. Mbeki's refusal to accept the standard scientific model of the disease. Political analysts, meanwhile, say they can see little political gain for him or for his party (which took 66 percent of the vote in the 1999 elections) in his stance. Most see it as a personal decision from a man who, since his teens, has lived largely in exile, petitioning world leaders to help fight apartheid. They say that Mr. Mbeki's desire to reject Western thinking -- and condescension -- is strong, and his speeches have repeatedly called for an African renaissance. ''He is very keen on doing things in an African way and not just accepting the gospel from the West,'' said Raymond Louw, editor of the weekly newsletter Southern Africa Report. ''You hear this all the time.'' Wishful thinking about a cheap cure may also have played a part, some say, since South Africa isn't nearly rich enough to afford $15,000 AIDS cocktails, (or even $3,000 ones, if drug companies cut prices, as they indicated they might last week) for the 13 percent of the population that is infected.

Others believe that Mr. Mbeki simply couldn't help himself. He has repeatedly displayed a stubborn inclination to master technical issues in his own way, and in a highly personal speech recently he told of Internet searches with dictionaries at his side as he looked for information that might help him formulate his country's AIDS policies. Whether his current approach -- convening a ''What Causes AIDS?'' panel divided between orthodox AIDS researchers and those who believe it is caused by malnutrition and parasites -- will help or hurt his country is an open question. Heading the panel of 33 experts is William Makgoba, who runs South Africa's equivalent of the National Institute of Health. Mr. Makgoba strongly supports the standard model of AIDS, but said that bringing the dissidents ''into the tent'' will be a good thing.

MR. MAKGOBA believes Mr. Mbeki to be a ''very intellectual person'' who is trying to inform himself on a disease that is ravaging his country. He wishes, however, that Mr. Mbeki had informed himself in private, fearing that he will be classified ''as one of those African leaders who doesn't care about science or technology.'' Tom Lodge, a professor of political science at the University of Witwatersrand, says that Mr. Mbeki shows the personality traits of what he calls ''an interferer, not a delegater.'' It is a trait that has come up in other arenas as well, he says.

At the moment, Professor Lodge points out, Mr. Mbeki is shuttling back and forth to Zimbabwe, trying to ease the tensions over the violence that has broken out as supporters of President Robert Mugabe have seized white-owned farms. But Professor Lodge says Mr. Mbeki should let his foreign minister do the traveling. ''He is running up to Harare every two minutes like an office boy,'' Professor Lodge said. ''The AIDS issue is the same. Maybe he will learn the lesson that a head of state does not busy himself with details.''

Source: New York Times

No comments:

Post a Comment