1 Mbeki - Aids 2000 - Juni
02 06 2000 Mail & Guardian (South Africa)
Year of lost chances for Mbeki
04 06 2000 Sunday Times (South Africa)
Health minister ducks AIDS question - and thereby answers it
04 06 2000 Sunday Times (South Africa)
Glaring omission mars Mbeki's defence to the Americans of his stance on AIDS
09 06 2000 Mail & Guardian (South Africa)
How Mbeki is hampering the renaissance
09 06 2000 Mail & Guardian (South Africa)
Still failing to grasp Aids nettle
11 06 2000 Sunday Times (South Africa)
A Third World dreamer, or a man who will change history?
18 06 2000 Sunday Times (South Africa)
AIDS conference organisers get ready for protesters - Strict security enforced in
Durban after SA unionist threatens 'another Seattle'
23 06 2000 Mail & Guardian (South Africa)
Time to break the silence
30 06 2000 The Guardian (UK)
A FIGHT FOR LIFE
30 06 2000 Mail & Guardian (South Africa)
Democracy and the pandemic
# 02 06 2000 Mail & Guardian (South Africa)
Year of lost chances for Mbeki<
He is at home on the international stage, but Thabo Mbeki battles to get his message through
at home. Howard Barrell reports
Thabo Mbeki ends his first year as president of South Africa bearing some resemblance to
Jan Smuts, the Boer general turned prime minister who led the country 60 years ago. Like
Smuts, Mbeki appears preoccupied with international issues and with projecting himself as
philosopher/statesman while indifferent to more pressing matters at home.
Those who have read the Smuts archive, like Renfrew Christie of the University of the
Western Cape, say it shows that South Africa's World War II prime minister was, in fact,
intensely concerned with domestic issues. He was, however, useless at communicating this
interest. And this failure contributed to his defeat in the whites-only general election of 1948
which brought the apartheid National Party to power. White voters who felt ignored by
Smuts looked elsewhere for leadership.
The same pattern is becoming evident in the case of Mbeki. He excels in, and takes obvious
pleasure in, international issues and in expressing his vision of renaissance in Africa. But,
when it comes to domestic issues of more immediate concern, he appears derelict - if not in
his actual interest in those matters then because he is bad at demonstrating his interest.
The cost for Mbeki has not, so far, been electoral. But there is already talk in the
parliamentary caucus of the African National Congress of "drift". An ANC MP, who
wanted to remain anonymous, spoke this week of "a loss of momentum since the beginning
of the year when we all seemed to know where we were going". And an ANC provincial
legislature member spoke privately of "no bloody strategic leadership for the party at all".
Mbeki's apparent preoccupation with matters global and philosophical may help explain the
growing frequency of contradictions between what he says as president of the ANC and
what the party's secretary general says. For Mbeki's attention is elsewhere. Whereas Mbeki
2 Mbeki - Aids 2000 - Juni
will sing praises to market capitalism, Kgalema Motlanthe will say we should all learn to
Whereas Mbeki will call for the creation of a black bourgeoisie, an ANC discussion
document for the meeting of the ANC's national council in July will denounce the idea.
And, whereas Mbeki will signal clearly his opposition to strike action by the Congress of
South African Trade Unions (Cosatu) to protest against unemployment, Motlanthe will
proclaim his support for it.
To the extent that Mbeki has engaged with his party, it has been to tinker, manage, balance
its various factions and, occasionally, to harangue. He has, in the opinion of a number of
public representatives in the party, however, not provided much leadership. One result of
this - perhaps one he considers useful, albeit achieved by default - is that the party continues
to be most things to most people: capitalist to some, socialist- inclined to others; Africanist
to some, a paragon of non-racial virtue to others.
Who is reflecting actual ruling party thinking is, at times, anybody's guess. And there
appears to be a declining interest in international business and diplomatic circles in divining
who that might be. South Africa is just not important enough - whatever leaders of the ANC
and the South African Communist Party need to believe - to warrant much attention. China
with a billion consumers, yes. Russia with more than 200-million consumers, vast natural
resources and nuclear weapons, yes. South Africa? Yawn.
Whatever the messages given out from Tuynhuis, the Union Buildings and Lutuli House,
the concrete evidence available thus far indicates that the government and the ruling party
do not have the political will to accelerate privatisation, to force through painful changes to
the public service and labour market regulations that they and their consultants have plainly
identified as necessary, and to foster on a vast scale entrepreneurial activity among the
impoverished black majority.
Moreover, the government and ruling party will not be credited with that determination and
capacity unless or until they actually do those things - without a hundred ifs, buts and
The law of diminishing returns applies on background briefings to journalists, business
people and others. The same is true of messages reaching the majority of people.
Expectations are excited by the first one or two undertakings that, say, bold economic
changes are in the pipeline. But, if the changes fail to materialise, interest and credulity tail
off precipitately. That is where we are at in South Africa. Verbal undertakings count for
little - except, perhaps, where they came from plainly effective performers in the Cabinet
such as Kader Asmal, the Minister of Education, and Mohammed Valli Moosa, Minister of
Environmental Affairs and Tourism.
Mbeki, we are told, expects Cabinet ministers to perform - and there are signs that some of
the early purpose that characterised his Cabinet shortly after its appointment in June last
year still survives. But until a Cabinet minister is fired for non-performance - for example,
for the non-expenditure of R198-million in poverty relief by the Department of Welfare and
Population Development - it will be difficult to take claims of increased Cabinet discipline
Until then, it may be similarly difficult for the millions of poor South Africans to believe
that the ANC, for all its rhetoric, and the government take them and their plight seriously.
Surveys show the gap between rich and poor, including that among black South Africans,
has been widening.
If, as seems clear from government economic policy, the poor are expected to wait for
job-creating economic growth and for the launch of a massive programme to foster small
and medium enterprises before they can gain an economic foothold in South African
society, they may have to wait another four or five years to see any real results. And no one
has yet told them that simply and clearly. Perhaps it is time someone did - and also told
3 Mbeki - Aids 2000 - Juni
them whether the government plans to create some sort of minimal social welfare catchnet
until then, an idea which has support even from the Democratic Party.
A dose of realism about the immense challenge we face in uplifting the social conditions of
the marginalised - and the absence of easy options for doing so - is something Mbeki is
more than capable of administering to South Africans without sugar coating.
Mbeki has shown admirable grit in holding to the spirit and much of the detail of his policy
on growth, employment and redistribution. To this extent, he has faced down the economic
Neanderthals in the ANC and the tripartite alliance. But the challenge before him is now to
follow through on policy - boldly to accelerate privatisation, restructure the civil service and
labour market, and to foster an entrepreneurial culture. And to ditch or leave behind those
too timid to travel the road he and his party have verbally committed themselves to. The
time for such boldness is early in his presidential term, early enough to give him at least a
three-year window before the next election to recover from any political damage he might
suffer in the battle.
It is possible that Mbeki is waiting until after the local government elections, likely later this
year or early next, before any bold follow- through. He could, after all, do with SACP and
Cosatu help in delivering ANC voters to the polls. If so, he will have to move quickly and
decisively after the local government elections. For the optimal window of opportunity will
close rapidly after that.
Failure to act then is likely to condemn South Africa to accelerating economic decline, and
all the promise Mbeki has appeared to personify will be exposed as illusion.
In this respect, a worrying facet of Mbeki's political personality is his evident taste for
isolation. There he has been gatekept by thinkalikes such as Frank Chikane, Director
General in the presidency, Mojanku Gumbi, his legal adviser, Essop Pahad, Minister in the
Office of the President, and Moss Ngoasheng, his economic adviser until Ngoasheng left the
presidency recently to concentrate on what has long been his main interest, his information
technology company. None has shown any promise of firing the policy-maker's imagination
in his or her lifetime or of providing Mbeki with challenging advice.
"They are a mirror bouncing back at Mbeki the same image of himself," remarked a senior
businessman well- connected in government and political circles. "There is no new light
Mbeki's most conspicuous engagement on a domestic policy issue has been on HIV/Aids - a
disaster on which he unwisely launched himself into tangled issues of detail. Only now,
after some nifty footwork by his media advisers, does he appear to be succeeding in
extricating himself from the mess into which he launched himself.
But in no case have Mbeki's political morality, his judgement, the quality of the advice he is
receiving, his propensity to become preoccupied with a foreign issue, the opacity of his style
and his presentational shortcomings come under closer scrutiny than over the crisis in
Some financial market analysts insist that a portion of the rand's precipitate fall over the past
six weeks, and the huge net outflow of funds from South African equities and bonds, can be
attributed directly to Mbeki's failure to deliver timeously and directly two messages on the
Zimbabwean crisis to the business and financial community. One of those messages was
that South African foreign policy - on Zimbabwe, as elsewhere - was being guided by,
among other things, the need to uphold property rights and the rule of law. The other was
that his government would on no account allow Zimbabwe-style farm invasions to occur in
There were several ways he could have conveyed these messages early on in the
Zimbabwean crisis without undermining his delicate dealings with the pathologically
sensitive Robert Mugabe. Yet he did not. Moreover, he missed an opportunity to do so in
4 Mbeki - Aids 2000 - Juni
his address to the nation on May 4, the day the massacre of the rand really got under way on
"It's Mbeki's Rubicon, and he hasn't crossed it," a market analyst said on the evening of that
A reassurance that Mbeki would not allow copycat farm invasions was eventually dragged
out of the president by New National Party leader Marthinus van Schalkwyk and Freedom
Front leader Constand Viljoen. But this came only on May 10 when Mbeki answered his
first round of presidential questions from MPs in the National Assembly in Cape Town.
Mbeki had, seemingly, deemed it unimportant to brief or reassure South Africans on the
By then, however, wider damage had been done - among others to some democrats'
confidence in the ANC. One such democrat was Pieter Venter, the ANC's media liaison
head in Parliament who resigned from his post and the party last week over the
government's policy on Zimbabwe. Interviewed this week, he described how, as he sat in
ANC strategy meetings in Parliament, he found himself silently asking a disturbing
question: "If the ANC's hold on power was ever threatened in the way that Zanu-PF's is
being, would it behave in the same way?
"From my observation of some people in these meetings and in the caucus, I eventually
came to the conclusion we could easily see the ANC behave like Zanu-PF," he said.
ANC parliamentary staff say Venter's departure represents no loss. That may be so. But the
government's uncommunicative response - or, rather, the presidency's response, since it has
been running foreign policy on the Zimbabwe crisis - has had a profoundly damaging effect
on white confidence in South Africa.
Again, there may be some in the ANC and elsewhere who would see no reason to mourn
such a development. But, for cooler minds, the haemorrhage of white skills does not play
well with - at very least - our national economic objectives.
There is a further level at which the Zimbabwean crisis has played out badly for South
Africa. Under the rubric of the "African renaissance", Mbeki has sought to present himself,
his party, his government and South Africans as modern democrats every one, keen to
prosper in the international market economy, pursuing a new way of doing things, seeking
to build strong institutions, and rejecting the "big man" syndrome and the corruption of
power that has bedevilled Africa and its development since the late 1950s.
Yet Mbeki's strange backwardness about laying out publicly at least a set of democratic
principles informing his policy on Zimbabwe has given the impression, in the words of the
politically well-connected South African businessman, that Mbeki believes that "solidarity
with old comrades from the liberation and anti-colonial struggles is more important than
democracy and the welfare of a population", in this case of Zimbabweans.
"We are being drawn back into the old boys' club," he said. "This has done very
considerable damage to the president."
The road back from that damage - and the missed opportunities of the past year - need not
necessarily be that long. Traversing it successfully and reasonably quickly is likely to
depend on at least four changes in Mbeki.
One, he may need to throw off a political lifetime of opacity and realise that communicating
with, and answering to, others is not cause for irritation but the very lifeblood of electoral
Two, he may need to get himself advisers unafraid to argue forcefully against his instincts
and viewpoints, and able to think outside accepted parameters.
Three, he may need to take to heart the aphorism that fortune favours the bold. And, four, he
may need to remind himself that his primary job is to build South Africa.
Stirring Africa and saving the world can come later - if there's time.
INDABA Internet Datenbank Afrika - Institut für Afrika-Kunde, Hamburg
5 Mbeki - Aids 2000 - Juni
6 Mbeki - Aids 2000 - Juni
# 04 06 2000 Sunday Times (South Africa)
Health minister ducks AIDS question - and thereby answers it<
Sunday Morning Assessment
BY AVOIDING the question why the government can't get to grips with AIDS, SA's
Minister of Health, Dr Manto Tshabalala-Msimang, inadvertently answered it this week.
Tshabalala-Msimang was invited to a debate hosted by the Centre for Development and
Enterprise which posed the question: "Why is the government struggling to make an impact
on the AIDS crisis?"
But instead of tackling it, she deftly rephrased the problem and asked the audience: "Why is
South African society struggling to make an impact?" While her question is an important
one, this change in emphasis was a tactical manoeuvre to shift responsibility rather than an
attempt to find real answers.
Instead of seizing the opportunity to acknowledge past blunders and inspire confidence in
the government's present strategies, TshabalalaMsimang chastised the audience for
believing that the government has a central role in tackling the AIDS crisis.
She shifted the focus from the government to individual responsibility - thereby
inadvertently questioning the government's ability to lead.
She said : "As government we cannot outlaw sexual contact," and added, with a giggle, "It is
too exciting to do so."
She said: "I am not saying this to minimise government responsibility but there is no way
government can make an impact on AIDS unless every individual takes responsibility for
their sexual behaviour."
Throughout the evening, she frequently returned to the same slogan: "Remember, every
While on the most simplistic level this approach seems to make perfect sense, it fails to take
into account that the low status of women in South African society, violence, poverty and
illiteracy all hamper the negotiation of safe sex between partners.
As Tshabalala-Msimang acknowledged later - contradicting her earlier approach - AIDS is
not just about sex.
It is about attitudes and behaviour and a slew of socioeconomic and cultural forces.
The government may have no role to play in the bedroom, but that doesn't mean it can
relinquish its responsibility to lead, to govern and to protect. That comes with the job. So far
the government has struggled to make an impact on the AIDS epidemic because of an
unwillingness to tackle the issue head on.
It has not listened to the advice of experts, nor acknowledged failures and mistakes in a way
that would prevent their repetition. It should admit that present strategy has helped
undermine confidence in efforts to preach prevention.
On Tuesday night, the minister preached that "every action counts".
Perhaps she should heed her own advice.
Respected academic vs the government on the key issues around the epidemic
THESE are key points in the debate between the Minister of Health, Dr Manto
TshabalalaMsimang, and the University of Natal's Professor Jerry Coovadia, the convenor
of the International AIDS Conference, due to be held in Durban in July.
Tshabalala-Msimang: "We can make laws, we can attempt to change people's behaviour but
we cannot change what's in people's minds and their hearts.
"That's the place where government responsibility ends and individual responsibility
Coovadia: "There have been problems and mistakes that have affected government
credibility. Sarafina 2 , Virodene, notification and the composition of the present
7 Mbeki - Aids 2000 - Juni
Presidential AIDS panel have all contributed to today's problems with controlling the
disease through prevention.
"Government is culpable."
ON THE PRESIDENT CONSULTING DISSIDENTS:
Tshabalala-Msimang: "The President never said HIV doesn't cause AIDS. The President
said we have developed strategies and put in a lot of resources and we are not seeing returns.
What is it we are not doing right?" Coovadia: "Government has contributed to the present
climate of confusion around HIV/AIDS by raising the possibility that HIV does not cause
AIDS and that certain antiretrovirals are toxic and poisonous. When government says
something that even raises an iota of doubt, the person in the street will ask: 'Why the hell
should I wear a condom? Why should I stick to one sex partner?' "
ON THE ADVISORY PANEL:
Tshabalala-Msimang: "It had never been an idea not to put South Africans on the panel. But
it was not going to be dominated by our scientists."
Coovadia: "[President Thabo Mbeki] had an alternative. He could have picked up the phone
and said: 'Hello, William [Makgoba, president of the Medical Research Council], this is
what some scientists in California are saying. Is it true or not?' "
INDABA Internet Datenbank Afrika - Institut für Afrika-Kunde, Hamburg
8 Mbeki - Aids 2000 - Juni
# 04 06 2000 Sunday Times (South Africa)
Glaring omission mars Mbeki's defence to the Americans of his stance on AIDS<
Carol Paton Before President Thabo Mbeki made his views on the use of anti-retroviral
drugs known, the AIDS movement in the US was enjoying a revival.
The disease in the developed world was under control and was fast losing its stigma as
celebrities "came out" about their status.
The campaign to make drugs more affordable in the developing world, kicked off by the
former Health Minister Nkosazana Zuma, had given the US AIDS movement a new lease
on life. Affordable drugs for AIDS became its main campaign issue.
So when Mbeki renounced the use of anti-retroviral therapy in South Africa, just as the US
activists stood poised to win their battle for cheaper AIDS drugs, they were gobsmacked.
They, and the US's public health officials, were equally stunned when he then made contact
with US scientists described as dissidents or AIDS denialists, holding views ranging from
the belief that HIV does not exist to the idea that there is no AIDS in Africa and that AZT
causes the disease.
When Mbeki wrote to US President Bill Clinton to defend these steps in the most passionate
of terms, it seems that AIDS activists, of which there are a few in the White House, were
sufficiently horrified to provide a copy of the letter to the newspaper the Washington Post.
A torrent of criticism burst forth.
By the time Mbeki arrived in the US last week, the perception had been created that he
doubted that HIV caused AIDS, that he "had done nothing" about the epidemic and that "he
refused" to give AIDS drugs to South Africans.
In most of this he had been grossly misunderstood.
Casting aside the emotional defence in his letter, which equated criticism of the dissidents
with the burning of heretics at the stake, Mbeki opted for a businesslike response to the
For the first time since the storm erupted, he offered a rational response. AIDS was a serious
problem, he said, which required a determined response. South Africa was running as large
an awareness campaign as possible and had taken steps to involve civil society in a
partnership to fight the disease.
But the provision of antiretroviral therapy to all those infected with HIV, even with the
promise that prices would be slashed by 85%, would consume the entire health budget.
Besides, as drug companies themselves admitted, patients on anti-retroviral therapy required
constant monitoring and a far better health infrastructure would be needed.
In addition to these practical problems there was an unsolved scientific riddle. While the
disease in the developed world had spread mainly among homosexuals, in Africa it was
clear it was a heterosexual disease. It was also a mystery as to why scientists had decided in
1985 that AIDS was not an epidemic in SA but the disease was out of control a mere five
It was these unanswered questions which had prompted him to contact scientists across the
board and convene a panel to promote their interaction, Mbeki said.
The experts, some of whom are on Mbeki's panel, agree that these are valid and useful lines
The underlying assumption, hinted at by Mbeki, may be a bit more controversial: that
scientific work should be done to investigate whether there are biological differences
between blacks and whites.
Leaving this aside, there is little doubt that Mbeki's rational approach worked, along with
some deft spindoctoring by US and SA officials. By the middle of his US tour, sentiment in
the media showed signs of becoming more even.
But although Mbeki clarified most misconceptions about his ideas on AIDS, he failed in one
glaring and vitally important instance.
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The Washington Post, the paper which had criticised Mbeki most vehemently, was quick to
point it out.
Mbeki had briefed the editors of the Washington Post at length while in town and,
afterwards, the paper ran an article carefully recounting his views. But it condemned his
steadfast refusal to use anti-retroviral drugs for the prevention of transmission of HIV from
mothers to babies.
The Post, seemingly annoyed at what it saw as obfuscation, pointed out that not only was
this a mistake but that Mbeki had erroneously downplayed research which has pointed to the
efficacy of anti-retroviral drugs in these circumstances.
After his impressively rational response on the broader questions of AIDS, Mbeki's answers
on mother-to-child transmission were disappointingly fuzzy.
Instead of the facts and figures that one might have hoped for, answers were lost in
generalities about subSaharan Africa.
Many of the assertions about the costs of blood tests, drugs and even health infrastructure
were unconvincing without the accompanying facts and figures.
This is particularly so in the light of studies by private health economists which have shown
that, rather than being unaffordable, attempts to prevent the transmission of HIV from
mothers to babies is cost-effective.
With facts hazy, all that was offered was the old emotional response.
Said Zuma, for instance: "All that people care about is this AZT - nobody asks me what we
are doing to make sure the babies survive [thereafter]. It is fuelled by the argument that we
need more to buy more drugs, rather than saving children's lives."
But Mbeki's US trip has shown that great strides can be made in a context of rational debate
This, and some credible research to examine the viability of a mother-to-child programme in
SA, would be very helpful in preventing the discussion sinking even deeper into dogma.
INDABA Internet Datenbank Afrika - Institut für Afrika-Kunde, Hamburg
10 Mbeki - Aids 2000 - Juni
# 09 06 2000 Mail & Guardian (South Africa)
How Mbeki is hampering the renaissance<
We need a more realistic assessment of President Thabo Mbeki to preempt exaggerated
expectations and the inevitability of his failing to meet these. It is time to liberate ourselves
of the misconceptions we have of the president, and in so doing liberate the president of the
misconceptions he may have of himself.
Months before Mbeki took office as president, Professor Wilmot James suggested that
Mbeki's government would require close monitoring with regard to democratic and human
rights. James intimated that institutions like his, the Institute for Democratic Alternatives in
South Africa, required independence to effect the plurality of opinions necessary to deepen
democracy. This perceived slight galvanised the African National Congress's publicity
machinery into action - James was roundly condemned by the organisation's national
working committee. Some went as far as to call for his dismissal.
Unfortunately for James, his comments could not have come at a more inopportune moment
as the media was beginning to warm to Mbeki. Having divested itself of a cautious and at
times hostile approach to Mbeki, the media had embarked on the exercise of portraying him
as an anti- populist intellectual. Mbeki was presented as a businesslike diplomat, studious
and a reflective scholar; a suave and urbane democrat and incorruptible. This was a
reconciler and pragmatist able to appease and accommodate the communists, the Africanists
and the high-flying capitalists. Reference was made to his timely appeal to the African
renaissance, a strategy which brought together an omnibus of aspiring black bourgeoisie,
black capitalists, black lawyers, journalists, academics - the very group that could become
the government's vocal critics.
Since taking office, a less appealing portrait is beginning to emerge. Political developments
project an image of a president with a propensity to accumulate and centralise power; a man
who is prepared to sacrifice his comrades to realise his ambitions. Associated with this is an
image of a president who is ultra-sensitive, unable to accommodate others and who is
impatient with differing opinions. A president who is unable to accept that he could be
mistaken, and has conveniently surrounded himself with sycophants.
The first signs of power accumulation and centralisation began with the ANC's decision to
delink the position of the premiers from that of the provincial chair. This gave Mbeki
inordinate power and influence over all levels of governance. Through the prerogative of
appointing premiers, the president directly influences the composition of the provincial
executives. The argument advanced then was that governance demands certain skills,
insights and expertise that popularly elected leadership may lack. It was argued that the
delinking would also frustrate narrow careerism that had blighted the organisation. Implicit
in this arrangement is the notion that whereas "the people" can be trusted with electing the
president, such a trust cannot be extended to electing the premiers.
Impressions abound that incumbents were appointed on the basis of their unquestioning
loyalty to the president. When the opinion of one premier was canvassed on an intricate
matter, he allegedly responded with the suggestion that his thoughts are those of the
president, whatever the president's thoughts are on the matter.
There are many skilled, competent, educated and tried-and-tested cadres in the ANC who
could have been selected, but they were overlooked. "Careerism" has not been solved by
circumventing the expression of the will of the people, but has instead introduced another
form of careerism and praise-singing. It has simply moved influence closer to the throne,
and curtailed the public expression of independent thought in the ANC and government.
The only time ANC members are quoted in the media is when they agree with or sing the
11 Mbeki - Aids 2000 - Juni
praises of the president. Otherwise they prefer to be quoted anonymously. One may simply
refer to the deafening silence that followed Mbeki's position on HIV/Aids.
The fact that Mbeki was elected the president of the ANC unopposed does not help. While
this may well be a tradition of the organisation, this practice can lead to untrammelled
confidence where a leader feels no need to accommodate different viewpoints. Overweening
confidence can lead to a disregard for opinions of the entire government. When a single
person influences all appointments, those who appointed them will inevitably shape the
opinions of appointees. History has shown that when enormous power is vested in one
person, leaders have often suffered from delusions of grandeur.
A troubling consequence of the president's apparently blind defence of his appointees is a
leniency that renders hollow his commitment to fighting corruption. There was the
appointment - even a promotion - of a minister (Minister of Justice and Constitutional
Development Penuell Maduna) who had knowingly lied to Parliament and caused the
wastage of at least R30-million of taxpayers' money. Secondly, the defence of Mpumalanga
Premier Ndaweni Mahlangu and a virulent attack on those who had on a principled basis
opposed his condoning of "political" lies. This defence went so far as to publicly undermine
the Public Protector. Lastly, the apparent condonation of the finding of a public commission
that a senior member of Parliament had fraudulently obtained a driver's licence. Each of
these cases required decisive action that demonstrated that corruption would not be
tolerated. The message sent, however, was that corruption of the inner circle could be
overlooked because of historical loyalty.
The fact that the power and authority to dismiss resides with the president means that it does
not matter whether the premier or the cabinet minister is competent or not; as long as the
incumbent is in the good books of the president, the individual concerned is guaranteed
protection. This became glaringly obvious with the retention of some non-performing
ministers. The likes of Maduna, Minister of Provincial and Local Government Sydney
Mufamadi, Minister of Housing Sanki Mthembi-Mahanyele and Minister of Public Works
Stella Sigcau come to mind. Maduna, notwithstanding a series of embarrassments in which
he involved himself, was promoted to a senior ministry. Mufamadi failed to instil a sense of
duty among the police. Towards the end of his tenure the police morale was extremely low.
The less said of Mthembi-Mahanyele and Sigcau the better. The performances of these
contrast sharply with the likes of Pallo Jordan and Derek Hanekom, ministers who were
removed from office. The axing of independent thinkers like Mathews Phosa fits neatly with
Mark Gevisser's portrait of someone who is insecure -- "deposing comrades not because
they are corrupt or inefficient, but because they threaten him".
This insecurity has extensive ramifications that go beyond political appointments. The
absence of plurality of opinion, and lack of debates in the country, has not been made easier
by the tendency of those in power to resort to mud-slinging and labelling. The ruling party
has come up with an effective strategy to discredit those who expose the inanities of its
policies, programmes and/or the government's inability to deliver by labelling them. Labels,
such as "counter-revolutionaries", "peace-time revolutionaries", "reactionaries" and
"charlatans" have become the refuge for the ruling party. Faced with an inability to engage
issues intellectually, the representatives have tended to invoke labelling and rubbishing
critics with the hope of closing the debates.
The president has also not been innocent in applying this tactic. In his congratulatory speech
on the occasion of Dr Mathole Motshekga's inauguration as Vista University's chancellor,
Mbeki decried the absence of black intelligentsia in public forums and policy debates.
Mbeki went further to suggest that the few intellectuals who are there, those promoted by
the media, "are an acute embarrassment" to the black majority. Such statements betray the
very notion of the African renaissance as they are meant to rubbish and stigmatise every
12 Mbeki - Aids 2000 - Juni
black intellectual who dares to question the dominant or official paradigms and discursive
practices in this country.
An African renaissance, or any renaissance for that matter, requires an environment that
encourages a flourishing and flowering of ideas. It requires an environment that promotes
robust and vibrant intellectual engagements. Robust engagement demands us to rigorously
unpack and expose the limitations or bankruptcy of the ideas of those with whom we differ.
Simply labelling them does not advance our arguments, it closes a discussion and introduces
a culture "where might, power and privilege determine right". The ANC does not need to
counter-attack every criticism. Sometimes it must leave space for debate and the expression
Reinforcing the culture of intolerance is the ubiquitous notion that there is "hierarchy of
sacrifice and contribution to struggle" and hence the "hierarchy of benefits". Such a notion
fails to appreciate that it is through the active participation of the [nameless] hundreds of
thousands of our people that the liberation movements were unbanned and political
prisoners released. It has also led some to think they hold a monopoly on revolutionary
credentials and copyright to what is in the best interest of the country.
Equally disturbing has been the president's failure to acknowledge the intellectual
contribution of the likes of Stephen Bantu Biko, Mangaliso Sobukwe, Anton Lembede and
Zeph Mothopeng. If the African renaissance is to succeed, then its building blocks are to be
found in the intellectual contributions made by the likes of Biko and Sobukwe. The
president can take a leaf from the likes of Sir Isaac Newton by acknowledging the
contributions of those who came before him. Newton said of his contribution "that if I have
seen further than the others, it is because I stood on the shoulders of giants".
Perhaps one of Mbeki's strong points is his ability to refurbish and repackage old ideas.
Most memorable in this regard are his I Am an African and Two Nations speeches, the
repackaging of the concept of African renaissance and lately his forays into medical science.
The success has been short-lived. While there was much ado following his declaration that
Afrikaners are Africans, the ANC and South African Communist Party documents continue
to reflect a historical conceptualisation of the subject.
The Two Nations speech, adapted from Benjamin Disraeli's prototype in his 1845 novel,
Sybil: Or, the Two Nations, is a thesis whose appeal to morality is betrayed by the call for
expansion of the black capitalist class. The concept of the African renaissance remains
opaque and diffuse. If it is to have any worth, the concept must be reclaimed from
politicians, most of whom do not derive their standing from the quality of their ideas. For
some in government it has become a sacred litany routinely used to conclude
speeches - however unrelated it may be to the content. The less said about his recycling of
the HIV/Aids debate the better. Suffice to mention that his latest tour to the United States
seems to have softened his stance on the matter. The gradual suppression of dissenting
views indicates that South Africa could do more with robust intellectual engagement within
and outside the ruling party.
Sipho Seepe is the campus principal of the Sebokeng campus of Vista University
INDABA Internet Datenbank Afrika - Institut für Afrika-Kunde, Hamburg
13 Mbeki - Aids 2000 - Juni
# 09 06 2000 Mail & Guardian (South Africa)
Still failing to grasp Aids nettle<
The government's attempts to airbrush President Thabo Mbeki's recent blunders in
HIV/Aids policy leave a nasty stain on the political and social canvas.
The fact that the president flirted with, or even bought into, the dissident position on
HIV/Aids, is his business and his business alone. The fact that he left the marks of his lapse
of good judgement not only on Aids policy but on the reputation of South Africa affects us
Presidential representative Parks Mankahlana is right when he insists that nowhere does
Mbeki express a belief that HIV is not the cause of Aids. Nor does he say anywhere that he
is a supporter of the Aids dissident position.
Unfortunately, this is not the point. Mbeki is a sufficiently canny and experienced politician
to understand that politics is about consequences, not about beliefs. It is also about the way
in which actions and pronouncements may be used in the broader dialogue of reality.
If Mbeki needs evidence of the truth of this, he should revisit the virusmyth.com website
where some of his initial researches into the Aids dissident position were apparently
conducted. Here he will find himself presented as the rallying point of an international
campaign of resistance against the mainstream of research into and treatment of HIV Aids.
"Support President Mbeki to find the truth about Aids", a click-through banner reads, "Sign
On the same website Mbeki will find a warm account of his interactions with prominent
Aids dissident Ravid Rasnick (who does not believe that HIV is the cause of Aids, but a
In short, whatever Mbeki may personally believe, his public persona will be inextricably
linked up with some of the more quixotic manifestations of the Aids dissident position.
And, though dissidents like Rasnick and Peter Duesberg would like to style themselves the
Galileos of contemporary science, most opinion is that they are modern-day flat-earthers.
There is no question that Mbeki has been tainted by the association.
A week ago New York Newsday spoke for much of American opinion when it said: "A
certain open-mindedness is fine. But a person can be so open-minded that his brains fall out.
At worst Mbeki is a callous demagogue - skillfully diverting attention from a public health
crisis he can't control. Or maybe he's a misguided fool. In any case he's in deep trouble."
If Mbeki failed to appreciate the political dangers, the United States's Clinton administration
is only too sensitive, and reportedly pursued diplomatic avenues to point out that the entire
binational process between the US and South Africa was being jeopardised by Mbeki's
perceived position on HIV/Aids. So, too, was South Africa's political pre-eminence among
the nations of Africa.
The US demand in the face of this was that Mbeki repudiate the sentiments he had
expressed. Thus far Mbeki's office has done a lot of airbrushing of the offensive bits of the
sorry history, but nothing to retract.
Its dominant response has been to kill the messengers, to vilify the scientists who begged for
reason, and to lambast the media which reported it.
No matter. Our skins are thick. What is more important is that Mbeki's second- guessing of
science has set back the fight against Aids.
By the year 2000, two decades after the start of the HIV/Aids pandemic, South Africa still
has no co-ordinated strategy or policy to fight the disease. The government must take much
of the blame.
The Aids dissidents debacle is not the first time the Mbeki government has second-guessed
science. The memory of Virodene, the industrial solvent that was going to cure Aids, is still
fresh, as are assorted other disasters, like the R14-million Sarafina II Aids play that was
going to educate the population.
14 Mbeki - Aids 2000 - Juni
Nor is this the first time that the government has failed to grasp the nettle. The appointment
earlier this year of a National Aids Council that could be relied upon not to challenge the
official position, but - by all accounts, as well as the evidence of its subsequent inertia - not
much else, is merely one in a long list of attempts by the government to stifle embarrassing
opposition to its failure to deal with the problem.
The time came a long time ago to do something decisive. In constructive spirit, because we
know that the president shares with all South Africans the desire to combat this scourge, we
have three suggestions.
The first is that he disband his committee of scientists. It will not promote debate, it will
only provide a platform for the disaffected in the scientific community.
Second is that the government should enter into meaningful debate with South African Aids
activists and scientists to frame a serious and co-ordinated policy to deal with the pandemic.
Finally, Mbeki should step back, leave science to the scientists and - for God's sake, Mr
President - look after the politics.
INDABA Internet Datenbank Afrika - Institut für Afrika-Kunde, Hamburg
15 Mbeki - Aids 2000 - Juni
# 11 06 2000 Sunday Times (South Africa)
A Third World dreamer, or a man who will change history?<
One year into his presidency, Thabo Mbeki goes in search of the ANC's lost soul, write
mondli makhanya and carol paton
ON THE eve of the AfricaEurope summit in Cairo in April, President Thabo Mbeki sat in
his hotel room with senior advisers and technocrats to draft the speech he would deliver to
heads of state from the two continents the next evening.
Technocrats from the South African departments of Trade and Industry and Foreign Affairs
haggled over how Mbeki could best convince European countries to direct investment flows
towards Africa and halt capital flight from the continent.
Opening the discussion, Mbeki picked up a wad of documents and moved them from one
end of the table to the other. "We need to say that capital must move from here to here," he
said. The technocrats then set about interpreting their graphs and tables into persuasive
information Mbeki could use in his argument.
And so it was that the speech went on to appeal for debt relief for poor countries, the
restructuring of the world economic order, increased direct investment in the least
developed countries and the opening up of their markets to African goods.
These were "simple propositions", Mbeki argued, that could be attained if there was a will.
Demystifying complex problems and then searching for practical solutions has been the
defining characteristic of the Mbeki presidency over the past year. It is a practice to which
he has adhered to the point of naiveté, as evidenced by the search for an African solution to
the AIDS problem. With Mbeki, it is a case of identifying a problem, suggesting a solution
then setting about removing the obstacles. Examples abound:
Union-friendly labour laws have had "unintended consequences" of stifling labour-intensive
small enterprises - they must be revised and relaxed accordingly;
The present model of outcomes-based education is not working, and the quality of
classroom activity is declining - draw up a new model that will work;
The police force is not making headway in cracking crime syndicates - harness top lawyers,
intelligence agents and the cream of the police force into a specialised unit called the
Scorpions and set them loose on the syndicates;
Violence has become a normal way of conducting politics in KwaZulu-Natal - cement the
co-operative relationship between the ANC and Inkatha and let the rapport seep down to
grassroots level; and
Investors are shunning South Africa and its neighbours as Western corporations associate
Africa with wars and unstable governments - play peacebroker while applying deft
spin-doctoring to alter the world's perceptions of Africa.
It is that simple - or so Mbeki tries to persuade those with whom he interacts. But, of course,
it is not that simple when one is running a country with a huge, racially defined wealth gap
and a state machinery that was geared towards self-preservation rather than delivering
services to the public. It gets even more complicated if that country happens to be on a
continent ruled by despots, kleptomaniacs and gunslingers and is therefore treated as a leper
by the moneyed world.
One of the first things Mbeki did when he took over the presidency was to preside over the
re-organisation of the government and work towards changing Africa's image abroad.
Policy co-ordination and implementation are now tightly controlled from his office, and all
directors-general report to Frank Chikane, the directorgeneral of the presidency. New
"super-directors-general" are to be appointed to run projects which span different
departments, such as tourism and the development of rural areas.
The provinces, which had developed spendthrift tendencies and poor financial controls,
have been reined in. All ANC premiers were selected directly by Mbeki as ANC president,
16 Mbeki - Aids 2000 - Juni
and the composition of their Cabinets had to meet the approval of the party's national
The Premiers' Forum, which used to rotate its monthly talk shops and braais among the
provincial capitals, has been replaced by the President's Forum, which holds monthly
work-like "co-ordination" meetings with Mbeki in Pretoria.
But it is the party on which Mbeki relies to bring forth his vision of the state as a piece of
The past year has seen an accelerated effort to get people whom Mbeki regards as the
ANC's better minds into strategic government positions. The original pack from the first
five years of ANC rule are now closely monitored by head office to ensure that they carry
out the party's mandate and are getting the necessary support from its union allies.
The most striking appointments of the past year have been those of former SA Secret
Service chief Billy Masetla as the director-general of Home Affairs and Jackie Selebi as
national police commissioner.
Both departments have been viewed as problem areas by government - the police force
because it stubbornly resisted transformation and was not implementing crime-fighting
policy as energetically as the government would have liked, and Home Affairs because poor
management had made it a stomping ground for fake documentation syndicates. They
therefore needed heavyweight intervention, and Mbeki turned to Masetla and Selebi. This
strategy is to become even more apparent in coming months as party-mentored managers
are appointed to run the main cities.
The use of Parliament as a governing mechanism has also been much better thought out.
Mbeki has used Parliament as a platform to make policy speeches with lasting resonance.
The core ideas and even phrases in Mbeki's parliamentary speeches have been echoed by
ANC MPs and ministers on hundreds of occasions - illustrating, on the one hand, a
disturbing sign of the tendency among party members to sycophantically agree with the
President whenever he speaks. On the other hand, it is also a sign of how successfully
Mbeki has provided leadership to ANC MPs and how he has been able to marshal their
The result is that while there might be less debate in the ANC parliamentary caucus, its
members are charged with a greater sense of direction. A key aspect of this is the new focus
on working with their constituencies, and ANC MPs are now expected to take up cudgels on
their behalf. Parliamentarians now have to spend an average of a week a month attending to
welfare problems and other development issues in the constituencies to which they are
assigned by their party leaders.
But the problem Mbeki has faced is that, as much as he wants to rely on his party to give the
country strategic direction and act as a reservoir for managers, it is no longer as
well-endowed as it once was with talent and energy.
The ANC now attracts people with their eyes on council seats and on tickets to
parliamentary chambers. Many of the party's brighter sparks have entered the private sector
and are no longer available for "deployment" by the party hierarchy. The ones the party
believed it "deployed" into the private sector to steer the "deracialisation of the economy"
have since developed their own empires and follow business agendas over which the ANC
has no control.
To counter this decline in the calibre of ANC members and a loss of control over
membership, Mbeki has instituted tight management of the party, coupled with a revisitation
of its vision. With the enthusiastic co-operation of secretarygeneral Kgalema Motlanthe, the
ANC is trying to rediscover the activist soul it lost when it came into power in 1994.
Mbeki has also gone fishing outside the ANC's normal waters for allies with whom to
co-manage the economy.
17 Mbeki - Aids 2000 - Juni
His first stop has been the black business community, which the ANC wants to prevent from
becoming a nursery for conservatism. By preaching that they should not feel ashamed of
amassing wealth but remain patriotic, Mbeki and the ANC want to keep affluent blacks
firmly within their sphere of influence. In discussions with black business leaders, Mbeki
and his lieutenants repeatedly urge them to develop a social conscience by implementing
sound labour relations and socially responsible investment decisions.
Another strategy has been to win over white business, thereby cutting it off from the
influence of parties like the Democratic Party, which the ANC views as one of the "forces
ranged against transformation".
Mbeki also realises it is business leaders more than politicians who interact with their
counterparts abroad, so getting them onside would work in SA's favour. To effect this, the
ANC has been trying to project the image of a government willing to listen to concerns
about laws which business leaders say stifle the competitiveness of the SA economy.
The formation of the International Investment Council, consisting of some of the world's
most influential businessmen, was also aimed at finding international ambassadors and
sending a message to South Africans that they should have as much confidence in their
country as the world's top business leaders.
In the past year, Mbeki's charm has won powerful - though often sceptical - players to his
side. He has begun to undo some of the mistakes made in the idealistic first five years of
democracy. On the international stage, he has established himself as a major player by
pushing a line that the world's problems can be solved if leaders apply their minds.
Mbeki has set himself a high standard. At worst, conditions beyond the control of the
administration could end in his falling from being seen as a statesman to just another Third
At best, he could carve out a place in history as a man who successfully challenged the
convention that a Third World leader needs an arsenal to change history.
INDABA Internet Datenbank Afrika - Institut für Afrika-Kunde, Hamburg
18 Mbeki - Aids 2000 - Juni
# 18 06 2000 Sunday Times (South Africa)
AIDS conference organisers get ready for protesters - Strict security enforced in Durban after
SA unionist threatens 'another Seattle'<
Amid concerns that the 13th International AIDS Conference, to be held in Durban next
month, could serve as the next stop on the global protest route, organisers have put in place
stringent security measures.
Besides enlisting the services of police and security companies to protect delegates from
possible crime and violence in Durban, organisers have also gone to great lengths to protect
delegates from each other.
Their plans to defuse tension among delegates include five "speakers' corners" in the
conference venue to allow people to air their views through a public address system, and a
"Vukani" (wake up) room for representatives of activist groups or communities to hand over
memorandums, resolutions or action lists to authorities.
There are only three weeks to go until the conference which, with an expected 12 000
delegates from around the world, is the biggest to be held in South Africa. It is also the first
AIDS conference to be held in a developing country. The six-day conference, which will be
opened by President Thabo Mbeki, will focus the world's attention on South Africa and on
the continent's burgeoning AIDS crisis. It will also focus attention on the President's
controversial approach to HIV and AIDS.
One of the major issues that has received attention in the build-up to the conference has
been the government's refusal to provide anti-retroviral treatment to HIVpositive women to
prevent transmission of the virus to their babies. Over the past two years, this has become a
burning issue for scientists and activists.
A Global March for Treatment Access will take place outside the Durban City Hall, just
hours before Mbeki's address.
The organisers of the march, Nobel prize-winning Medecins sans Frontiéres and South
Africa's Treatment Action Campaign, have been at pains to quell rumours that the march
will disrupt the conference and to emphasise that it will be peaceful.
But fears of violence were sparked months ago when South African trade unionists made
public their plans to create "another Seattle" - a reference to last year's World Trade
Organisation meeting which was disrupted by violent protests.
Tumediso Modise, AIDS co-ordinator for the National Council of Trade Unions, was
reported as saying: "We want to try and create another Seattle against pharmaceutical firms
and some governments which have not taken this AIDS issue seriously."
Added to this, a group of AIDS dissidents calling themselves ACT UP San Francisco, is
expected to cause disruptions at the conference. Members of the group - which is not linked
to the global AIDS activist group ACT UP - have been linked to violence at earlier
Their application to set up an exhibition stand at the event was turned down.
While the group's spokesman, David Pasquarelli, has publicly denied this, he is among four
members of the organisation against whom arrest warrants were issued by San Francisco
police last month after they barged into a meeting being held by activists not aligned to their
cause. Pasquarelli was charged with trespassing and assault.
In a letter to delegates, conference chairman Professor Jerry Coovadia said: "South Africa
has a zero to low tolerance level when it comes to protests and disruption when there is the
potential of causing harm to individuals and damage to property.
"However, in the spirit of our new South Africa, we will allow people to air their
"For this reason we have paid special attention to safety and security within the conference
19 Mbeki - Aids 2000 - Juni
Coovadia said certain zones in the conference centre had been demarcated for protests - as
long as they remained peaceful.
In the past year, organisers have already had to:
Quell talk of a boycott by those who wanted to protest against the South African
government's refusal to treat HIV-positive pregnant women with antiretroviral drugs;
Deal with protests from health workers and grassroots activists about the 700 (about R4
900) registration fee that will prevent many Africans from attending; and
Dispel rumours that pharmaceutical companies - some of the event's biggest funders - were
scaling down the size of their delegations and withdrawing support because of fears of
violence on the part of AIDS activists.
The most recent controversy was sparked by an invitation to a photographic exhibition at
the conference dealing with women and HIV. The photo used on the cover shows a naked,
voluptuous blonde femme fatale seated on the floor with an intravenous drip inserted in her
In an e-mail discussion forum, Heather Worth of the Institute for Research on Gender in
Auckland, New Zealand commented: "This is just the kind of soft-porn image of women
that advertisers use to sell cars. And here we are just about to attend a conference in Africa
where few women have access to the kind of drug therapy this photo portrays."
INDABA Internet Datenbank Afrika - Institut für Afrika-Kunde, Hamburg
20 Mbeki - Aids 2000 - Juni
# 23 06 2000 Mail & Guardian (South Africa)
Time to break the silence<
Michel D Kazatchkine and Didier Fassin
The controversy generated by President Thabo Mbeki's statements on the role of HIV as the
causal agent of Aids has led some investigators to question their participation in the
forthcoming 13th international conference on Aids to be held in Durban in the second week
In a letter to the secretary general of the United Nations and United States President Bill
Clinton, Mbeki, after reiterating the commitment of South Africa to the fight against
HIV/Aids and calling for specific African solutions to control the pandemic, questioned
whether Aids was indeed caused by HIV. In this respect, Mbeki relied on old theses
originally put forward by Peter Duisberg and David Rasnick that have been unanimously
rejected by the scientific community.
By raising this discredited issue again at a gathering of international experts to discuss these
matters, the president has provided the dissident scientists with an unexpected forum and
taken the risk of increasing doubt in the general population of South Africa about facts that
should not be called into question.
The fact that the virus is found in every patient with Aids, the chronological link between
infection and the occurrence of the disease, the beneficial effect of anti- retroviral drugs on
disease manifestations, the information gained from animal models and many other
experimental lines of evidence have all led the scientists to unreservedly recognise the virus
as the cause of Aids.
Beyond this controversy, one may, however, discern in Mbeki's statements deep concern
over the disarray that African countries have in the face of the pandemic, and his worry
about the inability of the international community to intervene in an appropriate and
effective manner. Indeed, the terms of his letter raise a number of issues of a historical,
social, ethical and political nature that need to be taken into consideration.
More than two-thirds of the world's 34- million HIV-seropositive people live in sub-Saharan
Africa, which itself only represents one-tenth of the world population. Aids has become the
number one infectious killer in this part of the world.
In South Africa it is estimated that more than four million people are infected with HIV. In
some of the largest cities in the region up to one in four people are infected with the virus.
Aids is now a threat to the life expectancy of the population, to the stability of families and
communities, and also to the national economy and development.
Given the growth rate of the epidemic and the current lack of access to care, it is difficult to
imagine that the situation will improve in the coming years. It is in this context that Mbeki's
letter calls for answers.
Even if HIV Type C, which is the predominant type of virus circulating in South Africa,
were to be more infectious than other strains, a number of other factors would still have to
be considered to explain the rapid progression of the epidemic and the high prevalence of
HIV infection in the country.
The emergence and initial spread of the disease occurred at a time in South Africa's history
which was marked by decades of segregation and apartheid. An accelerated growth of the
epidemic coincided with a period of instability at the end of this era. Similar phenomena
were observed in other countries subjected to comparable regimes, such as Namibia.
An increased risk of infection with HIV and other sexually transmitted diseases is strongly
linked with poverty, vulnerability and social and sexual violence. Such risk is also
associated with migration of labour far from home, inherited from the systems of the
bantustans, or else with alcohol consumption that started in the mining economy and is
perpetuated through unemployment.
21 Mbeki - Aids 2000 - Juni
Examples from other regions of the world, such as previously Soviet countries, demonstrate
that the end of long periods of social and political turmoil is associated with an increased
susceptibility to infectious epidemics. This, we believe, is what Mbeki is saying, when
discussing apartheid and the distinct epidemiological context of HIV infection in South
Africa and in the region in his letter.
The president's remarks also refer to the inability of the international community to put
forward appropriate answers to the Aids pandemic. According to UNAIDS, $165-million is
spent each year for prevention in Africa where 70% of infected people in the world live,
whereas $3-billion is spent on anti- retroviral drugs for the richest countries that represent
10% of infected individuals worldwide.
Prevention programmes may only be effective, from a public health perspective, if they are
implemented in the context of programmes aimed at reducing inequalities and violence and
of actions aimed at improving access to care.
If the Security Council of the UN, the World Bank and the G8 are now putting these issues
on the political agenda, and if some hope has been generated by the recent agreements
passed between UNAIDS and some of the major pharmaceutical companies marketing
anti-retroviral drugs, the moves are still too slow and too limited, and certainly not adapted
to the scale of the epidemic that South Africa is facing. This is also in Mbeki's statement and
is the context in which one should interpret the controversy that recently followed the
observation of adverse effects in therapeutic trials in South Africa.
The International Conference on Aids is held every second year. In 1996, at the time when
much hope was generated by the first reports of the results obtained with triple-combination
therapy, the conference slogan was global and full of enthusiasm: "One world, one hope".
Two years later, in Geneva, the message was still one of hope: "Bridge the gap". This year
in Durban, the conference emphasises the anxiety of the international community and the
need for telling the truth: "Break the silence".
We thus hope that Mbeki's statements, rather than being limited to a useless controversy,
will generate the necessary discussions between scientists and politicians. If HIV is
undoubtedly the cause of Aids, the control of the pandemic will require that social,
economic and political issues are addressed appropriately from a public health perspective.
These are reasons for us to go to Durban and for "breaking the silence".
Michel D Kazatchkine is professor of medicine at the University of Paris and director of the
National Agency for Research on Aids in France. Didier Fassin is professor of sociology at
the University of Paris and director of the Centre for Research on Public Health Issues
INDABA Internet Datenbank Afrika - Institut für Afrika-Kunde, Hamburg
22 Mbeki - Aids 2000 - Juni
# 30 06 2000 The Guardian (UK)
A FIGHT FOR LIFE<
MORE THAN 23 MILLION SUB-SAHARAN AFRICANS ARE INFECTED WITH HIV.
THE SCIENTIFIC ESTABLISHMENT SAYS THIS VIRUS CAUSES AIDS. BUT
THABO MBEKI, SOUTH AFRICA'S PRESIDENT, IS NOT CONVINCED AND HAS
EXPERTS SEEKING OTHER EXPLANATIONS.
SARAH BOSE Seldom can a scientific row have been played out for higher stakes.
Around a table in Johannesburg last month sat a collection of professors and doctors whose
collective brain wattage should be enough to floodlight the most impenetrable corners of
academic darkness. Not on this issue. What they were debating was the cause of Aids an
argument that goes back a decade and was near extinguished in the United States. Now,
however, it has crossed continents to be reignited in South Africa. The lives of millions
hang in the balance.
This is Thabo Mbeki's expert international panel, called together by him in advance of the
international Aids conference in Durban next month. All around them is human evidence of
the problem. In the streets of sub-Saharan African cities, orphaned children sleep out,
stigmatised and shunned by their communities, debarred from school and in danger of death
from malnutrition and sickness or a life of vagrancy and crime. Their parents died of Aids,
as did 2.6m worldwide last year, mostly under the age of 35. Sub-Saharan Africa is now
bearing the brunt of this latter-day plague.
In the west, it is largely accepted that the HIV virus is the cause of the epidemic. UNAIDS
the United Nations organisation which released a chilling report released this week says a
colossal 23.3m Africans living south of the Sahara are infected with HIV 70% of the total
infected worldwide and facing an early death without medical treatment.
The scale of the problem for governments such as President Mbeki's in South Africa is
terrifying. The antiretroviral drugs that have succeeded in halting the death toll in the west
are beyond their means. It isn't hard to see why Mbeki has balked at the implications and is
looking for another way. In the face of a scandalised Aids establishment, he declared he was
not convinced that HIV caused Aids. Africa, he said, must look for her own solutions.
He is tempted by the dissident ideas of Peter Duesberg, professor of biochemistry and
molecular biology at the University of California, Berkeley, which caused controversy in
the US 10 years ago. The attraction of Duesberg's theory is clear. Break the link between
HIV and Aids and there is hope for millions who, without medical treatment on a scale that
would bankrupt the country, face death within 10 years. And hope for future millions,
because he says Aids is not infectious. His argument faded out in the west as the infection
rate dropped because of changes in behaviour among at-risk groups and death sentences
were commuted by new drugs. But in Africa it has blossomed again, bolstered by the
assertion that Aids in Africa is a different disease because it exists in the heterosexual
community. The clinics are full of sick babies, not gay men.
The Mbeki government is looking for miracles. Two years ago, it rushed to back a cheap
purported Aids remedy called virodene, invented by Olga Visser, a technician previously
involved in cryopreservation attempts to deep-freeze people until scientists have found ways
to keep them alive forever. Virodene's active ingredient was an industrial solvent which was
banned from use on humans in South Africa. When the Medicines Control Council in South
Africa blew the whistle on virodene, declaring it unsafe, the Mbeki government closed the
This was followed by pronouncements that poverty and malnutrition were the cause of Aids
and a refusal to give mothers western drugs to stop them transmitting HIV infection to their
babies. Under pressure to conform from the West, with the 13th International Aids
Conference about to descend on Durban and threats from some scientists of a boycott,
Mbeki has set up his international panel to go back to basics and tell him what to think
23 Mbeki - Aids 2000 - Juni
about Aids. Duesberg is on it. So is Professor Luc Montaignier, the French scientist who
discovered the HIV virus and Dr Ann Duerr of the highly orthodox Centres for Disease
Control in Atlanta, Georgia. So is Professor Eleni Papadopulos-Eleopulos, a biophysicist
from the Royal Perth Hospital in Australia who doubts that HIV even exists.
Mbeki has been accused of inviting only the dissidents on to his panel, but there is a mixture
of true believers and heretics, and others were approached. Some will have chosen not to get
involved, for the argument has all the ferocity of a religious schism.
Gordon Stewart, emeritus professor of public health at the University of Glasgow and a
former World Health Organisation adviser on Aids, is one of two British members, both
dissidents to a degree.
He says the medical establishment is very good at turning on those who refuse to accept the
mainstream thesis. 'It is a matter of extensive and quite incredible demonisation not just
ostracism and censorship but also demonisation.'
Mbeki, in his own defence and theirs, claimed there was 'an orchestrated campaign of
condemnation' against certain scientists considered 'dangerous and discredited', with whom
nobody should communicate. 'In an early period in human history, these would be heretics
burned at the stake!' he wrote in a letter to heads of state, in which he compared the
silencing of the scientists to apartheid.
Andrew Herxheimer, the other British member of the panel, who is known for his role in the
respected Cochrane collaboration a database which assembles and compares all the
evidence for the efficacy of medicines from international clinical trials says he has been
warned. 'Various of my friends say 'you are a dissident. With all the good work you have
done, that will be the end of you',' he says.
Herxheimer's abiding interest is in the systematic compilation of evidence from trials and
reviews and on the cause of Aids, on transmission through blood and from mother to child,
it is murky, he says. 'They may be right, but I'm an agnostic. I want to see the evidence for
some of these statements.' Aids is diagnosed from an accumulation of general symptoms,
including weight loss, diarrhoea and fever in the absence of malnutrition or cancer. It has no
typical symptoms. Tuberculosis is rife in sub-Saharan Africa. Are people dying of TB or
Sometimes it is hard to tell. 'Many are dying of opportunistic infections,' says Herxheimer.
'TB and sexually transmitted diseases are the big, big problem, and poverty and
'The way that Aids is diagnosed is very unsatisfactory. I once came across a French epigram
which I love: Un idiot pauvre est un idiot; un idiot riche est un riche. In Africa, a person
with TB who is HIV negative has TB; a person with TB who is HIV positive has Aids. That
is not acceptable as a logic, or as a basis for policy.'
Tests detect only antibodies made in response to contact with the virus, the dissidents say.
That does not mean, they argue, that any virus remains in the body, yet that person is told
they are likely to develop AIDS in years to come. 'I think that what is so terrible about the
whole thing is that people equate HIV with a death sentence, which is rubbish,' said
Passions are high on both sides. Angry scientists who say there is no other explanation for
mass deaths which follow wherever HIV spreads denigrate the heretics. The dissidents talk
of censorship and cover-up. 'It really is a terrible scandal,' exclaims Professor Stewart. 'It has
been hyped up by the media and politicians and Hollywood and all kinds of activist groups.'
Aids in the UK is now a very rare disease, Stewart argues. As far as he is concerned, the
sickness afflicting Africa is not the same, and we should not be looking to failed UK
solutions. 'In the UK we have been unsuccessful. After 20 years we have no cure or vaccine
and the spread is continuing among at-risk groups.
24 Mbeki - Aids 2000 - Juni
'We have been criminally irresponsible we have told people they have Aids when they are
HIV positive and that's not true. We have told them there is no cure and no vaccine and they
are going to die. We have caused endless stress and even suicide. Families have worried
about whether their children are going to be infected. That's why it is such a panic disease.
The medical establishment has made the panic.'
Robin Weiss, a viral oncologist at the Institute of Cancer Research in London and a leading
authority on HIV, thought the Duesberg hypothesis had died out 10 years ago, when he and
his scientific colleague, the American Harold Jaffe, wrote a merciless dissection of its
failings in Nature magazine. He is appalled to find he was wrong.
'We'd all forgotten about him, but it has come up again,' he said.
Aids came out of nowhere in 1980, says Weiss, and by 1985 was the major cause of death in
both sexes in the west between the ages of 25 and 45, overtaking accidents, cancer and
everything else. Then came the powerful drug combinations which hit the HIV virus.
Mortality dropped by 80%. Duesberg had been telling people not to take the drug AZT. 'The
gay men in San Francisco who had lionised him went away sheepishly and got their drugs
because they didn't want to die,' says Weiss. 'He lost his constituency. Now he is going to
South Africa, where mortality isn't dropping by 80%.'
He understands the lure for Mbeki, confronted by the desperate fact that 25% of his
country's young people are HIV positive. 'It is a siren voice. It's like Odysseus and his
sailors hearing the sirens.
Odysseus strapped himself to the mast. Mbeki hasn't done that yet.
How terribly seductive how beautiful it must sound. Africa is bewildered, as we must have
been 650 years ago when the plague came along. This could have the same demographic
and economic impact.'
But the unbelievers are wrong, says Weiss, as they were a decade ago in San Francisco. He
would not change a word of his 1990 attack on Duesberg's theories in Nature. 'HIV is the
singular common factor that is shared between AIDS cases in gay men in San Francisco,
well nourished young women in Uganda, haemophiliacs in Japan and children in Romanian
orphanages,' he and Jaffe wrote. 'To deny the role of HIV in Aids is deceptive.'
Nothing, Weiss says, has changed. 'Everything that has happened in the past 10 years
strengthens the evidence that HIV causes Aids. It is a complicated disease, but that is it.'
He, too, was invited to join Mbeki's panel, but could not make the dates. But he, like every
other doctor and scientist involved in Aids, is watching what is going on with acute and
The bitter argument taking place cannot be dismissed, because the issues are too important.
The lives of too many are at stake.
If Mbeki continues to embrace the dissidents, the basic public health messages about
condom use and safe sex will be lost, as well as any chance of getting drugs to women in
childbirth to prevent them infecting their babies with HIV, a relatively cheap and effective
option. This is not ivory tower stuff. In Johannesburg and Durban, hypothesis meets the real
world of life and death.
INDABA Internet Datenbank Afrika - Institut für Afrika-Kunde, Hamburg
25 Mbeki - Aids 2000 - Juni
# 30 06 2000 Mail & Guardian (South Africa)
Democracy and the pandemic<
The run-up to the International Aids 2000 conference starting in Durban on July 9 has been
dogged by controversy
If asked to name a single issue that drew into unambiguous focus the most pressing
dilemmas facing this country today, one would have to answer HIV/Aids.
But, immediately upon giving that answer, one would need to redefine the question, if only
because HIV/Aids is not a single issue, but cuts across economic, cultural, political and
The tentacles of the problem make debate so fraught, answers so difficult and a
multidisciplinary approach imperative.
From July 9 about 10E000 delegates will gather in Durban to attend the International AIDS
2000 conference. The run-up to the conference has been dogged by controversy, largely
caused by the often contradictory, sometimes incomprehensible utterances about HIV/Aids
made by President Thabo Mbeki.
The president is to open the conference and all South Africans will be looking to hear a
message of hope, based upon clearly articulated goals for the management of the pandemic
in this country.
Such a message would not only offer hope to the approximately four million people living
with Aids in South Africa and spur on our increasingly exhausted and disenchanted Aids
workers. It would say something reassuring about the very nature of our new democracy.
For, alongside the (often maudlin) recent debates about the science of HIV/Aids in this
country, has been a much less-remarked-upon index of the nature of political power and its
What has emerged from government policy is a top-down form of decision-making in which
expert opinion has been thwarted or silenced. Remember now the ill-fated Virodene saga.
While Mbeki welcomed this witches' brew, the Medicines Control Council was replaced for
its refusal to endorse the product and, only after a considerable delay, did Professor
Malegapuru Makgoba, head of the Medical Research Council (a body charged largely with
confronting the pandemic) speak out against it.
It is completely inadequate to talk, as commentators have done, of the sad "interference" of
politics in medicine. Given the nature of the pandemic, the issue not only requires political
intervention but precise and canny political leadership of the highest order. Rather, what is
at issue is a hollowing out of proper democratic structures: it seems that people are
prevented or intimidated from speaking their minds.
It is, therefore, a pointed irony that Aids 2000 should take as its theme "Breaking the
silence". When I asked the organisers what this motto's specific reference might be, I was
referred to the conference website. I found, if you like, a silence.
In another irony, we remember that the president's panel of international experts, gathered in
Pretoria in May, was the occasion for many, intense mouthings about free intellectual
Critics of the government's actions were branded as members of the "thought police" by
presidential representative Parks Mankahlana.
Perhaps most worrying were the remarks made by Makgoba after the Committee of 33's
meeting. He said, on a series of experiments with Aids dissident Peter Duesberg, "that will
in all probability disprove his theories, or may prove him right".
It is difficult to underestimate the potential damage in a remark such as this. That a medical
scientist of Makgoba's calibre should feel it necessary to be drawn into what, to some of us,
looks like a cynical game in order to humour the state president is further evidence of what
I've called the erosion of democracy in this country.
26 Mbeki - Aids 2000 - Juni
Looked at through a different lens, what some hailed as Makgoba's statesmanlike behaviour
might appear as weak-kneed toadying to a president who will brook no contradiction even
from a man of science whom he has himself appointed.
The more we hear the government extolling the virtues of free and open debate, the more
virulent become the attacks on all those who criticise it.
For, looking at the evidence of HIV/Aids (mis)management in this country, it seems clear
that the personal journey of the president in relation to the illness is bedevilling and stalling
this country's hopes of effective policies. All indications imply that the president's own
views of the matter take precedence, requiring loyalty and even subservience.
Discourse surrounding HIV/Aids is currently the surest barometer of our national health.
Besides the president, we have a Minister of Health, Manto Tshabalala-Msimang, who, inter
alia, insists that on the matter of treatment she will "not play God" by deciding who will or
will not die. Rather than an abuse of authority, this is an abdication from it. If the task seems
too great, the minister should abdicate altogether and resign.
Mbeki has insisted that issues of poverty should be linked to Aids in Africa. Unfortunately,
the issue has been reported as one suggesting that poverty causes Aids and the
socio-economic has been muddled with the medical. However, if a government's duty is to
provide for its citizens, and given that South Africa is reported to have the highest rate of
HIV infection in the world, we have another problem.
Why does the newly democratic government in what Organisation of African Unity leader
Kofi Annan has called the "economic powerhouse of Africa" have soaring unemployment
and rocketing HIV- infection rates? It is not just the issue of a failure to provide basic health
care that suggests that economically our new democracy is not delivering. HIV/Aids is a
dangerous issue because it forces this uncomfortable recognition.
If the new democracy has a duty to educate its citizens then, again, HIV- infection rates tell
a sorry tale. The government's new five-year plan stresses the importance of awareness
programmes targeted at the youth. Yet researchers report high awareness and high infection
The kind of education vital to simply keeping our population alive is a failure. And this is no
surprise when the latest plan itemises as a primary goal the promotion of "safe and healthy
sexual behaviour". The document's very language itself fails to understand the crucial truth
that there is no such thing as "safe" sex.
And, finally, if the new democracy undertakes to provide free health care to children under
seven and to pregnant mothers then, at the moment, we face another failure.
The persistent refusal to offer prophylactic treatment for pregnant HIV- positive women is a
dangerous and glaring contradiction of the government's own policy. Despite the insistence
that HIV/Aids is a national crisis, there are still no protocols in place for its treatment.
In March Tshabalala-Msimang insisted that the government "was intensifying [its] fight
No matter how jaded one might be, one does not question the government's commitment.
One retains - following the president - one's democratic right to question and finds that the
issue is a searching one. It is to do with democracy and competent government within that
Timothy Trengove-Jones is an Aids researcher and academic
INDABA Internet Datenbank Afrika - Institut für Afrika-Kunde, Hamburg