Reviews of Debating AZT: Mbeki and the AIDS drug controversy
‘the ravings of [a] drivelling conspiracy-theorist, loony, crackpot, fruitcake. … I’m a
professional at spotting weirdos’ David Beresford, Mail&Guardian
‘I do not intend to engage in nonsensical debates on AZT or other AIDS-related
matters. I find the issues you raise a total waste of energy but perhaps more exciting
for ignorant people in the field. … Remember that I am the scientist and not you’
Malegapuru Makgoba PhD, then president of the South African Medical
Research Council, now Vice-Chancellor and Principal of the University of
KwaZulu-Natal, and chairman of the board, Mail&Guardian
‘I am emeritus professor of organic chemistry at UND. I am also a doctor of science
of Oxford University, and although I know little about AIDS and less about AZT, I
am trained to evaluate scientific argument. Your book on AZT ranks among the
biggest tosh that I have ever read, and far the most sustained. I would not think the
distinguished people whose approving comments you quote can have read much of
it. I have no wish to argue with you, it would be impossible to penetrate your
ignorant conceit, I would not wish to criticise your book, it would take too long. I
do not know whether your basic claims about AIDS are correct or not, I have not
seen the evidence, your book is not evidence, it is a prosecution brief drawn up by
an inferior lawyer. You do not think much of the medical profession, or of medical
research. To a certain limited extent and in defined circumstances, I would agree
with you, but in general your view is nonsense. If you seriously doubt this, try to
envisage life two centuries ago. On the other hand, many believe that the legal
profession are a potentially dangerous bunch. This I would agree with. Some
medical doctors are criminals, they do not usually get very far, there is rather little
to be made out of being a crook G.P. On the other hand, the fees that lawyers get
are entirely exorbitant, as a result, there are far too many of them, too many for
honest employment, and crooked lawyers have great opportunities that crook
medicos can only dream of. As a result many doctors are already afraid of giving
first aid for fear of litigation. It would be instructive to see your reaction if you
needed medical assistance, possibly for something urgent and nasty. Yours, but not
at all respectfully’ David Taylor DPhil, Emeritus Professor of Organic Chemistry,
University of KwaZulu-Natal, Durban
‘you are justified in sounding a warning against the long-term therapeutic use of
AZT, or its use in pregnant women, because of its demonstrated toxicity and side
effects. Unfortunately, the devastating effects of AZT emerged only after the final
level of experiments was well underway … Your effort is a worthy one. … I hope
you succeed in convincing your government not to make AZT available’ Richard
Beltz PhD, Emeritus Professor of Biochemistry, Loma Linda University School of
Medicine, California, inventor of AZT in 1961
‘It must be said in Mbeki’s defence that Brink … is an able lawyer who argues his
case with persuasive force. … “That was the first time I became aware of this alternative viewpoint,” Mbeki told me. … He was able to persuade the country’s most
experienced investigative journalist, Martin Welz, of the validity of his case, so that
Welz not only published a series of … articles on AIDS in his investigative magazine, noseweek, but also wrote a rapturous foreword to Brink’s book on AZT’
Allister Sparks, Beyond the Miracle: Inside the New South Africa (Jonathan Ball,
2003)
‘“That,” Mbeki told me, “is what sparked it off …”‘ Mark Gevisser, Thabo Mbeki:
The Dream Deferred (Jonathan Ball, 2007)
‘A hefty blow for free speech and against the strictures of dogma … Crisp. Logical.
Sometimes over the top. Bristlingly intelligent. Exhausting. Acerbic. Sometimes
vicious. For anyone who wants to know what Mbeki’s on about, it’s all here, in a
nutshell’ Yves Vanderhaeghen, deputy editor, The Witness
‘Christ this is good … beautifully written … extremely accomplished … so much
data. Makes the opposition’s platitudes look embarrassingly hollow … Eleni and I
think it’s really great’ Valendar Turner MD, consultant emergency physician,
Department of Health, Western Australia
‘No … you don’t [merely review the medical literature], it’s the way you write, it’s
the way you put it.’ ‘Anthony knows more about the science of this than all the
other AIDS dissidents put together’ Eleni Papadopulos-Eleopulos MSc, nuclear
physicist, Department of Medical Physics and Engineering, Royal Perth Hospital,
Perth, Western Australia
‘superb, extremely well researched, analyzed, written. … I could not have done a
better job. … Are you a scientist or do you collaborate with one? How could you
survey so many scientific publications as an attorney? … Could you publish your
article or a variant of it in a medical/scientific journal? It would strengthen our case
no end if scientific papers of that quality would come from several sources, not only
from Berkeley and Perth.’ ‘I still can’t believe he wrote that. He’s really a molecular
biologist pretending to be a lawyer’ Peter Duesberg PhD, Professor of Molecular
Biology, University of California at Berkeley, member of the National Academy
of Sciences of the United States of America
‘Absolutely spectacular … superb ... the definitive refutation’ Harvey Bialy PhD,
founding scientific editor, Bio/Technology (now Nature Biotechnology), and
scholar in residence, Institute for Biotechnology, National Autonomous
University of Mexico
‘excellent … the best, most comprehensive review on AZT currently available’
Etienne de Harven MD, PhD, Emeritus Professor of Pathology, University of
Toronto, Canada
‘Anthony Brink is a man of many parts: magistrate or barrister by day, musician by
night … prose stylist. Above all, dedicated and fearless. … his book … is clear and
crisp and his technical mastery most impressive’ Philip Johnson PhD, Emeritus
Professor of Law, University of California at Berkeley, US
‘outstanding … top dollar writing’ Hiram Caton PhD, Emeritus Professor of
Politics and History, and former Head of the School of Applied Ethics, Griffith
University, Brisbane, Australia
‘Deserves serious treatment. More strength to your arm’ Donald Woods
Very good. Convinced me completely’ Paul Foot
‘Absolutely amazing … a work of genius … he writes really well … I just love his
one-liners’ Rian Malan
‘very nice writing … you can’t really be a lawyer … I love the parallels with other
past failed medical panaceas – calomel etc’ Denis Beckett
‘an outstanding piece of work … enormously entertaining … expert, trenchant
devastation of AZT apologists’ Neville Hodgkinson, former medical
correspondent, London Sunday Times
‘extremely courageous … I thought I was beyond shockability but [Brink’s] revelations were stupefying. I think the marketing of AZT to pregnant women is an obscenity’ James P Hogan, science writer and science fiction novelist, Sligo, Ireland
‘wonderful … soldier on!’ George Kent PhD, Professor of Political Science,
University of Hawaii, US
‘[AZT: A Medicine from Hell] is a well written, lucid article for anybody to read. …
your arguments about prescribing this drug are excellent . … Perhaps when more
people like yourself who are not scientists come out publicly to clarify the issue on
this drug, pregnant women will be spared! Your article will now be additional prescribed reading for the students in my class’ Shadrack Moephuli PhD (toxicology),
senior lecturer, Department of Biochemistry, University of the Witwatersrand
‘What a good comprehensive review of the literature you performed! … During my
research I noticed a lot of resistance from many different people to believe our data.
In general there is resistance to the “bad news”‘ Ofelia Olivero PhD, staff scientist,
National Cancer Institute, US
‘amazing’ Margarette Driscoll, senior feature writer, London Sunday Times
‘a masterful piece’ David Rasnick PhD, pharmaceutical biochemist and patent
holder, California, US
‘a rare combination of incisive insight, entertaining wit, profound perspicacity, all
of which and a lot more being available through his racy, delicious pen. He exhibits
the uncommon gift of a timely turn of phrase that truly adds spice to the intellectual
content. … Mr Brink’s book will have an Illichean impact likely to cure the increasingly sick HIV-AIDS establishment in particular and the medical and governmental
establishments in general. His expose is both a diagnosis and a cure. … [It] will remain a classic eye-opener to the misdeeds of modern medicine for decades to come.
I am also sure that Mr Illich will give his imprimatur to Mr Brink at first reading’
Manu Kothari PhD, Emeritus Professor of Anatomy, Seth Gordhandas
Sunderdas Medical College, King Edward Memorial Hospital, Mumbai, India
‘Humor kan soms ‘n politieke daad van die ernstigste aard wees. Niks is gevaarliker as om onaantasbare persone en instansies belaglik te maak nie. … Wees gewaarsku – die boek het ‘n vreemde uitwerking op die leser. Enersyds laai dit iets
ondraaglik swaar – grotesk eintlik – op jou skouers, iets waarvan jy nie meer met
integriteit kan afkom nie. Andersyds moet jy nie verbaas wees as daar na dese ‘n
glimlag aan jou lippe kom pluk elke keer as jy die woord “AIDS expert” hoor nie.
… Die kersie op die koek – wat van Debating AZT ‘n meesterstuk maak – is die humor waarvan elke reël, asook die spasies tussenin, deurtrek is. … Brink se styl – die
samespel van ligsinnige humor en dodelike erns – laat my byvoorbeeld onwillekeurig dink aan die profetiese literatuur in die Bybel. … Anthony Brink deins
nie terug vir “lawsuits” nie. Hy [skryf] in die styl van meeslepende fiksie. Die boek
is ‘n taboebreker – nie in die eerste plek omdat dit die taboe-gelaaide tema van
VIGS in Suid-Afrika aanvat nie – maar ook en veral omdat dit alle genre-matige
grense verontagsaam. Volgens die antropoloog Mary Douglas het taboe te make
met verskynsels wat dreig om gevestigde klassifikasieskemas te ontwrig. Ook die
outeur van hierdie boek is in dié sin ‘n taboeverskynsel: ‘n advokaat uit KwaZuluNatal wat met innemende hubris die heilige teoretiese grond van die mediese
wetenskap betree. … Ek kan nie Debating AZT sterk genoeg aanbeveel nie – of jy
nou ‘n literêre ervaring wil hê, boeiende geskiedenis wil lees, meer te wete wil kom
oor die VIGS-polemiek, tot teologiese en filosofiese besinning gebring wil word, of
sommer net lekker wil lag. As ek die pous was (of ‘n leidende VIGS-navorser) sou
ek die stempel van goedkeuring op hierdie boek aangebring het: nihil obstat. Dit
staan geskrywe. Niemand sal ooit kan sê: “Ek het nie geweet nie”‘ Gerrit Brand,
books editor, Die Burger
Reviews of The trouble with nevirapine
‘Brink’s meticulously researched … detailed exposé on the controversial AIDS drug
… reads like a sophisticated crime novel and is full of harrowing facts you won’t
find anywhere else’ Christine Maggiore, founder, Alive&Well AIDS Alternatives,
Los Angeles, US
‘an amazing job … brilliantly dissects and avoidable tragedy: how misconceptions
and misunderstandings about a new medicine … caused a pointless, costly and
toxic mess that still needs clearing up. An important story with lessons for all of us
– and readable with it’ Professor Andrew Herxheimer MB, FRCP, Emeritus Fellow
of the UK Cochrane Centre, Oxford; tutor in clinical pharmacology and
therapeutics at Charing Cross and Westminster Medical School, London
University (ret.); advisor to the WHO; founder of Drug Therapeutics Bulletin; cofounder of the International Society of Drug Bulletins; and co-founder of
DIPEx.org
‘an expertly written piece about this very dangerous drug’ Dr Jonathan Fishbein
MD, formerly Director of the Office for Policy in Clinical Research Operations,
Division of AIDS, National Institute of Allergy and Infectious Diseases, US
National Institutes of Health
‘JUST SAY YES, MR PRESIDENT’
Mbeki and AIDS
ANTHONY BRINK
Open books
Open books
www.openbooks.tig.org.za
033 3442420
083 775 4174
arbrink@iafrica.com
The moral right of the author has been asserted.
First published on ………………… 2010
Set in 9 pt Palatino Linotype
ISBN: ……………………
The author
Anthony Brink is an advocate of the High Court of South Africa, and the convener
and national chairman of the Treatment Information Group (www.tig.org.za).
He is also the author of
Debating AZT: Mbeki and the AIDS drug controversy (2000)
Lying and Thieving: The fraudulent scholarship of Ronald Suresh Roberts in ‘Fit to Govern:
The Native Intelligence of Thabo Mbeki with reference to chapters 8 and 9 on AIDS: ‘A
clash of fundamentalisms 1: medical politics’ and ‘A clash of fundamentalisms 2: racial
politics’ (2007)
The trouble with nevirapine (2008)
RUDE LETTERS (2008)
Introducing AZT: ‘A world of antiretroviral experience’ (2008)
Poisoning our Children: AZT in pregnancy (2008)
And an honorary co-author of Mother to Child Transmission of HIV and its Prevention
with AZT and Nevirapine: A Critical Analysis of the Evidence, a scientific monograph
by Papadopulos-Eleopulos et al. (Perth, 2001).
His work has been translated into Spanish, Portuguese, French, Russian, Italian,
German, and Dutch.
You do not become a ‘dissident’ just because you decide one day to take up
this most unusual career. You are thrown into it by your personal sense of
responsibility, combined with a complex set of external circumstances. You
are cast out of the existing structures and placed in a position of conflict with
them. It begins as an attempt to do your work well, and ends with being
branded an enemy of society.
Václav Havel
The white man’s image of death has spread with medical civilisation and has
been a major force in cultural colonization.
Ivan Illich
In every epoch the ruling ideas are the ideas of the ruling class, i.e., the class
which is the ruling material force in society, is at the same time its ruling
intellectual force. The class which has the means of material production at its
disposal, has control at the same time over the means of mental production,
so that thereby, generally speaking, the ideas of those who lack the means of
mental production are subject to it.
Karl Marx
About the cover
The cover image of a maiden from the Bund Deutscher Mädel (German Girls League)
is taken from a Nazi Party poster. Should my linking the ethos of the pharmaceutical industry with that of the Third Reich appear gratuitous and extravagant, my
suggestion of moral equivalence seem indecent, it should be recalled that the largest
pharmaceutical and petrochemical cartel in Europe at the time, IG Farben, was the
leading financier of Hitler’s rise to power by 1932, and it later became the biggest
corporate beneficiary of the Nazis’ programme of aggressive war and plunder, and
the forced labour and medical experimentation that took place at the concentration
camp-serviced industrial complex at Auschwitz. Accordingly, Telford Taylor, lead
US counsel for the prosecution of IG Farben’s directorate at the Nuremberg War
Crimes Tribunal in 1947, urged that
these IG Farben criminals, not the lunatic Nazi fanatics, are the main war
criminals. If the guilt of these criminals is not brought to daylight and if
they are not punished, they will represent a much greater threat to the
future peace of the world than Hitler if he were still alive.
Twenty-four of IG Farben’s directors were jailed for crimes against humanity, all
of whom were sprung by 1951, many to take up executive positions on the boards
of the three corporations into which the cartel had been dissolved: Bayer, BASF and
Hoechst (now Adventis), and other drug companies.
Business continues as usual: pharmaceutical corporations are among the chief
sponsors of the George W Bush regime, with AZT manufacturer GlaxoSmithKline
(GSK) in the top ten most generous. Its US director of pharmaceutical operations,
Robert Ingram, organised a record-breaking $30 million dinner-plate fundraiser for
the Republican Party on 19 June 2002, for which Bush duly thanked him during his
address. ‘Among the top corporate donors’ at the bash the company was too, according to a report by CBS the following day, throwing in ‘at least $250 000’. GSK’s
ship came in on 27 January 2003 when, repaying the favour, Bush got Congress to
vote $15 billion ‘to turn the tide against AIDS’ in Southern Africa (and in black
Haiti and Guyana), half of which was allocated to buying AIDS drugs. In his State
of the Union address on 29 January 2008 Bush asked Congress for $30 billion.
‘Just say yes, Mr President’ (that HIV causes AIDS) quotes a front-page
Mail&Guardian headline on 15 September 2000, flagging an editorial urging Mbeki
to recant his heresy. The slogan was picked up by the Treatment Action Campaign
four days later. Having just refused to distance herself from Mbeki’s sceptical
stance on the issue at a Parliamentary media briefing a couple of days earlier, and
unwilling to answer yes or no to journalists’ questions about it, Health Minister Dr
Manto Tshabalala-Msimang attended a meeting of the Parliamentary Health Portfolio Committee on the 19th. Led by TAC leader Zackie Achmat, a group of about
fifty TAC demonstrators in ‘HIV positive’ tee-shirts gatecrashed the meeting to
show their ‘dismay and anger’ at government AIDS policy, and sat murmuring ‘just
say yes’ throughout her address. Accosting her on the steps of Parliament afterwards, they demanded this of her again, but she sent them packing.
The slogan ‘Just say yes, Mr President’ was conceived by ACT-UP, an AIDS drug
advocacy group in the US similar to the TAC, and appeared on banners carried on
street marches calling on President Ronald Reagan to fund the provision of AZT
and similar drugs to HIV-positive people – a wry inversion of his wife Nancy’s ‘Just
say no to drugs’ mantra in her campaign against prohibited smokeable and
snortable ones. After a taste of the medicine, however, the entire San Francisco
chapter of ACT-UP turned AIDS dissident and condemned AZT as a killer. In 2001
ACT UP founder Larry Kramer required a liver transplant on account of the hepatic
toxicity of AZT and a similar drug 3TC. With his liver swelling up, he says, Judge
Edwin Cameron on the Supreme Court of Appeal will soon be in the queue for one
too. Achmat’s experience of such drugs we’ll read about at the end of this book.
The KwaZulu-Natal Health Department adapted the slogan for an alarming public health notice placed in the Witness Echo supplement for African readers on 19
June 1997: ‘Last year 63% of females between 15 – 19 attending the Durban Sexually
Transmitted Disease clinic were found to be HIV positive, and will contract AIDS’
(they haven’t). “That’s why I say NO to sex, to have a brighter future!” said a pretty
African girl featured in the piece.
Mbeki sarcastically agreed to ‘Just say yes’ in his AIDS dissident manifesto Castro
Hlongwane, Caravans, Cats, Geese, Foot & Mouth and Statistics: HIV/AIDS and the
Struggle for the Humanisation of the African, circulated for discussion at an ANC NEC
meeting by the late Peter Mokaba in March 2002:
Yes, we are sex-crazy!
Yes, we are diseased!
Yes, we spread the deadly HI Virus through our uncontrolled heterosexual sex!
In this regard, yes, we are different from the US and Western Europe!
Yes, we, the men, abuse women and the girl-child with gay abandon!
Yes, among us rape is endemic because of our culture!
Yes, we do believe that sleeping with young virgins will cure us of AIDS!
Yes, as a result of all this, we are threatened with destruction by the HIV/AIDS
pandemic!
Yes, what we need, and cannot afford, because we are poor, are condoms and
anti-retroviral drugs!
‘Just dose it’ is a recent variant of the slogan: the title of an article urging HIVpositive people to swallow ‘HIV meds day in and day out, hard as it may be’ (because they’re extremely toxic) in the August 2006 issue of POZ, a glossy AIDS drugpushing magazine financed by the pharmaceutical industry. Emblematic of the total
failure of the Left to deconstruct AIDS as a capital-serving project of the medical
industrial complex (one of the subjects of this book), the piece was written by POZ
associate editor Laura Whitehorn – the former Weather Underground and Armed
Resistance Unit militant, who did fourteen years for bombing the Senate in 1983
and other symbols of American capitalist and imperial power, only to fall wholly
uncritically for one of its biggest rackets ever: AIDS.
How the haranguing of gays and illicit drug users by the new right in the US in
the seventies contributed to the appearance of AIDS in the early eighties, as a classic
instance of mass epidemic hysteria, was luminously charted in 1984 at the start of
the virus mania by the late Casper Schmidt, a South African psychiatrist, who was
practising in New York when he died in 1994. His thesis …… is applied and elaborated in this book to account for why AIDS seized the white South African imagination following the African National Congress’s accession to power in that year, as
a local variation on the same theme.
For Robin and Geoffrey
Contents
Foreword
Preface
‘For very great is the number of the stupid’
‘Just say yes, Mr President’ outlined
‘Just say yes, Mr President’: Mbeki and AIDS
Epilogue
Foreword
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‘Just say yes, Mr President’: Mbeki and AIDS
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Preface
‘… when historians assess the democratic credentials of Thabo Mbeki’s
government in future, it is likely that their most critical attentions will focus
on its responses to the HIV/AIDS pandemic … What explains Mbeki’s
apparent embrace of dissident ideology?’
Tom Lodge, Politics in South Africa (Cape Town: David Philip, 2002)
‘In 1998 Mbeki referred to the “escalating HIV/AIDS pandemic” as a
“pressing crisis”. Therefore, what is not properly understood is why and how
such a radical shift in his own views and from the policy position adopted by
the ANC national health plan took place.’
Mark Heywood, ‘The Price of Denial’, Development Update, February
2005
‘The HIV/AIDS issue is worthy of a book in itself.’
Brian Pottinger, The Mbeki Legacy (Cape Town: Zebra Press, 2008)
The most extraordinary situation currently obtains in South Africa, and it’s quite
unprecedented anywhere in the world. Since late 1999 President Thabo Mbeki and
Health Minister Dr Manto Tshabalala-Msimang have held and expressed views
completely out of kilter with those of the medical establishment and the general
public, both locally and internationally, in regard to the management of what experts, activists and journalists warn is a catastrophic public health emergency: the
AIDS epidemic, terrible already and calamitous to come. In fact government AIDS
policy had been contentious from the inception of ANC government under Nelson
Mandela in 1994, but it was Mbeki’s questioning of the safety of AZT at my instance
five years later, followed shortly afterwards by his consideration of heterodox scientific views about AIDS and its causes, that set off an international political earthquake and kept the AIDS controversy in the headlines throughout his first term as
President. As far as Mbeki’s position in the matter is concerned, most people whose
opinions derive from what they see on television and read in the newspapers consider him to have taken leave of his senses. The virulence with which he has been
assailed in the media has been extraordinary. For publicly sharing his concerns over
the toxicity of AIDS drugs and for emphasizing the primacy of nutrition in restoring health, Tshabalala-Msimang has for the most part succeeded Mbeki as the media’s whipping-boy, and is constantly condemned locally and abroad as incompe-
‘Just say yes, Mr President’: Mbeki and AIDS
tent and unfit for her office, with every cartoon of her viciously mocking and insulting, every photograph of her invariably accompanied by a derisory headline or
caption. Though he’d been mum about his thinking on AIDS for ages, venomous
denunciations of Mbeki, often in frankly ecclesiastical language, as a ‘denialist’, a
human rights violator, and a mass-murderer, along with demands that he be deposed as President of the country, flared up again in 2006 and persisted hotly into
the following year. Early claims made around the ignition of the controversy at the
turn of the decade that Mbeki’s non-conformist stance on AIDS evidenced that he
was mental ill were revived in 2008.
One of the objects of ‘Just say yes, Mr President’ is to set out what’s really been on
Mbeki’s mind. I happen to know because we are tuned into the same scientific
strains. They emanate from the Department of Medical Physics at the Royal Perth
Hospital, Western Australia. There’s Galilean chirping going on there, and once
you’ve heard it there’s no rest for you. The conventional wisdom, only two-and-ahalf decades old, turns out to be completely wrong. Which ought not to surprise
you too much because just a glance at the history of medicine reveals this usually to
be the case.
Whenever Mbeki’s predominantly white critics occasionally allow that he might
actually be on to something in highlighting the severe toxicity of AIDS drugs and
emphasizing the correspondence of poverty with the appearance of AIDS in Africa,
rather than alleged African sexual profligacy, the rider invariably added is that he
has been a poor communicator. But as will be seen from all of Mbeki’s public statements about AIDS cited in this book – often factually detailed and closely reasoned
– the contrary is true: he has been crystal clear in articulating his reasons for
doubting orthodox wisdom in AIDS.
Journalists and AIDS activists have pitched the AIDS controversy to the public at
the level of whether HIV causes AIDS. Simple enough – except that in this book
we’ll see that the question itself is off the mark because it misses and distracts from
the fundamental ones. It’s akin to debating the millennia-old medical theory that a
plethora of black bile caused melancholy. But what’s black bile? (Does it even exist
in us, this stuff that’s never actually been seen?) So what exactly do we mean by
‘HIV-positive’? What do we actually mean when we say someone is ‘living with
HIV’ or ‘has AIDS’? In the popular mind these expressions are currently charged
with more potent meaning than just about any other. But what precisely? Prepare
for a shock.
‘Just say yes, Mr President’ unpacks the heart of the Perth Group’s complaint
against Robert Gallo’s HIV-AIDS causation hypothesis in the plainest language I
could muster. So if you’re after an introduction to what caused Mbeki’s flame to go
out as an ardent believer in the HIV-AIDS story, without wading through a phone
book of heavy scientific papers (as he has), read this book. But for anyone really
serious about this subject, the critiques of medical physicist Eleni PapadopulosEleopulos and her colleagues, all published in scientific and medical journals of
Preface
high reputation, are a must-read – perhaps after a look first at some fine essays
written for lay readers by her co-author and collaborator, consultant emergency
physician Valendar Turner. Having read more about AIDS from all angles than is
good for me, I can tell you that in their analytical rigour and driving logic the Perth
Group’s papers (archived online at theperthgroup.com) come through like Bach
fugues – the finest music. To me at any rate. This book is very much the unauthorised version, however. My personal general ideological, political and cultural disaffections and antipathies, sharpened by my encounter with AIDS and perforce colouring this book, are too extreme and iconoclastic, too eccentrically off-beat, for it to
be anything else.
A frequent subject of Mbeki’s public statements about AIDS has been race. And
that’s where his critics concerning AIDS think he’s really lost it. I mean, hey, apartheid’s over, hadn’t he heard? As far as it’s possible for this umlungu to relate to
what he’s been saying, I think I know what he’s on about in that regard too. Long
before I had won him to my case against AZT – priming his enquiry into the larger
issue of what causes AIDS, and then the really big one, the HIV isolation question –
I’d been thinking very deeply about the AIDS construct’s ideological functions,
particularly what I perceived to be its service to deeply entrenched, sublimated
racist preconceptions among seemingly liberal and left-wing whites, coloureds and
Indians. In early 1997 I typed the title to an essay, ‘After Apartheid, AIDS: New
furniture for racist ideology’, and bumped my ideas off a few friends, but that was
as far as I got. I wrote a great deal else, but that was the hot topic that my professional and personal constraints didn’t allow me the time and space to chart. Running into AZT had been a disruptive enough encounter with evil that I hadn’t bargained on in my ostensibly middle class life. Researching and writing Debating
AZT: Mbeki and the AIDS drug controversy in the intense political climate of the time
left me quite spent – even though, unlike that hanging After Apartheid essay, Debating AZT was a relatively straightforward indictment of a massive corporate crime.
It’s still unwritten, but it’s become redundant now, because Mbeki beat me to it. As
we’ll see in this book, he’s identified its main currents perfectly. And in the bluntest
language.
Mbeki proposes that an inarticulate racism underpins the African AIDS construct.
Now I appreciate that the very suggestion is a big turnoff to nearly all non-African
progressives, and it’s irritatingly offensive to white liberals and the white left most
of all. Didn’t we back the struggle? From our lounges. And yet he persists. The
stock white response is that he’s obsessed about race. In this book I elucidate
Mbeki’s view on this score by excavating the racist attitudes and ideology immanent in the buried foundations of the AIDS construct, to which he refers, and by
demonstrating their archaeology in Western thought.
As to the meaning of ‘white liberals’, whose voice dominates the popular discourse about AIDS, I should concede that it’s hardly a precise expression, and I find
it very difficult to define. To me it denotes in South Africa an enduring patronising,
‘Just say yes, Mr President’: Mbeki and AIDS
paternalistic English mentality, shaped by a historical colonial assumption of inherent cultural superiority, an attitude of ethnic chauvinism filtered through time, a
spirit matured for the contemporary clime. It ubiquitously flavours the Englishlanguage press, notably in its AIDS reporting, with polite words often masking a
vicious animus. When my black friends use the term ‘liberal’, they do so with an
unmistakeably bitter gravamen. As a Sotho attorney summed up to me: ‘Their shit
is smooth. It doesn’t smell until after they’ve left.’ The various contexts in which the
expression ‘white liberal’ comes up in this book will elucidate it to anyone unsure
of why. I’d like to add that I mean no slight on people of colour in this focus. Many
African, Indian and coloured commentators have sounded off on AIDS just as dully
as white liberals have. Some of them feature in my tale.
When I refer to ‘racism’ I’m not referring to its raw expression epitomized by
Eugène Terre’Blanche and his iron pipe, as white liberals understand it, but to a
flint-hard bedrock of white cultural supremacism overlain with a topsoil of hypocrisy and artifice. Which I’ve tried to strip and blast. Exposing ugly white assumptions about African sexuality. And by ‘ideology’ I’m referring to a broad worldview
rather than to any rigidly defined set of political precepts. I’ll also examine some of
the broader ideological and political dimensions of AIDS suppurating out of several
acts in the AIDS drama on the home stage.
‘Just say yes, Mr President’ talks openly about all these unspeakable things –
sunlight being the best disinfectant, as the saying goes. Should you find any of my
theses tenuous or extravagant, who’ll deny that they contain at least some nasty
truth? It’s all written all up in a deliberately provocative hit-and-run polemical
style, intended to purge like a dose of salts.
Scholars seeking fortunes in all sorts of sociological, political and philosophical
treasures will find AIDS an overflowing trove; dedicated studies could fill volumes.
To anyone who might have wished for a less casual treatment than I have given
such topics, let me underscore my purpose: it’s not to tabulate for the academy, it’s
to advance a Realpolitik struggle against some very powerful, widespread and profoundly negative contemporary ideas. ‘Just say yes, Mr President’ is an endeavour to
interrogate and dismantle AIDS – as a characteristically and peculiarly Western
social and medical construct – medically, scientifically, ideologically, politically,
historically, economically, psychologically and sociologically. In one go. With
praxis in mind not library dust.
Soon after becoming aware in 1996 of what a vast scientific mess ‘HIV-AIDS’ is, and
feeling compelled to do something about it, because nobody else here was, I decided upon a strategy of taking AZT on first, and the tests and the HIV isolation
question later. Persuading Mbeki, Tshabalala-Msimang, and South Africa’s and
Britain’s leading investigative journalists, Martin Welz and the late Paul Foot, that
AZT, the original and still the biggest selling AIDS drug, is both deadly and useless
– with the volcanic international furore that followed – wasn’t a bad beginning, you
Preface
must admit. ‘Just say yes, Mr President’ is intended to finish what I started. So
whereas Debating AZT was a relatively lean, taut summary of what’s wrong with
the drug, the purview of ‘Just say yes, Mr President’ is much wider: it provides some
interesting history omitted from Debating AZT, relates all major developments on
the AZT front since December 2000, and thereby brings Debating AZT up to date,
but then goes on to address root scientific issues in the AIDS controversy never
mentioned, never discussed in the commercial media – indeed, hardly in the medical press. And it looks over some philosophical ones, lightly treated for a popular
readership. If Debating AZT was largely confined to lancing a conspicuous boil on a
thoroughly diseased body, ‘Just say yes, Mr President’ rips into its rotten innards. It
chats openly about AIDS’s basic troubles, both scientific and ideological, and includes the critical narrative, cultural analysis and philosophical comment that some
readers discerned hinted at between the lines in Debating AZT.
A leading science and science-fiction author, James Hogan (translated into ten
languages; Japanese and Dutch fan clubs), with whom I spent a couple of days
talking in Dublin in mid-2001, thought the story of how a lone radical activist lawyer had blocked the world’s largest pharmaceutical corporation at the time and
turned South Africa’s President and Health Minister adamantly and vocally against
its popular drug, to be worth telling in its own right, the demerits of the drug apart.
At his urging, I do so now. The bare bones of the tale were set out in Debating AZT,
and they are fleshed out in this book.
I haven’t in this book traced the history of the generation and erection of AIDS as
a medical construct in the US because it’s a story already well told – notably in The
AIDS Mirage by medical ethicist Professor Hiram Caton (University of New South
Wales Press, 1994, and free online); in Inventing the AIDS Virus by Professor Peter
Duesberg (Regenery, 1997); and in The Yin and Yang of HIV: A Great Future Behind it
by Valendar Turner and Andrew MacIntire, published in three parts in the Australian magazine Nexus in 1999, and also posted free online. Nor do I deal in this book
in any depth with the important South African nevirapine saga, in which the
Treatment Action Campaign won a High Court order, confirmed on appeal by the
Constitutional Court, requiring the government to provide the drug to HIV-positive
women in labour and to their newborn babies in the maternity wards of all public
hospitals. That affair and its aftermath is the subject of my book The trouble with
nevirapine. And it’s in another book, Poisoning our Children: AZT in pregnancy, that
I’ve reviewed the latest research literature reporting how AZT and similar drugs
injure and sometimes kill unborn and newly born babies. To keep this book within
a manageable compass I’ve drawn the historical line for my chronicle at the end of
Mbeki’s first term, during which the mania was at full tide, but an epilogue
sketches developments in his second, including his affirmation of his AIDS dissident thinking to his biographer Mark Gevisser in June 2007, and his ultimate defeat
on 25 January 2008, with the approval by the National Health Council of the provi-
‘Just say yes, Mr President’: Mbeki and AIDS
sion of AZT drug to pregnant women and their newborn babies, practically all African.
A question I get asked as often as ‘Aren’t you afraid of getting killed?’ is ‘Why are
you so interested in all this?’ As far as AZT is concerned, I think it has to do with
the misfit between the propaganda and the reality of what this stuff actually is; and
it’s difficult to imagine a more perverse inversion – perhaps a whiff of Zyklon B for
your daughter’s asthma. Then when AZT goes, you turn to the useless HIV tests,
and suddenly you’re plummeting down a scientific sinkhole. And as AIDS tumbles
into nothing, like a mathematical empty set, the modern world looks quite different. Its shape and its certainties become as disconcerting and alienating as an atheist’s in Catholic Spain during the bonfires. I’m not sure, though, whether having
ones eyes opened to the vacuousness of AIDS medicine is a blessing or a curse.
Since the ramifications are so huge and so troubling, ignorance about AIDS might
be one case where it’s better to be a happy pig than Socrates discontented.
But the AIDS controversy per se long ago lost its fascination for me. Junk science
loses its glitter quickly. I found that once I’d plumbed the sewer of AIDS’s scientific
foundations – and that didn’t take long – it turned into a monkey on my back, a
disagreeable burden dictating irresistible moral and political imperatives. Involving
terribly hard work and sacrifice. My real obsession is with the social meanings of
AIDS, what it says to us about the quality of Western culture, our values, our attitudes towards each other: why after the advent of democracy it took off in the
white South African mind, where it thrives most vigorously, and well after the
Americans had grown tired of it by the early nineties and the whole show had
moved along there into a protracted dying star decline; why it picked up again in
the US in relation to the African context as a foreign policy issue and a big news
item; why AIDS is as attractive a construct to white liberals and the South African
left of all hues as it is to the broad white right; and why it’s so appealing to many
gay men here. To doctors too. All this entails an enquiry way beyond the nuts and
bolts of AZT molecular pharmacology, the biochemical architecture of HIV antibody tests and all that. So if from this book you start getting the idea that AIDS as
an epiphenomenon, aside from its commercial value and political uses, is the consummate expression of a profound metaphysical malaise in our contemporary industrial society, a reeking grease-trap for many of its ancient spiritual ills, stoked in
South Africa especially by lingering racial alienation, you got the bonus package.
Anyone who’s been able to watch the AIDS controversy boiling in South Africa
without getting agitated along with the crowd must have noticed that questioning
the security of AIDS medicine’s dogmas is entirely forbidden – even though ‘AIDS
experts’ have continuously refashioned them, often fundamentally, since their conception in the early eighties. But challenge is illegitimate. It is absolutely taboo. To
quote Supreme Court of Appeal Judge Edwin Cameron, pontificating with ecclesi-
Preface
astical authority: ‘The premises on which the debate starts are unchallengeable. The
disease is incurable, it is fatal, and it will soon be rampant. Its spread, now at epidemic dimensions, is insidious. It occurs mostly in moments of intimacy between
two people who do not know that one of their healthy bodies harbours eventual
death for both.’ But the excitement whipped up by such hot talk has led to total
intolerance for the expression of doubt about any of these startling new ideas.
Before the AIDS age, the appellation ‘dissident’ used to carry an heroic cachet –
witness Gorbanevskaya’s Red Square at Noon. Today it is spat like ‘communist’ at a
McCarthy hearing in the fifties. Or ‘Mandela’ from white lips little more than a decade ago. Yet science’s most important ideas have been proposed by scientific dissidents: Galileo, Einstein, Harvey, Semmelweiss, Koch, Goldberger, for instance – all
of whom were at first savagely disparaged. And for medical dissidents there’s always a special kind of heat – since the business of medicine is so close to the
Church’s. Perhaps because of its historically honourable ring, ‘dissident’ has been
dropped from the parlance of professional AIDS activists and journalists in recent
years, and has been replaced by ‘denialist’, for its nice morally repugnant neo-Nazi
resonance.
The trouble that scientists critical of AIDS orthodoxy have getting into print is legion. And when they do manage to get published, their crushing debunks, effectively making fools of the ‘AIDS experts’, are simply ignored. Probably for the latter
reason. But also because they are bad for business, and business in AIDS is very
good. The spice-galleon just sails right on. As if its gut hasn’t just been torn out on a
razor reef.
This difficulty in getting heard was explained neatly by Anthony Liversidge in
his piece, The Limits Of Science, published in Cultural Studies Times in 1995:
As Thomas Kuhn pointed out [in The Structure of Scientific Revolutions], updating the received wisdom in a science is typically a no holds barred struggle where all the forces of bias and entrenched interest are brought to bear
against the challenger, at least until the weight of logic and evidence becomes
overwhelming, and perhaps even beyond that point. … Talk to any Nobel
Prize winner, and he/she will tell of the prejudice and close-mindedness
which met his/her novel publications. The establishment reviewers will
strenuously resist a new interpretation, and it doesn’t take a cynic to suspect
they are rationalizing their stake in the old paradigm, even if the motivation
is unconscious.
My intention in ‘Just say yes, Mr President’ is to ventilate the ‘new interpretation’.
Ideas unheard up to now outside a narrow circle of dissident cognoscenti. Mbeki
among them.
The First World consensus about AIDS is the fruit of incessant propagandising,
what we read and what we hear repeatedly, every single day, from self-appointed
experts and their faithful train: journalists galore. Thus has AIDS become our con-
‘Just say yes, Mr President’: Mbeki and AIDS
temporary reality, just as allegedly omnipresent syphilis (friendly women, drinking
cups, doorknobs) was our fathers’. Fraudulent drug company press feeds apart, this
misinformation is not deliberate, nor malign; on the contrary, it’s mostly terribly
sincere. And it’s won just about everyone: from both of our beloved Nobel laureates
and moral icons, Nelson Mandela and Desmond Tutu through to economic neoliberalism critic Professor Patrick Bond, who believes that antiretroviral drugs
would save ‘millions of lives’ in ‘South Africa’s worst-ever health holocaust’, scoffs
at their ‘alleged toxicity’, and urges our ‘genocidal’ government to fall in with the
activists advocating them; bright constitutional law enthusiast and warm-hearted
Judge Dennis Davis in Cape Town, who talks positively about nevirapine for pregnant women on television, having swallowed the swill without a burp; and Appeal
Judge Edwin Cameron who claims to actually takes this stuff, along with AZT and
its ugly sister 3TC. Telling everyone how great it is. Also how clever he is. We’ll get
onto him anon. And how.
This book’s focus on media representations of the controversy stems from Oscar
Wilde’s remark: ‘There is much to be said in favour of modern journalism. By giving us the opinions of the uneducated, it keeps us in touch with the ignorance of the
community.’ Certainly I can confirm from innumerable conversations with people
all over South Africa that the tenor of news reports and editorials on AIDS has perfectly reflected informed opinion here, by which I mean the thinking of the newspaper reading public, especially the formally educated classes, mostly white.
A fascination of mine is how power is maintained with the support of verbalized
ideas, and how ideas work as props to power relations, aggressively promoted and
defended by their beneficiaries. AIDS, I hope to show, pre-eminently serves the
reactionary, neo-conservative white liberal political agenda in South Africa. I’ve
heard it said that if you scratch a liberal you’ll find a fascist, and as you’ll see in this
book, liberal constructions of AIDS, and the behaviour of liberals around it, amply
demonstrate the truth of this quip. Ultimately AIDS ideology serves capital, and so
obviously so that it hardly needs stating. Since my object is the demolition of AIDS
as a medical and ideological paradigm in South Africa, and Mbeki observed in the
launch issue of ANC Today on 26 January 2001 that ‘The world of ideas is also a
world of struggle’, the exercise will necessarily require some rhetorical vigour.
A polite engagement with professional and lay exponents of AIDS medicine has
thus far not been possible. I have personally tried and failed. So has Mbeki. In my
opinion therefore the time has arrived to impeach the AIDS cult and its missionaries with a more robust approach than has heretofore been followed. At considerable
personal risk I don’t doubt – AIDS being less a disease than a business, a career, a
personal and political identity, and a quasi-religious affiliation with the deepest
ideological roots. ‘Just say yes, Mr President’ is not for delicate readers. Especially not
the self-important, the devout and the pious. It’s written for grown-ups, and it is
not suitable, as they said in the old days, for children and natives. It is not written
with what Mark Twain called ‘Sunday-school words’. Or ‘within Christian English
Preface
usage’, to quote Judge Taylor in Harper Lee’s To Kill a Mockingbird. It is contumacious, scurrilous, scandalous and extremely insolent. Not to mention over-the-top,
beyond the pale, and overboard. Totally ‘incorrect’ too. Without a nose for hyperbole and conceit, and a keen sense of irony, you could be appalled.
As mentioned, I have written ‘Just say yes, Mr President’ not as any kind of formal
treatise, but as an exercise in counterpropaganda – a stinging antidote, faithfully
within the violent traditions of Western medicine. As another of Mbeki and Tshabalala-Msimang’s screaming queen critics, playwright and actor Pieter-Dirk Uys,
has pointed out: ‘To be offended by this is very important, because if you’re offended, you listen.’ I agree with him – for once (this book will certainly offend him).
And as fellow AIDS dissident the late Professor Sam Mhlongo of Medical University of Southern Africa once urged me, it’s time for ‘bare knuckles’. To bust one in
the mouths of South Africa’s pantheon of living AIDS saints. Canonized by the media. Because as New York journalist Celia Farber has pointed out, ‘all attempts to
address [the virus/chemotherapy model of AIDS] soberly, journalistically, factually
have failed’. Predictably, Celia, since delusional thinking is always impervious to
reason. But fanaticism is helpless against scorn. (As Danton recognized, mocking
Robespierre: ‘He can’t fuck and he’s scared of money.’)
Like those seditious raps of the underground hip-hop MCs from the projects, this
then is fight music, a polemical blitzkrieg – intended to redraw some lines in our
contemporary intellectual battlescape, and to plunder and loot the high ground
claimed by Mbeki’s smug white liberal detractors with all the respect, restraint and
decency of an invading horde. Sacking their fancy conceptual fortress. In his own
engagements with them, Mbeki himself hasn’t minced his words, as we’ll see.
We’re both sarcastic bastards. It comes naturally when talking about AIDS experts,
AIDS activists and AIDS journalists, since, as Shakespeare explained, ‘The dullness
of the fool is the whetstone of the wits.’
Lest you suspect me of bigotry of any kind, let me assure you that some of my
best friends…. The original AIDS treatment activist, gay New York playwright
Larry Kramer wrote Faggots to raise a din. Kick political balls. Not wound. Obviously. Being one. Gay men, nearly all white, drive AIDS hysteria in South Africa,
but on the other hand the most energetic dissident activists in the US and the UK
have been gay too. Former KwaZulu-Natal Premier Lionel Mtshali’s witty retort to
complaints about his hotel bills once was to ask his critics whether they thought
that on his official travels he should rather over-night in the locations with the natives. I should hardly have to explain that I use such language in similar spirit. The
point of my use of even harder terms should be obvious.
If my gonzo style is outrageous, that’s because its subject is, but it’s hardly a
shadow of the obscenity of AIDS medicine, its ideologies, its politics and its commerce. At which we’ll be taking a hard and unstinting look. And dissecting with a
merciless, twisting knife. It’s sugared however (or soured if you’re at the sharp end)
with some terrific aphorisms. Many said they liked my choice of introductory epi-
‘Just say yes, Mr President’: Mbeki and AIDS
graphs in Debating AZT, so I’ve taken the cue and woven a bumper hamper full of
such apophthegms into ‘Just say yes, Mr President’ at every opportunity. Not a dyspeptic surfeit I hope.
As I did in Debating AZT, I’ve quoted and cited precisely, although I’ve sometimes clipped an irrelevant phrase off the end of a sentence without indicating so.
Occasionally I’ve combined quotations culled from different media reports of the
same events or appearances. I haven’t altered American spelling, nor the use or
non-use of italics. And AIDS is spelled Aids where it is in the citations. I also leave
upper case as is in quoted passages at the original start of a sentence (notwithstanding that ‘[t]his is more conventional.’). Paraphrase and words inserted into a
quotation to give sense to an excerpt appear between square brackets (phrases
plucked and inserted from elsewhere in the same passage are indicated by inverted
commas); any comment or explanation by me is italicised. As my sources are nearly
all indicated within the text, I haven’t drawn the conventional list at the end. That’s
in line with my purpose: to draw a political tract to smash windows, not write a
formal dissertation. An internet search engine will take you to most of the books
and articles to which I refer. Many of the old medical texts that I cite are long out of
print and outdated. Of course therein lies their special interest. As we watch medicine travelling in disastrous circles. Perennially missing the point.
Here then are the rude facts. Presented with caustics and vitriol. To draw attention. And provoke reaction. Because besides President Mbeki, no one in power is
taking any notice of AIDS medicine’s fundamental theoretical and empirical problems, its glaring epidemiological paradoxes and anomalies (most ‘AIDS experts’
and doctors wouldn’t even know what they are, if you asked them). The very ‘discoverer of HIV’, Professor Luc Montagnier of the Pasteur Institute in Paris, said at
the 6th International AIDS Conference in San Francisco in 1990 that ‘HIV’ needs ‘cofactors’ such as a mycoplasma that he was proposing; that it’s not stiff enough for
the rapine of which it is generally convicted; and that it absolutely needs accomplices, but AIDS experts with bills to pay and reputations to keep aloft don’t give a
damn. So they just laughed him off. Even though he’s their main man. (Imagine the
Pope saying, ‘Listen, I’m not so sure about this resurrection story anymore.’) Like
necromancers, AIDS experts need their potent, malevolent, invisible hobgoblin to
trade on, and sell their occult knowledge about – how to find it and how to deal
with it.
Consider Mbeki’s astute point, dead on target, during an official state visit to
Brazil in mid-December 2000: ‘… scientists don’t know what they are looking for
when testing for HIV’ – a matter at which we’ll be taking a stunning look in this
book. This is the President, a master economist, who’d twice earlier publicly raised
the issue of whether AZT is triphosphorylated within cells in the human body sufficiently for it to exert its notional antiretroviral action as a proviral DNA chain
terminator (it isn’t). Journalists had no idea what he was talking about, and so responded with mockery.
Preface
The principal thesis of Thomas Kuhn’s classic analysis The Structure of Scientific
Revolutions is that scientific knowledge does not accrue steadily and cumulatively; it
proceeds instead by ‘a series of peaceful interludes punctuated by intellectually
violent revolutions’, following which, ‘one conceptual world view is replaced by
another’ – his famous seismic ‘paradigm shift’. It is with this in mind that I have
written ‘Just say yes, Mr President’ so belligerently, lubriciously and irreverently.
Consequently this book contains some strong medicine, as I’ve cautioned. The kind
AZT advocates ought by rights to take to. Even as they choke on it like mustard gas.
Gasping on the floor after a hit by a cloud of hornets.
Rudely uncompromising, but necessarily so for my Kuhnian purpose, this book
is peppered with off-colour historical, religious and carnal allusions and diversions,
drawn in the worst taste and contrived to burst like psychic depth charges. I hope it
will catalyse new ferment in the public discourse about all aspects of AIDS in South
Africa, budge it beyond the bogus polarities in which it currently stagnates, and
trigger the beginning of its implosion as a medical model and social construct in
this country.
AB
Cape Town
May 2008
‘For very great is the number of the stupid’
Those who know that the consensus of many centuries has sanctioned the
conception that the earth remains at rest in the middle of the heaven as its
centre would, I reflected, regard it as an insane pronouncement if I made the
opposite assertion that the earth moves.
— Nicolaus Copernicus, Preface to De Revolutionibus, 1543
I have for many years been a partisan of the Copernican view because it
reveals to me the causes of many natural phenomena that are entirely
incomprehensible in the light of the generally accepted hypothesis. To refute
the latter I have collected many proofs, but I do not publish them, because I
am deterred by the fate of our teacher Copernicus who, although he had won
immortal fame with a few, was ridiculed and condemned by countless people
(for very great is the number of the stupid).
— Galileo Galilei, Letter to Johannes Kepler, 1596
‘It is not too late for Mbeki to change the growing perception of him as an
extremely intelligent man, but one whose intellect contains islands of irrationality
that are impervious to reason, who has difficulty in conceding an error of
judgement, and who prefers verbal play to the practical tasks at hand.’ Editorial,
‘Just say yes, Mr President’, Mail&Guardian, 15 September 2000
‘Mbeki – described by friends and even critics as among the smartest and most
capable leaders in the developing world – has become better known internationally
for his skepticism about conventional AIDS treatments than for any other reason.’
Jon Jeter, Washington Post, 6 July 2000
‘In the last few months, Thabo Mbeki has been introducing himself to the world as
a loon … making a spectacle of himself. … He read the scientific papers and now
talks confidently about “toxicities” and “the phosphoral relation [sic: the AZT
triphosphorylation problem].” He portrays himself as an educated skeptic about AIDS.
But his late night Web-trolling, credulity about what he read online, and $10
scientific phrases smack less of skepticism than obsession. The president of South
Africa is acting like a nutter. It’s a shame that Mbeki has been diverted by this
bizarre AIDS twaddle, because he is normally rational. … Mbeki’s AIDS paroxysm,
in short, is uncharacteristic of his lifetime of reasonableness. Why is he fixated on
questioning the Western consensus about AIDS? … Mbeki faces a health
Preface
catastrophe of unimaginable proportions. The West keeps haranguing him to buy
drugs that he can’t afford, without trying to find a solution that he can. For 58
years, he has never succumbed to desperation or folly, no matter how dire the
situation. If South Africa has become so troubled that even the unflappable Mbeki is
coming unhinged, the world should worry.’ David Plotz, ‘Thabo Mbeki: Why has
South Africa’s excellent president gone loco?’, Slate, 14 July 2000
‘… his continuing personal musings [have provided] a year-long Christmas present
to [the government’s] detractors, both here and abroad. Much of this has been,
frankly, Mbeki’s fault. But as the dust settles now and his government continues its
multibillion rand assault on Aids, we must not forget that this ordeal was not only –
or even principally – a story of presidential error. Aids – an opportunistic disease –
has attracted its fair share of opportunistic commentators. … Impatience with
testing [i.e. with Mbeki’s challenge to the reliability of HIV antibody tests] is a natural
instinct which I personally share. It seems like mere fiddling while Rome burns.’
Ronald Suresh Roberts, letter in Sunday Independent, 8 October 2000
‘President Mbeki’s persistent questioning of the link between HIV and Aids has
been an unmitigated disaster for South Africa. It has distracted the country from
dealing decisively with a social catastrophe, it has embroiled it in a long,
destructive debate with bitter racial overtones, it has weakened the president
internally after barely a year in office, and it has isolated him internationally, with
most of the world’s scientific community and political leaders looking on in horror
at his stubborn crusade to back the so-called Aids dissidents. … Tragically … a
whole range of critically important issues … are getting sidetracked by the
president’s personal obsession.’ Bryan Rostron, ‘Deadly dissent of a would-be
Galileo’, New Statesman, 16 October 2000
‘It is this implicitly racially governed as well as homophobic mindset that lies
behind Mbeki’s refusal of the judgment of the overwhelming majority in
contemporary science on the nature of the AIDS virus. On the one hand such a view
endorses an Africanist myth of a pure and primal Africa contaminated by a sinful
West, a reversion to the race theory of the apartheid state. It reflects on the other
hand the cloistered, driven mindset that produced the sham biology of Lysenko in
the final years of Stalin.’ Paul Trewhela, ‘Mbeki and Aids in Africa: A Comment’,
New York Review of Books, 19 October 2000
‘… scientists don’t know what they are looking for when testing for HIV.’ President
Thabo Mbeki, reported statement while on an official state visit to Brazil in midDecember 2000
‘The universal human response to Aids is denial. It is as though nobody can face the
awful reality of a calamity that rivals the great plagues of history.’ Ken Owen,
former editor of the Sunday Times, Leadership, December 2000
‘Just say yes, Mr President’: Mbeki and AIDS
‘… too often … [the] African National Congress under President Thabo Mbeki …
continues to view all politics through the lens of the national liberation struggle,
identifying racism as the basic problem … Among the tragic consequences of this
fixation [has] been Mbeki’s almost bizarre response to the AIDS epidemic.’ Jeffrey
Herbst, International Herald Tribune, 27 October 2005
‘… not even the most skilled and devious spin-doctor in the world would be able to
explain our president’s views and strategies on HIV/Aids.’ Max du Preez, Cape
Argus, 20 November 2003
‘The year during which President Mbeki openly gave sustenance to denialist beliefs
was a year of horror – for AIDS prevention, for AIDS implementation, for
everything. It was a year of nightmare.’ Edwin Cameron interviewed in ‘AIDS
Treatment News’, thebody.com, 13 July 2001
‘Basically he doesn’t believe that HIV causes AIDS. That is why everything is in a
mess.’ Zackie Achmat, founder and leader of the Treatment Action Campaign, in
the documentary film ‘A State of Denial’, 2003
‘Thabo Mbeki’s legacy is in danger; tragically, “the president with the inexplicably
contrary views on HIV/AIDS” would be most apposite at this stage.’ Richard
Calland and Sean Jacobs, ‘Thabo Mbeki: Politics and ideology’, in Thabo Mbeki’s
World: The Politics and Ideology of the South African President, edited by the
authors (University of Natal Press/Zed Books, 2002)
‘President Thabo Mbeki has sentenced many thousands of our fellow citizens to
death by pretending that HIV does not cause Aids.’ William Saunderson-Meyer,
Weekend Argus, 13 April 2002
‘Certainly with respect to AIDS, the president’s views have prevented the effective
marshalling and direction of public resources and social energy.’ Tom Lodge, then
professor of politics, Wits University, Politics in South Africa (David Philip, 2002)
‘HIV/Aids has decimated the population and perpetuated poverty. … Mbeki’s reluctance to sanction large-scale provision of anti-retroviral medication to HIV/Aids
patients and his personal association with dissident Aids denialists have, until recently, undermined official efforts to curb the pandemic.’ Tom Lodge, ‘Mbeki
leaves SA a mixed legacy’, Focus (journal of the Helen Suzman Foundation),
March 2007
‘Our President, Thabo Mbeki, is a truly miserable piece of work. He is bitter,
narrow-minded, vainglorious, officious, arrogant, pompous and racist. … He has
the effrontery, in his hysterical, illogical and ignorant denial of the HIV-Aids
scourge, to tell us that he does not know anyone who has died from Aids. When he
makes such outrageous remarks, does he not see what a fool he is making of
Preface
himself?’ Stephen Mulholland, ‘Mbeki’s legacy: misgovernance’, Citizen, 22
March 2007
‘In our country the issue of HIV/AIDS has for some time been fraught with an unusual degree of political, ideological and emotional contention. This is perhaps unavoidable, having regard to the magnitude of the catastrophe we confront.’
Chaskalson CJ, Langa DCJ, Ackermann J, Du Plessis AJ, Goldstone J, Kriegler J,
Madala J, Ngcobo J, O’Regan, J Sachs J, and Skweyiya AJ in Minister of Health
and Others v Treatment Action Campaign and Others (No 2) (CCT8/02) [2002]
ZACC 15; 2002 (5) SA 721; 2002 (10) BCLR 1033 5 July 2002
‘“The central problem,” says Achmat, “is the absence of political will. Why is the
president like this?” … Achmat’s theory is this: “The president doesn’t want to believe that people in Africa have a lot of sex.”’ Rory Carroll, London Guardian, 10
December 2002
‘Central to the problem [of Mbeki’s desire ‘to change the world’] is the issue of
whom Mbeki most comfortably allies himself with. The social forces represented in
the AIDS treatment example [i.e. the Treatment Action Campaign] are emblematic of
the challenge, for they evoke enormous potential for real solidarity, for changing
the balance of forces.’ Patrick Bond, then professor of economics, Wits University,
‘Thabo Mbeki and NEPAD: Breaking or shining the chains of global apartheid’,
in Thabo Mbeki’s World: The Politics and Ideology of the South African President
‘No one trusts Mbeki on this topic. He has already rejected advice from former
president Nelson Mandela, thousands of health professionals and advocacy groups,
by refusing to make anti-retroviral drugs readily available across the country. …
the terms genocide and infanticide are now regularly used by even professionals
and journalists to describe Mbeki’s Aids policies. A slow, painful death also awaits
South Africa’s economy.’ Patrick Bond, ‘Thabo Mbeki Addresses His
Compatriots’, Z-mag, 15 February 2002
‘Thabo Mbeki’s interventions in the AIDS debate resulted in widespread confusion.
As Judge Edwin Cameron (himself HIV-positive) put it when he addressed the
Durban AIDS Conference in 2000, Mbeki’s “flirtation with those who in the face of
all reason and evidence have sought to dispute the aetiology of AIDS … has shaken
almost everyone responsible for engaging epidemic. It has created an air of unbelief
amongst scientists, confusion amongst those at risk of HIV, and consternation
amongst AIDS workers (Cameron 2000).”’ Nicoli Nattrass, professor of economics,
director of the AIDS and Society Research Unit, University of Cape Town, The
Moral Economy of AIDS in South Africa (Cambridge University Press, 2004)
‘The whole point of the TAC and other Aids activists is that the country can never
deal with its Aids problem while the president is an Aids denialist, and while the
government keeps putting back the timetable for providing ARVs. … [Gordimer:] “I
‘Just say yes, Mr President’: Mbeki and AIDS
just can’t understand his [‘wholly incomprehensible’] attitude. Yet in many ways he
is an excellent president. He is so intelligent and such a well-read man.”’ RW
Johnson interviewing Nadine Gordimer, London Sunday Times, 21 November
2004
‘The dangers posed by the lone righteous gunman are all too apparent in Elaine
Epstein’s [documentary film] State of Denial, which (like Samantha Power’s recent
article in The New Yorker) details South African president Thabo Mbeki’s blind,
suicidal opposition to HIV-fighting drugs in a country grievously beset by AIDS as
well as ignorance. (Health workers report that patients eschew condoms and medication, according to what they interpret as the president’s wishes.)’ Jessica Winter,
New York Village Voice, 11 June 2003
‘AIDS campaigners who lobby for useful drugs for patients are accused of being
stooges of foreign drug companies. Mr Mbeki has now stopped espousing his
dreadful view that AIDS is not caused by a virus, but still shows little enthusiasm
for the anti-AIDS measures that almost everyone believes are needed. ... who will
tell him that his policies on AIDS ... are useless or dangerous?’ ‘A Man of Two
Faces’, Economist, 20 January 2005
‘Mbeki is responsible for the deaths of thousands of people.’ Zackie Achmat,
addressing supporters outside the Cape High Court, Cape Town, 21 June 2005
‘Mbeki’s handling of the AIDS issue has reinforced his image as a lone, remote intellectual and contrarian battling against the world. … In dealing with AIDS, Mbeki
may have wandered off on a deadly diversion that has helped place an entire nation in denial and needlessly taken the lives of millions of its citizens. … Underlying
the [government’s reluctance to provide antiretroviral drugs] was an unspoken
belief among Mbeki’s inner circle that spending money on ARVs would be futile,
since the real problem lay with the reasons for South Africa’s masses being particularly vulnerable to AIDS. At its most cynical, the view suggests that the exchequer was to be spared the cost of subsidising treatment for the poor and unemployed, who were a drain on resources rather than contributors to the state coffers.’
William Mervin Gumede, Thabo Mbeki and the Battle for the Soul of the ANC
(Zebra Press, 2005)
‘It seems we need a South African version of Professor Alfred C Kinsey [who]
became famous in 1948 when he released his seminal work, Sexual Behaviour in the
Human Male … It is well known that part of Thabo Mbeki’s HIV/Aids denialism
flows from his contempt for those who consider African sexual habits different to
those of other groups. It is also well known that we suffer from one of the highest, if
not the highest, levels of rape in the world. It is also likely that we have the highest
recorded incidence of baby and child rape in the recorded history of mankind. We
know of the belief, allegedly fostered by some traditional healers, that sex with a
virgin will protect or even cure a man of HIV/Aids. Then there is the cultural aspect
Preface
of male domination….’ Stephen Mulholland, ‘We need a local Kinsey report:
Unless we face the facts of sex abuse in South Africa, we will not conquer it’,
Citizen, 4 July 2005
‘Tragically he still shows signs of AIDS denialism. We at the TAC say, how can we
engage the comrade President, because he is not carrying out the policy of the government and the ANC.’ Zackie Achmat, addressing TAC national congress, 24
September 2005
‘When did we last hear our President mentioning HIV and AIDS? … These failures
start with a failure of leadership, beginning with the Presidency and the Ministry of
Health. … This lack of leadership on HIV is a betrayal of our people and our
struggle.’ Zwelinzima Vavi, Cosatu secretary general, at the TAC’s third national
congress, 25 September 2005
‘There are few rivals to Lysenko’s position in the South African AIDS debate. I wish
to give this dishonourable achievement to Anthony Brink, an AIDS denialist who
seems to have found the ear of the President.’ Zackie Achmat, John Foster Lecture,
University of KwaZulu-Natal, 10 November 2004
‘Now, with freedom and democracy, we did not expect a government that
questions the existence of HIV and tells us that antiretroviral drugs are poisonous.’
Dr Dennis Sifris, AIDS specialist physician, Johannesburg, Health-e, 28
November 2004
‘Something has gone wrong with the post-Mandela government. Every senior UN
official, engaged directly or indirectly, in the struggle against Aids, to whom I have
spoken about South Africa, is completely bewildered by the policies of President
Mbeki.’ Stephen Lewis, Race Against Time (House of Anansi Press, 2005)
‘The fact is that Mbeki has systematically shut down opposition and debate in …
the country at large. … He has even had the effrontery to tell towering figures such
as Nelson Mandela and Desmond Tutu to shut up. … Buffoons such as denialist
campaigner Anthony Brink imagine the pressure on the president came from white
journalists. The real heat came from ordinary people whose family members were
dying while an ideologically perverse and stiff-necked administration continued to
withhold drug treatment.’ Drew Forrest, deputy editor, Mail&Guardian, 28
October 2005
‘[The Constitutional Court] helped the Treatment Action Campaign acquire AIDS
medicines for pregnant women because the judges agreed the state was needlessly
killing tens of thousands of infants each year.’ Patrick Bond, director of the Centre
for Civil Society, University of KwaZulu-Natal, ZNet, April 2004
Q: ‘You’ve condemned South African President Thabo Mbeki’s view that HIV
doesn’t cause AIDS – as well as his opposition of HIV treatment.’ Cameron: ‘At the
‘Just say yes, Mr President’: Mbeki and AIDS
time, no one else in South Africa was speaking out about this. All that I did was
draw attention to what President Mbeki had done and said and what that meant for
HIV positive South Africans.’ Edwin Cameron, judge of the Supreme Court of
Appeal, POZ, January 2006
‘In the course of the HIV and AIDS debate, a demand was made that President
Mbeki should subtract himself from the debate, partly on the grounds that he was
making comments about issues of medical science on which he was not scientifically qualified to comment. He responded positively to this demand a few years
ago. Since then, he has not commented on this subject, except to explain and support the government’s comprehensive programme of action against HIV and AIDS.’
ANC Today, 28 January 2005
‘How sad, how unfortunate that the president of the country with one of the highest rates of HIV infection in the world is now effectively muzzled from speaking
about the subject. … it is regrettable that this is a president who, like King Lear, is
apparently blind to the harm that his personal obsession with he issue is doing to
his reputation, to his government’s health policy and to the patient community. …
Mbeki’s legacy, for all his other immense achievements, will always be seriously
blighted by his quixotic preoccupation with the linkage between HIV and AIDS.’
Richard Calland, Anatomy of South Africa: Who Holds the Power? (Cape Town:
Zebra Press, 2006)
‘… it’s not uncommon for my dear activist friends in the Treatment Action Campaign to describe the government’s policy as genocidal, based on [Mbeki’s] denialism. I’m so sorry, it’s such a life-and-death issue to the civil society forces I work
with across SA … the damage done to the progressive movement – and the society
as a whole – by AIDS denialists is so intense and deep ... It is … perhaps the most
serious problem here, with at least five million HIV+ people and a government unwilling to provide proper care, justifying its resistance by using Duisberg [sic: Duesberg], Rasnick, Brink et al.’ Patrick Bond, email to British investigative journalist
Janine Roberts, February 2006
‘Given your public and vocal position in the debate surrounding AIDS and HIV (a
debate which many see as prolonging the suffering and dying of many human beings), it is possible that some people may have difficulty in spending time socially
with you.’ Steve Dyer, saxophonist and university acquaintance, email to the
author, 6 September 2006
‘Do you think it ever worries Brink that he may be responsible for millions of
deaths?’ Warwick Swinney (a.k.a. ‘Warrick Sony’), musician, sound engineer and
former high school friend (with a Junior Certificate), email to mutual friend
Hamish Davidson, 20 June 2008
Preface
‘Been reading the brilliant Mbeki biography by Mark Gevisser and it’s amazing to
see the influence Brink had on him. Fuck man he must be responsible for millions of
lives!! Where is his head at – he’s not even a medical person. Look I stick with homeopathy and my kids haven’t ever had antibiotics but with a mass epidemic you
have to bend a bit.’ Warwick Swinney, email to Hamish Davidson, 16 October
2008
‘No-one has sounded the alarm where I work daily in the presidency and … said
there is a particularly alarming tendency of people dying. … nobody has said we
are losing 10 percent of our staff every year because of AIDS. … There has not been
any [such] indication.’ President Mbeki, City Press, 26 February 2006
‘Yesterday, City Press published views indicative of AIDS denialism by President
Thabo Mbeki. … Tragically, President Mbeki continues to belittle HIV/AIDS related
deaths to justify his personal denialism. He undermines government and ANC
policy but he lacks the courage to do so openly as an AIDS denialist. More seriously, the President’s denialism contributes directly to delayed testing, prolonged
illness and premature deaths. TAC demands that the Cabinet and ANC NEC act to
save lives. The time has come to put loyalty to the Constitutional rights to life,
health, dignity and equality before loyalty to a leader in denial. President Mbeki
deliberately minimizes deaths from HIV/AIDS related illness. His denial is deeply
offensive to people who live with HIV/AIDS and our families who bury us.’ ‘TAC
Statement on President Mbeki’s AIDS Denialist Remarks in City Press’, 27
February 2006
‘… the President remains an HIV denialist.’ Zackie Achmat, Toronto Globe and
Mail, 6 March 2006
‘… a disturbing rise in anti-science opinion … has permeated important public
health and public policy debate … the anti-HIV nihilist rhetoric [has had] tragic
consequences in lives lost. One need look no farther than South Africa, where such
AIDS-nihilism has infected the leadership of the country and disrupted access to
life saving prevention and treatment programs.’ Robert Gallo, director of the
Institute of Human Virology, University of Maryland School of Medicine,
Baltimore, Maryland, US, and author of the HIV-AIDS hypothesis, letter to
publisher and editor of Harper’s Magazine, 10 March 2006
‘The biggest problem we have in South Africa is that we have a president who
doesn’t believe that HIV causes Aids.’ Zackie Achmat, News24.com, 15 March 2006
‘It is precisely because Mbeki’s undermining of the science of HIV treatment costs
lives, that his position is so controversial. … Mbeki was portrayed as severely out of
step with scientific opinion … and as stupidly pig-headed in his insistence that all
avenues should be explored. In mid-October [2000] he announced his withdrawal
from the public debate on AIDS science because it was causing confusion and
‘Just say yes, Mr President’: Mbeki and AIDS
widening divisions between the ANC, Cosatu and the SACP. Despite this “public
withdrawal”, Mbeki continued to espouse denialist views … He was also linked
(via an electronic signature) to a notorious ANC dissident document probably
written by Peter Mokaba claiming, inter alia, that antiretrovirals were poisonous. …
The most pernicious legacy of President Mbeki’s dissident stance on AIDS has been
the erosion of the authority of science and of scientific regulation of medicine in
South Africa.’ Nicoli Nattrass, ‘AIDS, Science and Governance: The Battle Over
Antiretroviral Therapy in Post-Apartheid South Africa’, Centre for Social Science
Research working paper, 19 March 2006
‘President Thabo Mbeki … is still stewing in the cesspool of his denialist views …
Millions of South Africans live daily with the fallout from the HIV/AIDS scourge …
[thanks to] Mbeki’s dalliance with AIDS dissidents, and a refusal to accept the seriousness of the peril SA faces. … Neither Mbeki nor the inept Manto TshabalalaMsimang really believe HIV causes AIDS, despite government spin doctors’ efforts
to get them to shut up about the science of the disease. They do not believe in the
efficacy of antiretroviral medicine, the only globally accepted method for prolonging and improving the lives of people infected by the virus. … The ANC has still to
overcome its own deep denial about the virus. Despite having lost many of its finest
cadres to HIV/AIDS, the ruling party is yet to foster a climate of true and genuine
acceptance of the scale of this pandemic within its own ranks. … SA’s former apartheid rulers presided over a crime against humanity, a fact confirmed by the United
Nations. But their crime was not genocidal. It has taken a democratic ANC government, with a legitimate popular mandate, to be the true architects of a holocaust.’ Karima Brown, political editor, Business Day, 11 April 2006
‘Tragically, President Mbeki continues to display all the symptoms of denialism.’
Zackie Achmat, closing address, Microbicides 2006 conference, Cape Town, 26
April 2006
‘It’s under the president’s term of office that these deaths are occurring, so the person responsible for dealing with it has to be the president.’ Zackie Achmat,
Mail&Guardian, 23 June 2006
‘SOUTH AFRICA’S TOP TWELVE AIDS DISSIDENTS: 1. Anthony Brink … 3.
President Thabo Mbeki … A DEMOCRATIC ALLIANCE PUBLIC HEALTH
WARNING! … President Thabo Mbeki, Anthony Brink … deny the existence of the
human immuno-deficiency virus itself. … The DA’s objective in compiling this list
is to make it clear why these individuals are so dangerous, and raise public awareness about who they are and what they stand for. These individuals hide behind the
excuse of promoting scientific debate in order to promote views that are false and
dangerous. … The DA calls on the media, the public, and professional organizations to … exclude these individuals from positions of authority; deny their dissi-
Preface
dent views publicity; and take vigorous steps to pursue official action in respect of
any infringements of the law.’ Democratic Alliance press release, 20 October 2005
‘I personally think the kingpin of denialism is Anthony Brink, who rages about
ARVs being toxic. His relationship with the President is first-class.’ Fatima Hassan,
AIDS Law Project attorney, ‘Is there still denialism about HIV/AIDS in South
Africa?’, Harold Wolpe Memorial Trust lecture, Cape Town, 23 March 2006
‘A dangerous AIDS dissident … Anthony Brink, one of the most notorious AIDS
dissidents in the country … Brink, for those of you who don’t know it, is someone
who has caused a great deal of harm, to say the least of it. Many people claim that
his theories have had a considerable influence over President Thabo Mbeki’s disastrous views on HIV/AIDS.’ Johannes de Villiers (translated from Afrikaans), Die
Burger, 22 July 2006
‘You must read [the writing of] a crazy man called Anthony Brink and read all the
bad things they say about me. Do I care a damn? No, because I know it’s not true.
You can never base your policy, your work or your principles on what people think
of you.’ Zackie Achmat, Mail&Guardian Online, 30 November 2006
‘Brink could probably spell AIDS without consulting a dictionary, but that as far as
his real knowledge goes. He has a twisted, perverse anti-science agenda that is
based on him trying to “prove” the pre-conceived notion that AIDS is caused by the
therapies used to treat it – an utter and manifest nonsense. He has no scientific
qualifications that I am aware of nor any scientific publications.’ Nathan Geffen,
TAC national manager, Die Burger, 2 December 2006
‘… Anthony Brink [is] South Africa’s loudest AIDS denialist.’ Nathan Geffen,
journalism.co.za, 21 May 2007
‘I just wish that Mr Mbeki and the African National Congress would fight [AIDS]
the way they fought apartheid.’ Jim Yong Kim, former director of the World
Health Organisation’s HIV programme, at the start of the 16 th International AIDS
Conference in Toronto, London Times, 14 August 2006
‘Mbeki has not recanted his eccentric views on HIV. Instead of showing leadership,
he has retreated into a sullen silence on the subject.’ Rory Carroll, London
Guardian, 15 August 2006
‘[South Africa] is the only country in Africa, amongst all the countries I have
traversed in the last five years, whose government is still obtuse, dilatory and
negligent about rolling out treatment. It is the only country in Africa whose
government continues to propound theories more worthy of a lunatic fringe than of
a concerned and compassionate state. The government has a lot to atone for. I am of
the opinion that they can never achieve redemption. … I was appointed as envoy
for AIDS in Africa. I see my job as advocating for those who are living with the
‘Just say yes, Mr President’: Mbeki and AIDS
virus, those who are dying of the virus, all of those in and out of civil society who
are fighting the good fight to achieve social justice. It is not my job to be silenced by
a government when I know that what it is doing is wrong, immoral, indefensible.’
Stephen Lewis, UN Special Envoy for AIDS in Africa, addressing the closing
session of the 16th International AIDS Conference in Toronto, 18 August 2006
‘I don’t think we have any lessons to learn from South Africa. ... its President is an
HIV-denialist.’ Mark Wainberg, professor of molecular biology and virology,
head of McGill University AIDS Centre, Montreal, and co-chair of the 16th
International AIDS Conference in Toronto, chairing a session on new AIDS drug
trials, 17 August 2006
‘We as a world have sat back for far too long, watching South Africa continue to
deteriorate in terms of thousands of people dying of HIV. Why it is that a
government can continue to remain in power in a country despite all of the
evidence that it has abysmally failed to deliver the essentials to its population is
something that I clearly do not understand ... It’s something that burns a hole
through my heart. [At the 13th International AIDS Conference in Durban in 2000,
AIDS scientists had expected to find] a South African government that would be
onside with us. Instead … We found a denialist President in South Africa who
immediately turned his back on us and who immediately began to convene
committees that would articulate on his behalf that somehow it was in dispute
whether HIV was truly the cause of AIDS. … We were completely taken aback. We
were all insulted. … I for one am no longer prepared to take a back seat as a
scientist and not express my personal concern that this situation seems to have
continued unabated. … We have waited far too long to make this the crucial issue
of this time.’ Mark Wainberg, addressing a press conference at the 16 th
International AIDS Conference, 18 August 2006
‘What is happening in South Africa is a human rights violation that needs
leadership from outside of South Africa to address the crisis being created by the
South African government. [But there’s] a terrible silence … Bill Clinton can’t get
the words out of his mouth to criticise Thabo Mbeki. Kofi Annan can’t criticise
Thabo Mbeki ... The long-term consequences for South Africa are enormous. This
crisis has to be broken somehow. The African Union and the G8 and the EU have to
speak out about it. The British government, who are silent on this question, have to
find a way to intervene.’ Mark Heywood, London Guardian, 19 August 2006
‘The Treatment Action Campaign (TAC) demands that President Mbeki … Dismiss
Health Minister Manto Tshabalala-Msimang and her director-general Thami
Mseleku immediately. Since her appointment in 1999 and reappointment in 2005
[sic: 2004] by President Mbeki, she has … failed to address the HIV denialism in the
Presidency.’ TAC ‘Call to Action’ pamphlet, 21 August 2006
Preface
‘Calling for Health Minister Manto Tshabalala-Msimang to resign because of government’s failure to deal adequately with HIV/AIDS is like condemning the puppet
for stupidity while letting the puppeteer off the hook. … what we are faced with
when looking at the spectacle of Tshabalala-Msimang is the wholesale betrayal of
the poor … and her expedient refusal to defend them against the unscientific, lunatic extremities of her political master. … Whatever Mbeki and his government manage to achieve for South Africa’s future, nothing can remove the culpability of millions of preventable deaths that will forever stick to his name. And the message
from Toronto is that the rest of the world has woken up to this culpability. After 12
years as the toast of the international stage, SA has been returned to its familiar
place as the world’s pariah.’ Karima Brown, Business Day, 22 August 2006
‘[Mbeki] stop killing your countrymen. … everyone [ought] to rise up and tell
Mbeki to save his reputation and stop killing thousands of his own people. …
[Tshabalala-Msimang is] killing tens of thousands [of people by advocating nutrientrich foods for AIDS instead of ARV drugs].’ Sir Richard Branson, Sunday Times,
29 October 2006
‘This government is not doing enough … [It] is killing thousands of its own people.
… the little that they are doing could be seen as genocide.’ Sir Richard Branson,
African Eye news service, 30 October 2006
‘You could call … the president’s original lack of sympathy and public questioning
of both the causal link between HIV and Aids, and the effectiveness of anti-Aids
drugs [that] resulted in confusion and paralysis in the nation’s management of the
epidemic … genocide by sloth.’ Peter Mandelson MP (UK), New Statesman, 18
February 2002
‘Mbeki’s own appalling insistence that his lay research could trump the wealth of
scientific knowledge built up around the world cannot be forgotten or ever forgiven. He must carry to his bed each night the knowledge that his stubbornness has
sent thousands to their graves earlier than a more humble and humane approach
might have allowed. His semantic juggling with the definitions of “virus” and
“syndrome” to mock the life work of good men and women of medicine will be
forever on his conscience. … Mbeki may wish to contemplate the origins of the perception that he would put personal pride ahead of the welfare of his people. … Let
that be his personal torment.’ Brendan Boyle, Sunday Times, 5 November 2006
‘I do not believe [Mbeki] was in denial as much as he saw it as a conspiracy, a much
more traditional African response. Both Vice President Gore and I argued with
passion with him to move on this issue. And you know, we had polite responses. …
He simply listened politely and basically said to us, “We understand what we need
to do in our country,” and, “Thank you very much.”’ Donna Shalala, former US
Secretary of Health and Human Services, PBS Frontline television documentary
The Age of AIDS, 31 May 2006
‘Just say yes, Mr President’: Mbeki and AIDS
‘What disturbs me greatly inasmuch as we say people are aware of HIV, is the
continuing denialism among our people and some of our political leaders. … the
time for denialism is over.’ Nozizwe Madlala-Routledge, then Deputy Minister of
Health, addressing the annual congress of the Rural Doctors Association of South
Africa on 11 August 2006, reported in Izindaba, South African Medical Journal,
September 2006
‘Tshabalala-Msimang, in an open letter on the ANC website last Friday, complained
that her recent illness had been seen as “an opportunity to turn others into champions of a campaign to rid our government of the so-called ‘HIV and Aids denial at
the highest level’”.’ Despite this, Madlala-Routledge confirmed this week that “denialism has cost us time and lives”.’ Times, 26 November 2006
‘She has publicly admitted for the first time that the government has been in “denial at the very highest level” over Aids. … Mrs Madlala-Routledge has broken new
ground by taking her family with her for an HIV test – and has called on the president, Thabo Mbeki, to do the same. … “To me it is logical that people in the leadership see the need to do this,” she said. … What has happened in South Africa … is
sad and tragic … people are confused about treatment … and this has come about
because of the confusing messages coming from the very top.’ Nozizwe MadlalaRoutledge quoted in ‘African minister ends decade of denial on Aids’, London
Daily Telegraph, 11 December 2006
‘… the changes Mbeki’s handling of AIDS has effected upon South African national
culture … has been far more destructive than we care to admit. Until he stopped
speaking of these matters, Mbeki’s talk about AIDS was a mixture of ersatz science
and sociology. The science was primarily about the social and organic factors that
cause disease. The sociology was a treatise on the force of white racism and the
ways in which it has corrupted scientific knowledge. Yet these things may well
shroud the heart of Mbeki’s response to AIDS, which was neither scientific nor sociological, but profoundly political. As the historian John Iliffe writes in his recent
book, The African AIDS Epidemic, the government’s early resistance to antiretroviral treatment is perhaps best understood as “an insecure regime’s anxiety to maintain control over a situation perceived as threatening. The threat was that pressure
from a coalition of HIV-positive people, AIDS activists, political opponents within
and outside the ANC, pharmaceutical companies, and international opinion might
oblige the government to undertake an antiretroviral programme that it could neither administer nor afford at current drug prices, at the expense of its authority, its
health priorities and its wider developmental programme.” … [Mbeki’s] ideas
[about] AIDS and antiretroviral treatment [have] in common [a] frenzied anxiety
about an erosion of authority – perhaps even of national sovereignty. … What
Mbeki coaxed to the surface of SA’s political culture was an anxious man’s nationalism and a paranoid’s nativism – both of which instinctively lash out at the arrival
of technology and ideas from abroad. … Mbeki … treated the AIDS epidemic as a
Preface
pernicious attack on our sovereignty launched from abroad … he has made his own
sense of besiegement a nation’s sense of besiegement. In diffuse and unhappy ways,
he has triggered a flurry of trench digging across large strata of SA. It is a troubling
legacy to leave behind.’ Jonny Steinberg, Business Day, 6 November 2006
‘The deepest stigma impeding effective management of AIDS today appears to
come from the President’s continuing unwillingness or inability to lead effectively
and speak unambivalently on this issue.’ Judge Edwin Cameron, speaking at the
University of Cape Town, 15 November 2006
‘For far too long, the world was in denial. But over the past 10 years, attitudes have
changed. The world has started to take the fight against AIDS as seriously as it deserves. Financial resources are being committed like never before. People have access to antiretroviral treatment like never before. … Leaders must hold themselves
accountable – and be held accountable by all of us. That is why accountability is the
theme of this World AIDS Day. Accountability requires every President and Prime
Minister, every parliamentarian and politician, to decide and declare that “AIDS
stops with me”.’ UN Secretary-General Kofi Annan on World AIDS Day, 1
December 2006
‘Mbeki’s recent bout of denials can be equated to his HIV/Aids quackery at the turn
of the century in which he fatally refuted the scientific link between HIV and Aids.
… “He hasn’t been any more of a denialist in this case than any other leader. All
leaders defend their record,” said Richard Calland, executive director for the open
democracy advice centre at the Institute for Democracy in South Africa. “But any
leader who lacks empathy with his or her people [demonstrates] bad politics.” …
How to squander a legacy … Deny Aids. In 2001, President Thabo Mbeki began to
question the links between HIV and Aids. He established a presidential advisory
panel comprised of the world’s most notorious dissident scientists. … Mbeki does
not say anything substantive or persuasive about HIV and Aids.’ Vicki Robinson
and Rapule Tabane, Mail&Guardian, 2 February 2007
‘President Thabo Mbeki [has] an awful lot of explaining to do. So far he has never
been made to do it.’ Chris Barron, Mail&Guardian Online, 17 March 2007
‘For years Mbeki has pandered to fringe commentators who question the incontrovertible link between HIV and Aids, retarding government’s roll-out of the ARVs
that might to date have saved hundreds of thousands who have succumbed to the
disease.’ Tony Leon, ‘SA Today’, DA website, 24 March 2007
‘[In promoting Lysenko’s] doctrine of environmentally (as against genetically) acquired inheritance … Stalin too imagined that biology was susceptible to his own
ideological fetishism. … President Mbeki’s forays into biological science on
HIV/AIDS, in which he is as ignorant as Stalin in plant genetics, offer a parallel deriving from an imposed overriding ideological imperative. Still more, Mbeki is
‘Just say yes, Mr President’: Mbeki and AIDS
deeply conservative in not wanting – for whatever reason – to confront the historically developed current sexual mores of African men in South Africa. All the more
then does the dogma of “poverty” – so apparently radical, with the blame always
pointed elsewhere – serve as a blind.’ Virginia van der Vliet, ‘The Poverty Trap’,
AIDSAlert, 14 March 2007
‘South Africa really does have an odd head of state in Thabo Mbeki. … his strange
views on HIV/Aids … have cost South Africa tens of thousands of lives.’ David
Beresford, London Guardian ‘Comment is free’ blog, 21 March 2007
‘… the government’s disastrous policy on HIV/Aids – which has led to the loss of
many thousands of infected black women and babies’ lives – has been largely attributed to the dissenting views held by Mbeki. In fact, many believe, even some in
the ANC, that the shadow of Mbeki always hung over the wayward and sometimes
shocking comments on HIV/Aids of Health Minister Manto Tshabalala-Msimang,
whose own health could have been affected by the strain she must have taken for
the enormously disparaging public criticism she faced for years. It is arguable that
the catastrophic handling of the Aids crisis … was the single biggest indictment of
the Mbeki administration over the past decade.’ Ephraim Harvey, Cape Times, 3
April 2007
‘Speculation is developing once again in South Africa that President Thabo Mbeki is
planning to circumvent the constitution, leading the country into one-party rule. …
Fundamentally, suspicion of Mbeki’s motives with regard to the presidential succession is based on the belief that he simply will not surrender power. It is a belief
based on his record in power and what can perhaps best be described as his curious
personality. It is a belief and a record examined in detail by James Myburgh, a former speechwriter to South Africa’s opposition leader, Tony Leon. In a PhD dissertation at Oxford (The Last Jacobins of Africa – Thabo Mbeki and the making of the
new South Africa 1994–2002), Myburgh argues that the South African president is
no friend to democracy … Myburgh goes on to give a fascinating account and
analysis of Mbeki’s perverse stance on HIV/Aids, arguing that his insistence that
immune deficiency was caused primarily by malnutrition and poverty, rather than
a sexually transmitted virus, was ideologically driven. It offered a defence of the
dignity of the black majority; absolved the ANC of moral responsibility “and placed
the blame for the epidemic back onto the ‘legacy of the past’”.’ David Beresford,
London Guardian ‘Comment is free’ blog, 22 April 2007
‘Without question, he is personally responsible for the deaths and illness of many
thousands of his countrymen and women.’ Mark Weinberg, Brisbane Times, 5 May
2007
‘In SSA [sub-Saharan Africa] the vast majority of HIV infections are attributed to heterosexual HIV transmission while in the USA epidemic heterosexual HIV transmission is virtually absent. … The answer of mainstream medical science to the ques-
Preface
tion – why is epidemic heterosexual transmission so rampant in SSA and not in
most other regions – should be simple and direct. Epidemic heterosexual HIV
transmission requires a high prevalence and frequency of sex partner exchange (i.e.,
having multiple sex partners on a concurrent basis) and the pattern and prevalence
of these heterosexual risk behaviours in most SSA populations are sufficient to
sustain epidemic HIV transmission whereas the patterns and prevalence of these
risk behaviours in most other populations are not sufficient to fuel epidemic heterosexual transmission. … During the 1990s, as major political and social changes were
underway in South Africa, HIV spread steadily … An accelerated decrease in HIV
incidence in South Africa cannot be expected until there is full acceptance by policy
makers, especially the President, and the general public of the need to significantly
reduce risk behaviours … According to AIDS dissidents, the African AIDS diseases
by their conventional and widespread causes – malnutrition, parasitic infections
and poor sanitation – and have nothing to do with sexual risk behaviours. This hypothesis offers a simple and politically correct explanation for the predominant
heterosexual distribution of AIDS in SSA, a view that has apparently been accepted
by President Mbeki of South Africa. … Another false assertion is that because of
poor nutrition due to poverty most Africans have an “undermined” immune system that makes them more susceptible to HIV infection and the development of
AIDS. … The best that can be said about President Mbeki and his Minister of Health
is that they have been extremely unhelpful in developing adequate HIV prevention
and treatment programs: they are now hindering rather than promoting antiretroviral treatment (ART) programs. … President Mbeki of South Africa and
probably the majority of Africans are sceptical and just don’t want to believe in the
African origin of HIV/AIDS and are all too willing to listen to … conspiracy theories
and the theories of dissident scientists who do not believe HIV is the causative
agent of AIDS.’ Dr James Chin, Clinical Professor of Epidemiology, University of
California at Berkeley, and former head of the Surveillance, Forecasting and
Impact Assessment unit of the Global Programme on AIDS, World Health
Organization, Geneva, Switzerland, The AIDS Pandemic: The Collision of
Epidemiology with Political Correctness (Oxford: Radcliffe, 2007)
‘… it is a matter of common knowledge that the HIV/AIDS pandemic is wreaking
havoc on our economy and has already substantially lowered the life expectancy of
South Africans ... At best, government tends to smother civil society; at worst, it is
downright antagonistic towards it. For example, the relationship between the
Treatment Action Campaign (TAC) on HIV/AIDS and the government and the Department of Health is seriously skewed. There is no doubt that the TAC has done an
enormous amount of good work in making people conscious of the threats and
dangers of HIV/AIDS and on challenging the big pharmaceutical companies about
their pricing structures. What should have been a relationship of independent allies
working toward a common goal is perceived as a relationship of antagonists. And
the fault lies primarily on the side of the government.’ Mac Maharaj quoted in
‘Just say yes, Mr President’: Mbeki and AIDS
Shades of Difference: Mac Maharaj and the Struggle for South Africa, Padraig
O’Malley (Viking Penguin, 2007)
‘One hopes history will come to judge Mbeki’s AIDS dissidence as an aberration in
the African nationalist project. For an African nationalism congenitally suspicious
of foreign knowledge and technology beckons a future of low expectations.’ Jonny
Steinberg, Business Day, 5 June 2007
‘Thabo Mbeki is not now, nor has he ever been, an AIDS dissident.’ Ronald Suresh
Roberts, Fit to Govern: The Native Intelligence of Thabo Mbeki (STE Publishers,
2007)
‘[Alluding to Ronald Suresh Roberts’s Fit to Govern: The Native Intelligence of Thabo
Mbeki, Judge Edwin] Cameron warned against “the massive historical fraud” of revisionist historians who would sweep under the carpet the four to five years of
Aids denialism, a nightmare period when the coherence and substance of the Aids
programme was on hold.’ Maureen Isaacson, Sunday Independent, 24 June 2007
‘Recent attempts by President Thabo Mbeki’s official biographer, Ronald Suresh
Roberts, to airbrush Mbeki’s Aids denialism from the historical record smell of Stalinism – the era in which history was most cynically and viciously rewritten – and
trivialize the responsibility Mbeki carries for thousands of lives lost because he gave
credence to ludicrous denialist tenets about the cause of Aids and the efficacy of
antiretrovirals. … According to demographic modelling, if during the Mbeki presidency South Africa had rolled out ARVs for pregnant women with HIV and for
treating those sick with Aids … then at least 170 000 HIV infections could have been
prevented and more than 340 000 deaths averted. This amounts to what European
commissioner Peter Mandelson once described as a form of “genocide by sloth”.’
Nicoli Nattrass, Mail&Guardian, 20 July 2007
‘HIV denialism is lethal. It is responsible for the infections of at least several hundreds of thousands more people around the world than would have otherwise been
infected and died. South African President Thabo Mbeki and his health minister,
HIV denialists until last year, were among those in Africa whose refusal to be content with mere ostrich-like obliviousness, whose insistence on propagating flagrant
disinformation about the disease, amounted to an arguably criminal abrogation of
leadership. Last summer, when political pressure generated by the International
AIDS Conference in Toronto caused them to finally reverse their position, a scientific presentation there estimated that the number of HIV-infected people in South
Africa was approximately 25 per cent higher than otherwise because of that country’s policies.’ Mark Wainberg and John Moore, Toronto Globe and Mail, 4 July
2007
‘Treatment delivery is working and there can be no more excuses for losing this
momentum or letting millions die of AIDS.’ Zackie Achmat, Reuters, 18 July 2007
Preface
‘Mbeki is arguably the most intelligent national leader this country has ever had.’
Peter Bruce, Editor’s Note, Financial Mail, 17 November 2000
‘Mbeki is an exceptionally intelligent man, one of the sharpest and brightest
analysts I have ever met.’ Allister Sparks, London Guardian, 9 April 2004
‘… he read books at an early age which we thought were not for his standard. And
he was not talkative. He was reserved, even as a young person. And he had very
few friends because, you know, his mind was above average.’ Epainette Mbeki,
Fair Lady, November 2005
‘The 2005 Nobel Prize Winners for Medicine, Robin Warren and Barry Marshall,
were forced to relearn the message that to be a questioner of accepted truths, was to
expose oneself to denunciation as a permanent public nuisance. Their own curiosity, expressive of the human urge to know, led them to engage in a labour of love
to unravel the workings of the natural world.’ President Thabo Mbeki, ‘Letter
from the President’, ANC Today, 21 October 2005
‘There is also a “Socratic” inquisitiveness to which Mbeki is predisposed and which
underpins his leadership style and management practice. In this regard, his thinking finds expression in questions. He holds no concept or view sacred and aims at it
a quiver of questions, all of which have to be answered before he is content to move
on. … This is a powerful intellectual asset for any president, but can also be dangerous, as we have seen in his overt curiosity in unorthodox approaches to understanding the HIV/AIDS pandemic. … Mbeki is a man with … an egocentric view of
his own epic place in history; he knows his own mind, stubbornly so at times (as on
HIV/AIDS).’ Richard Calland, Anatomy of South Africa: Who Holds the Power?
(Cape Town: Zebra Press, 2006)
‘President Thabo Mbeki stunned and outraged campaigners yesterday by sacking
the country’s deputy health minister, the woman credited with ending a decade of
Aids denialism at the heart of the South African political leadership. Activists fear
that the decision spells a disastrous political regression on Aids, which could cost
the lives of hundreds of thousands of people. … by sacking his cabinet’s most forceful advocate of an aggressive campaign to provide drug treatment, Mr Mbeki has
reopened questions about his own acceptance of the science surrounding Aids. “He
has once again shown his contempt for those seeking scientific approaches to Aids,”
said Professor Nicoli Nattrass of the University of Cape Town. “This is a dreadful
error of judgement. It indicates that the President still remains opposed to the science of HIV,” the Treatment Action Campaign (TAC), South Africa’s biggest Aids
advocacy group, said yesterday.’ London Independent, 10 August 2007
‘Idasa analyst Richard Calland condemned Madlala-Routledge’s dismissal as “a
shameful error of judgment”.’ Sunday Times, 12 August 2007
‘Just say yes, Mr President’: Mbeki and AIDS
‘In many ways, Thabo Mbeki has been a successful leader of South Africa since he
took over from Nelson Mandela in 1999. … But there is one particular area in which
President Mbeki has been a scandalous failure: in confronting the scourge of
HIV/Aids. More than one in 10 of the population are infected. It has been estimated
that 1,000 South Africans are dying of an Aids-related illness every day. Yet President Mbeki for a long time refused to put his weight behind a safe-sex awareness
campaign and the rolling out of anti-retroviral drugs to prolong the lives of the infected. In the face of all credible scientific research, he has argued that Aids was a
“disease of poverty” rather than a sexual infection. Even now, when the link between the HIV virus and Aids is beyond dispute, President Mbeki is begrudging of
anti-retrovirals and criticises outside attempts to help to ease the problem as a
manifestation of neo-colonialism. … The social stigma and denial surrounding Aids
in South Africa will only be eradicated through strong political leadership. The
tragedy for South Africa is that such regressive attitudes seem as entrenched at the
top as they are throughout wider society.’ ‘Leading article: Death and denial’,
London Independent, 10 August 2007
‘What is it about South Africa’s devastating AIDS epidemic that President Thabo
Mbeki just doesn’t want to understand? Mr. Mbeki has catastrophically failed to
face up to his country’s greatest challenge. For years, he associated himself with
crackpot theories that disputed the demonstrable fact that AIDS was transmitted by
a treatable virus. He also insisted that he knew nobody with AIDS, even though
nearly 20 percent of South Africa’s adult population are estimated to be living with
H.I.V. And he suggested that antiretroviral drugs were toxic, and he encouraged
useless herbal folk remedies instead. As a result, thousands of South Africans have
needlessly sickened and died. ... Unlike other African countries, South Africa has
the financial resources and the medical talent to successfully take on its H.I.V./AIDS
epidemic. What it lacks is a president who cares enough about his people’s suffering to provide serious leadership. Only two more years remain in Mr. Mbeki’s
presidential term. Unless he finally starts listening to sensible advice on AIDS, he
will leave a tragic legacy of junk science and unnecessary death.’ Editorial, New
York Times, 14 August 2007
‘[The death of 900 people a day from AIDS is] like three jumbo jets crashing every
day. … too many died unnecessarily because of bizarre theories held on high.’
Archbishop Emeritus Desmond Tutu, speaking at Nelson Mandela University,
Eastern Cape, 31 August 2007
‘... what‘s difficult about tackling Mbeki is that he is so obviously an enlightened
man. he reads, he is erudite, he‘s good company.’ Peter Bruce, editor of Business
Day, editorial, 14 August 2007
‘[Mbeki] may well be the world’s most intelligent head of government.’ Steven
Friedman, Business Day, 22 August 2007
Preface
‘I have been concerned for a long time about the way in which Mbeki seems to be
drifting from reality. … Some of the worrying patterns of behaviour include his
continued duplicitous position on HIV and Aids.’ Max du Preez, Star, 23 August
2007
‘Thabo Mbeki … rank[s], with his friend Robert Mugabe, among the worst Presidents in the world. The backdrop is Mbeki’s twisted relationship with Aids, a disease that affects one in nine South African people and kills 900 of them a day. Specific events this past month concern two women, rivals in South Africa’s Aids
drama: former Deputy Health Minister Nozizwe Madlala-Routledge, whom Mbeki
fired on 8 August, and Health Minister Manto Tshabalala-Msimang in whom he
has retained total faith. Beyond the sycophants who surround Mbeki and his loyalto-a-fault cabinet, the consensus is widespread in South Africa that he fired the
wrong minister. And that in so doing he has laid bare the wilful ignorance and
criminal neglect with which he has responded to a humanitarian crisis of such vast
proportions that any half-decent leader anywhere else would not hesitate to flag as
his country’s overwhelming national priority. Yet Mandela’s heir, the man charged
with preserving the admirably principled tradition of the African National Congress, behaves as if South Africa’s Aids disaster is no such thing. … During Mbeki’s
first five-year term, he used to say, with the enthusiastic backing of his Health
Minister, a doctor, that Aids was not a sexually transmitted disease and that the
anti-retroviral drugs that have saved hundreds of thousands of lives around the
world were poisonous. He also famously declared that he knew no one who has
Aids. Since then, Mbeki has been bludgeoned into grudgingly starting to have antiretroviral drugs handed out. The government’s official policy on Aids today is
medically sound at last. But Mbeki continues to show an abject lack of leadership,
indicating – as his firing of the Deputy Health Minister shows – that he is less than
half-hearted in his commitment to the cause; that the great $64,000 question of
South African politics – what the hell is going inside Mbeki’s head on Aids? –
remains unanswered. Because he is an otherwise eminently rational, intelligent
man. While Mbeki has battled with repression, the crisis has cried out for Diana-like
theatrics. Mbeki should have gone out into the worst-affected areas and held the
hands of Aids patients; he should have publicly celebrated the Lazarus-like return
to life of people on the anti-retroviral programmes; above all, he should have gone
out of his way to set people straight on Aids, to counter the ignorance and
confusion he himself has sown, contributing immeasurably to the scale of the
catastrophe. … He seems oblivious to the callousness of the message he is sending
in persisting with the buffoonish Tshabalala-Msimang, a drinking buddy of longstanding, in a ministerial post that Mandela would have considered the most
critical in his government by far. John Carlin, London Observer, 2 September 2007
‘Today I speak to you as a person living with HIV/AIDS. I am healthy and I have
the hope of decades of natural life ahead because of my use of antiretroviral medi-
‘Just say yes, Mr President’: Mbeki and AIDS
cines. I speak to you also as chairperson of the Treatment Action Campaign and a
lifelong ANC member. … Since the advent of President Mbeki’s tenure more people
have died in their 30s than in their 70s. …President Mbeki has made a calamitous
mistake because of scientific denialism. … President Mbeki does not have the
power to bring people who have died back to life. … Fortunately, President Mbeki
also has the power to address this mistake. He has power to unite all of us with the
demand of science, human rights, accountability and hard work. He has the power
to appoint a new Minister Health and a new Director-General of Health. He has the
power to make science work for all of humanity and for the African Renaissance he
dreams for all of us. That brings me, nearly in conclusion to science. In a recent debate, the Director-General of Health claimed equality for “African science” and
“Western Science” with the treatment of HIV/AIDS. This a red-herring. It aims to
cause a racist division and will further undermine traditional healers and most importantly lead to an unnecessary loss of life.’ Zackie Achmat, ‘The tradition of
student mobilisation in the crisis of government and HIV/AIDS’, speech at
University of Cape Town, 6 September 2006
‘Today, public debate in South Africa tends to be characterised by the absence of
reason, and the font of that unreason is President Thabo Mbeki. After all, if
Archbishop Tutu (among many others) is correct in claiming that 900 South Africans die each day of Aids, many of them unnecessarily, surely that points to unreason? In fact, it is a record which should earn him a place in the dock at the International Criminal Court in The Hague.’ David Beresford, London Guardian
‘Comment is free’ blog, 17 September 2007
‘… supporting [Mbeki] at the outset of the Aids-denial debate [were] such loathed
personalities as Anthony Brink.’ Charles Molele, Sunday Times, 30 September 2007
‘The Mbeki regime has been an unmitigated disaster from the onset [for its] ineptitude [in its] failure to deal with HIV/Aids.’ Justice Malala, Sunday Times, 14
October 2007
‘HIV causes AIDS. So, what’s difficult? Which tyrant will stop me from saying that?
... We wasted time in debating the causality of AIDS in this country. People were
dying. When there is a fire, you don’t discuss the theory of combustion; you pick up
a bucketful of water and you fight the fire.’ Tokyo Sexwale, addressing the Cape
Town Press Club, 25 October 2007
‘Yet another prominent former ANC public representative has attacked President
Thabo Mbeki for his Aids denialism … [Speaking] at the Cape Town Press Club …
former ANC MP Andrew Feinstein … said yesterday: “The greatest tragedy … is …
the years we prevaricated in dealing with HIV and Aids due to the president and
health minister’s denialism. … And let’s not beat about the bush … they are Aids
denialists.” … He said the fact that their actions had “unnecessarily” cost tens of
thousands of lives was “unforgivable”. … Feinstein said the darkest days since
Preface
apartheid for him were when his conscience forced him to betray the confidentiality
of the ANC caucus and speak out over how Mbeki had told members that Aids was
a notion invented by the Americans to help pharmaceutical companies recoup their
investments. “We must never allow a return to a denialism that encompassed not
just the science of HIV/Aids, but a denialism that saw the party adopt the view that
a leader is always right (and) can do no wrong.” He also said Mbeki had failed the
party and the public through his “hubristic and inexplicable ongoing support” of
the “embarrassing minister of health” … Feinstein argued that [Mbeki] lacked the
necessary moral leadership [to lead the ANC and its] moral regeneration.” Cape
Times, 2 November 2007
‘I feel very strongly that what the country requires, because I do feel, is that the
country is in need of almost a moral regeneration, a moral revival.’ Andrew
Feinstein, Cape Town International Book Fair, Cape Town, South Africa, 14 June
2008
‘According to a long-awaited biography by Mark Gevisser, the president feels aggrieved that he was deflected from continuing to question the causes of the epidemic by colleagues who believed the country’s reputation was being damaged by
his views on Aids. Thabo Mbeki: The Dream Deferred describes how the president
contacted the author earlier this year to reiterate some of the views that caused uproar in the medical community before Mr Mbeki stopped talking publicly about
Aids several years ago. … Mr Gevisser recounts how Mr Mbeki phoned him late on
a Saturday evening in June to discuss Aids. The president asked the respected Johannesburg author whether he had seen a 100-page paper secretly authored by Mr
Mbeki and distributed anonymously among the ANC leadership six years ago. It
compared Aids scientists to latter-day Nazi concentration camp doctors and portrayed black people who accepted orthodox Aids science as “self-repressed” victims
of a slave mentality. It describes the “HIV/Aids thesis” as entrenched in “centuriesold white racist beliefs and concepts about Africans”. The author said he did have a
copy but the next day a driver from the presidency arrived with an updated and
expanded version. “There is no question as to the message Thabo Mbeki was delivering to me along with this document: he was now, as he had been since 1999, an
Aids dissident,” the author writes. … But Mr Mbeki was persuaded to “withdraw
from the debate”, which Mr Gevisser describes as “one of the most difficult [decisions] of his long political career”. After that the government agreed to distribute
ARVs in public hospitals and to adopt an Aids strategy that won wide approval
from many of those who had previously been its critics. “But that did not mean, in
any way, that he had changed his mind,” writes Mr Gevisser. “When I asked him in
2007 how he felt about having to withdraw from the Aids debate, he told me it was
‘very unfortunate’ that his initiative had been ‘drowned’.”’ ‘Mbeki admits he is
still Aids dissident six years on’, London Guardian, 6 November 2007
‘Just say yes, Mr President’: Mbeki and AIDS
‘In spite of the government’s about-turn on HIV/AIDS and its admission that HIV
causes AIDS, President Thabo Mbeki remains an “AIDS dissident” and regrets
having been forced to withdraw from the “debate” on the disease. This emerges in
Mark Gevisser’s biography of Mbeki, which has just been published. … He writes
in Thabo Mbeki: The Dream Deferred that the president admitted he was still an AIDS
dissident, and regretted bowing to pressure from cabinet colleagues to withdraw
from the debate. … Zackie Achmat, founder of the Treatment Action Campaign,
said yesterday Mbeki’s continued denialism was “deeply tragic” and “damaging”.
“The president is directly responsible for unnecessary deaths. He’s showed
continued arrogance. He continues to send out mixed signals,” Achmat said.’
Business Day, 7 November 2007
‘Mark Gevisser told the BBC Mr Mbeki thinks he has “failed on the issue of Aids”
and regrets dropping the debate. … “He feels even more strongly about the efficacy
of anti-retroviral (ARV) medication. He believes that ARV medication is toxic and
that it is a project that’s been imposed upon particularly vulnerable Africans by the
pharmaceutical companies,” Mr Gevisser said.’ BBC News, 7 November 2007
‘On one of the greatest controversies of Mbeki’s years in government – the
president’s attitude to HIV/Aids – Gevisser depicts Mbeki as remaining a sceptic
who still yearns to debate the cause and treatment of the epidemic. He admits that
the president’s views are wide open to be called bizarre.’ Chiara Carter, ‘Revealing
the custodian of dreams and political seducer’, London Independent, 10
November 2007
‘Amid the kerfuffle that broke with Gevisser’s revelation that Mbeki regrets that he
opted out of the Aids debate and his reassertion of his denialism, Gevisser says he
is a biographer, not a medical health practitioner and Mbeki is not his analysand.
Gevisser has offered up a portrait so balanced, so empathetic that he says he lost
friends when trying to come to grips with Mbeki’s Aids denialism. These people
actually believed he was a collaborator! “How would it have helped the understanding of the Aids issue if I had put the knife in?” he asks. This is how Gevisser
sees it: “You are so clever, so brilliant, so focused, so smart, you are so good at
mounting this campaign, that you managed to defeat the boere. People talk about a
negotiated settlement, but it was in fact a triumph. You win and you come home
and the people you have liberated are all dying from an illness for which there is no
cure. That is the dream deferred. Now there are people and now they are dying,
and there is nothing you can do about it. And what is more you are being accused
of being the man who is killing them. In the 1990s it was the exiles who brought
Aids to South Africa. So to me Mbeki’s Aids dissidence is a manifestation of the
dream deferred.” Gevisser quotes Hughes’s poem: What happens to a dream deferred?
Does it dry up/ like a raisin in the sun/ Or fester like a sore/ And then run? Gevisser has
written about this previously and Helen Epstein wrote that “… like Coriolanus,
Mbeki has stubbornly decided to debate Aids on his own terms … by denying 15
Preface
years of research on HIV and Aids”. Epstein wrote that Mbeki’s pride may well
destroy his own people. This will indeed be the ultimate disconnection.’ Maureen
Isaacson, ‘Mbeki Biography Reveals a Life of Loss’, Sunday Independent, 11
November 2007
‘Steven Friedman, senior research associate at the Institute for a Democratic South
Africa, said he was not surprised … that Mbeki remains an “AIDS dissident”. “His
opponents know he’s an AIDS denialist and his supporters don’t care. … The international community may influence his decision on whether or not to stand next
month [December 2007, for ANC president]”. The TAC said in its response that the
latest news about the president’s state of mind about the scientific approach to the
pandemic was “deeply tragic”. … Zackie Achmat, the Treatment Action Campaign’s founder, said another term with Mbeki at the helm of the party would be “a
tragedy” for the country and the continent.’ Business Day, 12 November 2007
Q: ‘Did you put it to him that history may hold him responsible for the deaths of
hundreds of thousands of people?’ A: ‘No …’ Q: ‘How do you think history will
judge him?’ A: ‘I think the deepest scratch against his legacy will be the way he
dealt with HIV and Aids.’ Q: ‘Do you think that he intellectualises all this to the
extent that the deaths of so many people because of his policies doesn’t actually
bother him?’ A: ‘I think that he believes that the damage caused by ARVs is greater
than the damage caused by Aids.’ Chris Barron interviewing Mark Gevisser,
Sunday Times, 18 November 2007
‘Let us look at this “work” of his that is not done. What “work” is this? Let us start
with the controversy, re-opened by Gevisser’s book, about Mbeki’s Aids denialism
(or the pedantic belief that he is a “dissident” and not a “denialist”). Now, if you
were president of a country in which there are, conservatively estimated, 5.5 million
people living with HIV, and in which almost 1000 Aids deaths occur every day,
would you be debating the link between HIV and Aids, or would you be moving
quickly to provide anti-retroviral drugs? This is Mbeki’s greatest failure, his shame
and the shaming of us as a nation. Only five months ago, Mbeki was still dispatching his driver to drop off Aids denialist literature with Gevisser, plainly pointing to
the fact that he is not at all interested in the success of the government’s antiretrovirals roll-out. Something is deeply wrong with a party – and country – that
wants to return to power a man so clearly heartless and unfeeling about the suffering of his people. Something is sick when such a man believes he still deserves to
lead.’ Justice Malala, ‘Who would want more of Mbeki?’, Times, 19 November
2007
‘Mbeki’s … record on … HIV/Aids has brought international derision.’ William
Saunderson-Meyer, Witness, 24 Nov 2007
‘South Africa is ... headed ... by President Thabo Mbeki, a man who remains an HIV
denialist and recently told a biographer that he regrets withdrawing from publicly
‘Just say yes, Mr President’: Mbeki and AIDS
discussing his beliefs. He has compared Aids scientists to Nazi concentration camp
doctors and portrayed black people who accepted orthodox Aids science as “selfrepressed” victims of a slave mentality. ... Our greatest impediment is wishful,
brutal stupidity.’ Ben Goldacre, ‘Aids quakery [sic] in Africa, and nearer home’,
London Guardian, 1 December 2007
‘His yearning for a specifically African approach to the continent’s problems is the
reason why he continues to question so strongly the supposedly “Western” view
that HIV causes AIDS, and hence opposes proper treatment of the disease. Astonishingly, Mr Gevisser reports that Mr Mbeki has not changed his weird and destructive views on HIV/AIDS. Furthermore, he even regrets having kept silent on
the subject over the past few years.’ ‘Thabo Mbeki: Mystery Man’, Economist, 29
November 2007
‘… once you humanise someone, then maybe it is easier to sympathise with them,
even if you are fighting them on AIDS. … The only person that would know Mbeki
is himself, but that is if he spends years in therapy.’ Mark Gevisser, interviewed in
the Weekender, 1 December 2007
‘The President is an intellectual dissident with a lifelong habit of fighting against
the majority view. … But that same contrarian instinct is also behind … his skepticism, in the face of overwhelming scientific evidence, that HIV is the principal
cause of AIDS. … independent-minded stubbornness can look like callousness
when millions of lives are at stake.’ Time, 5 December 2007
‘Looking back on this year’s events, Zapiro said that … “most off the scale on the
lunatic meter” was Mbeki’s revival of the Castro Hlongwane document which
questioned the link between HIV and Aids. In an interview with Mark Gevisser
about the biography, Thabo Mbeki: The Dream Deferred, Gevisser asked, if I put the
knife in about Aids, what good would it have done? Of course you should put the
knife in, Zapiro said. Aids continues to be “the number one issue of importance. I
am so upset and angry that it has been so badly handled and that Nosiviwe [sic:
Nozizwe] Madlala-Routledge was fired.”’ Cartoonist Jonathan Shapiro (‘Zapiro’)
interviewed in the Sunday Independent, 23 December 2007
‘What I’ve noticed throughout the years is that his intelligence is above average. As
a result people are unable to reach up to him … and he won’t come down to them.’
Epainette Mbeki, Sunday Times, 23 December 2007
‘Mbeki will forever be associated with his idiocy over Aids. In one sense, it could be
said that the initial culprit was Mandela who, despite the best efforts of Aids campaigners, said nothing until seeing the light after leaving office. If he had spoken
out and instructed his government to do likewise in 1994, it is possible that hundreds of thousands of lives could have been saved. But Mbeki went several leagues
further – by adopting an absurd, flat-earth position that denied the link between
Preface
sex, HIV and Aids. This position has been proved beyond any doubt to be wrong,
yet Mbeki persisted with it, meaning those fighting the disease, also had to fight
their government.’ Gavin Evans, Times, 22 January 2008
‘Thabo Mbeki’s legacy will largely be defined by his intransigence on the greatest
public health threat facing South Africa, HIV/AIDS. In order to understand the
gravity and sheer irresponsibility of Mbeki’s apparent denialism, we need only look
at the evolution of a potentially manageable disease into a pandemic that has
claimed the lives of millions of South Africans. … What the whole HIV/AIDS saga
reveals is that Mbeki lost his sense of judgment because of his personal hubris. …
There has been much speculation about why a man who prides himself in rationality should be so irrational in such a critical issue for his nation. … Thabo Mbeki had
shown that under his stewardship nationalism would trump even the most deadly
public health issue of his time.’ Xolela Mangcu, To the Brink: The State of
Democracy in South Africa (UKZN Press, January 2008)
‘Mbeki’s [‘disastrous HIV/Aids policy’ has] been wildly unpopular within the
ANC, especially within the tripartite alliance. The delay in the rollout of antiretroviral drugs is often termed criminal. It is hard to fault the oft-expressed view that
Mbeki’s racially-based denialism of a South African tragedy is a dereliction of duty
which borders on genocide. … Mbeki has never been a populist or a man of the
masses. His convoluted diatribes posing as philosophy tend to bore and confuse,
and provide little evidence of any vitality of thought.’ Jan-Jan Joubert, chief
political reporter, Die Burger, address at Harvard University, 8 January 2008
‘The president’s … Partnership Against Aids that was launched in 1998 by then
deputy president Mbeki … delivered little more than the schizophrenic report of his
International Advisory Panel and the truly crazy Castro Hlongwane missive.’
Jonathan Berger, head of policy and research, AIDS Law Project, Mail&Guardian
‘ThoughtLeader’ blog, 15 February 2008
Q: ‘As President Thabo Mbeki ends his term of office, what do you think will be his
greatest legacy?’ A: ‘I think he’s done many things right, but the two big spots on
his legacy are the ways he dealt with HIV/Aids and Zimbabwe. He started out being very open and realistic, ready to deal with problems and recognising them, but
in the course of time, his entourage has isolated him from reality and he became
increasingly detached. This is not unique, [it] happens to many rulers.’ Q: ‘How do
you mitigate such splendid isolation?’ A: ‘It requires a deliberate effort to remain
aware.’ George Soros, interviewed by Mail&Guardian editor Ferial Haffajee,
Mail&Guardian, 19 February 2008
‘Mbeki and Manto Tshabalala-Msimang condemned thousands of South Africans to
certain death by denying them HIV/Aids treatment.’ Mondli Makhanya, editor of
the Sunday Times, editorial, 4 May 2008
‘Just say yes, Mr President’: Mbeki and AIDS
‘Mbeki started off with a great initiative to restore Africa’s pride and her place in
the international community with the African Renaissance and Nepad. But in the
end he did Africa more damage than most African heads of state with his bizarre
notions, and criminal denialism, on HIV and Aids.’ Max du Preez, Daily News, 15
May 2008
‘[With] his bizarre position on HIV/AIDS … Mbeki has gone from lame-duck president to pariah of the ANC.’ Edwin Naidu, Sunday Independent, 18 May 2008
‘In his latest column in The Times [Justice Malala] has … called for President Mbeki
to be charged with crimes against humanity, either in this country or at the
International Court for Human Rights. … Not once in his presidency have we even
seen the spark of leadership from Thabo Mbeki. He is bookish, doesn’t like people
very much, can’t take criticism and doesn’t inspire confidence. But that’s no reason
for Malala to suggest he sees out the rest of his days wasting away in a prison cell.
Besides, blind stupidity is not a criminal offence. … There are some serious
whackos out there as I’ve discovered over the years and few more whacko than
those who are in positions of power. … I would suggest that we let Mr Mbeki end
his short term in office without making life any more difficult for him than it
already is. A despised man, he leaves no legacy worth the mention and that must be
punishment enough for any politician.’ David Bullard, ‘Out to Lunch’ at
freeracer.co.za, 10 July 2008
Q: ‘When many people outside of South Africa think of Thabo Mbeki, they think of
his more controversial moments, for example his questioning the link between HIV
and AIDS … How much have these positions obscured his real accomplishments?’
A: ‘What has got to be said is that they have damaged his reputation hugely, both at
home and abroad. There’s no question that particularly his position on HIV/AIDS
has done much damage to his reputation.’ Mark Gevisser, ‘Thabo Mbeki’s
Successes, Failures in South Africa’, NPR, 11 June 2008
‘How does one understand a man who is among the finest minds of his generation,
yet doggedly denies the scientific evidence over HIV/Aids? … Gevisser is at his
strongest tackling the most difficult subject of all – Mbeki’s denial of the science
surrounding HIV/Aids. With tens of thousands of South Africans dying around
him, the President searched out his own explanation for the pandemic, rejecting
what he saw as the easy consensus of the medical profession: a consensus that he
believed portrayed Africans as sex-crazed germ carriers, “doomed to an inevitable
mortal end because of our unconquerable devotion to the sin of lust”. Combining
this angry denunciation with a distrust of globalization, a rejection of the greed of
pharmaceutical companies and an almost pathological belief that the world was
conspiring against him, Mbeki joined the ranks of the Aids denialists. Pressure from
his Party has in recent years persuaded Mbeki to step back from the Aids controversy: South Africa now has an effective programme providing anti-retrovirals. But
Preface
Mbeki himself has not changed his intense scepticism about the medical orthodoxy
on the subject, and his Health Minister still peddles ridiculous solutions involving
traditional medicines and dietary supplements. Gevisser, who is an Aids activist,
struggled for years to finish the book because with his subject’s stand on the subject.’ Martin Plaut, ‘No denial’, Times Literary Supplement, 22 August 2008
‘A healthy skepticism of conventional wisdom on Aids turned to denialism in the
highest echelons. More than a decade passed before government finally began seriously addressing treatment. In the meanwhile, the epidemic brought death to the
door of tens of thousands of families.’ Ray Hartley, editor of the Times, editor of
thetimes.co.za, and deputy editor of the Sunday Times, ‘The Wild Frontier’ blog,
28 August 2008
‘His reputation started to suffer blows principally at first over his rather strange
views on AIDS. As people were dying in extremely large numbers from AIDS, the
President and his Health Minister insisted on these rather peculiar policies while
people were dying all around them.’ Chris McGreal, London Guardian Africa
correspondent, audio interview on guardian.co.uk, 15 September 2008
‘In South Africa, at the beginning of this decade, Aids scepticism gained currency
with a political class dismayed at the prices being charged for life-saving medicines.
Under the influence of Duesberg and his fellow “dissidents”, Thabo Mbeki’s government chose to delay for several years public provision of anti-HIV drugs. The
economist Nicoli Nattrass estimates that this decision – made amid one of the
world’s worst Aids epidemics – may already have cost hundreds of thousands of
lives.’ Richard Wilson, ‘Against the Evidence’, New Statesman, 18 September 2008
‘The South African president, Thabo Mbeki, has never courted popularity, sometimes seeming to revel in his image as a cerebral and remote figure … the technocrat and intellectual … But while Mbeki will be remembered for engineering a deal
that pulled Zimbabwe back from the brink – if the unity government agreement
works – he will also be remembered for his bizarre stance on HIV/Aids. For all his
accomplishments, Mandela largely ignored the virus, which infects an estimated
5.3m South Africans and kills 600 people a day. Hopes were high that Mbeki would
tackle this killer when he became president in 1999, but those hopes were dashed
when he sided with dissident scientists and quacks who denied that HIV caused
Aids and argued that anti-retroviral drugs could shorten, rather than extend, lives.
Civil society groups and medical organisations were blocked from setting up treatment projects, even as drug prices tumbled. Hundreds of thousands of people were
dying on his watch but, to international dismay, Mbeki stayed firm. Commentators
claimed he was “inhibited” by statements he had made in the past and felt he could
not go back on them – as if politicians do not make U-turns regularly. Under
pressure, Mbeki “withdrew from the debate”. Only in 2004 did South Africa finally
start a national treatment programme, just in time to neutralise HIV/Aids as an
‘Just say yes, Mr President’: Mbeki and AIDS
election issue. Some even suggested Mbeki did not want to spend scarce resources
and chose to let the virus decimate the poor and unemployed.’ Mark Tran, ‘Thabo
Mbeki: Profile: South African president can claim credit over Zimbabwe
negotiations but has mystified observers with his attitude to Aids’, London
Guardian, 19 September 2008
‘Then there was the shadow-side to the Mbeki presidency … Aids denialism
confounded many of Mbeki’s colleagues, who by and large remained silent about
their disagreement with his views, and to this day remains a terrible blot on his
rule. Not only did the president’s espousal of quack science see him clash with
virtually the whole world aside from health minister Manto Tshabalala-Msimang, it
translated into a mountain of avoidable deaths in a country that had one of the
highest infection rates in the world. While Mbeki was eventually pressured into
effecting saner HIV/Aids policies, many believe he remains a denialist.’ Chiara
Carter, ‘Thabo Mbeki’s downfall’, Cape Argus, 20 September, 2008
‘His government did much to improve housing and health care but his refusal to
accept the causes and scale of the AIDS crisis reversed many of the social advances.’
Donna Bryson, International Herald Tribune, 20 September 2008
‘As Mark Gevisser’s magisterial biography of Mbeki, A Dream Deferred, was
poised for the presses, Mbeki couriered Gevisser an updated copy of the Castro
Hlongwane document that expounds AIDS denialist and dissident positions, saying
it accurately reflected his views. Mbeki wanted it clear-cut in Gevisser’s text that he
still questioned the link between HIV and AIDS and regretted withdrawing from
the debate under pressure from the cabinet. What remains murky are the reasons
for Mbeki’s intransigence. He indulges in sophistry that doesn’t grasp scientific
process. Science is a systematic explanation of the world as it is experienced, not a
revelation of a philosophically incontestable reality.’ Brent Meersman, Weekender,
20 September 2008
‘Personally I would have liked to see him impeached for causing the deaths of
many hundreds of thousands of people living with HIV.’ Zackie Achmat quoted in
‘OUT! How Mbeki was toppled’, Sunday Times, 21 September 2008
‘As president, Mbeki is widely credited with helping the South African economy to
mature and for helping broker difficult political deals across the continent (most
recently last week in Zimbabwe). But he has been heavily criticized for siding with
HIV/AIDS skeptics and blamed for delays in the country’s fight against the disease.’
David McKenzie, ‘Analysis: Mbeki’s departure “the end of an era”’, CNN.com, 21
September 2008
‘[Mbeki’s] complex political legacy across Africa … includes the championing of an
uplifting African Renaissance philosophy – while disastrously questioning the scientific basis of the continent’s most brutal scourge, AIDS. … Perhaps his greatest
Preface
blunder as president may be rooted in his fascination with intellectual debates.
Mbeki astonished the medical world in 2000 by wading into AIDS policy on the
side of “denialist” scientists, who questioned the viral nature of the disease. His
government’s initial, overly cautious response to the devastating disease – which
infects more than 10 percent of South Africans – was fiercely condemned by AIDS
experts.’ Paul Salopek, ‘Mbeki’s legacy, like him, enigmatic’, Chicago Tribune, 21
September 2008
‘He came under attack for … a glaring AIDS epidemic … Internationally, Mbeki
earned ignominy for questioning the cause of AIDS.’ Karin Brulliard, ‘S. Africa’s
Mbeki Agrees to Step Down: Move by President Follows Recall Vote’,
Washington Post, 21 September 2008
‘One of his mistakes [‘Mbeki, a cool, cerebral figure’], according to critics, was his
failure to address HIV and AIDS with urgency, delaying the introduction of antiretroviral medication. Robyn Dixon, ‘South African President Thabo Mbeki forced
out’, Los Angeles Times, 21 September 2008
‘… on his watch the ANC has pursued disastrous policies over AIDS … South Africa has more people with AIDS than any other country. Aids activists argue that
for his links to the dissident scientists who dispute a link between HIV and AIDS
alone, he should long since have been forced to resign.’ Editorial, Financial Times,
reprinted in the Citizen, 21 September 2008
‘His international reputation suffered in 2000 when he began a catastrophic association with the dissident scientists who dispute a link between HIV and Aids, ensuring that thousands were denied access to antiretroviral drugs.’ Alec Russell,
‘Arrogance leaves a dream derailed’, Financial Times, 22 September 2008
‘Democratic Alliance leader Helen Zille said … Mbeki leaves a “checkered legacy”
because of his refusal to accept the causes and seriousness of the AIDS epidemic,
which now kills more than 900 South Africans per day … “His denialism of
HIV/Aids … cost thousands of lives.”’ ‘South Africa’s Mbeki resigns after power
struggle’, New York Times, 22 September 2008
‘Mr Mbeki has failed South Africa in … signal ways that have outraged international opinion. … his preposterous pseudoscientific denial that HIV causes Aids has
had terrible consequences for public health in a nation that has the highest number
of carriers of the virus.’ ‘After Thabo Mbeki: South Africa’s president departs
with dignity but limited achievement’, London Times, 22 September 2008
‘Even if [the] court of history takes a benign view of his policies on Aids (he denied
the link between HIV and Aids and blocked free access to anti-retroviral drugs) and
qualifies them as an aberration, his views on Aids were closely bound to his obsession with race. He accused those with a more conventional view of the disease of
denigrating black people as vice-ridden germ-carriers. Aids and his policy of prop-
‘Just say yes, Mr President’: Mbeki and AIDS
ping up the dying Mugabe regime will go down as the two great stains on his period of office.’ Editorial, ‘Failed hero’, London Guardian, 22 September 2008
‘In Mr. Mbeki’s view the West oppressed the rest of mankind. Obsessed with race
and colonialism, Mr. Mbeki undermined the response to the HIV/AIDS pandemic
in South Africa. To him, orthodox science “portrayed black people ... [as] victims of
a slave mentality.” Rejection of the HIV/AIDS orthodoxy was necessary to confront
“centuries-old white racist beliefs and concepts about Africans.” Hundreds of thousands, maybe millions, of South Africans died needlessly while Mr. Mbeki
defended rejectionist scientists who claimed AIDS wasn’t caused by HIV.’ Marian
Tupy, ‘Mbeki’s Legacy’, Wall Street Journal Europe, 22 September 2008
‘“We have lost confidence in Mbeki,” [‘ANC treasurer Matthews Phosa’] said.
“There have been problems for a long time.” He mentioned Mr. Mbeki’s … handling of AIDS. Mr. Mbeki allied himself with scientists who say HIV does not cause
AIDS, and label life-saving anti-retroviral treatments a conspiracy of the pharmaceutical industry even as the country developed the worst AIDS epidemic in the
world and 800 people a day died of the disease.’ Stephanie Nolen, ‘Mbeki falls
victim to the stealthy politics he pioneered’, Toronto Globe and Mail, 22
September 2008
‘He always gives convoluted intellectual reasons that don’t make sense. Mbeki is
not an intellectual. This is a good thing. I am scared of intellectuals as leaders. We
need simple-minded people in government. ... One emotion he exhibits is a visceral
hatred of the West. He likes being an Englishman but hates the West.’ Professor
Robert Schrire, University of Cape Town, ‘He teaches graduate and
undergraduate courses in international organisation and rational choice theories’,
Wolpe Trust lecture, ‘The Legacy of President Thabo Mbeki’s Foreign Policy’,
Cape Town, 23 September 2008
‘British newspapers branded South Africa’s outgoing President Thabo Mbeki a failure yesterday for disastrous policies on Aids and Zimbabwe.’ ‘British newspapers
brand fallen Mbeki a failure for his policies on Aids and Zimbabwe’, Cape
Times, 23 September 2008
‘The choices Mbeki made as president of both the African National Congress (ANC)
and South Africa were entirely his own, and they were not always wise and just.
History will judge him harshly for his stubborn refusal to listen to reason on issues
such as HIV/AIDS.’ Editorial, Business Day, 23 September 2008
‘Although an intellectual, Mr Mbeki has always been quirky, picking over truths
that others take for granted and aggressive in defence of his own theories. Experience of racism in Britain as well as South Africa may have been formative and his
views were often based on race rather than class. Mr. Mbeki’s defence of his bizarre
refusal to acknowledge the link between HIV and AIDS was often accompanied by
Preface
attacks on white perceptions of black sexuality, delivered with venom. He saw at
the heart of the AIDS debate a conspiracy of white drug companies and hinted that
antiretroviral drugs were poisoning Africans.’ Richard Dowden, London Times, 23
September 2008
‘Mr Mbeki’s record has been mixed. … In his nine year presidency, Mr Mbeki – an
aloof, rather prickly intellectual – got one big thing right, one big thing wrong. His
free market economic strategy has helped create a prosperous black middle class
while delivering strong growth … This forward-looking approach to the economy
stands in stark contrast to Mr Mbeki’s bizarre views on the Aids pandemic which is
ravaging his country. His refusal to accept the link between HIV and Aids and his
apparent suspicion that white drug companies were using antiretroviral drugs to
“poison” South Africans has been disastrous. There are now nearly 6 million South
Africans with HIV and 1,000 Aids-related deaths in the country every day.’
‘Opinion: Can Jacob Zuma continue Thabo Mbeki’s most significant legacy?’,
London Daily Telegraph, 23 September 2008
‘One of the saddest aspects of Thabo Mbeki’s rule was the unwillingness of his
Cabinet members to speak out on the issue of HIV/AIDS and to challenge the President’s strange ideas. … Thabo Mbeki would stand up in Parliament and question
the link between HIV and AIDS and set in motion a series of events so bizarre, it
still hurts my head to think about them.’ Laurice Taitz, managing editor of the
Times Online, ‘Nothing to do in Joburg besides.…’ blog, 24 September 2008
‘His government did much to improve housing and health care but his refusal to
accept the causes and scale of the Aids crisis reversed many of the social advances,
causing despair among the global scientific community and condemning an estimated 900 South Africans per day to death.’ Clare Nullis, Pretoria News, 24
September 2008
‘Jimmy Carter … once crashed straight into the Mbeki AIDS madness, and it seems
to have scarred him for life. “Frankly, I’m glad to see him (Mbeki) gone,” Carter
told guests at the Carter Centre on Tuesday night. … Carter reckoned the closest he
had come to hitting someone was Mbeki. Carter was there when Bill Gates Snr offered Mbeki funds for antiretrovirals. Mbeki rejected it, saying they were “a plot of
white people against black people”. … “I think with (Mbeki) gone, that is good,”
Carter said again for good measure.’ ‘Jimmy Carter wanted to clobber Thabo
Mbeki’, Business Day, 25 September 2008
‘Yesterday the Treatment Action Campaign (TAC) said they agreed with Carter’s
statements. TAC leader Zackie Achmat said it was sad that it took so long for the
ANC to recall Mbeki. He said Mbeki’s failure to act promptly resulted in millions of
premature Aids-related deaths. “We think the (former) president (Mbeki) has done
enormous damage to our society. … Since he came into power, at least two million
‘Just say yes, Mr President’: Mbeki and AIDS
people have died prematurely,” said Achmat.’ ‘Jimmy Carter pleased to see Mbeki
booted out’, Daily Dispatch, 25 September 2008
‘The decision by newly sworn-in President, Kgalema Motlanthe to remove Manto
Tshabalala-Msimang from the Health Ministry, is an inspired one that sends a
strong signal to the country about Aids. He appointed Barbara Hogan to the position, signalling that the debate over government’s approach to Aids has ended.
Tshabalala-Msimang, with the support of former president, Thabo Mbeki, presided
over the disgraceful failure of the government to accord Aids the seriousness it deserved. Hogan must deliver on the new ANC leadership’s promise to finally tackle
this massive social problem with conviction.’ Ray Hartley, ‘The Wild Frontier’
blog, 25 September 2008
‘“And he has made his mistakes,’ Moeletsi [Mbeki] says, “no doubt.” The Aids debacle is the one that stands out most in his mind. To the world back then, it was
denialism. To Moeletsi it was “the wrong policy for such a big problem affecting
our country”.’ Star, 25 September 2008
‘Claiming that over two million South Africans died of AIDS during Mbeki’s presidency, Achmat said that “at least 300,000 deaths could have been avoided had the
President merely met the most basic constitutional requirements”.’ PlusNews, 26
September 2008
‘The decision by the ANC to recall President Thabo Mbeki … was long overdue. …
his culpability in the death of hundreds of thousands of people in South Africa with
HIV/Aids cannot be underestimated and its impact will be felt for generations.
Death certification by Stats SA shows more than 1,5-million deaths in the ages 0–49
and more than two million new infections during his rule. The long-overdue rollout of a comprehensive antiretroviral programme, compounded by state-sponsored
pseudo-science, has left 524 000 people desperately in need of the life-saving
treatment unable to access it. As a direct result life expectancy has dropped every
year Mbeki has been in office.’ Zackie Achmat, ‘Crimes of the great denialist’,
Mail&Guardian, 27 September 2008
‘[Mbeki’s] HIV/AIDS policies resulted in the avoidable death of hundreds of thousands of people living with the condition, who were denied proper medication,
nutrition, access to basic services and information about the disease.’ Editorial,
Amandla!, 27 September 2008
‘[If the Cabinet members who resigned with Mbeki] genuinely believed that they
share the responsibility for all of Mbeki’s decisions, then do they also feel jointly
responsible for the AIDS deaths caused by Mbeki’s pathetic response to AIDS?’
Peter Bruce, ‘The Thick End of the Wedge: The Editor’s Notebook’, Business Day,
29 September 2008
Preface
‘In the immediate aftermath of his departure, his image, inside and outside South
Africa, is of a flawed, austere and stubborn man whose legacy is an economic boom
which has unfortunately left the poor behind: … six million people (out of 43
million) are HIV-positive, the majority of whom will almost certainly die from
Aids.’ Ivan Fallon, Chief Executive of Independent News & Media UK, Daily
News, 3 October 2008
‘We also want more action with regards to the reduction of HIV infections, in
effective treatment for tuberculosis and other infectious diseases, as well as
widespread HIV prevention, treatment and support programmes.’ Jacob Zuma,
‘Letter from the President’, ANC Today, 3 October 2008
‘Health is about ensuring that the future of the youth of our country is not blighted
by the scourge of HIV and AIDS. … Through our comprehensive plan for HIV and
AIDS Care, Management and Treatment Programme, we have initiated the largest
number of people on antiretroviral treatment in the continent and globally. Yet we
still have millions of people being afflicted by HIV and AIDS, both the infected and
affected. Our country has seen the human face of this scourge, with many young
orphans resulting from the premature deaths of their parents. … It is crucial that we
change the behaviour of people who are driving the epidemic. It is critically important that those who need treatment are able to get it; we must also ensure that
there is compliance with the treatment regime that is required.’ Barbara Hogan,
Minister of Health, addressing a press conference, Pretoria, 2 October 2008
‘South Africa’s new health minister pledged yesterday to “get things right” over
Aids, after years of denialism by former president Thabo Mbeki and blunders by
her predecessor … “You don’t have to be a health expert to understand the
challenge this country is facing when it comes to the Aids pandemic,” she told a
press conference in Pretoria. … South Africa has the world’s highest number of
carriers of HIV. Some 5.5 million out of a population of 47 million are estimated to
be HIV positive. “It is critically important that those who need treatment are able to
get it,” said Hogan … “I am passionate about getting things right. We will as a
matter of urgency examine all the gaps in delivery.” Hundreds of thousands of
South Africans have died from Aids over the past 14 years of ANC government,
while Mbeki, who succeeded Nelson Mandela as president in 1999, has been
lambasted for claiming that HIV does not lead to Aids.’ Alex Duval Smith, ‘South
Africa to draw a line under years of denial about HIV/Aids’, London Guardian, 3
October 2008
‘She was teary eyed when she spoke of the privilege and honour to assist those suffering with HIV/Aids. “My goodness, to be given that privilege to actually help, is a
gift that I am really grateful for. Certainly, it’s disrupted my life, certainly there’s
heartache about it – there’s other things I wanted to do.” Hogan said that she
planned to retire from Parliament and reclaim her personal life, but the plight of
‘Just say yes, Mr President’: Mbeki and AIDS
those who suffered compelled her to accept the appointment. “I think we underestimate the heroism of the people who live with this kind of burden.”’ ‘Hogan: HIV,
TB are huge challenges’, Daily Dispatch, 3 October 2008
‘I could go on about Manto Tshabalala-Msimang, but suffice it to say that the
deaths on her watch of 300 000 people who could have been saved by life-prolonging drugs does not commend her for high office.’ Justice Malala, ‘Subservience
breeds tyranny’, Times, 6 October 2008
‘After years of denialism and foot-dragging from the department of health, it is encouraging to hear the minister confirm that she regards HIV and Aids, which infects around half a million people each year, as one of the most serious health challenges facing this country. … The federation welcomes the minister’s intention to
press for more funds to roll out life-prolonging anti-retroviral drugs to as many
people as possible and meet the target to give 80 percent of HIV-positive people
access to ARVs by 2011.’ COSATU press statement, 7 October 2008
‘“We have had a decade of obstruction and HIV denialism from Mbeki and Tshabalala-Msimang”, [‘François Venter of the Reproductive Health and HIV Research
Unit at the University of Witwatersrand’] told The Lancet. … The minister never
shook off labels like “Dr Garlic” and “Dr Beetroot” for preaching the virtues of nutrition rather than antiretrovirals. At the 2006 AIDS conference in Toronto, she became an international embarrassment, putting garlic and lemons on the South African stand. The former UN envoy for AIDS in Africa, Stephen Lewis, said her policies were “worthy of a lunatic fringe”. … South Africa now has the world’s biggest
antiretroviral treatment programme, with more than 450 000 patients receiving
therapy by the end of February. But critics said the success was despite TshabalalaMsimang rather than because of her, as was the provision of dual therapy for the
prevention of mother-to-child-transmission of HIV/AIDS, which was only approved nationally this year – 4 years after being recommended by WHO.’ Clare
Kapp, ‘New hope for health in South Africa’, Lancet 2008; 372:1207-1208
Q: ‘Do you think this will silence certain politicians, for example in South Africa
and the like, or others who have also questioned the role of HIV in all this?’ A: ‘Yes,
we hope it will quieten the conspiracy theorists and others who assert ideas that
have nothing to do with research.’ Professor Bjorn Vennstrom, Nobel Committee
member, on the award of the Nobel Prize for Medicine 2008 to Luc Montagnier
and Francoise Barré-Sinoussi for their alleged discovery of HIV, interviewed on
Swedish Radio (translated), 6 October 2008
‘… is Thabo Mvuyelwa Mbeki really an intellectual? Some would say it was exactly
his pseudo-intellectual nonsense that created the gap for the present wave of antiintellectualism. … Need more evidence? Then I offer you … the crazy ranting of
Health Minister Manto Tshabalala-Msimang.’ Max du Preez, acting editor of
noseweek, editorial, October 2008
Preface
‘At the opening of the International AIDS Vaccine Conference 2008 in Cape Town
the new Minister of Health, Barbara Hogan, repeatedly stressed the importance of
scientific, “evidence-based responses” to stop HIV. … “We know that HIV causes
AIDS,” said Hogan, a point that former president Thabo Mbeki publicly contested.
... Deputy minister for Science and Technology, Derek Hanekom, praised activists
in the Treatment Action Campaign for pushing forward the HIV agenda in South
Africa – which he described as the “eye of the storm” of the HIV/Aids epidemic. He
urged everyone in HIV prevention “to intensify our efforts”.’ Claire Keeton,
‘Hogan wants a new approach to AIDS’, Times, 14 October 2008
‘“It was imperative to get ahead of the curve of this epidemic ten years ago. We all,
for various reasons, have lost ground,” Hogan told the opening ceremony of an
AIDS Vaccine conference in Cape Town. “We also wasted time despite having one
of the best plans to cope with the epidemic,” she said, adding South Africa must
now show more urgency in implementing a national programme launched last year
to fight HIV/AIDS. Mbeki drew sharp criticism shortly after coming to power in
1999 when he questioned accepted AIDS science and failed to make life-prolonging
anti-retroviral drugs (ARVs) widely available. … The comments on Monday were
her most critical yet of the Mbeki government’s stance on HIV.’ Reuters, ‘S. Africa
wasted time in AIDS fight, minister says’, 13 October 2008
‘Hogan said that more than half of all public hospital admissions are Aids-related
and more than one quarter of the national health budget goes to fighting the disease.’ IOL (Sapa-AP) ‘Speed up Aids research, asks health minister’, 13 October
2008
‘Barbara Hogan’s statement that HIV does cause Aids is proof that a monumental
and definitive shift in outlook has taken place in the Health Department under her
tenure. The DA welcomes this statement of fact, which for so long, no one in our
leadership has been able to make. We believe this will be the beginning of a new
and much brighter phase in South Africa’s battle against HIV/ Aids.’ Mike Waters,
DA Health spokesman, 13 October 2008
‘The previous beleaguered regime of Manto Tshabalala-Msimang existed in a bunker of opprobrium and arrogance, its officials serving a deathly ideology of denial,
listening only to a president who sacrificed his people on the altar of loony science.
The department reflected the racial chips on president Thabo Mbeki’s shoulders
and so saw health not as a service but as a battle of us against them. … This week
[Barbara Hogan] made things right with the science community, thus bringing rationale [sic] back to the centre of the fight against HIV/Aids. Mbeki alienated scientists in the first years of his presidency and it’s been a battle of attrition ever since.
Now trust from an essential community may be back on the horizon. This week
Hogan declared there was no doubt about the cause of Aids, putting to bed a use-
‘Just say yes, Mr President’: Mbeki and AIDS
less debate that took up too much of our airtime.’ Editorial, ‘At last an end to
lemons’, Mail&Guardian, 17 October 2008
‘On the HIV and Aids debate in particular, I believe his biggest missed opportunity
was his failure to inspire the nation to rise up against the monster. The public
needed inspiration. It was sorely missing and, sadly, now threatens to define his
presidency – which is a pity when you consider that, despite these debates, South
Africa soldiered on to create the biggest antiretroviral roll-out programme in the
world. Its strategic plan is today the envy of the world – a fact often conveniently
forgotten by those seeking to crucify him.’ Onkgopotse Tabane, Altron group
executive, ‘This is Mbeki’s legacy – judge it’, Sunday Independent, 19 October
2008
‘There is no excuse for the hoops through which the country jumped for years as
the presidency and the health ministry cast about with charlatans offering industrial solvents and health diets as a way to combat the disease. … The failure of
Mbeki and his top team to embrace the AIDS issue … and to emblazon his own
leadership in confronting the challenge will always be marked against his name. …
tragically his legacy will probably not be celebrated for [his political achievements],
but will be remembered for … his ambiguity on HIV/AIDS.’ Brian Pottinger, The
Mbeki Legacy (Cape Town: Zebra Press, 2008)
‘Under [Mbeki’s] guidance … the government wasted precious time in addressing
the critical challenge of HIV-AIDS. While over-engaging in protracted intellectualism, many people suffered without much-needed medical help in our cities, towns
and villages.’ ANC treasurer-general Mathews Phosa, speaking at a debate of
Mbeki’s legacy, Atlas Studios, Milpark, Johannesburg, 14 October 2008
‘A new study by Harvard researchers estimates that the South African government
would have prevented the premature deaths of 365,000 people earlier this decade if
it had provided antiretroviral drugs to AIDS patients and widely administered
drugs to help prevent pregnant women from infecting their babies. The Harvard
study concluded that the policies grew out of President Thabo Mbeki‘s denial of the
well-established scientific consensus about the viral cause of AIDS and the essential
role of antiretroviral drugs in treating it. Coming in the wake of Mr. Mbeki’s ouster
in September after a power struggle in his party, the African National Congress, the
report has reignited questions about why Mr. Mbeki, a man of great acumen, was
so influenced by AIDS denialists. … “I feel ashamed that we have to own up to
what Harvard is saying,” Ms. Hogan, an A.N.C. stalwart who was imprisoned for a
decade during the anti-apartheid struggle, said in a recent interview. “The era of
denialism is over completely in South Africa.”… “The tragedy of Thabo Mbeki is
that he’s a smart man who could have been an international statesman on this issue.
To this day, you wonder what got into him.” … said Richard C. Holbrooke, the
former ambassador to the United Nations in the Clinton administration who heads
Preface
a coalition of businesses fighting AIDS.’ Celia Dugger, ‘Study Cites Toll of AIDS
Policy in South Africa’, New York Times, 25 November 2008
‘Former President Thabo Mbeki’s letter to the ANC has cleared one thing up: He
really was a bit of a looney tunes president. Little has been written or said about
some of the crackpot junk in his recently aired letter to the ANC. Here are some
paragraphs: “I have taken note of the campaign that some in our ranks, supported
by some in our media, have waged for many years focused on discrediting me in
particular, given the senior positions I have occupied in the ANC, and the ANC in
general. I have been constantly and acutely aware of the fact that this campaign has
been based on outright lies and deliberate and malicious distortions.” Mbeki’s
words bring to mind the famous Carly Simon lyrics: “You’re so vain, I bet you think
this song is about you”. You see, life is a slightly more varied and interesting tableau than Mbeki imagines it to be. There are very few people with the time or the
inclination to while away the hours coming up with ways of assaulting Mbeki’s
integrity. Especially while he was doing such a handsome hatchet job on himself in
a weekly online column which can only be described as looney tunes.’ Ray Hartley,
‘The Wild Frontier’ blog, 3 November 2008
‘You say that history will judge your presidency. The rough draft is looking appalling: 300 000 people died for lack of antiretroviral medication because you intimidated all of us into a despicable silence on HIV/Aids. I can only hope, comrade,
that you sleep easy at night with such a statistic hanging over you. For myself, I can
only say: never, never again should such moral dereliction sit at the head of our
noble movement!’ Justice Malala, ‘Dear Thabo Mbeki, please shut up’, Times, 03
November 2008
‘On the 22nd of August 2006 Senator Barack Obama, during a tour of Africa, visited
South Africa and met with members of the Treatment Action Campaign in Khayelitsha. He also visited Site B Clinic in Khayelitsha were he saw the work that TAC’s
Treatment Literacy Practitioners do on a daily basis in clinics across the country.
During the closed session of their meeting TAC members suggested to Senator
Obama that he run for president. Obama took a strong position on preventing and
treating HIV/AIDS and was critical of President Mbeki and the South African government’s response to the epidemic and their disregard and animosity towards the
Treatment Action Campaign.’ TAC newsletter, 4 November 2008
‘South Africa is one of the countries most severely affected by HIV/AIDS. At the
peak of the epidemic, the government, going against consensus scientific opinion,
argued that HIV was not the cause of AIDS and that antiretroviral (ARV) drugs
were not useful for patients … In 1999, President Thabo Mbeki, under pressure to
provide zidovudine (ZDV or AZT) for prevention of mother-to-child HIV transmission (PMTCT) and AIDS treatment, announced that the drug was toxic and dangerous to health and that the government was not going to provide it. He then ques-
‘Just say yes, Mr President’: Mbeki and AIDS
tioned whether HIV was the cause of AIDS, and this broadened the debate from the
usefulness of ZDV to the usefulness of all antiretroviral (ARV) drugs in fighting the
AIDS epidemic because they all target HIV. … Access to appropriate public health
practice is often determined by a small number of political leaders. … More than
330,000 lives … were lost because a feasible and timely ARV treatment program
was not implemented in South Africa.’ Chigwedere et al. (Harvard School of Public Health), ‘Estimating the Lost Benefits of Antiretroviral Drug Use in South
Africa’, Journal of Acquired Immune Deficiency Syndromes (49: 410-15), Epub
ahead of print in December, 16 Oct 2008.
‘Mr Achmat, who leads the Treatment Action Campaign, which successfully
lobbied for the eventual reversal of government policy, claimed Mr Mbeki had
“blood on his hands”. He called for him to be summoned to a judicial inquiry or the
Truth and Reconciliation Commission.’ BBC News, 7 November 2008
‘I feel ashamed that we have to own up to what Harvard is saying. The era of denialism is over completely in South Africa.’ Barbara Hogan quoted in ‘Study Cites
Toll of AIDS Policy in South Africa’, New York Times, 26 November 2008
‘Zackie Achmat, South Africa’s leading Aids activist, called for Mr Mbeki and his
former health minister, Dr Manto Tshabalala-Msimang, to answer questions before
a special commission of inquiry into the deaths of hundreds of thousands of people
who were denied access to antiretroviral drugs. … South Africa has the largest
caseload of HIV sufferers anywhere in the world. About 1,000 people a day die of
Aids; a fact that Mr Mbeki – who once claimed he did not know a single person
who had died of the disease – resolutely refused to accept. A scholarly man whose
“denialism” appeared at odds with his much vaunted intellectualism, Mr Mbeki is
also accused of having tolerated a host of charlatans touting bogus Aids cures under the guise of “traditional” African medicines.’ ‘Thabo Mbeki must answer for
needless deaths of 365,000 Aids victims, says activist’, London Times, 27
November 2008
‘Mbeki’s denial that the virus was the prime cause of Aids (he avoided a complete
denial of any link at all) was the oddest feature of his otherwise too-cerebral presidency … Since he was ousted by his party in September, the South African Government has been trying to extract itself from this poisonous legacy … denying lifeprolonging treatment to his country’s citizens.’ Bronwyn Maddox, ‘“Lethally
perverse” denial of science’, London Times, 27 November 2008
‘In SA, HIV denialism by ousted president Thabo Mbeki and his quixotic health
minister Manto Tshabalala-Msimang has already resulted in at least 330 000 preventable deaths and 35 000 babies born with HIV. According to a recent study by
the Harvard School of Public Health, between 2000 and 2005, Mbeki’s government
stalled on delivering a national antiretroviral programme and ensuring babies were
born free of HIV. There’s now empirical evidence that political obstruction has
Preface
blocked access to life-saving drugs. Civil society, the opposition and business have
been shouting for many years for government to be more proactive in tackling the
pandemic. Then, finally last year, this push culminated in the birth of the ambitious
National Strategic Aids Plan 2007-2011, one of the world’s most progressive policies
on the deadly disease. SA now has the biggest treatment programme in the world
with 575 000 people on antiretroviral drugs. … The cards have definitely shifted, it
seems, with Hogan driving home the message: “I’m sorry I even have to state it –
we all know HIV causes Aids.”’ Sharda Naidoo, ‘Time Bomb’, Financial Mail, 28
November 2008
‘“Those people are dead because of the previous health minister and the previous
president. It’s that simple,” said Dr Francois Venter, head of the Southern African
HIV Clinicians Society.’ Agence France Press, 29 November 2008
‘Mark Heywood, deputy chair of the SA National Aids Council, said: “The war is
over. This doesn’t mean that there won’t be disputes and that the Treatment Action
Campaign will be muted when we have issues to raise – but it means that the level
of resistance that we once encountered is over. Today is the day we start working
and we are glad that this is a new beginning.” Heywood, speaking in Durban at an
event to commemorate the 20th anniversary of World Aids Day, was referring to
the recent appointment of Barbara Hogan as health minister and the sea change she
has brought to the government’s response to HIV-Aids. “Today is an unprecedented show of unity and it is not fake unity. For the first time, the government is
taking this epidemic seriously and is doing something about it,” Heywood said. …
Hogan, who attended the Durban event, said a new day had dawned in the fight
against HIV-Aids. … “We have got off to a marvellous start; we are united in
fighting this disease. We have been sitting here in unity with politicians, traditional
leaders, unionists, the National Aids Council and civil society, and we are gaining
momentum to reach our goals of reducing infections and up-scaling antiretroviral
treatment to curb mother-to-child transmissions.” … Former UNAids director Peter
Piot said he was impressed by the partnership the government had formed with
civil society to fight the epidemic – a first for South Africa. “It is clear that a new
morning has begun in South Africa. I am glad to note that the health department
will be accountable for reaching its strategic goals and that we have tackled the
leadership problem. It is a signal of powerful hope.”’ Times, 2 December 2008
‘It is not often that the cost of political leaders being wrong gets quantified. It’s
doubly important to bring science to bear on such a question when people have
paid with their lives, as happened with the AIDS epidemic in South Africa under
the leadership of then-president Thabo Mbeki. An article from the Harvard School
of Public Health AIDS Initiative published this week … provides such a service by
estimating the benefits lost through underuse of antiretroviral (ARV) drugs in
South Africa. … It concludes that the lack of an ARV drug programme caused the
loss of more than 330,000 lives – consistent with an estimate along different lines by
‘Just say yes, Mr President’: Mbeki and AIDS
the South African economist Nicoli Nattrass … – and that 35,000 babies were
needlessly born with HIV. … Mbeki was deposed in September, and his successor,
Kgalema Motlanthe, moved swiftly to replace Mbeki’s chief accomplice, health
minister Manto Tshabalala-Msimang, with Barbara Hogan. Hogan has rejected the
dissident line, subscribed to by both her predecessor and Mbeki, that AIDS is not
caused by HIV. Moreover, describing herself as “ashamed” about the estimates, she
has declared that “the era of denialism is over completely in South Africa”. ... The
needless deaths that occurred in South Africa prompt reflection on Mbeki’s now
infamous presidential AIDS advisory panel on the link between HIV and AIDS …
In retrospect, the panel, constituted as it was, should never have been supported.
Yet several of the country’s key scientific institutions explicitly endorsed its establishment, and also desisted from criticizing Mbeki. Along with his cabinet, they
bear some culpability for the consequences that have now been documented. There
is a moral to this tragic tale that may prove relevant in other contexts. In a young
democracy with a historically hierarchical culture, and with attitudes often hardened by a colonial past, scientific institutions need not only to guard their independence fiercely but also to make their reasoned voices heard above the fray of
political sycophancy.’ Editorial, ‘The cost of silence? Analyses of AIDS deaths
attributable to misguided policies in South Africa carry lessons for scientific
leaders’, Nature, 4 December 2008
‘One out of five people in South Africa live with HIV/AIDS. And for a long time,
this has been denied by the government for complex reasons. Unfortunately, none
of these are valid. … But it is calculated that probably something like 30,000 [sic]
people died, who should not have died, because they were not being given the
medicines that they should have been given, the antiretrovirals, for instance,
because the government just denied the very existence of HIV/AIDS. They fought a
very stupid battle against big pharmaceutical companies, which under most
circumstances would be a valid one, claiming that AIDS is, you know, a Western
invention, it’s an attempted genocide of the African population, and the
pharmaceutical companies are poisoning the population. So we’ve been distracted
by secondary considerations, when the real issue was what do we do to try and
make it possible for people who are afflicted with HIV/AIDS to get the necessary
medicine. How do we prevent the transfer of HIV/AIDS from mothers to children,
for instance? That was a huge issue in the country. … I think that South Africa is
only really now starting to feel the economic consequences of that, because it is
affecting huge, huge sums of people. People in the country tell me that they spend
one or two days a week just going to funerals.’ Breyten Breytenbach, Democracy
Now, 26 December 2008
‘Mr Mbeki … has continued to talk nonsense about HIV/Aids, from which 30 per
cent of the population is said to be suffering.’ Editorial, ‘Why Thabo Mbeki had to
go as ANC president’, Daily Telegraph, 5 Jan 2009
Preface
‘Obviously we cannot be brought to pardon or sympathise with Mbeki’s … stance
on Aids … but Gevisser helps us to understand … how – and why – he has
developed such seemingly monstrous attitudes. It is fitting that Gevisser should
present the story as the unfolding of a tragedy, as Mbeki evolves from the
“reasonable revolutionary” into the seeming madness of his final moments in
power.’ André Brink, ‘André Brink compares two writers’ accounts of Thabo
Mbeki’s disastrous presidency’, London Daily Telegraph, 17 April 2009
‘Thabo Mbeki’s presidential legacy is coming under increasingly critical scrutiny,
not only from political rivals and opponents but also from more objective analysts.
Among the most damning is the study by Nicoli Nattrass, director of the Aids and
Society Research Unit at the University of Cape Town and visiting scholar with the
Health Economics and HIV/Aids Research Division at UKZN, which shows that the
delay in the government’s roll out of antiretroviral treatment has led to approximately 171 000 HIV infections and 343 000 deaths that might otherwise have been
prevented. Those are appalling figures, and the fact that they include mother-tochild infections makes them all the more distressing. … Mbeki’s denialism affected
many facets of his leadership in both domestic and international affairs, but there
are few in which the cost to the people, in suffering and death, has been so evident
and so terrible. For the 343 000 dead, there is no way to retrieve the situation. For a
nation soon to choose new political leaders, however, there is a lesson to learn. The
core function of a government is to care for the welfare of its people, and of the environment upon which the wellbeing of humanity depends. With a leader known
for prickliness, his intellectual remoteness and his insistence on getting his own
way, the Mbeki administration put its political aspirations ahead of the people’s
needs. As the Western Cape example illustrates, different leadership yielded different consequences. The nation needs leaders who are accessible and open-minded,
willing to be guided by validated expert opinion and big enough to concede that
their own thinking could be flawed. The quality of leadership can literally be a
matter of life and death.’ Editorial, ‘Cost of denial’, Witness, 16 March 2009
‘Feinstein and Johnson both deal with the Aids crisis and Zimbabwe, two of
Mbeki’s most paranoid and dangerous failures of policy. It seems that to Mbeki, if
the West wanted something, it was his duty to oppose it: thus Aids drugs were a
conspiracy to denigrate and poison the African … But the statistic which will hurt is
that, according to a recent Harvard study, Mbeki’s Aids denialism has led to the
avoidable death of over 300,000 South Africans, including 85,000 babies. Johnson
has in the past pointed out that not even the Apartheid government killed this
many people.’ Justin Cartwright, Spectator, 22 April 2009
‘Except for Malegapuru Makgoba, Thandwa Mthembu and Max Price, many of the
vice-chancellors chose not to challenge openly Mbeki’s nonsense on HIV/AIDS.
Some even tried to provide some pseudo-intellectual cover for Mbeki. They be-
‘Just say yes, Mr President’: Mbeki and AIDS
trayed the idea of scholarship and failed to protect the weakest in our country.’
Sipho Seepe, Business Day, 20 May 2009
‘The crisis in South Africa’s public healthcare system seems to deepen by the day,
despite new Health Minister Aaron Motsoaledi’s claims to the contrary. In fairness
to Motsoaledi, he has to wrestle with the legacy of policy incoherence and official
miserliness left by Thabo Mbeki. As we report today, the ANC has consistently underfunded state hospitals and shifted resources away from them amid of a burgeoning Aids epidemic. State health spending per citizen declined after 1996, returning to the same levels almost a decade later. A further toxic inheritance of the
Mbeki era is the greatly increased cost burden of treating the millions of South Africans infected with HIV. If he and his deluded former health minister, Manto Tshabalala-Msimang, had faced the facts and acted promptly, many sick people might
have avoided infection.’ ‘A legacy of incoherence’, Opinion, Mail&Guardian, 29
May 2009
‘… a catastrophe is unfolding that will claim thousands more lives, as a consequence of fourteen years in which the party failed its people on the most important
challenge to confront it.’ After Mandela: The Battle for the Soul of South Africa,
chapter ‘The AIDS Betrayal’, Alec Russell (Hutchinson, 2009)
‘South Africa has the largest burden of HIV/AIDS and is currently implementing
the largest antiretroviral treatment (ART) programme in the world.’ Dr Aaron
Motsoaledi, Minister of Health, foreword to South African National HIV
Prevalence, Incidence, Behaviour and Communication Survey, 2008, June 2009
‘The HIV/Aids denialism at the apex of the state [‘a decade of health policy failure
under former president Thabo Mbeki, his health minister Manto TshabalalaMsimang and Director General Thami Mseleku’] had an immensely damaging
effect on doctors’ morale and convinced many of them that their employer cared
little for the lives of their patients.’ Editorial, Mail&Guardian, 3 July 2009
‘Something remarkable has happened in South Africa’s struggle against the worst
Aids epidemic the planet has seen: doctors and health experts have begun to use
the word “hope”. A recently published report by the Pretoria-based Human
Sciences Research Council found that … 11 per cent of all South Africans over the
age of two are HIV positive. … Some of the newfound optimism stems from the
political upheavals of recent months. President Thabo Mbeki’s departure from
office in September last year triggered a sharp shift in policy. Mr Mbeki’s denial of
the link between HIV and Aids delayed the provision of anti-retroviral medicines to
HIV sufferers, contributing to the increase in Aids-related deaths. Under Mr Mbeki,
the government eventually implemented an extensive anti-retroviral programme
but official ambivalence inevitably undermined the effectiveness of policy, not to
mention safe sex and other prevention campaigns.’ ‘HIV/AIDS: A glimmer of hope
shines amid the epidemic’, Financial Times, 16 July 2009
Preface
‘During nearly 10 years of denial and neglect, South Africa developed a staggering
Aids crisis. Around 5.2 million South Africans were living with HIV last year – the
highest number of any country in the world. Young women are hardest hit, with
one-third of those aged 20-to-34 infected with the virus.’ ‘South Africa launches
Aids vaccine trial’, London Independent, 20 July 2009
‘By all accounts, it is again a country on the brink. Nearly two decades after South
Africa marked the end of the apartheid era, the combination of the global economic
crisis and a looming peak in AIDS deaths has revealed the true cost of 10 years of
bad governance. Life expectancy has dropped from an average of 63 a decade ago
to 50 years for men and 53 for women. … If the term of a president can be measured
by life and death, then Thabo Mbeki’s 10 years in power in South Africa came at a
high cost. … Beyond the 330,000 AIDS deaths attributed directly to the previous
government by Harvard University, it is difficult to calculate the damage of failing
to provide life-saving antiretroviral treatments to the 5.7 million people with HIV.
… AIDS deaths are expected to reach an all-time high in the next 12 months, while
the Government’s investment in treatments is the lowest per capita in the region,
says Nicoli Nattrass, the director of the AIDS and Society Research Unit. “The most
recent model [shows] the denialism of the Mbeki era cut off at least 1 per cent of
South Africa’s growth rate per year over the last 10 years,” Professor Nattrass says.’
… But those who believe the departure of Mbeki and his health minister, Manto
Tshabalala-Msimang, from the political stage has meant immediate improvements
should think again, says Francois Venter, president of the Southern African HIV
Clinicians Society. “The damage was done and it cannot be repaired overnight,”
says Dr Venter, who runs an HIV clinic treating several thousand patients in central
Johannesburg. “Many of my patients even today still fear antiretroviral drugs and
believe that they are extremely toxic.” ‘AIDS crisis gathers force’, Brisbane Times,
21 July 2009
‘Finally there is a small light flickering at the end of the dark tunnel of HIV/Aids. ...
maybe we can start to overcome the legacy of Mbeki and Tshabalala-Msimang.’
‘End of Madness’ editorial, Mercury, 24 July 2009
‘“We have the challenge everyone is aware of. We have to make up for some lost
time, but we are looking forward,” Clinton said at a U.S.-funded clinic where
patients receive antiretroviral drugs. The clinic visit underscored a new juncture in
U.S.-South African relations after years of tensions over AIDS … Clinton was
accompanied to several of her meetings by Eric Goosby, the U.S. global AIDS
coordinator. That “shows how eager we are to broaden and deepen our
relationship” with the new government led by President Jacob Zuma, she said.’
‘Clinton Hails Zuma’s Policies on HIV/AIDS: New South African Government
Eschews Skeptical, Unscientific Approach of Past’, Washington Post, 8 August
2009
‘Just say yes, Mr President’: Mbeki and AIDS
‘Who was to know ... that hundreds of thousands of black South Africans would be
allowed to die of Aids because of the president’s arrant conviction that he knew
better than the scientists? ... one quickly forgets the grimness of the Mbeki era. We
know now that if anyone were to face charges of genocide, it would not be Achmat
but Mbeki. A Harvard University study last year conservatively estimated that the
prolonged refusal by the Mbeki government to provide antiretroviral drugs
through the public health-care system resulted in some 365 000 early deaths. It is
difficult to imagine that Zuma could prove to be worse than Mbeki.’ William
Saunderson-Meyer, ‘A reminder of grim times’, Witness, 15 Aug 2009
‘Health Minister Dr Aaron Motsoaledi … appointed in May, has earned praise for
his willingness to listen, acknowledge the mistakes of the past and offer new ideas
after taking over a ministry accused of failing – on Aids in particular. South Africa
has an estimated 5.5 million people living with HIV, the highest number of any
country. As the epidemic raged, then-president Thabo Mbeki denied the link
between HIV and Aids, and his health minister, Manto Tshabalala-Msimang,
mistrusted conventional anti-Aids drugs. The leading international medical journal,
The Lancet, devoted its latest issue to health problems in South Africa ... In an
editorial, The Lancet said … the policies of Motsoaledi’s predecessor, TshabalalaMsimang, had “not only led to the unnecessary deaths of more than 300 000 South
Africans (who were denied antiretroviral medicines), but also squandered much of
South Africa’s hope for enlightened post-apartheid government”. Motsoaledi has
said of the previous government’s stance on Aids: “It was wrong and it set us back
10 years.”’ Sapa-AP, ‘Health clinics set up to reduce deaths’, Pretoria News, 9
September, 2009
‘Mbeki was right to ask questions. His mistake was to accept the first answer given
– Aids could be a hoax – and proceed accordingly. Once he’d taken that position, he
was too proud to back down, and a terrible price was exacted.’ Rian Malan,
Resident Alien (Jonathan Ball Publishers, 2009)
‘I’ve been connecting with the youth, pitching the policy of the ANC, which is very
clear, which says HIV causes AIDS. That’s the policy of the organization. The
awareness campaign, I led it, as I chaired the organization that dealt with this from
the government point of view. So this is what we have been doing as a government
and in terms of policy, as well as the ANC. We have been actually making people
aware and undertaking programs. I’ve just spoken here about the comprehensive
program on HIV and AIDS which is the policy of the ruling party, is the policy of
government.’ President Jacob Zuma interviewed on CNN, 25 September 2009
‘Once internationally condemned for its handling of the AIDS crisis, SA is now
being lauded by the world’s leading organisation for combating the disease. The
Joint United Nations Programme on HIV/AIDS (UNAIDS) regional director, Mark
Stirling, yesterday gave the thumbs-up to President Jacob Zuma ‘s administration’s
Preface
approach to the HIV epidemic, saying: “What I see in SA is very responsible
leadership and governance.” Former president Thabo Mbeki was slated by 82 of the
world’s leading scientists for his contrarian approach to HIV/AIDS, and a Harvard
study estimated that 330 000 lives would have been saved if the government had
not delayed providing AIDS treatment until 2005. Last week, Zuma told CNN that
Mbeki’s unorthodox views were his own and not government policy.’ Tamar Kahn,
‘South Africa: Country Wins Plaudits for Aids Approach’, Business Day, 1
October 2009
‘While Mbeki’s and Tshabalala-Msimang’s pursuit of the holy grail of a cure for
HIV/Aids – based on such remedies as potatoes, garlic or toxic chemicals – may
have ended where it belonged, in the realm of the witch doctors, South Africa’s
health crisis has only worsened.’ David Beresford, ‘South Africa: Health reform
has a long way to go’, Guardian Weekly, 15 October 2009
‘Chairperson, honourable members – Our young democracy faces significant
challenges. … The first of these challenges relates to our economy. …The second
challenge that I wish to highlight is no less grave. Indeed, if we do not respond with
urgency and resolve, we may well find our vision of a thriving nation slipping from
our grasp. Recent statistics from the Department of Health, Human Sciences
Research Council, Medical Research Council, Statistics South Africa and other
sources paint a disturbing picture of the health of our nation. They show that nearly
6 out 10 deaths in our country in 2006 were deaths of people younger than 50 years.
If we consider mortality trends over the last decade, we see that the age at which
people die has been changing dramatically. More and more people are dying
young, threatening even to outnumber in proportional terms those who die in old
age. Honourable members, South Africans are dying at an increasing rate. The
number of deaths registered in 2008 jumped to 756 000, up from 573 000 the year
before. At this rate, there is a real danger that the number of deaths will soon
overtake the number of births. The births registered during this period were one
million two hundred and five thousand one hundred and eleven (1 205 111). The
Independent Electoral Commission had to remove 396 336 deceased voters from the
Voters Roll during September last year and August this year. What is even more
disturbing is the number of young women who are dying in the prime of their life,
in their child-bearing years. In 2006, life expectancy at birth for South African men
was estimated to be 51 years. By contrast, life expectancy in Algeria was 70 years
and 60 years in Senegal. These are some of the chilling statistics that demonstrate
the devastating impact that HIV and AIDS is having on our nation. Not even the
youngest are spared. Some studies suggest that 57 percent of the deaths of children
under the age of five during 2007 were as a result of HIV. This situation is
aggravated by the high tuberculosis prevalence. The co-infection rate between HIV
and TB has now reached a staggering 73 percent. Statistics indicate that the
numbers of citizens with TB number at 481 584. These statistics do not, however,
‘Just say yes, Mr President’: Mbeki and AIDS
fully reveal the human toll of the disease. It is necessary to go into the hospitals,
clinics and hospices of our country to see the effects of HIV and AIDS on those who
should be in the prime of their lives. It is necessary to go into people’s homes to see
how families struggle with the triple burden of poverty, disease and stigma.
Wherever you go across the country, you hear people lament the apparent
frequency with which they have to bury family members and friends. Chairperson,
Honourable members – Let me emphasise that although we have a comprehensive
strategy to tackle HIV and AIDS that has been acknowledged internationally, and
though we have the largest anti-retroviral programme in the world, we are not yet
winning this battle. We must come to terms with this reality as South Africans. We
must accept that we need to work harder, and with renewed focus, to implement
the strategy that we have developed together. We need to do more, and we need to
do better, together. We need to move with urgency and purpose to confront this
enormous challenge. If we are to stop the progress of this disease through our
society, we will need to pursue extraordinary measures. We will need to mobilise
all South Africans to take responsibility for their health and well-being and that of
their partners, their families and their communities. All South Africans must know
that they are at risk and must take informed decisions to reduce their vulnerability
to infection, or, if infected, to slow the advance of the disease. Most importantly, all
South Africans need to know their HIV status and be informed of the treatment
options available to them. Though it poses a grave threat to the well-being of our
nation, HIV and AIDS should be treated like any other disease. There should be no
shame, no discrimination, no recriminations. We must break the stigma
surrounding AIDS. In just over a month, we will join people across the globe in
marking World AIDS Day. Let us resolve now that this should be the day on which
we start to turn the tide in the battle against AIDS. Let us resolve now that this
should be the day on which we outline those additional measures that need to be
taken to enhance our efforts. Let World AIDS Day, on 1 December 2009, mark the
beginning of a massive mobilisation campaign that reaches all South Africans, and
that spurs them into action to safeguard their health and the health of the nation.
Though a considerable undertaking, it is well within our means, and we should
start now, today, to prepare ourselves for this renewed onslaught against this
epidemic. We have very impressive awareness levels in our country, well over 95
percent. We should now seriously work to convert that knowledge into a change of
behaviour. We have demonstrated in the past that, working together as a nation, we
can overcome even the greatest of challenges. We can and will overcome this one.
But we must begin by acknowledging the true nature of that with which we are
confronted. We should not be disheartened by what we find. Rather, we should be
encouraged to act with greater energy and motivation to overcome. I have
instructed the Minister of Health, as we prepare for World Aids Day, to provide
further detail to the nation on the impact of HIV and AIDS on our people. He will
do so next week. The important factor is that our people must be armed with
Preface
information. Knowledge will help us to confront denials [sic] and the stigma
attached to the epidemic. Informed by this understanding, we expect that the South
African National AIDS Council, under the leadership of the Deputy President of the
Republic, Mr Kgalema Motlanthe, will develop a set of measures that strengthen
the programmes already in place. We must not lose sight of the key targets that we
set ourselves in our national strategic plan. These include the reduction of the rate
of new infections by 50 percent, and the extension of the antiretroviral programme
to 80 percent of those who need it, both by 2011. Prevention remains a critical part
of our strategy. We need a massive change in behaviour and attitude especially
amongst the youth. We must all work together to achieve this goal. As we prepare
for World Aids Day, and as we undertake the programmes that must necessarily
follow, let us draw on our experience of mass mobilisation and social engagement.
The renewed energy in the fight against AIDS and in mobilising towards World
Aids Day must start now, by all sectors of our society. Working together, we cannot
fail. Chairperson, Honourable members – The NCOP has led the way in taking
Parliament to the people. We should build on this innovation to foster a close
working relationship between government and citizens and between parliament
and the people. I have come before you to ask for your cooperation and support in
renewing this communal spirit and cooperation. It will help us to deal with the
challenges we face, especially HIV and AIDS and its impact. Whatever challenges
we face, we will overcome. Whatever setbacks we endure, we will prevail. Because
by working together we can and will build a thriving nation. I thank you.’
President Jacob Zuma, address to the National Council of Provinces, Cape Town,
29 October 2009
‘The fight against HIV/Aids needs to be intensified, Health Minister Aaron
Motsoaledi said on Friday. “Reports from the Lancet Medical Journal says South
Africa forms 0,7% of the global population, yet carries 17% of the HIV burden, he
said. “We need to come out with guns blazing fight this scourge.” Motsoaledi was
addressing a conference in Midrand on living with HIV/Aids. He assured delegates
that the government, including President Jacob Zuma, was committed to
supporting HIV/Aids campaigns in its continued struggle against the virus. “A war
is still going to be won. We’ll only win when we stand together as government ... as
civil society. We need to undertake a massive campaign of voluntary counselling
and testing,” he said.’ Mail&Guardian online, 6 November 2009
‘Young Communists League leader Buti Manamela said Mbeki and TshabalalaMsimang denied hundreds of HIV-positive people access to antiretroviral drugs
when they were in government. “We cannot have a situation where people
continue to die because of those who presided over government as president and
health minister and who refused to provide antiretrovirals. … [They] are
responsible for many deaths … People who refused to accept the existence of
HIV/Aids also refused to save our nation. … Those who have denied the existence
‘Just say yes, Mr President’: Mbeki and AIDS
of HIV/Aids must be … tried for genocide,” he said. … He was addressing at least
1000 SACP supporters yesterday at the local stadium just outside Rustenburg,
North West, at a rally to mark the closing of the party’s Red October Campaign.’
‘Charge Mbeki and Manto with genocide’, Times, 8 November 2009
‘“In 11 years – from 1997 to 2008 – the rate of death has doubled in South Africa.
That is obviously something that cannot but worry a person,” Health Minister
Aaron Motsoaledi told reporters at parliament in Cape Town. … Motsoaledi said
the figures called for a “massive change in behaviour and attitude” toward AIDS
among South Africans. “On the figures, it’s shocking. As to whether it has been
affected by what we did in the past 10 years, to me that’s obvious. … I don’t think
we’d have been here if we’d approached the problem in a different way,” he said.
“It’s a really obvious question. Yes, our attitude toward HIV/AIDS put us here
where we are.”’ Mail&Guardian online, 10 November 2009
‘[Motsoaledi] said that in 2007, the total number of deaths – from all causes –
registered in South Africa was 573,408; in 2008, this figure had leapt to 756,062. …
“If in 2008 it’s 756,062 it means the rate of deaths increased by more than 100
percent within... 11 years,” he said. Researchers attribute the sharp rise in the total
number of registered deaths to the Aids pandemic. … When you take the global
average of HIV/Aids, the country is 23 times the global average,” he said. Contacted
for comment later on Tuesday, former president Mbeki’s spokesman, Mukoni
Ratshitanga told Sapa: “No, he (Mbeki) would not like to comment.” Citizen, 10
November 2009
‘Last week President Zuma revealed an utterly dumbfounding “fact” – Aids caused
a staggering 32 percent surge in registered deaths in 2008. This meant more than
180,000 more deaths last year than in 2007. The story made global headlines. It
looked as if the apocalypse so long predicted had at last arrived. Early this week the
Minister of Health, Aaron Motsoaledi, repeated the numbers at a press briefing.
Again, mass coverage resulted. … I started making calls. StatsSA were clueless, but
I eventually got an explanation from Dr. Debbie Bradshaw at the MRC in Cape
Town. She said, “I don’t know where the problem lies but Zuma somehow got the
numbers wrong. The minister of health too. Somebody transposed two digits.
Somebody must be dyslexic. We will forward a memo on the subject to the health
minister.” In other words, there is no apocalypse. No massive Aids-related death
surge. If anything, death registrations are stable.’ Rian Malan, ‘Did Zuma &
Motsoaledi get their AIDS stats wrong?’ Politicsweb.co.za, 13 November 2009
‘“Let the politicization and endless debates about HIV and AIDS stop,” Zuma said
in a speech on World AIDS Day. … The United States said on Tuesday it would
provide an additional $120 million funding over two years for ARV drugs in
response to a request from Zuma.’ Reuters, 1 December 2010
Preface
‘[Mbeki] denies that he ever said HIV does not cause Aids. He denies there was a
lack of action or confusing action on his part.The honourable thing would have
been for him to deny it, particularly using the opportunity tomorrow. Perhaps he
should have used the opportunity to just come out and say it was a mistake and it’s
a regrettable mistake, and apologise … for presiding over hundreds of thousands of
Aids-related deaths. … He should apologise for the suffering of all those people
who died in that period. … We are so relieved and so happy that finally we have a
government prepared to lead the battle against this epidemic from the front. We’ve
got a minister [of health, Dr Aaron Motsoaledi] who is mobilising society.’
Zwelinzima Vavi, Cosatu secretary general, World AIDS Day press conference,
30 November 2009
‘[Mbeki] must lead the campaign against HIV/Aids. He must set up the campaign
himself and join the forces that are fighting against this scourge. That would be the
most honourable thing to do while he is still alive.’ S’dumo Dlamini, Cosatu
president, at the above press conference
‘As we learned with our handling of HIV and Aids, denialism and prevarication in
the face of the crisis only benefit undertakers.’ Fikile-Nstikelelo Moya, Editor of
the Witness, inaugural editorial, ‘Complacency is Fatal’, 9 April 2010
‘“The National Union of Metalworkers of South Africa applauds President Jacob
Zuma for disclosing his HIV status after taking a public test,” said spokesman
Castro Ngobese. “Zuma buries the denialism, aloofness, poetic and bookish
approach to the HIV/Aids pandemic associated with the presidency during the 10
year tenure of president Thabo Mbeki.”’ ‘Zuma buries denialism: Numsa’, Citizen,
26 April 2010
‘Further to complicate the challenges with which we have had to contend, the matters that have been raised by some of our opponents have required that we engage
a discourse that relates to intellectual paradigms relating to philosophy, ideology
and politics. All this, including the practical politics to which we necessarily had to
respond, has imposed on the National Executive the obligation to consider and respond correctly to the dialectical relationship between the two phenomena of human existence, the objective and the subjective. Confronted by the reality that as
Government we must govern, and therefore take decisions that have a national,
structural and long-term impact, we have consequently had the task to relate the
subjective to the objective, to find the necessary relationship between theory and
practice.’ President Thabo Mbeki, final address to Cabinet, 24 September 2008
‘... an element I consider to be of vital importance if Africa is to Claim the 21st
Century – the need for Africa to recapture the intellectual space to define its future,
and therefore the imperative to develop its intellectual capital! ... Another
celebrated African intellectual, Ngugi wa Thiong’o, drew attention to the
responsibility of the African intelligentsia to play its role in ‘the making of Africa’.
‘Just say yes, Mr President’: Mbeki and AIDS
When he spoke in 2003 at a conference to mark the 30th anniversary of the
establishment of CODESRIA, the Council for the Development of Social Science
Research in Africa, he said:
“Despite her vast natural and human resources, indeed despite the fact that
Africa has always provided, albeit unwillingly, resources that have fuelled
capitalist modernity to its current stage of globalization, Africa gets the rawest deal.
This is obvious in the areas of economic and political power. But this is also
reflected in the production and consumption of information and knowledge. As in
the political and economic fields, Africa has been a player in the production of
knowledge.
“The increase in universities and research centres, though with often shrinking
resources, have produced great African producers of knowledge in all fields such
that brilliant sons and daughters of Africa are to be found in all the universities in
the world...
“CODESRIA is reflective of the vitality of intellectual production in Africa and
by Africans all over the world.
“Has this vitality resulted in the enhancement of a scientific and democratic
intellectual culture? Are African intellectuals and their production really connected
to the continent?
“Even from a cursory glance at the situation it is clear that there is a discrepancy
between the quality and quantity of this production of knowledge and the quality
and quantity of its consumption by the general populace. Ours has been a case of
trickle-down-knowledge, a variation of the theory of trickle-down economics, a
character of capitalist modernity, reflected more particularly in its colonial
manifestation, which of course is the root base of modern education in Africa. And
here I am talking of social production and consumption of knowledge and
information in the whole realm of thought, from the literary to the scientific.
“Since our very mandate as African producers of knowledge is to connect with
the continent, it behoves us to continually re-examine our entire colonial heritage,
which includes the theory and practice of trickle-down knowledge. This means in
effect our having to continually examine our relationship to European memory in
the organisation of knowledge.”
Thus did Ngugi, as did Armah, and Tiyo Soga before them, challenge the
African intelligentsia to understand that their very mandate as African producers of
knowledge is to connect with the continent, precisely to act as a motive force for the
renaissance of Africa.
From this surely it must follow that one of the tasks of this renaissance, which
would enable us to give a positive reply to the question – Can Africa Claim the 21st
Century? – must be the cultivation and nurturing of an African intelligentsia which
understands its mandate in the same way that Ngugi understands the mandate of
the African producers of knowledge.
Preface
I believe that in this regard the African intelligentsia has to understand that it
has to carry out a veritable revolution along the entirety of what we might call the
knowledge value chain. It must therefore address in a revolutionary manner the
integrated continuum described by:
Analysis of African reality and the global context within which our Continent
exists and pursues its objectives;
The policies relevant to the renaissance of Africa that would seek to transform
the reality discovered through analysis;
The politics Africa that needs to translate these policies into the required
transformative programmes; and,
The institutions that must be put in place to drive the process towards the
renaissance of Africa.
I am certain that when it proceeds in this manner, seeking both to understand
our reality and to change it, our intelligentsia will rediscover its mission as a vital
agent of change, obliged critically to re-examine the plethora of ideas emanating
from elsewhere about our condition and our future, including what have become
standard prescriptions about such matters as the democratic construct, the role of
the state and civil society, good governance, the market economy, and Africa’s
relations with the rest of the world.
Thus should we depend on our intelligentsia as our educators and no longer
mere conveyor belts of knowledge generated by others outside our Continent about
ourselves and what we need to do to change our reality.’ Thabo Mbeki, ‘Africa
must define its own future’, Thabo Mbeki Lecture Series inaugural address, 30
May 2010
‘What puzzles me is why people do not want to think.’ President Thabo Mbeki,
SABC 3 television, 8 February 2004
‘Just say yes, Mr President’: Mbeki and AIDS
The human understanding when it has once adopted an opinion (either as
being the received opinion or as being agreeable to itself) draws all things else
to support and agree with it. And though there be a greater number and
weight of instances to be found on the other side, yet these it either neglects
and despises, or else by some distinction sets aside and rejects, in order that
by this great and pernicious predetermination the authority of its former
conclusions may remain inviolate.
—Francis Bacon
Sometimes people hold a core belief that is very strong. When they are
presented with evidence that works against that belief, the new evidence
cannot be accepted. It would create a feeling that is extremely uncomfortable,
called cognitive dissonance. And because it is so important to protect the core
belief, they will rationalize, ignore and even deny anything that doesn’t fit in
with the core belief.
— Frantz Fanon
Faced with the choice between changing one’s mind and proving that there is
no need to do so, almost everyone gets busy on the proof.
—John Kenneth Galbraith
Men fear thought as they fear anything else on earth – more than ruin, more
even than death. It is fear that holds men back – fear lest their cherished
beliefs should prove delusions, fear lest the institutions by which they live
should prove harmful, lest they themselves should prove less worthy of
respect than they have supposed themselves to be. … Thought is subversive
and revolutionary, destructive and terrible, thought is merciless to privilege,
established institutions, and comfortable habit. Thought looks into the pit of
hell and is not afraid. Thought is great and swift and free, the light of the
world, and the chief glory of man.
—Bertrand Russell
We would rather be ruined than changed;
We would rather die in our dread
Than climb the cross of the moment
And let our illusions die.
—WH Auden