TAC responds to open letter published by AIDS denialist former President
JOHANNESBURG, 8th MARCH 2016: On March 7, 2016 former president of South Africa Thabo Mbeki published a letter titled “A brief commentary on the question of HIV and AIDS”. The letter comes seven and a half years after Mbeki was forced to step down as President of South Africa and forms part of a series of letters attempting to reframe the Mbeki Presidency. The letter can be read here.
The Treatment Action Campaign (TAC) has a long history of struggling against the state-sponsored AIDS denialism of Thabo Mbeki and his Minister of Health Manto Tshabalala-Msimang. In 2002 we won a landmark case in the Constitutional Court compelling the state to make antiretroviral treatment available to HIV-positive pregnant women.
Following this ruling we monitored the provision of treatment to pregnant women and advocated for a wider rollout of treatment to HIV-positive people. Even with a judgement from the highest court in the land and continued public pressure, the HIV treatment programme only gained significant momentum once Mbeki and Msimang were removed from office in 2008.
The impact of Mbeki’s AIDS denialism was catastrophic. Two independent studies have estimated that delays in making antiretroviral treatment available in the public sector in South Africa resulted in more than 300,000 avoidable deaths. It also resulted in an estimated 35,000 babies being born with HIV who would not otherwise have been HIV-positive.
Under Mbeki’s watch life-expectancy in South Africa dropped to 54 in 2005. Life-expectancy has recovered dramatically in the post-Mbeki era to 63 in 2015. This increase is widely attributed to the ambitious rollout of antiretroviral therapy in the public healthcare system under the leadership of Health Minister Aaron Motsoaledi.
Many of our family members, friends and comrades died while Mbeki’s government dragged its feet and indulged pseudo-scientific nonsense. Yet, neither in his letter, nor in any other forum that we are aware of, has Mbeki apologised or showed any remorse or acknowledgement of his role in the over 300,000 avoidable AIDS deaths in South Africa.
Instead, he has chosen to repeat many of the flawed arguments he used in the early 2000s. We provide brief notes below in response to some of his arguments, but we will not engage with those arguments in more detail, nor will we engage with any of the other red herrings in his letter.
The important point, and the point Mbeki still refuses to face, is that he intentionally delayed the introduction of life-saving treatment to the people he was trusted to serve. His actions led to at least 300,000 avoidable deaths. He has refused to take responsibility or to apologise to any of those who suffered directly or indirectly because of his actions. For this history will judge him harshly. He deserves it.
1. In his letter Mbeki quotes Stats SA figures from 2006 ranking HIV as the ninth highest cause of mortality in South Africa. As done previously, Mbeki fails to place the Stats SA data in proper context. The data he quotes is based on the cause of death written on death certificates. There are a number of reasons why this underestimates the role of HIV. Firstly, for stigma-related reasons HIV was often not written on death certificates. Secondly, in many cases where the cause was indicated as TB or pneumonia, HIV would in fact have been the underlying cause. Thirdly, many people would have died of AIDS-related diseases without ever having known their HIV status – especially so given the much lower testing rates in Mbeki’s time. Mbeki’s misuse of Stats SA data is nothing new. TAC e.g. published a briefing note on it in 2008. Maybe more disturbingly, a 2001 Medical Research Council report on the matter seems to have been ignored by the former President.
2. The latest estimates from the Medical Research Council’s Rapid Mortality Surveillance Report show that the average life expectancy in South Africa has reached nearly 63 years, an increase of nearly 9 years since the low in 2005. We also recommend this 2013 article by Nathan Geffen published in the journal HTB South: South Africans are living longer: antiretroviral treatment vindicated.
3. In his letter Mbeki writes “[I must also mention that I never said “HIV does not cause AIDS”. This false accusation was made by people who benefitted from trumpeting the slogan ‘HIV causes AIDS’ as though this was a religious edict. What I said is that ‘a virus cannot cause a syndrome’. As you know, AIDS is an acronym for ‘Acquired Immune Deficiency Syndrome’ – therefore AIDS is a syndrome, i.e. a collection of well-known diseases, with well-known causes. They are not, together, caused and cannot be caused by one virus! I said that HIV might be a contributory cause of immune deficiency – the ID in AIDS!]” Mbeki is simply wrong. A virus can cause a syndrome and it has long ago been proven that HIV causes AIDS. His word games in this regard are a cowardly form of confiscation.
4. We will not engage with Mbeki’s quotations from the document “Castro Hlongwane, Caravans, Cats, Geese, Foot & Mouth and Statistics”, nor with his quotations from an AIDS denialist film. We see no point in responding to patently absurd conspiracy theories. For those interested in revisiting stale old AIDS denialist arguments and our responses to them we recommend the website AIDS Truth.
Statement issued by the Treatment Action Campaign, 8 March 2016