What a Fool Believes......

In early September 2006, at the International Conference on AIDS hosted in Toronto, South Africa's Minister of Health, Dr. Manto Tshabalala-Msimang, was met with boos and hoots of derision when she denounced the role of antiretroviral drugs in the treatment of AIDS, and instead made the claim that a diet of African potatoes, garlic, lemon, and beetroot could keep the disease under control. She made this announcement with the imprimatur of the South African President, Thabo Mbeki, who has long been an HIV denialist and who has repeatedly claimed that antiretroviral drugs are "toxic" and useless in treating AIDS. More specifically, Mbeki has insisted that HIV is not the cause of AIDS, and has instead insisted that this disease is really the outcome of "colonialism" and "apartheid." Five years ago, Mbeki gave a speech in which he stated that conventional views of AIDS causation reinforced the image of Africans as "germ carriers." After bitter accusations from AIDS scientist Malegapuru Makgoba to the effect that Mbeki was responsible for "genocide," Mbeki relented and agreed to distribute antiretroviral medications; however, Mbeki never renounced his view that AIDS is really caused not by HIV but by poverty and "the legacy of apartheid."

Following the Health Minister's announcement that a diet of African potatoes, garlic, lemon, and beetroot could keep the disease at bay, more than 60 internationally acclaimed AIDS scientists, including the putative "co-discoverer" of HIV, Dr. Robert Gallo, demanded that Mbeki fire Dr Manto Tshabalala-Msimang, describing her as an "embarrassment" who has "no international respect." How could Mbeki -- who graduated from the British University of Sussex with a Master's degree in Economics -- have fallen prey to the line of thinking, influenced by Dr. Peter Duesberg, that holds, in the face of overwhelming scientific evidence to the contrary, that HIV is not the cause of AIDS? There are now more than 30 drugs available to treat HIV infection -- nucleoside reverse transcriptase inhibitors and nucleotide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), fusion inhibitors (FIs), integrase inhibitors (IIs), and adjunctive therapies such as hydroxyurea -- and more drugs become available almost every year as science evolves (one integrase inhibitor was recently released, and another is currently in late-stage testing).

By combining these drugs -- typically by combining protease inhibitors with reverse transcriptase inhibitors and / or non-nucleoside reverse transcriptase inhibitors -- doctors in the US and the UK are now able to keep patients with HIV alive indefinitely. This is not to deny the reality of serious side-effects associated with Highly Active Antiretroviral Therapy (HAART), including lipodystrophy and peripheral neuropathy, but the bottom line is that these drugs are highly effective, when taken in strict compliance with treatment regimens, in preventing the advance of this disease, and are able to suppress HIV to the extent that the most sensitive assays available are no longer capable of detecting the presence of HIV particles in the bloodstream of infected patients. Yet in the country that now has the highest prevalence of HIV in the world, the government insists that these treatments should not be the mainstay of treatment, and instead resorts to measures that caused the scientists who authored the letter demanding the firing of South Africa's Minister of Health to write the following: "To deny that HIV causes AIDS is farcical in the face of the scientific evidence; to promote ineffective, immoral policies on HIV/AIDS endangers lives; to have as health minister a person who now has no international respect is an embarrassment to the South African government. We therefore call for the immediate removal of Dr Tshabalala-Msimang as minister of health, and for an end to the disastrous, pseudo-scientific policies that have characterized the South African government's response to HIV/AIDS."

When confronted with criticism of his handling of HIV / AIDS treatments, Mbeki insists that his detractors are "racists" and that "traditional African medicine" is as effective, if not more so, than established, highly effective modern treatment regimens. AIDS activists and scientists were outraged by the views expressed by Dr. Tshabalala-Msimang in Toronto, and by a display of vegetables as part of the treatment for AIDS at the government stand (no antiretroviral medicines were on display). Yet Dr. Tshabalala-Msimang was selected by Mbeki to become Health Minister precisely because of her discredited and ludicrous views, and because she has expressed the view that antiretroviral medications are both dangerous and useless.

It is estimated that as many as one in five South Africans carry HIV, and in some parts of the country, doctors believe that the prevalence of this disease is much higher. As this quackery masquerades as science, the health of between five and 10 million people infected with HIV continues to decline. These people will almost certainly die unless the South African government changes course immediately.

PHILIP CHANDLER