In an article in The Star last week the Minister in the Presidency, Essop Pahad, attacked the journalist Patrick Laurence. Laurence's article of the previous week, he wrote, suffered from "sloppy journalism and woefully inadequate research", lacked "rigour", reproduced "inaccuracies as fact", and made assertions without "producing any substantial evidence". It was, Pahad concluded, an "illiberal" and "irresponsible" abuse of freedom of the press.
And what had Laurence done to provoke this tirade?
He had questioned the propriety of Pahad touting for sponsorship for Ronald Suresh Roberts's recently published ‘biography' of President Thabo Mbeki. And he had commented that the book itself erred in pretending that Mbeki had never dallied with AIDS "denialism." (Laurence's response to Pahad on the first issue can be found here.)
Pahad accused Laurence of trotting out the "old trope of the president being an Aids denialist without providing one shred of evidence." President Mbeki, Pahad insisted - citing Roberts as his authority -"has never denied that HIV causes Aids."
For all those who actually witnessed Mbeki's contestation of the scientific orthodoxy on HIV/AIDS between 1999 and 2002 - and regardless of whether they supported or opposed his endeavours - Pahad's contention is a laughable one.
As such it is tempting to dismiss it out of hand. Yet that would be to underestimate the power of forgetting, the determination of the presidency to rewrite the historical record, and the capacity of such simple propaganda - endlessly repeated - to distort the memory of historical reality.
"Where", Pahad asked rhetorically, "has the president actually denied the link between HIV and Aids? Where is the evidence of denialism?"
The following account will try and provide an answer to those questions, by setting out the evolution of President Mbeki's views on the causal link between HIV and AIDS between 1999 and 2002. Mbeki was not born an AIDS ‘dissident' he became one. And understanding the chronology is a necessary counter to the insidious effects of the disinformation currently being disgorged by the presidency.
In October 1998 then Deputy President Thabo Mbeki and the then Minister of Health, Nkosazana Zuma, put a stop to the health department's piloting of anti-retroviral treatment for the prevention of mother-to-child transmission - for reasons which remain inexplicable.
It was only the following year that (now President) Mbeki was first introduced to the "alternative viewpoint" on HIV/AIDS, through the writings of Advocate Anthony Brink. According to the best available evidence Mbeki only really began taking a serious interest in the ‘dissident' literature in late October 1999 - although he proceeded to immerse himself in the subject thereafter.
The initial attraction of Brink's writings to Mbeki lay in his emphasis on the toxicity of AZT. This provided a new rationalisation for his (by then) already longstanding refusal to allow the provision of this drug through the public healthcare system.
Mbeki's other guide into this alternative view was the journalist Anita Allen. They met in November 1999 after Mbeki responded to earlier efforts of hers to contact him. The two worked closely together over the following few years on the HIV/AIDS issue.
In late January 2000 David Rasnick, a leading proponent of the ‘dissident' theory on AIDS, was contacted by President Mbeki's Office. He was sent eight questions which Mbeki had asked of the Minister of Health, Manto Tshabalala-Msimang - with her answers attached. Rasnick, and a colleague, Dr Charles Geshekter replied at length by fax the following day.
They stated that while the minister's answers "faithfully reflect the views of many in the medical establishment, nevertheless, her responses expose many of the problems and contradictions inherent in trying to understand AIDS in Africa." They suggested instead that five even more fundamental questions be asked, including "Does HIV cause AIDS?"
Elsewhere in their response they stated that the "real causes of AIDS in Africa" were "socio-economic status, poverty, malnutrition, tuberculosis, diarrhea, respiratory infections, malaria and other parasitic infections."
At the end of February the health department announced that, on Mbeki's instigation, an international panel of experts was to be convened in May to re-assess various aspects of the science of HIV/AIDS. According to Mbeki's spokesman, Parks Mankahlana, the panel was to review "everything about AIDS" including, "whether HIV leads to AIDS, whether there is something called HIV, for an example."
In the run up to the meeting of the panel Mbeki did not directly question the link between HIV and AIDS, but instead stridently defended the right of AIDS ‘dissidents' (such as Rasnick) to do so.
On the April 19 Deputy President Jacob Zuma read out a statement to parliament, on behalf of the presidency, which stated that Mbeki would not prejudge the conclusions of the panel's scientific inquiries. "Accordingly, at no point has the President said that he challenges the view that HIV causes AIDS, or the contrary."
On May 3 Cabinet announced the composition of the thirty member panel (there were a further three facilitators). At least 14 out of the 30 were signatories to internet petitions contesting the "hypothesis" that HIV causes AIDS. See here and here (and here). Among the questions the panel was tasked to answer was: "what causes the immune deficiency that leads to death from AIDS?"
Shortly before the panel met on May 6 a further three non-dissidents were added to the panel (to give them a slight majority) - reportedly after intervention by the Clinton administration. As others have pointed out, this 50/50 split - which implied equal legitimacy - represented a rigging in the ‘dissidents' favour, as they represented an extremely marginal viewpoint in the scientific community. Or, to put it in ANC language, they had been given a ‘minority veto' by Mbeki.
In his address to the panel Mbeki stated that he was "embarrassed to say" that in reading up on the AIDS epidemic [in late 1999] he had "discovered that there had been a controversy around these matters for quite some time. I honestly didn't know. I was a bit comforted later when I checked with a number of our Ministers and found that they were as ignorant as I, so I wasn't quite alone. What we knew was that there is a virus, HIV. The virus causes AIDS. AIDS causes death and there's no vaccine against AIDS. So once you are HIV positive, you are going to develop AIDS, and you are bound to die".
In late May 2000 Mbeki was asked, during a BBC online interview whether he though HIV led to AIDS. He replied: "That's one of the issues that the scientists are discussing. I've never made any judgement on that. It is an issue they are debating."
Thus, after taking an interest in the dissident literature in late 1999 Mbeki had by May 2000 defended the legitimacy of, and provided a public platform for, the AIDS ‘dissidents'. He was on record as saying that he had neither rejected, nor accepted, the view that HIV caused AIDS.
It was on July 9 that Mbeki first publicly questioned the causal link between HIV and AIDS. In his address to the International AIDS conference in Durban he stated that it seemed to him that the phenomenon of immune collapse among black Africans could not be blamed on a single virus.
In an interview with Time Magazine, September 4 2000, Mbeki stated that, "the notion that immune deficiency [AIDS] is only acquired from a single virus [HIV] cannot be sustained." When asked whether he was prepared to "acknowledge that there is a link between HIV and AIDS?" he replied, "This is precisely where the problem starts. No, I am saying that you cannot attribute immune deficiency solely and exclusively to a virus."
Over the following days various ministers were asked whether they believed HIV caused AIDS. Most refused to answer in the affirmative - clearly out of fear of being seen to contradict Mbeki. Tshabalala-Msimang, Kader Asmal, Trevor Manuel and Essop Pahad himself, were all reported to have evaded answering the question directly. It was only on September 13 that Labour Minister Membathisi Mdadlana broke ranks to publicly state, "Yes, of course HIV causes AIDS."
In his written reply to a question posed to him in parliament on the September 20 Mbeki reiterated his position: "There is no doubt that there are many factors that result in the breakdown of the body's immune system. Repeated infections, malnutrition, lack of access to clean water, impact negatively on the immune system." For Mbeki the contention that HIV contributed to this immune deficiency was an unproven one, although he was keeping an open mind on the matter. "There may well be a virus that also results in a breakdown of the immune system", he added.
In his spoken reply he answered derisively to the question of whether HIV caused AIDS: "When one asks a question: does HIV cause AIDS, the question is: does a virus cause a syndrome? How does a virus cause a syndrome? It cannot, really, truly....I think it is incorrect from everything that I read to say immune deficiency is acquired exclusively from a single virus."
On September 28 Mbeki addressed the ANC caucus in parliament behind closed doors. Howard Barrell reported in the Mail & Guardian the following week that, in the meeting, Mbeki had spoken approvingly "of a conference of about 60 dissident scientists held in Uganda in September; quoted from a document from that conference challenging the view that HIV causes AIDS; said (again) that the HI virus had never been isolated." (The declaration of the conference can be accessed here.)
He also "told ANC MPs that it was their duty to inform themselves so that they could counter the huge propaganda offensive that was being mounted to say that HIV caused AIDS."
He also, "repeated his view that if one agrees that HIV causes AIDS, then it must be treated with drugs, and those drugs are produced by the big Western drug companies; these drug companies therefore need HIV to cause AIDS, so they promote the thesis that HIV causes AIDS."
He also, "said the CIA had become involved in covertly promoting the view that HIV causes AIDS; as part of the same effort, the US government was ignoring what the dissidents' conference in Uganda had demonstrated...."
He also said it was not "clear that members of his Cabinet supported him on the HIV/AIDS issue; he wanted to know where they stood". At this point, apparently, "there was some muttering in the caucus from some MPs who pointed accusingly at, among others, Membathisi Mdadlana."
The report was so accurate a number of ANC MPs canvassed by Angela Quintal for Sapa "discounted that the information was acquired by way of routine leaks by ANC MPs, and insisted their caucus had somehow been bugged." The week after it was published the police swept parliament for bugs.
On October 4 in Business Day the head of the ANC presidency, Smuts Ngonyama, took issue with an article in which the newspaper's parliamentary correspondent, Wyndham Hartley, had called for the pressure to be kept on cabinet ministers to acknowledge the causal link between HIV and AIDS. Ngonyama (or Mbeki) stated that:
"Hartley should read President Mbeki's speech at the Durban international AIDS conference and his comments in the recent issue of Time magazine. He will see that, among other things, what the president is challenging is the assertion that AID AIDS without S is the exclusive fault of a single virus. To substantiate his opinion, Hartley must produce evidence that HIV is the sole cause of AIDS."
On October 19 the Sunday Times reported that Mbeki was "withdrawing from the public debate on the science of HIV and AIDS." On the morning of October 26 Mankahlana, head of communications in the Office of the President, passed away. He was 36 years of age.
It was evident from comments Mbeki made over the following year that his views remained unchanged, even though he now sought to obscure them somewhat - particularly in his interactions with outsiders.
As Drew Forrest pointed out in October 2001 while the "hard fact" was that Mbeki was an AIDS dissident the picture was clouded by "his awareness - sharpened by his rough treatment at the hands of foreign journalists - that dissidence is not an intellectually respectable position in the wider world. His views are, therefore, veiled by a smokescreen of ‘nondenial denial', academic quibbling and obfuscation."
Mbeki nonetheless remained consistent in his view that HIV was not the sole or even main cause of AIDS (conceding only that it might be some kind of contributing factor).
When he was asked, in an interview on April 24 2001 whether it would not be an example for the president to take an HIV test Mbeki replied: "No, but it is setting an example within the context of a particular paradigm."
In an interview with ITN on May 3 2001 Mbeki stated that "the question of the collapse of people's immune systems - a virus is part of that. But there are other factors which cause the collapse of immune systems, as a result of which people suffer from Aids."
In an interview with The Times (London), May 31, he said that "You cannot say that immune deficiency is caused solely by one virus - that's not correct. It is caused by the virus plus a whole number of other things, such as lack of clean water, poor nutrition and the inability to deal with a range of diseases, including TB."
In an address on October 12 2001 to an insider audience Mbeki attacked the orthodox scientific view of AIDS as an expression of an all-pervasive an eternal white racism. Those campaigning on the streets for the provision anti-retroviral treatment to HIV/AIDS sufferers, he said, were demanding:
"...that because we are germ carriers, and human beings of a lower order that cannot subject its passions to reason, we must perforce adopt strange opinions, to save a depraved and diseased people from perishing from self-inflicted disease... Convinced that we are but natural-born, promiscuous carriers of germs, unique in the world, they proclaim that our continent is doomed to an inevitable mortal end because of our unconquerable devotion to the sin of lust."
By 2002 the stubborn refusal to allow anti-retroviral drugs through the public health care system had resulted in the opening up of deep divisions within the ANC. In early February former President Nelson Mandela voiced veiled criticisms of the continuing refusal of the government to allow for the provision of anti-retroviral treatment for the prevention of mother-to-child transmission.
On March 15 -17 2002 the ANC National Executive Committee met to discuss the HIV/AIDS issue. On the first day of the meeting Mbeki loyalists on the ANC strongly criticised Mandela for breaking ranks. Peter Mokaba operated as Mbeki's point man on the HIV/AIDS issue. One source on the NEC told the Mail & Guardian Mokaba "was provided far more air time than we were," while another said, "It appeared as if he had the endorsement of the party leadership."
At the meeting the NEC discussed the document - Castro Hlongwane, Caravans, Cats, Geese, Foot & Mouth and Statistics: HIV/Aids and the Struggle for the Humanisation of the African - and decided that it should be distributed to party structures.
This document can be read as the definitive expression of Thabo Mbeki's views on "HIV and AIDS". The preface to the document stated that it accepted that "our people" suffer a "serious problem of AIDS". It accepted that the "essential part" of AIDS is "immune deficiency" and that this could be acquired.
It rejected as "illogical the proposition that AIDS is a single disease caused by a singular virus, HIV." While HIV "may be one of the causes of this immune deficiency" it could not be the only cause. Instead it argued that "there are many conditions that cause acquired immune deficiency, including malnutrition and disease."
In the main text it claimed that Mankahlana had not died of AIDS, but rather been "vanquished by the anti-retroviral drugs he was wrongly persuaded to consume":
"He suffered from anaemia and received dedicated attention from his doctor. Nevertheless he died prematurely, because some... advised him to take anti-retroviral drugs. The professionals who fed him the drugs that rendered his anaemia treatment ineffective by destroying his immune system, remain free to feed others with the same drugs. They live to tell us and the world that their patient, who was not their patient, died of a virus they had never found in his body."
The document also claimed that Nkosi Johnson - the young AIDS activist who had eventually succumbed to the disease - had also been "vanquished by the anti-retroviral drugs he was forced to consume" (not, in other words, by a virus).
An electronic version of the document emailed out by Mbeki's muse, Anita Allen, indicated that it had been authored on the president's computer.
(In a letter to The Star in 2004 Allen defended Mbeki against claims that he did not communicate his thinking properly. On the issue of HIV/AIDS she asked whether it was "really possible that anyone doesn't know what the president thinks?" She then listed the various occasions on which Mbeki had expressed his views concluding with Castro Hlongwane. She added that anyone who thought Mokaba had been "the sole editor of this belongs to the walking dead.")
In an interview published at the end of March 2002 Mokaba told the New York Times: "HIV? It doesn't exist...Anti-retrovirals, they're quite dangerous. They're poison actually. We cannot allow our people to take something so dangerous that it will actually exterminate them." Unlike Mandela Mokaba was not carpeted by the Mbeki-ites for speaking out of turn, presumably he was speaking on Mbeki's behalf.
In mid-April - under huge pressure from civil society, the judiciary, and from within the ANC itself - government abandoned its principled opposition to the provision of anti-retroviral drugs. Cabinet announced, on April 17 2002, that ARV's would now be provided through the public health care system for the prevention of mother-to-child transmission, as well as post-exposure prophylaxis for rape victims. (It would only be in August the following year that cabinet would agree to a full roll-out of ARV's to HIV/AIDS sufferers).
On June 9 2002 Mokaba died from "natural causes". He was 43 years of age. After his death Drew Forrest observed that there were other AIDS dissidents within the ANC, but none who propagated their views with such intensity. His loyalty to Mbeki was one factor:
"But given the rumours that swirled around his condition for years, his regular visits to traditional healers, and the well-attested tale that Mbeki personally talked him out of using anti-retroviral drugs, such behaviour looked like an unusually aggressive form of denial."
Mbeki's views seem to have remained unchanged, even though he rarely articulates them in public any more. He did tell a Malaysian newspaper, in February 2003, that in order to respond to "AIDS" (note, not "HIV/AIDS") you need to address the question "of what leads to immune deficiency. Malnutrition and common illnesses will lead to it. You need to respond in a comprehensive fashion."
And in an interview with the Washington Post (September 25 2003) he commented that, "Personally, I don't know anybody who has died of AIDS." Asked whether he knew anyone with HIV, he replied, "I really, honestly don't."
Last month Judge Edwin Cameron warned, the Sunday Independent reported, "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."
As the president's confidant and enforcer is it really possible that Pahad doesn't know what Mbeki believed (and probably still believes) about the absence of a causal link between HIV and AIDS? How then can one explain his confident misrepresentation of Mbeki's past views, and his aggressive dismissal of Laurence's perfectly reasonable commentary?
It certainly suggests a mentality - to use the words of Arthur Koestler - which believes that "truth is what is useful" to the president, "falsity what is harmful." And as Mbeki struggles to secure a third term as ANC president, it is clearly useful to claim that this "nightmare period" never really happened.