Kgalema Motlanthe's views on AIDS in 2000

Extracts from interviews with the then ANC secretary general, August and September 2000

During his brief period in office as South African President Kgalema Motlanthe helped put an end to eleven years of AIDS quackery and denial at the highest levels of government by replacing Manto Tshabalala Msimang with Barbara Hogan as health minister in September 2008. However, as secretary general of the African National Congress between 1997 and 2007 Motlanthe was not immune from President Thabo Mbeki's strange views on HIV and AIDS. Below are two extracts from interviews conducted by the academic Padraig O'Malley with Motlanthe in August and September 2000, at the height of President Mbeki's challenge to the scientific orthodoxy on the disease.

Extract of interview by Padraig O'Malley with then ANC Secretary General Kgalema Motlanthe, August 22 2000:

Padraig O'Malley: Talking about issues one thing struck me, and this is something that I have probably developed an obsession with, and that is with AIDS, HIV/AIDS. Last year when I was interviewing ministers and the like I would ask what in the next 15 years was the major challenge facing SA, and they would say crime, the economy, whatever. No-one said AIDS. Then I would say, "Why didn't you say AIDS? You're wearing a pin."

Then they would say AIDS is related to this, that and the other and it's a challenge but there are many challenges we're facing. My own view is that unless AIDS is the challenge, that unless you marshal all resources to beat this, that the rest is almost irrelevant. There will be no children at the schools, there will be no teachers, there will be no public servants and there will be no social and economic transformation.

Yet even as I went through your presentation that had been prepared, the tactics and strategies, you have the five basic pillars, you've got the objectives, there's one section on AIDS and the AIDS programmes and it kind of says there's the President's Partnership in AIDS, HIV has been identified as a national concern, whereas to me the wording should perhaps have been that HIV/AIDS has been identified as the national concern and that everything else is subordinate to this because unless you get it under control you're going from apartheid to AIDS oblivion. Why does the ANC as an organisation, as a government, not pay more attention, be seen to be more visibly putting this forward that this must be the priority of the national agenda?

Kgalema Motlanthe: Well it can't be the priority. It is a priority and we have done everything in our power to bring awareness, highlight it. As you say, all of us on our jackets we've got the pin, because it is also the collapse of the immune system. You can't begin with AIDS. The human immune system collapses under certain conditions. Even in the past - people are undernourished and exposed to all kinds of hazards, their system becomes weaker and weaker and collapses.

Sometimes people just don't eat at all and the system collapses and once the immune system has collapsed opportunistic diseases find very low resistance and can actually kill that person. So in a way this one called AIDS doesn't kill. It is the opportunistic diseases that kill people because once your immune system has collapsed you contract flu like I did two weeks ago.

It will be with you for ever, there is no waking up, there is no recovery. Tuberculosis as tuberculosis is curable, there is a cure for it, it can be cured. It is the totality of these opportunistic diseases when your immune system has collapsed that kills you. So society is still trying to isolate the virus so that it can develop a cure for that virus, but in the interim to the extent that all of us are convinced that it is spread through body liquids and that one of the surest ways of transmitting it is sexual intercourse, which is what happens in most cases, it means we must do something about that so that we try and stop the spreading of that virus and do all the relevant things.

 If, for instance, you are diagnosed as having symptoms of this disease our concern is that we should have the medical profession saying that we have diagnosed this patient and the symptoms are that there is going to be a syndrome of these diseases, opportunistic diseases which are likely to kill this patient, how can we treat these diseases?

When they say you are HIV positive in certain communities because the palliatives and drugs that are available are expensive, very, very costly, very few people can afford them on a regular basis. In essence it means, well you are dead. It's a matter of time.

You'll be dead by such and such a time. And we say why can't we have an approach that says you show the symptoms, you are HIV positive, live a normal life, you're coughing, let the cough be treated as it were so that people must be able to get treatment for these opportunistic diseases. Firstly most of them would have treatment.

O'Malley: What I am still getting back to is why of all the priorities there are would you, rather the ANC at the top -

Motlanthe: If you ask me I would say our biggest priority, priority number one in this country is education. If we were to have, in my view, a national education campaign, another one and another one until you bring up the levels nation-wide, education skills so people can be part and parcel of the modern world in terms of technology information, information and other things.

I think we can overcome the spread of AIDS, I think we can. Then also you see the information flow could be multiplied, part of the problem is ignoring the situation. So if you had to prioritise AIDS, because part of the difficulty would be - you know the predictions on how devastating it's going to be come from insurance companies that want to increase the premiums for insurance and so on.

I've heard these arguments when I was in the union, the Chamber of Mines, Old Mutual coming across to say this is what is going to happen, so many people would have died of AIDS, this is going to deplete the fund and therefore we must increase the premiums and so on. They had those arguments and they are Doomsday arguments basically. And I am saying a bad thing is a bad thing. It doesn't need to be exaggerated.

A deadly thing is a deadly thing, it doesn't need to be exaggerated. The motive of, for instance, insurance companies that want to increase premiums for their benefit in positing statistics and making projections of how we will be decimated, we need a bit of caution because if truth be told from what people were saying about countries such as Uganda there shouldn't be anybody left there right now and of course people are still there.

Then you've got your other story that says, no Uganda has found a way, an effective way of turning this thing around. It doesn't make sense to me, but that's the way it will come across. There is always an educated explanation because this thing, the fundamental about this difficulty is that this virus still has to be scientifically isolated.

That's the fundamental question because once it is scientifically isolated then the scientists will develop a proper counter for it and we will be much closer to the solution of the problem. That's why it's a symbol, it's not one disease, it's a symbol of opportunistic diseases which kill you because your immune system has collapsed.

This thing that causes your immune system to collapse must still be, the virus must still be isolated. There is no evidence anywhere that there has been any isolation of it. That is why people try various drugs to buy a little bit of hope and of course the pharmaceuticals are happy to make money out of it as well.

O'Malley: It's a boon for the pharmaceutical industries.

Motlanthe: It is, and they are very powerful. They in turn, out of the money they make, they also sponsor conferences, they sponsor effective opinion makers, public opinion makers, and in this country we have seen a massive, massive campaign calling for a drug called AZT to be given to women who are rape victims and there is an absence of concern. If this thing works, this drug, surely it should work even if there has been concern, even when there is no rape, even if the consultant is concerned, surely it should work even in that instance?

O'Malley: Do you think there is a campaign being mounted or being backed by the pharmaceutical companies?

Motlanthe: Well the producers of the drug they are very happy, they have so many sales persons, they think they could secure government approval and a commitment that it would be made available and it is something that has to be taken on a daily basis, made available to rape victims, pregnant mothers and that kind of thing, people who are living with HIV. They would make quite a rake in out of it and yet there is no proof that it actually helps.

O'Malley: Just talking about rape, and this is deviating from my written down questions, it's one that I've puzzled over for many years, that why do you think the level of rape and particularly gang rape is so high in SA?

Now the Medical Research Council has issued a study which says that only about one rape in ten is reported. Compared to other countries that keep statistics, I put it in that context because some countries don't, why do you think that SA consistently comes out as the most rape-prone country in the world and now the respected MRC says - and by the way only one in ten is being reported, we thought that only one in two was being reported but it shows now that the figure is one in ten, that it's probably ten times higher than we think.

Motlanthe: That's a point I was making. In my view a bad thing needs no exaggeration because it is a bad thing. One murder is bad enough, it doesn't require to be exaggerated, more people killed, for society to be moved by that. The same applies to rape because it is a criminal offence. Now you know in the past, in the run-up to the elections last year, the media, they even had an ad on TV involving a South African born American actress.

O'Malley: I remember that.

Motlanthe: Saying that every three minutes 17 women are raped in this country. And you know where the figure came from? Do you know where the figure came from? A police officer was asked and he said, "Yes, these are the figures for reported rape", and then he said, "No, only one in 35 rapes are reported." That hampers you. Then they did the calculation, permutation, rounded out the figures then divided them down, if I recall. What it then means is this huge figure, in essence every 17 seconds a woman in SA is raped, or every three minutes 17 women - something like that. But it was one such upset statistic. The people now take that, if those statistics are also extrapolated properly - if that kind of statistic is extrapolated over a period of time across the country it actually means you can say at some point every woman should have been raped in this country. But you know there are cases of rape in this country and under the current conditions there is sufficient confidence for people to report that and I don't think there is any basis for anybody to say, no, this is actually the tip of an iceberg. How did they come to this determination that it's only one in ten that gets reported? How do they know about the nine? How do they come to that? This formula, where does it come from and on what is it based? I am saying it's a bad thing because you end up arguing about the statistics which clearly is bad. Rape in itself is bad enough. If it is one rape it is bad enough. Society should be revolted by it and take all the necessary steps to ensure that the action if it has already happened, because if there's anything that gets reported it has already happened.

They can't prevent it from that point onwards with regard to that specific victim, but you must put systems in place, support systems, counselling and all of those things for the victim on the one hand. For the perpetrator on the other hand, the offender, he must be apprehended, brought to book and dealt with in accordance with the criminal justice system. Sometimes these are people who themselves are not normal, either a psychopath or somebody who has got some disturbed background.

What do we do with them? You've got to ensure that the victim is not permanently destroyed by that misfortune. On the other hand you've got to try and develop sufficient awareness in society that people who display certain tendencies need help and the sooner they are reported to the relevant authorities for them to be helped in time the better.

O'Malley: Pre-empted.

Motlanthe: That's only what any and every rape case should evoke from us. But once people are saying that all it has to do is that the figures are not respectively matched so you must say it's only one out of ten, so you exaggerate it, I don't think it helps.

Extract from second interview by O'Malley with Motlanthe, September 15 2000:

O'Malley: OK this is the last question. They say, and this comes back to where our conversation began six weeks ago. They say the government is not doing enough about AIDS and I agree, I don't think the government is, to be honest with you.

Motlanthe: Well they are wrong. I'll tell you why. You see, and this is one of the things that would explain to you how racism manifests itself outside of the law because now you see we've removed all the racial laws but the legacy of racism, more especially in the realm of ideas, is still very much with us and the former ruling bloc controls the mass media in this country and they have deliberately - and I will explain to you in one sentence what our position is with regard to AIDS. AIDS is acquired immune deficiency syndrome.

Now that means your body defence mechanism is down and out, it's a condition in a human body. Our understanding of that is that TB if not treated, if you contract TB and it's not treated it eats away and lowers your immune system to a point where it can actually lead to AIDS once your immune system has completely collapsed.

But TB would also be regarded as an opportunistic disease, that once malaria, another disease, has caused a decline of your body defence system, when you contract TB your body will not be able to defeat TB and therefore that condition would be described as AIDS. So there are about 30 odd different diseases that are regarded as opportunistic diseases which would kill you if your immune system has collapsed.

There's a virus called HIV which is one of 69 possible causes of the collapse of the body immune system and our position is that from all accounts this virus has not been isolated and photographed and studied under controlled conditions as to what it's behaviour is. Therefore it remains one of the many causes and not the sole cause of AIDS and therefore the response to AIDS is informed by that totally, that there is ongoing research work by scientists to try and isolate this virus.

Now there are people who are driven by pharmaceuticals who say that that question must never be asked because pharmaceuticals produce drugs on the basis that HIV causes AIDS, period. It is the only cause of AIDS and that's it. Any other question, you are a dissident, you are bad, you are malicious, you are dangerous to society, you will be responsible for the deaths of so many children and this and that and so on. It's all crap from the pharmaceuticals. That's our view and I can give you another example.

 I had a meeting with the leadership in Uganda. A few years ago the figures of people who were reported to be HIV positive and suffering from AIDS were huge. It was like Uganda's population was going to be wiped away. And they said to me when I said, "What have you done to turn this thing around?" they said to me, "No, the figures were exaggerated in the first place. We have just continued with our normal - "

O'Malley: ... drug?

Motlanthe: No, the statistics were -

O'Malley: But generated by the drug industry?

Motlanthe: Yes, were exaggerated. So that if you were to pull them out now and do your own calculations there shouldn't be anybody walking around in Uganda now. But because the population is still there they had to find an explanation and the only explanation they could find was that Uganda has succeeded to turn this thing around.

They won't tell you what the Ugandans have done, they will not, because they have continuously said, "We've continued with awareness programmes, prevention programmes and so on", which is what we are doing here and the government has done a great deal on that. What the government has refused to do, for which it's being maligned and crucified today, it refused to be railroaded into contracting with Glaxo-Wellcome for the supplies of AZT, a drug called AZT, which everybody said AZT must be prescribed for pregnant mothers, for raped women. The government has refused because the drug is expensive and it turns out that it was not developed for that purpose.

The scientists say so. Glaxo-Wellcome have said that it was licensed for that but because they had mobilised the entire media and so on they were able, of course, to create a picture that the government is not committed, doesn't care because they repeat lies. But like everything in life the truth will out on this matter and that's why we are not concerned. We know what we have to do, we must continue to ensure that our people practice A, B, C, they abstain, they remain loyal to one partner and they condomise as some kind of prevention from spreading the disease and also that once people have contracted this disease they should still be treated for the opportunistic diseases. TB is curable to the extent that if somebody shows symptoms of TB they must be treated for TB. It shouldn't be labelled as AIDS and therefore as there is no cure for AIDS, therefore you're condemned to death. That's our position.

O'Malley: Do you think, again, that whites use this in a racist kind of way to whop the ANC?

Motlanthe: No, they are gullible. You see half of them don't read but they regard themselves as well informed because they're white. The reason why when you ask - you ask any of the experts whether they have seen evidence, any piece of document that says scientist so-and-so in such a country has isolated this HIV virus and photographed it and studied it's modus vivendi under controlled conditions, they will swear at you.

They will tell you that question was answered twenty years ago, they will tell you you are giving audience to dissidents. They will not tell you because it's not there. That's why they become vicious because it is simply not there. They take it on authority and then it gets passed on like that but there's no authority, it's a lie repeated by those who are supposed to know better. The truth of the matter is that if they were to admit that indeed no such thing has happened, I mean it would cause serious reverberations across the scientific world.

O'Malley: They'd all be out of a job.

Motlanthe: Yes. It would be like when Galileo invented the telescope and said the earth is not flat after all, it's round, it caused serious reverberations. That's what will happen with this thing.

O'Malley: I must thank you very much. I appreciate the time you have given me.

Click here to sign up to receive our free daily headline email newsletter