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‘Just say yes, Mr President’

Mbeki and AIDS

___________________________

ANTHONY BRINK

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If ever there was in the world a warranted and proven history, it is that of vampires. Nothing is lacking; official reports, testimonials of persons of standing, of surgeons, of clergymen, of judges; the evidence is all embracing.

Jean Jacques Rousseau

Later we will realize many times how mistaken we were in concepts that were so familiar they became part of us and were an automatic part of our thinking. Often we need to change our concepts, not only the general concepts, the social or philosophical ones, but also sometimes our medical concepts.

Ernesto Che Guevara

‘Just say yes, Mr President’: Mbeki and AIDS

The success of our constitutional venture depends upon robust criticism of the exercise of power. This requires alert and critical citizens. ... [The South African] Constitution places particular store upon free and fair political activity. And it gives constitutional recognition to the fact that freedom of speech and expression ... is an indispensable adjunct to free and fair political activity. The overall structure of our Constitution, thus, lays an emphasis on the effective and inclusive functioning of democracy, and highlights this in the special protection it gives to the aspects of free speech and expression which safeguards political activity. It is in this context, too, that ... the fundamental rights chapter grants every citizen the right ‘freely to make political choices’. This freedom could scarcely be enjoyed unless there is vigorous, free and informed political debate. ... The ambit of political activity ... spans a broad and encompassing area.

Cameron J (now JA) in Holomisa v Argus Newspapers 1996 (2) SA 588 WLD.

The SABC television evening news on Friday, 9 October 1998, opened with a dramatic announcement by newsreader Nadia Levin:

The HIV/AIDS crisis facing South Africa was highlighted today in an historic live address to the nation by Deputy President Thabo Mbeki. President Mandela did not give the address as previously planned, because he’s been ordered to rest by his doctors. Mbeki’s speech spearheaded an initiative for greater partnership between government and society. There are 1 500 new HIV infections each day in this country.

Cut to a clip of some black toddlers. Apart from one blubbing, as kids sometimes do, which he stops when he begin sucking his thumb, as kids usually do, all look healthy and content. No, says reporter Robyn Curnow: ‘These are the faces of HIV/AIDS, faces that tell a story that many South Africans don’t want to hear, but today Deputy President Mbeki came to this children’s home and made South Africa listen. At midday he urged everybody to change “the way we live and how we love”.’ Cut next to a cutesy staged set that has Mbeki sitting in an armchair surrounded by more black children (‘the faces of HIV/AIDS’) placed all around him, one resting his head on his left knee. Looking straight ahead into the camera, with his hands together in his lap, Mbeki commences an awful proclamation: the country was in the grip of a terrible plague; it might not be visible but it was everywhere; those of us who could not or would not see it were vainly denying the magnitude and horror of it; and unless we changed our sexual habits South Africa would soon be laid waste. So went his speech, broadcast in full earlier in the day – ‘10 Minutes to Save the Nation’, as the National HIV/AIDS and STD Directorate called it – and printed on a banner behind him:

Partnership Against AIDS

DECLARATION

HIV/AIDS is among us.

It is real. It is spreading.

We can only win against HIV/AIDS if we join hands to save our nation.

For too long we have closed our eyes as a nation, hoping the truth was not so real.

For many years, we have allowed the H-I-Virus to spread, and at a rate in our country which is one of the fastest in the world.

Every single day a further 1 500 people in South Africa get infected. To date, more than 3 million people have been infected.

THE DANGER IS REAL

Many more face the danger of being affected by HIV/AIDS.

Because it is carried and transmitted by human beings, it is with us in our workplaces, in our classrooms and our lecture halls.

It is there in our church gatherings and other religious functions.

HIV/AIDS walks with us. It travels with us wherever we go. It is there when we play sport. It is there when we sing and dance.

Many of us have grieved for orphans left with no one to fend for them. We have experienced AIDS in the groans of wasting lives. We have carried it in small and big coffins to many grave yards.

At times we did not know that we were burying people who had died from AIDS. At other times we knew, but chose to remain silent.

And when the time comes for each one of us to make a personal precautionary decision, we fall prey to doubt and false confidence. We hope that HIV/AIDS is someone else’s problem.

CHANGING OUR WAY OF LIFE

HIV/AIDS is not someone else’s problem. It is my problem. It is your problem.

By allowing it to spread, we face the danger that half of our youth will not reach adulthood. Their education will be wasted. The economy will shrink. There will be a large number of sick people whom the healthy will not be able to maintain. Our dreams as a people will be shattered.

HIV spreads mainly through sex.

You have the right to live your life the way you want to.

But I appeal to the young people, who represent our country’s future, to abstain from sex for as long as possible. If you decide to engage in sex, use a condom.

In the same way I appeal to both men and women to be faithful to each other, but otherwise to use condoms.

PARTNERSHIP

The power to defeat the spread of HIV and AIDS lies in our Partnership: as youth, as women and men, as business people, as workers, as religious people, as parents and teachers, as students, as healers, as farmers and farm-workers, as the unemployed and the professionals, as the rich and the poor – in fact, all of us.

Today, we join hands in this Partnership Against HIV/AIDS, united in our resolve to save the nation.

As Partners Against AIDS, together we pledge to spread the message!

Every day, every night – wherever we are – we shall let our families, friends and peers know that they can save themselves and save the nation, by changing the way we live and how we love. We shall use every opportunity openly to discuss the issue of HIV/AIDS.

As Partners Against AIDS together we pledge to care!

We shall work together to care for those living with HIV/AIDS and for the children orphaned through AIDS. They must not be subjected to discrimination of any kind. They can live productive lives for many years.

They are human beings like you and me. When we lend a hand, we build our own humanity, and we remind ourselves that, like them, each one of us can become infected.

As Partners Against AIDS together we pledge to pool our resources and to commit our brain power!

There is still no cure for HIV and AIDS. Nothing can prevent infection except our own behaviour.

We shall work together to support medical institutions to search for a vaccine and a cure.

We shall mobilise all possible resources to spread the message of prevention, to offer support to those infected and affected, and to destigmatise HIV and AIDS and to continue our search for a medical solution.

And so today we join hands in the Partnership, fully aware that our unity is our strength. The simple but practical action that we take today is tomorrow’s insurance for our nation.

Accordingly, we pledge that whenever we meet and study, work and sing, play and enjoy one another’s company, we will protect ourselves and our partners against HIV and AIDS.

Together, as Partners Against HIV/AIDS, we can and shall win.

I have asked for your time to listen to this urgent message because there is no other moment, but the present, to take action!

I thank you for your attention and urge you to ACT NOW!

In the excerpt of Mbeki’s address broadcast on the eight o’ clock news, the news editors zoomed in on its central idea, his call for mass behaviour change:

By allowing it to spread we face the danger that half of our youth will not reach adulthood. Their education will be wasted. The economy will shrink there will be a large number of sick people whom the healthy will not be able to maintain. Our dreams as a people will be shattered. But I appeal to the young people, who represent our country’s future, to abstain from sex for as long as possible. If you decide to engage in sex use a condom. In the same way I appeal to both men and women to be faithful to one another, but otherwise to use condoms.

‘In Cape Town workers listened to one of this country’s most important speeches, while in Bloemfontein hundreds of people marched in support of the Deputy President’s call for action,’ says Curnow speaking again. ‘And around the country flags flew at half-mast, a sad reminder for the nation that has one of the fastest HIV growth rates in the world.’ The visuals now move to Parliament with Table Mountain in the background, where indeed the flags hang low as if to mark some terrible national tragedy. ‘Representatives from business, sports and entertainment, religion, trade unions, people living with AIDS, women’s groups and the youth all pledged to do something.’ A series of whom then appear making promises. To do something. ‘It’s believed that almost a million people in KZN [KwaZulu-Natal province] are HIV-positive,’ laments reporter Fauzia Moodley. ‘About 29% of pregnant women are HIV-positive and more than a third of their babies will be born with the AIDS virus.’ A hospital doctor and a university virology professor come up next to spin their scary stories. Moodley concludes the evening’s drama: ‘At the moment there is no cure for AIDS, but treatment is available to prolong life and to reduce the amount of virus in the body. Unfortunately it is too expensive to be widely offered at state hospitals.’ It’s called AZT.

With Mbeki as visionary commander-in-chief, the country was going to war against HIV, the frightening menace that threatened it with oblivion. Under our flies.

Until then almost completely overshadowed by the sparkle of Mandela’s personal magic, Mbeki’s televised Partnership Against AIDS declaration was his first big appearance in the public eye. What was ironic was that the subject in which he made his earnest and faithful début would be one for which he would be universally attacked as the world’s most scrofulous modern heretic just a year later. Month after month, throughout the five years of Mbeki’s first term as President himself, and into his second, the fire beneath him would be tended and fed, slow-roasting him mercilessly for his sins, like a medieval non-conformist spread-eagled on an iron grate.

This is the story of the apostate’s progress.

Debating AZT reached Minister of Health Dr Mantombazane Edmie Tshabalala-Msimang in just the nick of time. Two articles in the Sunday Times in May 1999 spurred me to send my manuscript to her predecessor, Dr Nkosazana Dlamini-Zuma. The first, on the 2nd, reported: Zuma rejects cheap AZT:

The government has refused to provide AZT treatment to pregnant women infected with HIV despite being offered the drug at the cheapest price in the world for the past two years – 70 percent of the price charged in the US and Britain. In that time, 120 000 babies have been infected with HIV. The lives of half these babies could have been saved by the drug. The Department of Health has said the costs of the treatment are too high, but it has not made the drug’s manufacturer, Glaxo Wellcome, a counter offer.

It was par with the kind of tendentious media coverage of the controversy that had shaped a unanimous public consensus in favour of the drug. What the report omitted was that Dlamini-Zuma had a friend in UNAIDS executive director Peter Piot: AZT programs for HIV-infected pregnant women were difficult to implement, he said, even at the level of pilot studies; it was a ‘very complex issue’. Hoosen (‘Jerry’) Coovadia, then professor of paediatrics at the University of Natal, agreed: ‘I fear even beyond the price of the drugs, there are many problems to be solved before the treatment can become widely available.’

The following week, in the same style and tone, the newspaper claimed: Zuma in dramatic AZT about-turn: Hospital’s go-ahead to distribute drug to pregnant women with HIV signals shift in health policy. Actually no policy reversal had taken place; the Gauteng Department of Health had simply given the nod to UNAIDS supplying some donated AZT to the Chris Hani-Baragwanath Hospital in Soweto. And her special advisor Ian Roberts pointed out that Dlamini-Zuma hadn’t even been consulted. As her spokesman Khangelani Hlongwane made clear in the report, the government’s reservations about AZT were soley financial at that stage.

‘The problem lies not with the government,’ Mbeki had shrugged in answer to the government’s critics regarding the non-delivery of AIDS drugs. ‘The problem lies with pharmaceutical companies’ exorbitant prices … making it impossible for the government to make them available.’ Commenting on a protest over the price of AZT by AIDS drug activists on 28 April, Mbeki’s spokesman Ronnie Mamoepa reiterated the President’s view:

If the price is reduced we will have no problem with the treatment. But it is for the pharmaceutical company to act. As long as AZT is only available at exorbitant prices it makes it impossible for the government to make it available to ordinary people. It is incumbent on the pharmaceutical companies to reduce the cost and price of AZT, and therefore the calls for AZT to be made available should be directed at the pharmaceutical companies.

To which AIDS Law project director Mark Heywood reacted: ‘We are not the government’s friend on this issue, but GlaxoWellcome could be doing more to make AZT available at cost price. We are fighting for people living with HIV and those HIV-positive women who are pregnant.’

My revelations about the dangerous toxicity of the drug in the Citizen a few weeks earlier in the course of my debate with South Africa’s top AIDS treatment expert, Dr Desmond Martin, president of the Southern African HIV/AIDS Clinicians Society, evidently hadn’t yet been officially noted.

I reacted to the Sunday Times reports by emailing Roberts on 19 May, asking him for ‘a postal address for the submission of some materials I believe the Minister will find invaluable in staving off her critics regarding her decision on AZT. I support her 100%!’ Roberts replied the same day: ‘Thank you for your expression of support. At this time around elections it is best sent to [my home address]. I await your data with interest and will send a copy to the Minister.’ Opting to use email instead, I sent Roberts an amplified version of my AZT debate, then subtitled Questions of safety and utility, including further citations from the medical literature concerning the drug’s toxicity and carcinogenicity.

Roberts acknowledged receipt on the 27th:

Thank you for sending me the email and the attachment. I will pass it on to the Minister of Health after the elections and the [new post-Mandela] Cabinet appointments have been made [by President Mbeki].It will then get the attention it deserves. You have clearly researched this topic in great detail and I guess you have read more than anyone I have come across so far in South Africa. I share many of your concerns regarding the risk benefit ratio of zidovudine in therapy particularly in the therapy that involves non-HIV infected individuals where, in my view, information is so scant that such an assessment is impossible to make. I also share your concerns that it appears that too freely in this country of ours, people have come to a conclusion on this topic without much scientific evidence to back these conclusions.

On 23 July Roberts confirmed: ‘I have now sent your document to the Minister of Health.’ On the same day, Howard Barrell on the Mail&Guardian (later its editor) reported, Ban on AZT to pregnant women under review:

New Minister of Health Dr Manto Tshabalala-Msimang is reviewing the ban on the use of the antiretroviral drug AZT by HIV-positive pregnant women to prevent infection of their unborn children. … Curbing the rate of new HIV infections was her ‘number one priority for this year’ so ‘the time has arrived to review the decision’ not to supply AZT to HIV-positive pregnant women ... taken by her predecessor, Dr Nkosazana Dlamini-Zuma, on the grounds that AZT was too expensive and its benefits to the unborn children of HIV-positive women were not clear enough. One of Tshabalala-Msimang’s first acts after her appointment as health minister was to call a meeting of people and groups working to curb the HIV/Aids pandemic. Activists spoke of a new sense of purpose after the meeting. One HIV/Aids worker praised the ‘sense of urgency she brought to the meeting, the questions she asked and her willingness to listen. It was a breath of fresh air’. Next week, the interministerial committee on HIV/Aids, usually chaired by President Thabo Mbeki, is due to meet, and her suggestion for a review of her predecessor’s ban on AZT treatment for HIV-positive pregnant women is likely to come under discussion.

The pressure on me at the time is indescribable. I was working after-hours quite alone in the country – supported by a small network of concerned scientists and dissident activists scattered thinly around the world – with the pealing of salaried professional AIDS treatment activists and drug-pushing journalists mesmerizing a spellbound public, and drumming against my ears like the exhortations of those rabbis in the Warsaw Ghetto, who’d bought the promises announced through German officers’ bullhorns and, unable to imagine the evil lying ahead, urged their flock to pack their things for voluntary relocation in the East: ‘We’re going to a better place. We’re going to a better place.’

The first sparks in the AZT controversy had flown on the same day that Mbeki announced his Partnership Against AIDS, when Dlamini-Zuma cancelled a five-site pilot trial in which AZT was being given to HIV-positive pregnant women – all black – at Chris Hani-Baragwanath Hospital and Zola Clinic, Coronation Hospital, Witkoppen, Empilisweni and Sebokeng. Her spokesman gave the reason:

Our problem is with the economic viability of the intervention, not with the long-term cost-effectiveness of the project. People can advance all sorts of arguments but the government won’t make a commitment that it can’t sustain. The bottom line is that the government does not have the money. If there is a windfall from somewhere, then the government might reconsider its decision. Governments have to take difficult decisions and this is one of them.

Anyway, said Dlamini-Zuma, ‘AZT treatment will have a limited effect on the epidemic as we are targeting individuals already infected. ... The only cure is to prevent infection in the first place.’ It was an economic decision: ‘If you have limited resources, you may decide to put your resources into

preventing mothers getting infected in the first place.’ Roberts summed up matter of factly: ‘There is not much point in running a pilot study unless you can implement its findings.’

Hearing which, Professor Nicoli Nattrass at UCT’s School of Economics scolded: ‘It is economically illiterate and shockingly ill-informed to argue that we cannot afford to give pregnant women AZT.’ Glenda Gray, co-director of the Perinatal HIV Research Unit at Chris Hani-Baragwanath Hospital in Soweto, fumed likewise: the government ‘preferred incoherent campaigns instead of things that will really turn the tide against AIDS … South African politicians must know that the whole world is watching them.’ Knowing better than the Minister did, Heywood decided that ‘Dr Zuma does not understand the issues. These drugs should be given during birth and in the week post-birth.’ And he intended taking the government to court to force it to provide AZT to all HIV-positive pregnant women as a constitutional right, he said. He repeated his plans in the March 2000 issue of Focus: ‘I believe there is a very strong legal case under the Constitution for giving AZT to pregnant women, both as regards the rights of children to health care and the reproductive rights of women. AZT can be shown to be cost effective and affordable. The government knows it’s on weak ground when it comes to AZT for pregnant women.’ Why, Mbeki himself had declared that ‘people with AIDS had a “moral entitlement” to mercy treatment,’ Heywood pointed out in the Sowetan on 1 December 1999. ‘[In a piece he’d written and sent to the Sunday newspapers for publication on 7 March 1998, Mbeki] wrote that the cruel games of those who do not care should not be allowed to set the national agenda.’ The cruel drug industry executives pricing life-saving AZT out of reach. ‘Save our babies, Dr Zuma’, pleaded Carol Paton’s headline in the Sunday Times in the weekend. Your Decision against drug treatment puts thousands at risk.

The decision to call off the AZT pilot study, however, had the backing of the Ministerial Task Force on AIDS, which Mbeki, still Deputy President, had established and chaired. None of the private sector members of his new Partnership Against AIDS had been consulted before the decision to cancel the study was taken – perhaps because the strenuous opposition of its dominantly white private sector members was predictable. As Morna Cornell’s was: the director of the AIDS Consortium, a network of virtually every local AIDS organisation around, condemned it as ‘unacceptable … The decision has a huge impact on the people we work with. We want to know that the concerns we’ve raised have been heard. A partnership implies the possibility of influencing a decision, being involved in a process.’

Touting AZT for sale at ‘preferential pricing’ for administration to HIV-positive pregnant women in South Africa, GlaxoWellcome had first approached Dlamini-Zuma in 1996, but she wouldn’t bite. The company’s next trick was described with a straight face by the Mail&Guardian on 22 August 1997 as ‘a bouquet of assistance … While Glaxo would sell the drug to the government at its usual price to avoid it being re-exported, the difference in cost between the actual and the discounted price would be ploughed back to fund training for AIDS counsellors and building private consulting rooms at clinics, among other options’. Needless to say, Dlamini-Zuma wasn’t impressed by that offer either. When the results of Schaffer’s short-course AZT mother-to-child transmission study in Thailand came through in early 1998, the company tried again, this time offering a 30% discount. The Department of Health Exploratory set up pilot studies at five sites, but, as just mentioned, Dlamini-Zuma pulled the plug on government funding a few months later, even though, so eager was GlaxoWellcome for the business that it had now reduced its price by three quarters.

Condemnation of Dlamini-Zuma’s rejection of GlaxoWellcome’s solicitations to bulk-buy its AZT and to supply it across the board to HIV-positive pregnant women in South Africa had been universal. Top science journal Nature had been carping about it since October, the month before she cancelled the perinatal AZT pilot trial. On 4 March 1999 the journal groused further: ‘South Africa’s minister of health, Nkosazana Zuma, has refused to alter her decision not to pay for a pilot programme administering the antiviral agent AZT to HIV-positive pregnant mothers. This is despite increased threats of a boycott of the World AIDS Congress in Durban next year’ and notwithstanding a special visit by the ‘president of the International AIDS Society, Mark Wainberg ... to persuade Zuma to reverse her earlier decision’ on AZT – ‘mildly toxic’ he would later describe it. Determined he was too, also lobbying Mandela, his deputy Mbeki and Finance Minister Trevor Manuel.

In its 5 February issue, the Mail&Guardian quoted Wainberg saying they should ‘support Zuma in recognizing that perinatal treatment is a cost-effective way forward, and in making funds available for this. South Africa must consider itself to be at war. Its number-one enemy … is not some neighbouring country threatening its borders. It is HIV.’ Although he claimed that his meeting with Dlamini-Zuma had left him ‘encouraged and confident’, her spokesman Vincent Hlongwane made clear that the government would not reconsider its decision: ‘What we are saying is that we don’t have the budget for it. That position has not changed. It has not been influenced by the research findings coming from Chicago or anywhere else’ – referring to a meeting of Wainberg’s society a few days earlier in Chicago, where data in support of short-course AZT treatment had been presented. The meeting, also attended by South African AIDS experts, had been held to discuss the boycott calls in regard to the impending International AIDS Conference in Durban, including the proposal that Dlamini-Zuma be barred from attending if she didn’t change her mind. But Hlongwane emphasized that her decision was not just her’s but the entire government’s, which was ‘fully briefed’, he said: ‘The Cabinet’s position is to rather use the money we have for prevention. The majority of south Africans do not have AIDS now, but that could change if we don’t focus on prevention.’

‘Ludicrous’, ‘autocratic’, ‘extraordinary’, was the furious response of unnamed AIDS activists quoted by the M&G. It was ‘unacceptable’, said AIDS Law Project attorney Fatima Hassan, and ‘if the government has not significantly shifted its position on mother-to-child transmission and other AIDS policy issues … by September’, Heywood warned that he and his fellow AIDS activists would ‘not rule out’ a boycott. They’d show the government who was in charge of AIDS policy.

Nature deplored Dlamini-Zuma’s obstinacy, given that ‘Glaxo-Wellcome is offering AZT to the South African government at 75 per cent below the price for developed countries, and has offered to hold that price for five years’. The journal went on to make all the familiar noises, concluding in blinking incomprehension that the African National Congress didn’t think Dlamini-Zuma quite as useless as it did – ranking third on the party election list, right after ANC president Mbeki, and her former husband, party deputy president Jacob Zuma. And better esteemed even than Zulu strongman Mangosuthu Gatsha Buthelezi, the Inkatha Freedom Party boss (and political gigolo of Margaret ‘The ANC is a typical terrorist organisation’ Thatcher). Although what any of this was doing in a science journal it’s hard to say. Unless you appreciate that Nature is all about a very Tory kind of science.

Sometime in October 1999 Tshabalala-Msimang read the manuscript of Debating AZT, which Roberts had given her in July. It took her like a cold shower. She changed her mind about the drug completely, let Mbeki in on what she’d discovered, and passed the manuscript on to him after copying it for some of her top officials and aides. ‘That was the first time that I became aware of this alternative viewpoint,’ Mbeki told Allister Sparks, during his research for Beyond the Miracle: Inside the New South Africa (Jonathan Ball Publishers, 2003): ‘Mbeki himself confirmed that the first person to draw his attention to [dissident criticism of AIDS causation and treatment orthodoxy] was a lawyer and part-time jazz musician named Anthony Brink, then practising in the provincial city of Pietermaritzburg. … It must be said in Mbeki’s defence that Brink ... is an able lawyer who makes his case with persuasive force.’ Mbeki was appalled. With the entire South African medical establishment crooning ignorantly about the virtues of AZT, he decided to take matters in hand personally: he went online, and looked up and printed the toxicity papers cited in Debating AZT, many of which had been posted there by the medical journals in which they had originally appeared, if not in full then summarised in the researchers’ abstracts. Given the gravity of the issue and its vast implications, the master strategist then picked his moment – and his place, as he explained through his spokesman Parks Mankahlana afterwards: ‘There is no other forum that is as widely representative as a parliament of any democracy where citizens can exchange their views.’ It’s ‘the highest organ of public debate’.

On 28 October Mbeki addressed Parliament’s second chamber, the National Council of Provinces:

To close, let me make a few remarks about two issues that are at the very heart of our quest for the humane and caring society of which we have spoken before. I refer here to the issues of rape and HIV/AIDS. Very correctly, just over a month ago, this House debated the question of violence against and the rape of women and children. We noted the resolution that emerged from that discussion, supported by all the provinces, political parties and all members of the Council, condemning these completely unacceptable acts of violence and calling for consistent and severe sentences against all perpetrators of such heinous crimes. The approach adopted by the NCOP [National Council of Provinces] on this and other matters is constructive and in keeping with the sense of outrage that violent crimes invoke in our communities. As a people whose struggle and sacrifice defeated one of the most pernicious systems of our time, we can and must wipe out of our communities this scourge of violence and abuse of our people. One rape that occurs is a rape too many. Through our concerted action, we must make this clear to all who carry out this terrible crime. Accordingly, it is unnecessary and counter-productive for anybody to propagate untruth about the incidence of this crime in our country. For example, in 1997 the South African Police Service published statistics alleging than only 1 rape out of 36 was reported. Whereas the number of rapes actually reported that year was just over 52 000, an extrapolation was then made that on the basis of the estimate of the extent of under-reporting, over 1,8 million rapes had in fact occurred. You will be as surprised as I was to learn that in the fact the SAPS itself does not know what the estimate of 1 out of 36 was based upon. They can offer no explanation as to how they decided to publish figures which they cannot substantiate in any way whatsoever. The tragedy is that many of us have taken these purely speculative figures as fact. Clearly, this will not help us properly to fight against the terrible crime of rape as we cannot base our actions on untruths. Similarly, we are confronted with the scourge of HIV/AIDS against which we must leave no stone unturned to save ourselves from the catastrophe which this disease poses. Concerned to respond appropriately to this threat, many in our country have called on the government to make the drug AZT available in our public health system. Two matters in this regard have been brought to our attention. One of these is that there are legal cases pending in this country, the United Kingdom and the United States against AZT on the basis that this drug is harmful to health. There also exists a large volume of scientific literature alleging that, among other things, the toxicity of this drug is such that it is in fact a danger to health. These are matters of great concern to the government as it would be irresponsible for us not to heed the dire warnings which medical researchers have been making. I have therefore asked the Minister of Health, as a matter of urgency, to go into all these matters so that, to the extent that is possible, we ourselves, including our country’s medical authorities, are certain of where the truth lies. To understand this matter better, I would urge the Honourable Members of the National Council [of Provinces] to access the huge volume of literature on this matter available on the Internet, so that all of us can approach this issue from the same base of information. … Thank you.

Mbeki’s media liaison officer, Tasneem Carrim, confirmed he had done so himself. Three days later, the Sunday Independent quoted her telling that he had acquired a ‘thick set of documents’ about the dangers of AZT from the Internet: ‘The President goes into the Net all the time.’

Since the media-instilled notions that AZT saves babies and that South Africa had the highest rape rate in the world had taken deep root in the mind of white South Africa, Mbeki’s speech provoked outrage. As he stabbed its holy cows successively, the liberal Sunday Independent bellowed in the weekend: ‘For a leader who has shown such statesmanship in the vital task of making Africa a prosperous continent, it is surprising that President Thabo Mbeki has not shown the same dedication to the most injured citizens in our own country.’ To its credit, Reuters immediately reported Mbeki’s statements about AZT without deprecating comment of the kind that had followed every news report about Dlamini-Zuma’s disinclination to buy the drug from GlaxoWellcome (formerly Burroughs Wellcome, now GlaxoSmithKline, and from now on referred to by the company’s current name) for dispensing in hospitals and clinics, and it made an unusually impartial mention of AZT’s ‘supposed’ benefits. The South African Press Association’s idea of a news report about Mbeki’s extraordinary initiative, on the other hand, was to release the drug merchant’s wounded reaction as news, just as the South African Broadcasting Corporation used to headline apartheid politicians’ responses to criticism by the civilised world. In an article under the title, Mbeki Has Been Misinformed About AZT: Glaxo Wellcome, the company complained about being taken by surprise, repeated all the usual lies about what great stuff AZT is, and boasted about all the countries it had penetrated, all the regulatory authorities it had screwed.

The company’s full statement went like this:

Press Release: Glaxo Wellcome Response To AZT Safety Allegations: Glaxo Wellcome refutes the statements questioning the safety of the anti-HIV medication, AZT, that were made by President Thabo Mbeki to the National Council of Provinces in Cape Town today. Following extensive international and local trials carried out on AZT, the medicine has been approved for use in numerous countries including those with the most stringent regulations, such as the United States and members of the European Community. Over ten years ago, South Africa’s Medicines Control Council (MCC) joined the US Food and Drug Administration (FDA) and other regulatory authorities around the world in giving AZT its stamp of approval. The MCC has not indicated any current concerns to Glaxo Wellcome about the use of AZT. For more than a decade, AZT has extended and improved the quality of life of millions of people living with HIV/AIDS around the globe, said Dr Peter Moore, Medical Director of Glaxo Wellcome South Africa, adding that hundreds of healthcare workers who have been exposed to the virus in the work situation have also benefited. There are no court cases against Glaxo Wellcome, regarding the safety of AZT in South Africa or abroad. In fact, AZT has been authorised by the FDA and the MCC in South Africa, as well as the Centers for Disease Control in Atlanta – the worldwide authority on communicable disease control and management – for use in pregnant women after their first trimester, to prevent mother-to-child transmission of the virus, he said. We are concerned that the President is encouraging NCOP delegates to access information on the Internet – which is not routinely medically reviewed and should therefore not be taken as an authoritative or necessarily correct source of information. Glaxo Wellcome said the President’s remarks would potentially raise unwarranted concerns among patients currently using the medication, who as a result may decide to stop the treatment without consulting their doctors, and so endanger their health. Glaxo Wellcome applauds the President’s commitment to fighting this scourge in South Africa and welcomes the opportunity to discuss with him any concerns he may have regarding the safety of AZT, as the company honestly believes that in this case the President has been misinformed, concluded Moore. Issued on behalf of Glaxo Wellcome. Contact person: Dr Peter Moore.

Moore’s statement, ‘Following extensive international and local trials carried out on AZT, the medicine has been approved for use in numerous countries including those with the most stringent regulations’, was false on all scores, except ‘approved for use in numerous countries’. In truth, AZT hit the market internationally after a single small clinical trial, conducted not internationally but in the US, namely, the Phase II trial preceding US Food and Drug Administration approval. In licensing AZT, the rest of the world just followed the FDA’s lead without independently investigating the drug’s efficacy and toxicity. Drug regulators in other countries took it on trust that the Americans knew what they were doing and did it properly, and that the clinical trial data were sound. In reality, as we’ll read in Licensing AZT in the appendices, they were rotten to the core. Certainly, as Moore claimed, scores of AZT trials have been conducted since the Phase II trial – but not for licensing purposes. The American Phase II study was the pivotal, decisive one. GlaxoSmithKline relies on it in all its literature in support of the life-saving claims it makes for AZT, and other drug regulatory authorities rely upon it in turn. For instance, immediately after the Phase II trial, AZT was licensed in Britain on the strength of it – even before the US. As far as Moore’s other studies are concerned, Tim Hand, an associate professor teaching behavioural pharmacology, neuroscience and endocrinology at Oglethorpe University at Atlanta (himself HIV-positive, drug-free and healthy) commented in an analysis in the Reappraising AIDS newsletter in September 1996, Why Antiviral Drugs Cannot Resolve AIDS:

Nearly all ... large, randomized, controlled studies yielding skeptical or frankly negative conclusions about AZT’s therapeutic or prophylactic efficacy [several studies cited] were funded by sources other than Wellcome. So were studies showing that AZT is immune suppressive [ibid], has no enduring ability to suppress HIV levels [ibid], and has pharmacokinetic properties that preclude the possibility that it will work in HIV-positive patients as intended [ibid].’ On the other hand, ‘Glaxo-Wellcome continues to promote AZT with misleading studies that trivialize toxicity. For example, the European-Australian Collaborative Group [Cooper et al. in New England Journal of Medicine, 1993] claimed that AZT benefits healthy HIV carriers, and that “severe haematologic or clinical side effects were rare”. Supported by the Wellcome Foundation, this paper contained some of the most breathtaking procedural and statistical blunders ... exposed in a series of hostile letters to the editor of the New England Journal of Medicine (329:1895 and 330:1758).

Brian Deer reported in the London Sunday Times in August 1994 that a panel of experts convened by the FDA in June had discussed Cooper’s paper, and that ‘its broad conclusions had been rejected’. That’s how bad it was – a study sponsored by the manufacturer, conducted by a ‘familiar face on the company-sponsored conference circuit ... provided with media services by its public relations firm’.

Concerning Moore’s familiar assertion that ‘AZT has extended [the lives of] people living with HIV/AIDS’, Licensing AZT in the appendices will take a look at the key Phase II study that gave rise to this foul lie. In the meanwhile, we recall mention in Debating AZT of a letter by Phillips et al. to the New England Journal of Medicine in 1997 reporting precisely the opposite: ‘Extended follow-up of patients in one [AZT] trial, the Concorde study, has shown a significantly increased risk of death among the patients treated early.’ Confronted with the outcome of the Concorde trial in the MNet Carte Blanche television documentary, The AZT Debate, broadcast by MNet on 7 November 1999, Moore retreated from his ebullient defence of AZT in the manner of a criminal accused caught out in cross-examination. It was put to him: ‘In 1994 the Concorde trial – the most comprehensive AZT trial yet undertaken – damned the drug. It concluded that the drug was too toxic for most people, did not prolong life, nor did it stave off AIDS in HIV-positive people. Nevertheless AZT continued to flourish worldwide.’ Moore responded: ‘The Concorde study is a classic study but we must realize that they used AZT as a monotherapy, meaning it was used on its own. The days of using AZT as a monotherapy are gone.’ Would it be reasonable to understand from his answer that administered alone without other drugs AZT doesn’t actually extend life after all? And that he was retracting his false claim in his press release? For which he would have been gaoled had it been uttered in a court of law. Being perjury on oath. Even if wrapped in virtue: ‘... the company honestly believes that in this case the President has been misinformed.’ Not the sort of guy Ralph Waldo Emerson would have had round to dinner, since, ‘The louder he talked of his honour, the faster we counted our spoons.’

As for Moore’s claim that ‘AZT has improved the quality of life of millions of people living with HIV/AIDS around the globe’, his first fib was in the price. Limiting it to the rich in the First World at the time, and not around the globe in any meaningful sense at all. The second is that millions have taken it. That isn’t true either. There are no records, but critics fear that a few hundred thousand could have been exposed. Thirdly, it would surprise any oncologist to hear a drug manufacturer claiming chemotherapy improves the quality of patients’ lives. AZT being just that. The opposite is notorious – something to bear with courage and strength. For instance, Keith Kroebbel was asked how he felt taking AZT in the 1994 BBC Panorama television documentary, A Ray of Hope: ‘As if I had been poisoned. Very, very seasick. It wasn’t a throwing up kind of nausea, it was a seasickness that was in my bones, and headaches, inability to concentrate or respond.’ And on stopping: ‘I felt great. I felt so much better.’ Studies by Wu, and by Lenderking et al. pertinently looking into what AZT does for the ‘quality of life’ of people taking it found precisely the opposite of what Moore alleged. We’ll be dealing with the studies soon. A new one by Bechtl et al. confirms them too. Moore’s lies are so flagrant, you’re left shaking your head. But then again kids, this is a pharmaceutical executive talking.

After SAPA’s loan of its news service to GlaxoSmithKline for free propaganda airtime, it reported a statement by Tshabalala-Msimang made directly after the parliamentary session in which Mbeki ordered AZT investigated. Supporting him, she confirmed that there was indeed

a body of scientific research and information which indicated that AZT was a dangerous drug, and had not been designed for the treatment of HIV/AIDS. Because it was unable to target only the human immunodeficiency virus when it went to work in the body, it further weakened the immune system. There was also a danger that ... mothers taking the drug might produce children with disabilities. Tshabalala-Msimang said her ministry would not like to look back ten or fifteen years down the line and find it had exposed the vast majority of historically disadvantaged people in South Africa to a dangerous drug. … there was no data proving that AZT was of any use to rape victims.

And as she added in a statement to the SABC, she was considering how best to investigate the matter ‘so that we really have concrete information in our hands’. All spot on.

But quoting from the company press release, SAPA gave Moore the last word: Mbeki was irresponsibly encouraging parliamentarians to research the drug on the Internet for themselves, Moore said, because they might come across materials that doctors had not vetted. But the literature to which Mbeki was referring came straight out of the medical press, all of it peer-reviewed. Published on the Internet for professionals to read. In line with one of the Internet’s original purposes: the rapid communication of scientific information. But eventually serving an unintended function: democratizing it. So that it’s accessible in the contemporary electronic age by lay people too. To anyone who just takes the trouble to look for it. Mbeki was raising ‘unwarranted concerns’ about AZT’s safety, Moore added; patients might even ‘stop the treatment without consulting their doctors’. Having regard to all the direly negative medical literature published about AZT, much of it recent – crucially Papadopulos-Eleopulos’s et al. damning A critical analysis of the pharmacology of AZT and its use in AIDS, their monumental analysis and critique published a few months before as a special supplement to Current Medical Research and Opinion – one must assume that Moore finds browsing through Fortune more interesting than Lancet or Biochemical Pharmacology. But Moore and his local CEO John Kearney were later to concede privately that Mbeki wasn’t so wide of the mark after all.

Working over the weekend in a frantic damage-control exercise – one can imagine the international faxes flying – Moore amplified his company’s not guilty plea with a new adjective. The Sunday Independent quoted the company’s chinless wonder saying: ‘It appears that the President has been gravely misinformed about the safety aspects of AZT.’ If Moore intended the public to understand from this further Nixonian asseveration that his company’s drug was safe, the grave misinformation was his. Grave because as a statement for and on behalf of his company it was fraudulent. Even if he assured the rattled public on television a week later: ‘Glaxo Wellcome are a reputable company. We do not lie to people.’ But as the offal bubbled, lots more prevarication from the reputable company would follow.

The Sunday Independent article also quoted Moore repeating his complaint: ‘We have never been made aware by the MCC [Medicines Control Council] that there are any safety issues around the drug.’ This is not surprising: Debating AZT, expanded to include some of the political heat following Mbeki’s AZT talk in the National Council of Provinces, described how after Nature’s local correspondent, Stellenbosch University zoologist Michael Cherry, had criticised him in ‘Mbeki’s Claims on AZT are Problematic’ in Business Day on 18 January 2000, Mbeki sent him a copy of just-published review of AZT’s molecular pharmacology the following day, suggested that he ‘contact the Perth scientists ... directly’ (the authors, Papadopulos-Eleopulos et al.) and reproached Cherry for his slovenly journalese – stating that the ‘question we must all answer, including the scientists, is whether we should continue to harm the health of the women of our country to avoid “causing public confusion”’. On receiving the paper, Cherry asked Mbeki for a couple of weeks to consult a colleague about it, because he didn’t ‘know very much about this subject’. Finding two leading ‘AIDS experts’, Professor Gary Maartens and Dr Carolynn Williamson of the University of Cape Town, equally clueless, Cherry next approached South Africa’s top pharmacologist Peter Folb, formerly head of the Medicines Control Council for seventeen years. How Folb disgraced himself in lazily hashing a review of the paper was described in Debating AZT. Folb’s successor as director of the Medicines Control Council, Helen Rees, in charge at the time the controversy broke, and whom I directed to Current Medical Research and Opinion’s Internet archive at which the paper was posted, evidently didn’t understand it either. And so had no idea what the authors were talking about when discussing AZT’s ‘IC50’ or ‘inhibition concentration’, and the issue of its ‘intracellular triphosphorylation’. Didn’t bother finding out, before reporting to Tshabalala-Msimang that AZT was just fine. Or maybe she asked Folb. Which would have been about as much use as asking the dustman. But in any event, the first duty to keep abreast of the literature, and to react to it responsibly by pulling the drug, was that of the manufacturer and not of any licensing board. Particularly after the publication of Papadopulos-Eleopulos’s et al. exposé, blowing the whistle for game over. It was admittedly published in a high-class specialist academic medical journal, out of sight of the general scientific masses, but the company couldn’t have missed it: On 12 May 2000, a few months after it came out, Nature broadcast its publication in a dedicated feature article: [Current Medical Research and Opinion] editor defends publishing key AZT paper – after extensive fine-tooth combing peer-review over ‘many months … an extended period of time’. In short, because of its enormous implications, the paper was given the third degree treatment by its pre-publication reviewers, but they couldn’t fault it. After which there could be no defence of AZT. Except by the scientifically illiterate. Any more than mercurous cyanide for hosing down the female slipway. For ‘disinfection’. Or concentrated carbolic acid – alternating with the scalpel – for containing rowdy impudence in wives and daughters. Nipping it in the bud. Curing their ‘hysteria’. Which, believe it or not, they used to. One day we’ll be wondering with equal incredulity how it was ever possible that doctors gave people AZT, raped and pregnant women especially.

Stung by Mbeki’s disparagement of its goods, the mother company in Britain issued a public statement decrying the government’s investigation of AZT: ‘Our stance is that we do not regard the review as necessary or justified but we will in no way interfere with the review.’ Perhaps the company was still savouring the stink caused when the BBC documentary, A Ray of Hope, exposed its attempt to suppress negative findings about the drug, urgently conveyed ahead of the main report, by the overseers of the Concorde trials in a special preliminary letter to Lancet in April 1993, which concluded: ‘Concorde has not shown any significant benefit from the immediate use of zidovudine compared with deferred therapy in symptom-free individuals in terms of survival or disease progression, irrespective of their initial CD4 count.’ Findings negative enough for leading ‘AIDS expert’ consultant immunologist Professor Anthony Pinching in London to recommend, HIV carriers advised to stop their treatment, as the Daily Telegraph reported him saying on 3 April 1993: ‘It is now clear that AZT is not the answer and people should hang around until other [drug] trials are concluded. … [Concorde] brought us back to earth.’ And likewise, sufficiently cogent to inspire a one hundred-and-eighty degree about-turn in Dr Deborah Cotton of the Harvard School of Public Health, a member of the FDA advisory board that had recommended the licensing of AZT for prescription to asymptomatic HIV-positive people. Science quoted her three weeks later: ‘In my own practice, this sways me towards waiting before recommending AZT.’ But not Phase II trial leader Margaret Fischl, who told medical journalist Joan Shenton that she’d be continuing to give AZT to anyone with CD4 cell counts of less than eight hundred.

In AZT is Death, published in Spin in August 1993, Celia Farber reported Concorde trial overseer Dr Ian Weller’s comment to her: ‘I think it’s very hard, if you’ve been giving AZT to large numbers of patients, to swallow this result.’ Probed about whether there’d been pressure to massage the negative results, he responded affirmatively. ‘A woman standing next to him, also on the Concorde team, nodded emphatically and finally burst out: “Yes, there has been pressure, and it has been placed at the very highest level. … The most frustrating thing is that I can’t tell you about it.”’ Weller concluded, ‘We’ve carried out this study against incredible adversity, but we are not going to cave in to any pressure. We’ll win the battle in the end. We show the science; that’s all that matters.’

A couple of days after AZT’s big day in Parliament, I received a telephone call from Smuts Ngonyama, Head of Presidency and Communications in the African National Congress, asking me for details of the local and foreign AZT litigation to which I’d alluded in Debating AZT, and to which Mbeki had referred in Parliament. I filled him in about the Hayman case in preparation here (subsequently launched by the widow of an attorney killed by AZT), the Threakall case leading several others brought in England, and the Nagel, McDonnell and Emerson cases in the US – unaware at that point that the Threakall action had been withdrawn a month earlier, and the Nagel and McDonnell cases had stalled before take-off. He was pleased to hear about the triumphant Emerson judgment in September (to be discussed later), confirmed on appeal in a unanimous decision of the Maine Supreme Court a couple of weeks after our conversation.

A day or two later, Dr Kgalema Motlanthe, ANC Secretary-General, urgently requested a copy of my manuscript. If he had harboured any doubts about Mbeki’s judgment in the matter before that, Debating AZT swung it for him. His office immediately prepared a supportive press release, ANC Speaks on AZT / ANC Statement on the Outcome of the SADC Health Ministers on HIV/AIDS and the Usage of AZT, and sent it to me for preview and comment. That the AZT controversy just ignited by Mbeki was apprehended by the highest echelons of the governing party to represent a political hot potato with dangerously divisive potential among the party’s leadership cadres, to say nothing of the rank and file, was suggested by the fact that its first official public reaction – due for release, I was told, the following day – had not been shown to anyone else, apart from Presidential Spokesman the late Parks Mankahlana and Joel Netshitenzhe, director of the Government Communications and Information Service. At its core it read:

In the light of many uncertainties regarding the AZT drug, the South African Government needs to exercise utmost care and responsibility in taking a decision on whether the drug should be distributed on a massive scale to the public. The directive of President Thabo Mbeki to the Health Minister with regard to investigating these matters will effectively contribute to establishing these necessary facts. We express our support for ongoing research into the effects of exposure of children and mothers to these drugs.

As the ANC was busy settling the language of its press release in its final form, the South African Human Rights Commission issued a statement on 7 November asserting that Tshabalala-Msimang could be charged with human rights violations for denying AZT to pregnant women. Two days later the Medicines Control Council’s chairperson Helen Rees issued a ‘preliminary report’ assuring Tshabalala-Msimang that AZT was safe for such women. ‘The drug being out there is justified,’ said Rees eloquently. Yes, AZT had known side effects, some of them potentially serious, but the potential benefits outweighed the risks, she said. ‘Just remember that all medicines must be treated with respect. There is virtually no medicine that’s totally free of side effects’ especially ‘heavyweight’ drugs used to save people from life-threatening illnesses. ‘We always, always, look into it’ when people like Mbeki question drug safety. The safety of AZT was ‘not a static situation’, Rees said, and qualified the MCC’s hasty imprimatur by saying that another more detailed report was in the pipe for release in about two months time as the first was ‘fairly superficial’.

It certainly was, Helen. Faithful recitations of all the stock myths about the value of the drug, neither report dealt pertinently with recent foetal toxicity reports and the crucial triphosphorylation problem, notwithstanding that I had provided Rees with a copy of Debating AZT, which canvassed the toxicity literature, and had given her Librapharm’s Internet address at which Papadopulos-Eleopulos’s et al. recently published epitaph on AZT was archived, exhaustively reviewing the molecular pharmacology of AZT and concluding that not only is the drug very poisonous, it’s completely useless as an anti-HIV agent. In fact, that Rees hadn’t taken Mbeki’s concerns seriously emerged from a patronising statement she later made to Newsday in New York on 11 July 2000:

most researchers ... concluded long ago that the HIV-fighting value of antiretroviral drugs (such as AZT) were worth the awful side-effects they can trigger. … case closed. So what gives with South Africa? You can’t just view this matter as a health issue, South Africans wearily explain. You also must see it as a political issue. It’s all wrapped up in the South African liberation movement, observed Dr. Helen Rees, who chairs South Africa’s Medicines Control Council. Today, nothing is beyond debate – and that is a heady thing for this long-repressed nation. ‘I don’t have a problem with someone who says, “Go back and look at this again”,’ Rees said, because people need room to learn and grow.

The pity of it was that she felt above taking her own advice.

The final draft of the ANC’s press release, issued on 9 November put it this way:

The ANC is further encouraged by the preliminary report of the Medicines Control Council restating what President Mbeki and the Minister of Health had articulated about the known side effects related to AZT use as strengthening the call to ensure that maximum caution with regards to the safety of the drug is arrived at first, before further action is taken. In the light of many uncertainties regarding the AZT drug, the South African government needs to exercise the utmost care and responsibility in taking a decision to avail this drug on a massive scale, with regards to long-term safety and cost implications.

In its annual report for the year, the ANC took a stronger line, recording categorically that AZT would not be made available by the government because of ‘unanswered questions regarding efficacy and toxicity’.

I had single-handedly stymied an aggressive marketing initiative by the world’s largest multinational pharmaceutical conglomerate at the time, peddling a useless and extremely toxic drug for wide-scale administration to pregnant women, overwhelmingly poor and black. It was an immense relief to me. A thrill too, even as I worried daily about retaliation, given the gargantuan stakes. A friend told me that GlaxoSmithKline ‘hated’ me – and throughout the ranks too: his conversation in a bar with two of its street-level sales representatives had suddenly gone very sour at mention of my name. Retaliate the company later did, but luckily the bullet, so to speak, missed.

On 3 November Associated Press reported the medical establishment’s backlash to Mbeki’s AZT safety inquiry directive. Casting him as misinformed and irresponsible, the article went: ‘... his claim that a widely used AIDS drug is dangerous has set off an uproar, producing bafflement and shock among physicians and advocates who say AZT is safe. … The controversy threatens to set back efforts to fight the disease.’ The report scoffed at Mbeki’s statement that there is a ‘large volume of scientific evidence alleging that, among other things, the toxicity of this drug is such that it is in fact a danger to health’, and his allusion to ‘dire warnings’ – issued by the likes of Hayakawa et al. in 1991: ‘... it is urgently necessary to develop a remedy substituting this toxic substance, AZT’; Lewis and Dalakas in 1995: ‘... the prevalent and at times serious ... mitochondrial toxic side effects are particularly broad ranging with respect to their tissue target and mechanisms of toxicity: Haematological; Myopathy; Cardiotoxicity; Hepatic toxicity; Peripheral neuropathy’; Papadopulos-Eleopulos et al. in May 1999: ‘... the scientific literature [elucidates] a number of biochemical mechanisms which predicate the likelihood of widespread, serious toxicity from use of this drug’; and Brinkman a month before his speech: AZT and similar drugs ‘are much more toxic than we considered previously’.

Without ascertaining what studies he had in mind, the news service countered reflexively, jumping to take sides with Mbeki’s detractors: ‘Reputable scientists have issued no such warnings, and it was unclear what he was referring to.’ No doubt the scientists just-mentioned would marvel at learning that they had all been cast as disreputable. AP then trotted out some ‘reputable scientists’ to straighten Mbeki out: Joseph Perriens, head of the care and support division of the UN AIDS program in Geneva, said AZT was ‘perfectly acceptable. … It causes slight side effects ... but ... so do many medicines.’ In fact, the research reports of real scientists, as opposed to fat-butted medical bureaucrats in soft jobs bouncing drug company sales propaganda, told a different story. ‘Worries about AZT’s safety surfaced in the early 1990s but have long faded,’ he said. Actually, not faded, but not acted on. Perriens urged Mbeki to ‘inform himself better about the toxicity of [AZT], which is not really as serious as he thinks, and he should probably recast the debate in terms of cost. [He’s] not doing his people a service.’ Had the UN guy kept abreast of the literature, current in particular, he might have rendered a better one himself. Saul Johnson, a paediatrician giving pregnant black women AZT at Chris Hani-Baragwanath Hospital, found Mbeki’s statements ‘very distressing because it sets back the whole agenda [and raises] the issue of where he gets advice’. The Medical Research Council’s director of AIDS research, Salim (‘Slim’) Abdool Karim remonstrated: ‘I think if the President doesn’t want to provide AZT, he should find an excuse based on fact.’ As if Karim had the facts, and Mbeki didn’t. ‘It’s the standard of care in many countries,’ he said. Which is not saying much, when one considers that most useless and poisonous medicaments, universally popular in their heyday but now abandoned and unthinkable, once wore the same epithet. ‘I can only assume that he has been given this information and accepted it in good faith. I don’t think the President would deliberately try to mislead us.’ Karim clearly didn’t consider the amazing possibility that the head of the country was actually much better informed than the roly-poly ignoramus heading the country’s AIDS research programme. Telling us at about the same time that there was ‘no new evidence in the medical literature in the last year on the adverse effects of AZT’. After a whole lot.

The experts all sounded like John Moore at the Aaron Diamond AIDS Research Centre at New York’s Rockefeller University (now at Cornell University) – perhaps the loose equivalent in rank as an AIDS prelate to the Vatican’s Cardinal Ratzinger (before his ascension) – in his letters to me before my excommunication. (The terse warrant he issued is contained in Debating AZT):

Mr Brink, I have read your articles on AZT published in the Citizen. It is sad that you are uncritically championing the view that AZT is a poison, since what you say is substantially incorrect scientifically, and you potentially could cause great damage to public health in South Africa if politicians listen to you. The absurdities of the Duesberg/Horowitz arguments were long ago revealed, and their cases destroyed, in the USA; they do not deserve to be thrust down the throats of the people of South Africa. … think before trying to damage the unborn children of South Africa in the future.

Actually I hadn’t made any ‘Duesberg argument’. Peter Duesberg, Professor of Molecular Biology at the University of California, Berkeley, and the best-known AIDS dissident, contends that the extreme toxicity of AZT arises from its indiscriminate and random termination of human DNA synthesis. I disagree, as we’ll see in Is AZT a DNA chain terminator? in the appendices. And Horwitz doesn’t have any arguments; he’s just wrongly thought by everyone to have first synthesized the drug – about which we’ll read in the scoop story that the true inventor told me, recounted in Inventing AZT at the end of this book.

Moore went on in a second endless plea to me under the heading, Why AZT is not poison. It’s an entertaining vignette, fabulously illustrating how constipated the medical mind can get. Substitute mercury or arsenic compounds for AZT as you read it – the big drugs a few decades ago, for which doctors would be struck off were they to prescribe them today – and you’ll get the idea:

Let me tell you why I found your articles so potentially damaging. At a time when AIDS researchers in the USA are trying very hard to persuade the South African health ministry to reverse Zuma’s absurd decisions on the provision of AZT to pregnant women, anything that plays into her hands and adds false credibility to her arguments is very dangerous. Granted, Zuma’s objections to AZT are based more on the fact that it is made by a Western company than on scientific grounds, but she is already poorly advised and does not need to be further confused. Perhaps her successor will show a more enlightened attitude to the health and wellbeing and her country’s children. … Nobody pretends that AZT is a miracle drug. In the context of established HIV infection, it does very little. It’s not powerful enough, and the virus can readily mutate to escape from it. But it’s a useful addition to some cocktails that include protease and other reverse transcriptase inhibitors. However, whatever AZT’s limitations in the context of preventing disease progression, there is rock-solid evidence from multiple trials in several countries that AZT reduces the rate of maternal-fetal HIV transmission.

The illogic of this latter contention never jars the ‘AIDS experts’. That AZT alone has been found ineffective to knock down all those mutating viruses infecting people ‘living with HIV’, but it works a dream they say, when fed to pregnant women. Especially given that AZT has no significant effect on what ‘AIDS experts’ call their ‘viral load’. And that the administration of AZT towards the end of a pregnancy to prevent the mother infecting her baby is going to be like closing the stable door after the horse has bolted – several months having preceded the treatment within which the virus will have had the opportunity to jump the gap via all that shared blood, and to ‘reverse transcribe’ itself, as the ‘AIDS experts’ explain it, indelibly into the baby’s DNA.

‘Put simply, for most children, acquiring HIV infection at birth is a death sentence, and the mode of death is pretty miserable. Stopping these, substantially avoidable, infections, even with a drug as weak as AZT, is the only sensible course of action.’ Though widely believed, like so many other medical superstitions, there is no epidemiological support for Moore’s claim by way of any controlled study: this idea that HIV-positive babies are doomed to die young. It’s a subject to which we will return. And as we read in Debating AZT, several recent studies have found that children exposed to AZT in the womb have a much higher mortality rate and incidence of serious disease and birth defects than unexposed children. Suffering ‘pretty miserable’ deaths – thanks to the pills their mothers were given.

‘Like all drugs, overdosing with AZT is ill-advised. If one takes too much of any drug, there will be toxicities. But the “AZT is incompatible with life” argument holds no water from the practical, clinical perspective.’ A study we’re still to discuss by Lenderking et al. found AZT to be life-threatening even at the lowest dose recommended by GlaxoSmithKline. And whatever one’s ‘perspective’, it’s hard to come up with any meaning for the skull and crossbones decal embossed on a broad orange stripe (industrial code for extremely dangerous chemical toxin) on bottles of AZT manufactured by Sigma Chemical Company for research use other than that AZT is a deadly poisonous substance.

‘You could use your writing to do good here, by helping persuade the South African government to save the lives of some of its unborn children by providing a useful, although not perfect, drug to HIV-infected pregnant women. The alternative is far, far worse.’ To which the recently late radical social critic Ivan Illich had a general retort: ‘The compulsion to do good is an innate American trait. Only North Americans seem to believe that they always should, may, and actually can choose somebody with whom to share their blessings. Ultimately this attitude leads to bombing people into the acceptance of gifts.’ Socrates had another angle: ‘The only good is knowledge and the only evil is ignorance.’

In a graduation ceremony speech at the University of the Witwatersrand on 1 December, UCT Vice Chancellor and World Bank director Mamphela Ramphele contended that the government’s sudden loss of enthusiasm for AZT evidenced a ‘lack of respect for a scientific base for health care planning’; that there was a ‘subtle but visible anti-intellectualism seeping into the body politic which discounts the value that experts can, and do, add to human development’; and that ‘the bitter fruits’ of this ‘anti-intellectualism’ were most evident in national AIDS policy. The absence of any ‘coherent management strategy yet developed by the government … results not from lack of expertise in South Africa, but in its disregard by those in government, with tragic consequences’. It was ‘nothing short of irresponsibility, for which history will judge it severely’. By real intellectual doctors like me, she meant. Who go for drugs like AZT. After reading the advertisements in our journals.

On the same day, World AIDS Day, visiting professional AIDS activist VIP, Cleve Jones, thought he would give the government what for, as he unrolled bits of his AIDS Memorial Quilt in Cape Town, the famous one that he’d started, and which he was carrying around the world on permanent holiday: ‘I have been asked to say to President Mbeki and the Parliament that this decision [to withhold AZT until shown safe] is contrary to the principles of the African National Congress and the constitution of South Africa.’ As if the American dropping in knew better than they did. ‘It is scientifically misinformed. It is economically unsound and it is morally bankrupt.’ Yeah, yeah, yeah. When’s your plane?

Mbeki’s indication in Parliament that he’d personally researched the literature on AZT published online – explicitly confirmed by his media liaison officer two days later – ricocheted around the world, with journalists adding a negative gloss to their reports in order to discredit his concerns about the drug. For instance, Financial Mail editor Peter Bruce wrote on 5 November: ‘It was, I think, Newsweek that alerted us to the fact that our President is an Internet junkie. Apparently he spends hours on the Web late at night, trawling for useful speech material he can’t find in the local media. So when he was pounced on the other day for daring to question ... the efficacy of AZT as an anti-Aids drug, I did a quick Web search of my own.’

Bruce hit an archive of lay articles about AZT posted by Dutch AIDS dissident activist Robert Laarhoven at – ‘denigrating AZT as a danger to human life’, Bruce said – but he admitted that he was struck by the sinister sight of Sigma’s orange Jolly Roger label for AZT. (It’s no hoax – I have a 25 mg phial of AZT bearing the famous insignia.) The equivalent of that yellow badge for nuclear hazard – stand back. Who in their right mind wouldn’t be startled? That the stuff is lethal is the very point of the label’s Zyklon-B warning, thrice announcing ‘Toxic’ in English and several other languages, with the message driven home by it’s funereal decal set against the deadly colour. Bruce advised however that Mbeki desist from searching the Internet for information on anything because ‘there is a lot of rubbish’ there. Thanks for that, Pete. Presumably you weren’t referring to the US National Libarary of Medicine with its fifteen million papers archived online.

‘Most times, coming up with something new works for him and makes him seem learned and deep.’ Bruce’s facile comment captured perfectly white reaction to Mbeki’s announcement. In common with white journalists and commentators in South Africa and elsewhere, Bruce was unable to conceive of the possibility that on the subject of AZT Mbeki was indeed ‘learned’, that he really was onto something ‘deep’: an enormous public health issue that everybody else had missed, and that his intervention, sparing thousands of African babies the effects of exposure to the drug in the womb, might in time be judged visionary, heroic.

Bruce went on: ‘Sometimes he may, just may, bump into something truly nutty and repeat it. … it is worth musing on the capacity of some powerful people to become intrigued by things they do not fully understand or cannot fully explain.’ Particularly the non-Europeans. Not so hot at science and mathematics, as the old government said. With such deficits, Mbeki must have battled to ‘fully understand’ the ‘truly nutty’ conclusion of Papadopulos-Eleopulos’s et al. thirty-thousand word analysis and critique of the bio-chemistry of AZT – the one he’d sent to Nature’s South African correspondent, asking whether he’d read it, as he himself had done:

AZT underwent clinical trials and was introduced as a specific anti-HIV drug many years before there were any data proving that the cells of patients are able to triphosphorylate the parent compound to a level considered sufficient for its putative pharmacological action. Notwithstanding, from the evidence published since 1991 it has become apparent that no such phosphorylation takes place and thus AZT cannot possess an anti-HIV effect. [Mbeki is alive to the triphosphorylation problem, and has twice been reported mentioning it.] However, the scientific literature does elucidate ... a number of biochemical mechanisms which predicate the likelihood of widespread, serious toxicity from use of this drug … Based on all these data it is difficult if not impossible to explain why AZT was introduced and still remains the most widely recommended and used anti-HIV drug. [The continued administration of AZT] either alone or in combination ... to HIV sero-positive or AIDS patients warrants urgent revision.

Parliamentary Opposition reaction to Mbeki’s revelations about AZT was as dull as the media’s. The Inkatha Freedom Party’s AIDS spokesperson Ruth Rabinowitz MP expostulated: ‘AZT is the cornerstone of AIDS treatment ... Anyone questioning these facts, questions the integrity of the entire body of 20th century science and of the scientific and medical fraternity, and suggests a conspiracy of vast unprecedented proportions.’ Only, mercury and arsenic were the cornerstones of syphilis treatment until a few decades ago. Without any conspiracy. And that AIDS looks a rerun of an old history movie. With a fearsome sex disease burned out best, said the doctors – and now again – with some of the deadliest poisons imaginable. Paraphrasing Democratic Alliance MP Mike Ellis, the Natal Witness report described him tipping his hat to the party’s masters in the marble halls of Johannesburg: ‘By directly questioning the operations of one of the world’s largest pharmaceutical companies, the government is sending the wrong signal to other multinationals seeking to set up operations in South Africa.’ DA leader Tony Leon instinctively took GlaxoSmithKline’s side in the Daily News on 22 December: ‘President Thabo Mbeki muddied the waters ... by quoting dubious sources on the supposed “toxicity” of this drug. Closer to the truth is that the government simply does not want to pay for it.’

I was the ‘dubious source’. After a telephone call to Ellis, I’d sent him Debating AZT to give Leon to read, ahead of a meeting Ellis told me they had imminently scheduled with Moore. To pat his feathers down. A chicken struck on the head with a stone. Clucking indignantly. Apparently the attorney wasn’t much impressed by the content’s of the advocate’s brief. As we aren’t by Leon’s habit of impugning the integrity of those with whom he disagrees (more to follow).

And it didn’t come as too much of a surprise reading a view of the matter taken by ‘Dr Des Martin, president of the HIV/AIDS Clinicians Society, which represents the country’s expertise in antiretroviral therapy’, as the Sunday Independent billed him on 14 November in Mbeki ‘out of step’ over AZT safety fears: ‘It works, it is a godsend, it is preventing thousands of children being born HIV-positive.’ The MRC’s Karim, to whom I’d sent Debating AZT earlier in the year, said in another article in the same newspaper, The denigration of AZT outdated and irresponsible: ‘I think well-meaning individuals like that fail to draw the distinction between therapy and prophylaxis. All the evidence they quote from is from old therapy studies and largely therapy for adults.’ The ‘individual’ was I, described in the report as a ‘sceptic apparently engaged in a crusade to discredit AZT [who] declined to be named or quoted’ (as Roberts had requested, asking me to keep my head down). Karim told me on the phone that he’d received Debating AZT but not read it. Which, no doubt, is why he misrepresented it. ‘Therapeutic doses are different from prophylactic doses used for mother-to-child prevention, so they’re missing the point. They’re making a counter-argument against an argument we’re not making.’ Karim’s contention seemed to be that therapeutic doses might be unacceptably toxic but not prophylactic ones. (In fact the doses are the same.) To this weary lawyer, his wordplay had the familiar rhythm of a fraud accused tap-dancing around the point. That my main concern was precisely the grave harm to which babies in the womb are exposed via so-called AZT prophylaxis was reflected in my detailed piece in the Citizen two days later: Is AZT safe for babies? It was an excerpt from my much-expanded Debating AZT manuscript. Which Mbeki and Tshabalala-Msimang had taken the trouble to read. The country’s AIDS research boss hadn’t bothered.

An isolated call in South African journalism for a reasoned response to Mbeki’s AZT safety inquiry directive, out of tune with all the angry shouting, was by Citizen managing editor Martin Williams. The day after Mbeki’s initiative, Williams’s editorial, Mbeki right about AZT, commented that he had

behaved impeccably in this matter ... sensibly taking cognisance of a substantial body of medical ... data. … In doing so he has opened up the debate rather than trying to stifle it, as Glaxo Wellcome seems to prefer. The drug company expressed concern that Mbeki was encouraging parliamentarians to access information about AZT on the Internet. Why shouldn’t decision-makers, or anyone else, read whatever is available in order to make up their own minds?

A week later, responding to the furious local and international condemnation that Mbeki had drawn, Williams’s editorial, Mbeki is not misinformed, displayed Sigma’s skull and cross bones AZT label, and, providing some addresses of Internet databases for readers to look at, urged them to research and think the issues through themselves and draw their own conclusions – a distinctly thoughtful suggestion from the journalist responsible for getting the ball rolling by publishing my essay, AZT: A Medicine from Hell, earlier in the year. And University of California African history professor Charles Geshekter’s wet blanket on the African AIDS scare a couple of months before that.

Nature, the world’s loftiest scientific journal, was not amused by the unprecedented intervention of the unruly politician from the colonies. Bridling at Mbeki’s meddling intrusion into the hallowed preserve of the medical and scientific establishment, it published a critical report by its local correspondent Cherry on 4 November. Under the title, South Africa says AIDS drug ‘toxic’ (with inverted commas to pooh-pooh the worry), it blithely discredited Mbeki’s concern that ‘our country [should not] take the irresponsible step of supplying AZT ... until the drug’s safety was established’ by insinuating that he was a heartless phoney: ‘The statement was being seen as an attempt to justify the government’s tardiness in making AZT available in state hospitals even to rape victims and pregnant women.’

Cherry’s article was endorsed by a derisory covering editorial, written with the inimitably imperious hauteur of an Englishman talking to his wayward wog: Keeping the record straight on AIDS: Recent statements by South Africa’s president on the hazards of AZT need a sympathetic but firm response. A highlight of the lesson was its repeated use of the word ‘firm’ – the right thing to be when dealing with the natives. Not toeing the line. And the sentiment ‘sympathetic’: these easily baffled sambos need to be shown the way.

Firmly. Like at Amritsar in 1919. After which, General Dyer mentioned the gratification he fetched from watching his men firing for a solid ten minutes into ‘that seething mass of sweating niggers’ trapped inside the walls of the enclosed city square. Delivering a ‘moral lesson’, he told the subsequent inquiry. In how to behave. Likewise, closer to home, after Colonel Graham ‘cleared’ the Eastern Cape Zuurveld a century earlier, by dispatching with powder and ball just about every Xhosa man, woman and child encountered, Cape Governor Cradock assured Lord Liverpool, Secretary of State for the Colonies, that ‘The whole of the Kaffir tribes have been expelled from His Majesty’s territories ... and I am very happy to add that in the course of this service there has not been shed more Kaffir blood than would seem to be necessary to impress on the minds of these savages a proper degree of terror and respect.’ And in a precursor eighty years ago to Bush’s recent sport, Churchill, then Colonial Secretary, scorned the ‘squeamishness’ of those horrified by his use of English poison gas against the ‘uncivilized tribes’ of Afghanistan. Right after the atrocities of the First World War. It was the ‘application of modern science to modern warfare’, he said, to ‘spread a lively terror’ in order to ‘procure a speedy termination of the disorder which prevails on the frontier’. From the same firm guy, risen to Prime Minister two decades later, to deliver the Germans a lesson at Dresden and Cologne. Doing his duty.

Assuring us, despite the abundant contrary evidence, that ‘AZT and its successor treatments [are] the most effective weapons against the disease’, the editorial chided Mbeki incoherently, huffing and puffing pompously:

raising questions about the desirability of treatment using AZT [notwithstanding] its acknowledged toxicity [on the basis that] taking such concerns seriously is one thing; endorsing policy statements that appear to be based on an incomplete understanding of the scientific principles involved, with potentially tragic consequences, is a different matter. The criticisms currently being voiced in South Africa, where the disease has a stronger hold than anywhere else in the world, are familiar. But they have also been carefully assessed, and in most cases firmly rejected, by those best placed to make such judgements, namely the world’s leading scientific experts. … The positions already taken by the Medicines Control Council and the Medical Research Council give optimism that sound reason will eventually prevail. Hopefully, the government will choose to listen to them rather than to others whose glib appeal masks an obscure agenda.

A clever playwright writing a burlesque parodying an English doctor with a public school tie couldn’t have come up with better lines.

The guy with the ‘glib appeal’ and ‘obscure agenda’ to whom Mbeki was listening was revealed in Nature two weeks later. Pointing an indignant prosecutorial finger in an article, AZT critics swayed South African president, it charged that there is ‘evidence that the president may have been influenced by a Pietermaritzburg-based lawyer, Anthony Brink’. The lawyer’s writs had annoyed Medical Research Council president William Makgoba too: ‘... remember that I am the scientist and not you.’ But Einstein anticipated the complaints fifty years earlier: ‘We should be on our guard not to overestimate science and scientific methods when it is a question of human problems; and we should not assume that experts are the only ones who have a right to express themselves.’

A fortnight later another article in Nature, entitled Concern at cheap AIDS drug fears, bewailed a joint statement ‘issued by the health ministers of South Africa, Botswana, Zambia, Namibia, Mozambique, Swaziland, Lesotho, Zimbabwe, Malawi, Tanzania, Angola and Rwanda at a meeting in Johannesburg this month’ in which the ministers stated their ‘grave concern over possible side effects as a result of their toxicity’ and called for research into the effects of ‘unnecessary exposure of children and mothers to these drugs’. Stating the terribly obvious, Cherry wrote: ‘This action is understood to have been heavily influenced by the South African government’s position.’ The lead theme of his piece was that the US Elizabeth Glazer Paediatric AIDS Foundation had been miffed by Mbeki’s statements because they threatened to derail its plan to spend the million dollars that it had allocated to buy AIDS drugs. (The Wall Street Journal told us on 12 July 2000 that the foundation had panhandled $15 million more from the Bill and Melinda Gates Foundation for the same purpose.) Heck Lizzie, we can’t have these Negroes in Africa deciding for themselves what’s good for them and their kids. (And thereby messing with the corporate agenda that our philanthropy actually serves). They must be helped. By Americans, who know what’s best.

The Star noted on 9 November that Mbeki’s startling parliamentary announcement had resulted in GlaxoSmithKline being ‘inundated with calls from concerned patients and medical professionals on whether they should continue using AZT’. This called for damage control, and pronto. The company’s top local officers, Kearney and Moore, requested an urgent meeting with Tshabalala-Msimang, their purpose announced in the same article, which reported that they were ‘scheduled to hold talks today with the Health Ministry to clarify Mbeki’s claim that the widely used drug is dangerous’. In other words pretend that it isn’t. Although the company had persistently denied Mbeki’s claim in Parliament that there was a large body of medical literature on AZT’s dangerous toxicity, Health Director General Ayanda Ntsaluba said after the meeting that ‘Glaxo acknowledged, in response to a comment from the Minister that the concerns raised by Mbeki were not new’, that ‘it was fair to say there was no consensus among scientists on the safety of AZT’, and that the company had accepted the view expressed at the meeting by Tshabalala-Msimang that ‘there was nothing irresponsible in Mbeki raising these concerns’. Ntsaluba added that the company had promised its co-operation in the safety enquiry by delivering all available relevant data. The promise was broken. None of the published papers reviewed in Debating AZT, which reported the profound cellular toxicity of the drug, were passed on to the MCC for consideration. That much emerged from a further false statement by Moore, made to the press immediately after the meeting, and reported by the Natal Witness the following day: ‘The review ordered by President Mbeki of the anti-AIDS drug is neither necessary nor justified … there is no new data [sic] that will raise legitimate concerns about AZT’s safety.’

In point of fact, two months earlier in September, Brinkman noted in Lancet that AZT and similar drugs

are much more toxic than we considered previously. … The layer of fat-storing cells directly beneath the skin, which wastes away ... is loaded with mitochondria [intracellular organelles crucial to energy metabolism] … other common side effects of [AZT and related drugs are] nerve and muscle damage, pancreatitis and decreased production of blood cells … all resemble conditions caused by inherited mitochondrial diseases.

And Blanche et al. noted in the same issue: ‘Our findings support the hypothesis of a link between mitochondrial dysfunction [in babies] and the perinatal administration of prophylactic nucleoside analogues’ – their findings being eight children born with mitochondrial dysfunction, that is, seriously impaired energy metabolism and corresponding muscle and other cell damage, resulting in cardiomyopathy and muscle weakness. Five children, of whom two died, presented with delayed neurological symptoms (severe brain damage in the form of massive cortical necrosis, cortical blindness, epilepsy and spastic tetraplegia) and three were symptom-free but had severe biological or neurological abnormalities. Four of the children had been exposed in utero to AZT and 3TC (a similar drug) combined, and four to AZT alone. None were HIV-positive. In advance of publication of Blanche’s et al. findings, the UK Committee on Safety of Medicines had issued a warning to doctors on 7 July 1999 about ‘the risk of mitochondrial dysfunction in infants born to HIV infected mothers treated with zidovudine (AZT) to prevent vertical transmission.’ But reporting this, in a sparkling illustration of the AIDS activist mindset at work, (an online clearing-house for AIDS drug propaganda, like our own industry-supporting Health-e) added its own advice: ‘... it is important that women do not stop their treatment in an unplanned way due to scare stories about the effects of antiretrovirals on unborn children.’ Scare stories.

On 16 November, a little over two weeks after Mbeki’s address on AZT in Parliament, Tshabalala-Msimang backed Mbeki on the toxicity of AZT in an extensive, closely reasoned statement to the House. What was clear from it was that she was well on top of the research literature on the drug. Her main points were that AZT remained much too expensive for the government to buy for mass distribution whatever its merits; but moreover, it was a failed chemotherapy too poisonous for cancer treatment, and was itself a proven carcinogen in rodent studies – all as reported in the literature reviewed in Debating AZT. Some highlights:

AZT is a drug that was developed for use in chemotherapy for cancer patients. It was, however, never used in cancer patients because it was regarded as too toxic to use. Tests have clearly shown that rats that were exposed to high levels of AZT for prolonged periods of time, developed vaginal cancer. [In fact, at human equivalent doses during pregnancy.] This is a very serious finding. Other toxicological data exists with respect to AZT, including damage to nerves, muscles and bone marrow. All of this data needs to be assessed very thoroughly. … As the Minister of Health I have a responsibility for ensuring that South Africans get appropriate and affordable healthcare. This responsibility extends to ensuring that no healthcare intervention has a long-term negative effect on people. With the evidence before me, I believe that the proper thing to do is to invite both the South African Medicines Control Council and a group of independent scientists, approved by Southern African Development Community health ministers, to review the use of AZT, and to inform me and other SADC health ministers of their position.

Although studies had been published supporting the use of AZT, she said, ‘there are other scientists who say that not enough is yet known about the effects of the toxic profile of the drug, that the risks might well outweigh the benefits, and that the drug should not be used.’

After canvassing the most obvious shortcomings of each and every research report published to date on the claimed benefits of using AZT in pregnancy to prevent mother to child transmission of HIV (MTCT), Tshabalala-Msimang emphasized that

there is evidence of the toxicity of AZT that has been published in scientific literature. For example, baby mice that were exposed to AZT through the placenta of their mothers, developed tumours. Over the past two years additional toxicological data has been published in the scientific literature raising similar toxicological concerns regarding MTCT exposure in studies performed in monkeys and in humans. … [The] toxicity debates around the various drugs are particularly marked in the issue of MTCT. The toxic effects of the drugs in babies is doubled because they get their own dose of the drug, plus they get a dose from their mothers during labour and delivery.

And, more importantly, during gestation.

Tshabalala-Msimang cited the warning from history that I sounded in Debating AZT:

We have to bear in mind that drug-related horrors do occur. This is all too apparent when we remember that a drug called Stilboestrol, which was given to pregnant women and which for years was considered perfectly safe, was later found to cause vaginal cancer in young girls whose mothers had taken the drug. We have to be very, very careful. And so, from time to time, drugs that were considered to be safe, do get withdrawn from the shelves when side-effects are discovered. This is normal. It happens all the time.

She concluded by pointing out: ‘This is a very difficult question that we are trying to answer as more research data becomes available to us. … We simply do not have enough information ... on the appropriateness of the drugs to make any decisions that might have long-term health effects on the lives of children born to HIV-positive mothers.’ As for the other use for the drug that the activists were clamouring for: ‘AZT was not registered in South Africa or anywhere else in the world for use by women who were raped … We have absolutely no idea of what the effects are, either short-term or long-term, of using AZT, a known carcinogen, on healthy people. The use of AZT [for HIV prophylaxis after rape] is, at the present time, illegal, aside from it being dangerous.’ And she was struck by the fact that ‘it is only in South Africa, and nowhere else in the world, that AZT has been registered … to treat health care workers following needle-stick injuries. This concerns me.’ Especially since there was no good clinical trial evidence that it actually worked for ‘this purpose’, she said.

Tshabalala-Msimang’s scepticism of the ability of the industry-friendly drones on the MCC to come up with anything but pusillanimous whitewash was evident from her proposal that independent scientists be engaged to assist in the investigation. Her gloomy apprehensions about the incompetence of the MCC were soon to be realised. But even the outside help she got proved useless.

The South African Cohrane Centre in Cape Town, to which she turned, is part of an international network of study groups advising governments on the value of medical interventions and treatments. Which should be ‘evidence-based’, they sensibly say. Tshabalala-Msimang may have been encouraged to learn that one of the founders of the Cochrane Centre group, clinical pharmacologist Andrew Herxheimer, Emeritus Fellow of the Cochrane Centre in the UK, and WHO advisor on essential drugs for developing countries, considered that AZT ‘was never really evaluated properly and that its efficacy has never been proved, but its toxicity certainly is important. And I think it has killed a lot of people, especially at the high doses. I personally think it not worth using alone or in combination at all.’

But if Tshabalala-Msimang was hoping for the same sort of independent, critical intelligence from the Cochrane Centre down here in Cape Town, she would soon be disappointed. For a start, the local centre was funded by and nested in the Medical Research Council, full of people feeding off the virus/chemotherapy line – which blew any possibility of an impartial take on the subject. And one of the two Cochrane staffers who reported to her on Benefits and risks of interventions aimed at reducing mother-to-child transmission of HIV infection. South African Minister of Health, Dr ME Tshabalala-Msimang, December 1999 was Patrice Matchaba, a gynaecologist, who, in the South African Medical Journal in April the same year, had just said hooray for AZT: Providing AZT in pregnancy – if not now then when? In fact, so enthralled was he by the chemical fight against AIDS that he was writing a novel about it, Deadly Profit (David Philip, 2000), all about how greedy the pharmaceutical industry is when it comes to pricing its life-saving miracle drugs out of reach. And then, when the book flopped, he took a job as director of the pharmaceutical giant Novartis. Just like that. Which all goes to show. His colleague Jimmy Volmink, it emerged from several papers he published afterwards, was a big fan of AZT for pregnant women too. And what he, as a specialist in Primary Health, knew about the toxic pharmacology of AZT was also zero, as Tshabalala-Msimang was soon to discover. No wonder she contemptuously chucked their report into the bottom drawer and ignored their requests to meet with her. What was the point?

Having thought, apparently, that if it simply ignored the uncomfortable story it would just go away, the US press now gave the South African AZT rumpus a belated note. On 25 November, tucked away on page thirteen, an article in the New York Times sought to discredit Mbeki and Tshabalala-Msimang’s concerns:

‘There is toxicity, but this is not a sweet, this is a drug,’ said Dr. Joseph Perriens, who heads the care and support program of the United Nations AIDS program in Geneva. ‘To combat a fatal disease, it is perfectly acceptable to use drugs slightly more toxic than an aspirin … AZT is a valuable therapeutic drug. Its efficacy is a very important consideration and needs to be taken into account.’ … Stirring a furor among doctors and researchers who treat patients infected with the virus that causes AIDS, government officials here have been questioning the safety of the standard anti-AIDS drug AZT, saying they suspect it may be too dangerous to justify its use. … The statements have touched off a flurry of protests from doctors and others concerned about AIDS in this country, which has one of the world’s highest rates of infection with H.I.V., the virus that causes the disease.

The Mail&Guardian appears to have been tremendously wowed by Moore’s assertion during a television programme about the AZT controversy on Carte Blanche on 7 November 1999 that ‘Glaxo Wellcome is absolutely serious about the safety of its drugs – it is absolutely paramount to the company’, because the once radical newspaper packed off its visiting American journalist Aaron Nicodemus to supplicate the corporate high priest for an authoritative refutation of Mbeki and Tshabalala-Msimang’s stated worries about the drug. One the public could confidently rely on. Right out of the mouth of the accused. Fantastic!

Moore had frankly acknowledged the validity of the government’s concerns about the safety of AZT at his meeting with Tshabalala-Msimang. But no sooner was he out the door than he pretended that there weren’t any. In his article, Truth and lies about AZT, published on 1 December 1999, Nicodemus quoted him thus: ‘Moore said AZT’s toxicity has been well documented. In the 28-day treatment of pregnant mothers and for needle-stick injuries, Moore said several studies have found no evidence of permanent side effects.’ Blanche et al., reporting death, blindness, spasticity, epilepsy and muscle-atrophy among AZT-exposed babies three months earlier in Lancet, didn’t consider them temporary inconveniences. Plenty of studies have reported that AZT ingestion even for short periods causes serious toxic side effects, as we read in Debating AZT. And the late South African attorney James Hayman discovered to his mortal cost. ‘Long-term use of AZT does contain risks, including cancer, anaemia and a reduced white blood cell count. These side effects develop in about five percent of patients who use the drug for more than six months.’ The percentage and the term that Moore claimed were childish inventions, the glib lies of a doctor unaccustomed to challenge from his patients or anyone else, contradicted inter alia by the results of the licensing study that preceded FDA approval of AZT in the US, and, notably, by the first formal investigation (to be discussed below) of the frequency of serious side effects from antiretroviral drugs reported for the first time two years later in 2001. ‘One has to look very carefully at the possible effects and benefits of any drug. Why is AZT being singled out? [Mbeki’s concern that AZT is dangerous, and Tshabalala-Msimang’s claim that it was shelved as an experimental anti-cancer drug because it is so toxic] is nothing new. If AZT is not safe, why has it been allowed on the market in South Africa for 10 years?’ You tell us, guv.

It was remarkable reading Moore, both a pharmacologist and a medical doctor with a veritable scrabble set of letters after his name, openly concede in the Mail&Guardian that AZT can cause cancer in people taking it. Because GlaxoSmithKline had never done so before. On top of those cited in Debating AZT, some more recent papers back him up.

Down to Earth, India’s leading science and environment magazine, ran an article, Role reversal: Anti-HIV drugs can mutate the genes of an embryo, in its March 2001 issue, citing a study by Walker et al.:

NRTIs [nucleoside reverse transcriptase inhibitors], such as AZT ... used for preventing the transmission of the AIDS virus from an expectant mother to her child may cause genetic mutation in the offspring. … Currently women are warned only of a theoretical risk. But studies conducted on rats show that offspring exposed to NRTIs as embryos can develop NRTI-induced cancers after middle age ( February 20, 2001).

As Walker put it, ‘We have confirmed that the risk is more than theoretical.’ The article explained: ‘During their study, the researchers compared 71 new-born rats which had been exposed to AZT alone or in combination with the drug with 3TC, another kind of NRTI. … They found significantly higher genotoxic and mutagenic effects in the exposed babies.’ But ‘the findings should not be considered alarming’, Walker said, because AZT is good at preventing babies from getting HIV from their mothers. Better to get cancer.

Dorrucci et al. reported in the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology on 1 April 2001 that rates of invasive cervical cancer in women ‘with long-term HIV infection continue to rise in the HAART era’, and, after some random speculations to account for why, finally suggested that researchers should take a closer look at the role of ‘antiretroviral therapy in the development of this disease’. Three days later Frisch et al. published an investigation of the association of HIV seropositivity (treated with what drugs we can reliably guess) and cancer in the Journal of the American Medical Association. Irrespective of the degree of the patient’s ‘immunosuppression’, they found a higher incidence of both ‘AIDS-defining’ and ‘non-AIDS-defining’ cancers than occurred among HIV-negatives. The authors surmised that some of these cancers – of the lip, testes, lung, penis, and soft tissue and blood – were ‘probably attributable to lifestyle factors among persons with AIDS’ such as smoking and human papillomavirus infection (that mangy scapegoat again). They didn’t think to consider a role for the treatment in the development of these cancers, we see. As Walker, Dorrucci and their colleagues did, in company with GlaxoSmithKline’s surprisingly frank Peter Moore.

But not honest for long: interviewed for Vivienne Vermaak’s documentary, The Truth on AZT, broadcast on 12 December, Moore was asked: ‘How does Glaxo react to new research which claims the drug causes cancer, birth defects and deaths?’ His response: ‘I’m not aware of the data that you’ve just mentioned to me.’

The MCC provided Tshabalala-Msimang with a second shabbily drawn report on AZT in late January 2000. At a parliamentary press briefing on 8 February, she disclosed that she’d rejected it too:

You will recall that in his address to the NCOP, the President instructed us to investigate concerns around the toxicity of the antiretrovirals. We have commenced with this task. We asked the Medicines Control Council (MCC) to make available to us information that would assist in determining the risk benefit assessments of the use of the antiretrovirals for different indications. The initial reports we got were not to our satisfaction. I have now recently received the latest report from the MCC which I am studying.

In the course of a radio interview on 15 March, Tshabalala-Msimang restated her dissatisfaction with the failure of the MCC to address the issue of AZT’s long-term risks in its reports, and said that she had commissioned further investigation. But four days later the New York Times reported her announcement that the government had decided not to provide AZT in public hospitals, for the reason that ‘There is not enough information for me as the Minister of Health to expose women to a drug that we do not know about.’

Word about the toxic trouble with AZT spread north: Zimbabwe’s Minister for Health and Child Welfare, Timothy Stamps, told the Zimbabwe Mirror later in the year, on 24 November, that ‘the side effects of taking anti-retroviral drugs outweigh the benefits’. He added that ‘without “supplementary drugs” that inhibit other “opportune infections” [sic] like meningitis and tuberculosis, the use of anti-retroviral drugs would not help much’. Even the faraway Russians took heed of Mbeki’s alarm clarion concerning AZT. President Vladimir Putin was interviewed in the same month on Austrian state television. Taxed by a journalist for withholding the drug from pregnant women, Putin’s answer was that its efficacy was uncertain and that it was dangerous, and that he needed healthy babies for his growing country and economy. When the journalist responded that such a position was irresponsible, Putin angrily quit the show.

Mbeki and Tshabalala-Msimang’s parliamentary statements about the dangerous toxicity of AZT were paralleled in the British House of Commons some fifty years earlier. From the late eighteen-hundreds until the early 1950s, a dreadful disease epidemic blighted thousands of English babies entering their second year. As their faces flushed red they became inconsolably miserable, wouldn’t feed, couldn’t bear light, and grew autistically detached from their mothers. In some cases fingers and toes dropped off from gangrene. Countless died – about a quarter of those who developed the affliction. Doctors variously blamed acrodynia or ‘Pink disease’ on long winters, proximity to rivers, bad food, a ‘peculiar neurosis of the vegetative nervous system of young children’, and, inevitably, on a virus. In one medical paper, the popularly rumoured possibility that the babies were being poisoned by the deadly heavy metal mercury in their teething powder had only to be stated to be rejected. (What better way to sooth teething pains than by simply poisoning off nerve cells in babies’ tender gums with a potent neurotoxin.) But public disquiet about the suspect ingredient persisted, eventually surfacing during question time in Parliament in 1951. Anticipating the coming heat, the patent medicine manufacturers dropped mercury from their teething powders – and from deworming medicines popular in Germany, where it was killing older children – whereupon the epidemic disappeared.

The reaction of medical experts fifty years ago to the impertinent implication by politicians of one of their medicines as the cause of the Pink disease epidemic exactly matched their later reception of Mbeki’s public statements about AZT. The Oxford Illustrated Companion to Medicine (3rd ed., 2001) tells that ‘Even when faced with strong evidence, powerful paediatricians refused to believe it or even test the evidence’ – their scepticism surely redoubled by the affirmations of contemporary tomes, such as their drug handbook, the 24th edition of Hale-White’s Materia Medica: Pharmacy, Pharmacology and Therapeutics in 1939, which described mercury as ‘one of the most valuable medicines we have. … Children take mercury very well.’ Except that doctors have rather different ideas now: Dreisbach and Robertson’s standard reference Handbook of Poisoning (Appleton & Lange, 12th ed., 1987) now advises that ‘The administration of mercury in any form to children should be avoided.’ Never mind swallow it, don’t even inhale stray atoms vaporising from spills lying in tiny floor cracks: ‘The exposure limit must be observed at all times; frequent air sampling is necessary.’ Other reasons for medical scepticism were the infrequency of Pink disease – identified in only about one in every few hundred cases of children soothed with mercurial teething powder, and the fact that mercury had been an established drug with a centuries-long history of use in Western medicine. Like AZT it was a ‘standard of care’. A great antiseptic, no doubt about it. Killing everything. Like an American search and destroy mission, shooting anything that moved, with possibly a couple of Vietcong among the dead. But within a couple of years of public and political identification of mercury as the cause of Pink Disease, the doctors came round. The 23rd edition of Martindale: The Extra Pharmacopoeia, published in 1953 noted: ‘It is suggested that pink disease is due to an idiosyncrasy to mercury. In Manchester, where the condition is common, there is a history in almost every case to the ingestion of mercury, usually as calomel [mercurous chloride] in teething powders, and in the urines of affected infants an excess of mercury has been found in three-quarters of the cases.’

The difference between the British and South African parliamentary involvements was that unlike those British MPs, Mbeki was not merely asking worried questions; he spoke of ‘a large volume’ of peer-reviewed clinical and research literature on the exceptional toxicity of AZT reviewed in Debating AZT – and still the ‘AIDS experts’ weren’t interested. No one wondered: ‘What’s he actually referring to?’ Because they didn’t want to. They’d made up their minds, and, as is universally known, there’s nothing as uncomfortable as having to change one’s mind about a passionately held conviction. Such as that AZT saves lives. It’s why Ofelia Olivero, a research scientist on the staff of the US National Cancer Institute, who has published several papers reporting the carcinogenicity of AZT in animal models, told me she finds so little interest in the implications of her findings for humans exposed to AZT in the womb. No one wants to know. Especially not the ‘AIDS experts’, AIDS activists and AIDS journalists who’ve irrevocably staked their reputations on it.

CHAPTER

Three days after Mbeki set off the siren about AZT, a former science journalist on the Star, Anita Allen, personally handed him some critiques of the HIV/AIDS model written by dissident scientists, which she’d downloaded off the Internet. She’d become aware of its problems in April 1999 on reading the AIDS chapter in Nobel laureate biochemist Kary Mullis’s book, Dancing Naked in the Mind Field (Pantheon, 1998). Her interest piqued, she ran an online search and hit an archive of critical papers, thereafter compiling a dossier of about a hundred pages worth and sending them to scientists she thought would be interested. But weren’t. So she sent them them to Mbeki under a covering letter, pointing out that contemporary AIDS science was all wrong. Three months later a handwritten note from Mbeki himself rolled off Allen’s telefax machine late at night, inviting her to meet the next morning. There she handed him four discs containing a huge collection of dissident papers. At the end of an hour-long discussion Mbeki asked her: ‘What exactly do you want me to do?’

Allen conveyed a proposal just made in an article for lay readers that had appeared in three parts in the Australian magazine, Nexus, commencing in June 1999, under the title A Great Future Behind It: The Yin and Yang of HIV. At the end of which, authors Valendar Turner (of the AIDS dissident ‘Perth Group’) and journalist Andrew McIntyre suggested that

it is inexorably drawing nearer to the time when world governments will convene an international, adjudicated debate on this subject. In contrast to the 13,775 participants from 177 countries who attended the June [1998] Geneva AIDS Conference, this should be a small gathering where a dozen or so experts from each side put their respective cases to a disinterested group of scientists of the utmost stature, for example, another dozen made up largely of Nobel laureates. There is a precedent [discussed by Glover in Nature 394:4] for such a ‘consensus conference’ or ‘conference de citoyens’ in common sense and ‘along the lines of a model invented in Scandinavia and since applied in the United Kingdom and elsewhere’. A ‘jury’ of 14 people ‘screened for independence from interested parties’ have issues ‘debated in front of them by scientists, non-governmental organizations, industrialists and other bodies.’

Mbeki agreed, anticipating big trouble coming: ‘I’m going to be slaughtered, you know.’ He was on the point of changing his mind about AIDS completely, and it would be quite a turnaround. In common with every other top member of the ANC, he had been taken for the ride, spooked by the claims of the ‘AIDS experts’ along with everyone else. Everyone but an initially unimpressed Mandela.

‘By 1989 we could see AIDS all around us in the countries where we were in exile and we were already seeing some HIV-positive comrades,’ said Ralph Mgijima, then ANC Secretary for Health based in Lusaka, Zambia, and later Superintendent-General of Health for Gauteng. Tshabalala-Msimang, who’d completed a spell as registrar in the gynaecology and obstetrics section of Muhimbili Hospital in Dar es Salaam, and earlier as superintendent of Lobatse Hospital in Botswana, shared the exiled ANC leadership’s rising alarm. Recounting in June 1992, she said: ‘I worked in Tanzania and I saw cases of HIV and AIDS in the early 1980s, and have been continually attending workshops and courses on HIV and AIDS since then.’ With a medical degree taken in Russian from the First Leningrad Medical Institute, a master’s degree in public health from the University of Antwerp in Belgium and a certificate in Health Care Systems Planning from the UK (on top of a Bachelor of Arts from Fort Hare before she left the country in 1962, and several English and American public health diplomas too), she founded the ANC’s health department in exile and got involved in the fight against AIDS early on, ensuring that it was put on the ANC’s policy agenda by the late 1980s.

In early 1989 the ANC convened a health workshop in Lusaka, at which AIDS topped the agenda. It was followed by another a year later in Maputo, a few months after Mandela was released from prison by the apartheid regime. Mkhonto weSizwe Commander-in-Chief the late Chris Hani worried there:

Some of us might regard this as a diversion from the important task of transfer of power to the people, [but it was imperative that we] learn to tackle these problems head on … Those of us in exile are especially in the unfortunate situation of being in the areas where the incidence of this disease is high. … We cannot afford to allow the AIDS epidemic to ruin the realization of our dreams. Existing statistics indicate that we are still at the beginning of the AIDS epidemic in our country. Unattended, however, this will result in untold damage and suffering by the end of the century.

Tshabalala-Msimang presented a paper at the Maputo conference, in which she argued the white feminist wisdom that ‘In a situation where women have no control over their fertility and the sexual behaviour of their partners, the prevention of AIDS becomes difficult’, and the white medical wisdom that prostitution among Africans, engendered by the migrant labour system, was the main vector for the spread of AIDS. Just as local virologist Barry Schoub and others had contended in the South African Medical Journal (74(4):153-7) the year before, offering wise advice for a radical social control programme: ‘Serious consideration will have to be given to efforts to shrink the promiscuous core of prostitution, irrespective of the guise under which it is practised. The role of legislative control of prostitution needs to be investigated, but what is more important is addressing the social and societal conditions which lead to prostitution.’ Meaning sweeping the streets and throwing all the black bitches in prison for a start, and then maybe relaxing apartheid a bit. (Not to be put off by the hobgoblin of consistency, or maybe he’d forgotten, just the previous year Schoub had reported in Transactions of the Royal Society of Tropical Medicine and Hygiene (1987;81(5):874-5) his finding: Absence of HIV infection in prostitutes and women attending sexually-transmitted disease clinics in South Africa . But then he’s the AIDS expert.)

As Mbeki would later point out, the idea that HIV spread during intimacy between the sexes was a new development, because the experts had all agreed at first that it was something only gays got. In 1983 the Director General of the Department of Health, Coen Slabber, stated that AIDS posed a threat to homosexuals only. But there would be no public health campaign about this, he said, because ‘Homosexuality is not accepted by the majority of the population and certainly not by the Afrikaans speaking population. To advocate that homosexuals use the condom is therefore very difficult.’ AIDS as the lot of gay men exclusively was the newspaper story too: ‘Homosexual’ disease kills SAA Staff reported the Argus on 4 January 1983, followed five days later by ‘Gay’ plague: More victims? in the Sunday Times. Well, this was after all what the American experts said, the New York Times reported on 11 May 1982: New homosexual disorder worries officials, and they’re clever.

A couple of years down the track, however, the medical and popular understanding that AIDS was a gay thing had been supplanted by the idea that AIDS was something for heterosexuals to fret about too. Whenever they met someone new. The government accordingly appointed an AIDS Advisory Group in 1985; but among heterosexuals an epidemic of AIDS was still regarded by government as a distant spectre: Willie van Niekerk, Minister of Health and Population Development, said in 1987 that ‘Although a relatively small number of cases has been diagnosed so far in South Africa, the disease certainly has the potential to become a major problem.’ Caused by South Africans having getting down too much: ‘Promiscuity is the greatest danger, whether one likes it or not,’ he warned the nation the following year. ‘We have to say that. It is a fact. There is no way one can say, “I still want to sleep around but I don’t want to get AIDS.”’ He added the year after that: ‘It has the potential to lead to chaos in Africa and South Africa, not only destroying the social and political structures but to lead to economic chaos.’ Ruben Sher, an immunologist on the AIDS Advisory Group, warned around the same time in similar vein that AIDS could become a ‘biological holocaust’, his popeyes bulging. Adopting her sort of Calvanist sexual morality was the only way to head it off, adjured van Niekerk’s successor as Minister of Health, Rina Venter, in 1990: ‘Everyone must strive for themselves and those closest to them to change their risky sexual behaviour and settle for a single sex partner, preferably within a marriage.’ Soon government sponsored AIDS Training and Information Centre (ATIC) branches were operating in every major city to spread the new message, nearly all run by young whites, and a special AIDS research programme was established by the Medical Research Council.

AIDS as a new idea didn’t spread naturally, even if the post-94 ideological climate was conducive – for reasons to be examined ahead. Like Nazi ideology in the thirties, the notion among the public that a newly mutated virus was jumping between genitals was implanted, germinated and watered by means of an intense propaganda campaign – more intense, extensive and sustained in South Africa than anywhere else in the world. Following on the apartheid government’s basic AIDS awareness initiatives, ‘Soul City’ was a private one founded in 1992 that sold its package of ideas about the new hazards of sex via ‘edutainment’ in print, radio and television media. ‘Soul Buddyz’ was a sub-project aimed specifically at preteens. ‘Beyond Awareness’ was launched in 1998: a multimedia project conducted by a consortium of non-governmental AIDS organizations on behalf of the National Department of Health’s HIV/AIDS and Sexually Transmitted Diseases Directorate. The project went beyond instilling the fear of AIDS; it was specifically contrived to dampen sexual activity, especially among the young. The following year an extraordinarily ambitious campaign called ‘loveLife’ was launched targeted at teenagers, applying slick commercial propaganda techniques to brand ‘safe sex’ as cool. Alleging on its website that ‘More than 5 million South Africans are living with HIV, more than in any other country in the world’, among other scare stories, it attracts its colossal corporate and government funding by claiming that ‘achieving carefully targeted reductions in high-risk sexual behaviour among young people – including delaying initiation of sex, reducing the number of sexual partners, managing STI’s, and increasing condom use – can dramatically change the course of South Africa’s HIV/AIDS epidemic. That’s the kind of change that loveLife is working to achieve.’ In 2001 the government assembled an AIDS Communication Team (ACT), a consortium of several organizations, to run the Health Department’s Khomanani AIDS information campaign – specifically to encourage people to ‘Get tested for HIV’, as a poster went, in order to ‘make healthy choices’, such as ‘Get early treatment’, right at the top of the list.

This propaganda drawing people into the pharmaceutical industry’s market for treatment with AZT and other AIDS drugs, with their poisoning symptoms seen as ‘progression to AIDS’, rechromed precisely the same medical leitmotifs founding the deadly Wassermann/Salvarsan syphilis con in the first half of last century. Health authorities urged the public to undergo the useless Wassermann test (legally mandatory before marriage in numerous American states) and, if they were positive, to submit to injections with arsenic – a patented compound of it called Salvarsan and its derivates, manufactured by Bayer in Germany. An American public health poster in the thirties claimed: ‘SYPHILIS…. SIX OUT OF TEN CURED BECAUSE THEY DID NOT WAIT TOO LONG’. In truth, on arsenic you can only go one way. (Doctors ascribed the consequent mental deterioration, other neurological impairment and other organ damage, heart especially, culminating in general paralysis, dementia and death, to tertiary- or neuro-syphilis.)

But there was a whole lot more to it than a burgeoning communications industry. In 1992 the AIDS sector really started taking off in South Africa. To address the declared new menace, the national budget for AIDS was quadrupled from R5.4 million the previous year to R20 million (that sum quintupled to R100 million two years after that, and climbing almost exponentially since). A tollfree national AIDS helpline was set up for the worried public to be worried even more by telephone counsellors talking about ‘window periods’ and the right strong American medicine to take and so on. In a joint intiative, the apartheid health ministry and the ANC established a collaborative of NGOs, local, provincial and national government, the ANC Health Secretariat, business, labour and clergy, and other interested individuals to draw a grand National AIDS Plan. Tshabalala-Msimang and Dlamini-Zuma, both ANC doctors in line for Cabinet positions, were prominently part of it. The National AIDS Coordinating Committee of South Africa (NACOSA) as it was called convened a conference in Johannesburg in October under the title ‘South Africa United Against AIDS’. United in the view that a new virus was ripping through the country, and nothing less than a national defence mobilized at the highest level of state would be able to stop it.

The whole project concerning the strange new disease identified a decade earlier by American doctors, for which Anglo-American multinational drug companies had just the cure, was financed by the American National Institutes of Health and several hugely wealthy American corporate philanthropies: the Carnegie Corporation, Atlantic Philanthropies, the Rockefeller Brothers Fund and the Ford Foundation, some of whom would become the backers of the the professional AIDS drug lobby group, the Treatment Action Campaign later on.

In 1993, with the ANC poised to sweep South Africa’s first democratic election set for the following year, NACOSA convoked a meeting of forty health experts to discuss how best to ensure that AIDS was put at the top of the ANC government’s agenda as a special project of the first importance. As Dlamini-Zuma, head of NACOSA’s strategy subcommittee later put it, ‘it was obvious that AIDS was going to be one of this countr’'s greatest crises – in terms of health and the economy – and that the government was not going to get around to doing anything unless prompted’. Cross-cultural fault-lines appeared in approaches aired there. When white delegates emphasized what they considered to be the primary role of migrant labour in the spread of AIDS – alleging that black miners consorting with city prostitutes were bringing HIV home to their rural wives – Health Minister in-waiting Dlamini-Zuma sighed: ‘White people just don’t understand the issues.’ But they dominated AIDS policy throughout the Mandela era nonetheless. The conference resolved to set up an independent advisory panel chaired by Dlamini-Zuma, to be called the National AIDS Council (NAC), and proposed a substantial governmental budget for an extensive media campaign, wide-scale education and support programmes, free condoms, and a standing national AIDS commission to operate out of the President’s office, to be headed by a deputy minister with executive clout over other departments.

But in April 1994 newly inaugurated President Mandela couldn’t see what the fuss was all about. He slashed the proposed budget by three quarters, and refused to be crowded by AIDS chatterboxes with long faces, talking about people having too much sex all the time. Other people. The National HIV/AIDS and STD Programme was situated in the Health Department instead. Tshabalala-Msimang was tucked away in Mandela’s Cabinet as Deputy Minister of Justice, although did take the chair of the parliamentary Health Committee. Years would pass before Mandela as President gave AIDS a public mention in South Africa. On 7 August 1998, addressing the National Council of Provinces in Parliament, Mandela warned at last:

There is another killer that haunts our land. The Department of Health reports that the provinces have introduced a wide range of initiatives to address the HIV/AIDS epidemic, as part of the national effort. And yet the reality is that we are as a nation not doing nearly enough if we are to avoid the situation towards which present trends are taking us – of some two million AIDS orphans in a matter of years, and a loss of 1% of our potential GDP. In order to harness the resources of our society more effectively in this critical battle, the government is working towards building an active partnership, across all sectors and communities, around practical programmes to avert this disaster.

Mandela’s initial coolness to the AIDS craze infuriated Nthato Motlana, his personal physician and prominent apartheid resistance activist: ‘I get so angry. I go to Mandela … and I give him hell. The response by the previous apartheid government was a national disgrace. The response by my government ... has also been disgraceful.’

Not as if Mandela was oblivious to all the enthusiasm. He’d delivered the opening address at NACOSA’s first conference. Quarraisha Abdool-Karim, later to be the first director of the National HIV/AIDS Programme, followed him to the podium as the next speaker, but he’d said it all, she said, and ‘there was very little to add. He knew all the issues, everything that had to be done.’ Indeed, he was full of how social conditions made ‘the black community even more susceptible to the sex related virus’, and the pressing need ‘to convince the majority of black South Africans to change their sexual behaviour’ to avoid ‘this scourge’. Sexually disciplined whites in the suburbs didn’t need such tutoring, his speech implied. But from Mandela’s subsequent lack of interest in AIDS when he took power, it was obvious that he hadn’t yet bought the whole spiel, and that what he’d been spouting were the fantasies of concerned white and Indian AIDS experts, who were running the AIDS show here, and who had written every word for him. Mandela would be reborn as a believer much later on, following an evangelical visit to his home by Judge Edwin Cameron.

Mandela unconvincingly explained his indifference to the festivities to David Dimbleby in the documentary Nelson Mandela: The Living Legend, broadcast on BBC One on 5 and 12 March 2003:

Africans are very conservative on questions of sex. They don’t want you to talk about it. I told them we have got this epidemic which is going to wipe out our nation if we don’t take precautions. ‘Advise your children that they must delay as much as possible before they have sex. When they do, let them have one partner and condoms.’ I could see I was offending my audience. They were looking at each other horrified.

So he took his advisors’ advice to drop the subject, he said: ‘I wanted to win and I didn’t talk about AIDS.’ Why didn’t he start jabbering about AIDS after winning, then? Because he ‘had not [had] time to concentrate on the issue’. In any case: ‘It’s no use crying over spilt milk.’ About which Cameron remarked: ‘He more than anyone else could through his enormous stature have reached into the minds and behaviour of young people. A message from this man of saint-like, in some ways almost god-like stature would have been effective. He didn’t do it. In 199 ways he was our country’s saviour. In the 200th way he was not.’ He didn’t go around telling his people that they needed to control themselves so they wouldn’t get sick and die about ten years later.

But in any case, the ANC’s 1994 National Health Plan for South Africa, drawn with helpful input of experts from the WHO and UNICEF, took AIDS very seriously, prophesying fearsomely:

Forecasts to the year 2000 predict that there will be between 4 and 7 million HIV-positive cases, with about 60 per cent of total deaths due to AIDS, if HIV prevention and control measures remain unaddressed. Similarly, credible predictions indicate that by the year 2005, between 18 per cent and 24 per cent of the adult population will be infected with HIV, and that the cumulative death toll will be 2.3 million, and that there will be about 1.5 million orphans. … In view of the devastating implications of the HIV/AIDS epidemic for South Africa, it is mandatory to define prevention and control interventions plus comprehensive care for those already infected, within the context of the Bill of Rights.

And on 21 July, soon after taking office as Minister of Health, Dlamini-Zuma announced that the Cabinet had considered NACOSA’s National AIDS Plan, and that ‘In principle, the government accepts the plan, but that doesn’t mean we’ll implement it word for word.’ Everyone was pleased.

At the ANC’s 49th National Conference in Bloemfontein in December, on the other hand, AIDS got nary a mention, aside from a single passing reference in a resolution concerning the ‘problems of youth’.

In 1995, without consulting the NAC, and with her officials circumventing conventional tender procedures, Dlamini-Zuma assigned R14.2 million of a European Union grant to the production of a AIDS awareness play, Sarafina II, inspired by an earlier musical of the same name that had been a hit in the US. When white AIDS activists and journalists slammed the show as a waste of money, both Mandela and Deputy President Mbeki spoke out in Dlamini-Zuma’s support. Mandela suggested that the pounding Dlamini-Zuma was taking over the play arose from pharmaceutical corporation antagonism on account of her unprofitable emphasis on prevention rather than treatment. Under persistent media and activist pressure, however, Dlamini-Zuma eventually called the play off, fairly questioning whether it would have been so savaged had its writer and producer, Mbongeni Ngema, been white. A further round of controversy was generated by the anonymous donation of R10 million to the Department of Health as a contribution to what was considered by critics as the wasted cost of the play. The donor was determined by the Public Protector to be ‘a white South African businessman’ with no stake in the affair, who was concerned that AIDS awareness should be kept up and who didn’t want to see the foreign donor pool drying up.

As far as Dlamini-Zuma was concerned, the NAC’s objection to the project marked the end of its relevance in formulating AIDS policy. She might also have grown tired of whites continuing to tell blacks what to do. A deal that emancipation in 1994 was supposed to have ended. Zweli Mkhize, ANC health MEC for KwaZulu-Natal explained the sentiment: ‘There is in this country a long history of whites telling us what do with our bodies and you’ll find some resentment of that still. There has always been this debate about Africans determining what is right for Africans, not whites.’ A point totally lost on AIDS Consortium director Morna Cornell: ‘I don’t think anyone can give a simple explanation for why our AIDS program has failed. But the race issue is huge. It’s like we eliminated apartheid but it left behind this huge wall that none of us knew how to tear down or get around.’ When the NAC’s members were put out again, this time by Dlamini-Zuma’s proposal that AIDS be made a notifiable disease, they sought a meeting. Dlamini-Zuma’s answer came in the form of a letter signed by Health Director General Olive Shisana telling their chairperson that their council was no more, and that they could all go home now. Thanks.

Shisana herself was off next, to take a job mid-year with the WHO in Geneva. In the fallout over the the procedural irregularities involved in the allocation of funding to the Sarafina project, Shisana blamed Dlamini-Zuma. But Mbeki stood by the latter, and had his office issue a statement in her support.

Cameron, gay founder and first director of the AIDS Law Project, co-founder of the AIDS Consortium and a member of the NAC from the start, was upset by all this. In February 1996 he approached Mandela for a powwow to discuss government AIDS policy. You people are messing it up.

At the time I chaired a national convention on AIDS, my co-chair and I made every effort we could to get an audience with President Mandela, and we didn’t succeed. … Our efforts, which were sustained and determined and insistent, to get President Mandela to involve himself personally in the epidemic were unsuccessful. … The fact is that President Mandela had a huge job. He saved our country. He didn’t do what we what we would have wanted on AIDS. Whether history will fault him, I’m not clear.

Mandela dismissively delegated Deputy President FW de Klerk to meet with him instead. Who listened indulgently but without much interest. In the flapping judge. In the middle of the meeting, de Klerk’s co-deputy unexpectedly strode in. On his arrival he gave Cameron a caring hug. Unlike Mandela and de Klerk, Mbeki took it all very seriously. He expressed his grave concern about the epidemic. He engaged animatedly with Cameron, and sought his advice on strategies and policy options. Recalling his tête-à-tête with Mbeki, Cameron told the New Yorker on 13 May 2003: ‘He really, really cared.’ A couple of years later, in Cameron’s view, he’d suddenly stop caring. Really.

Unlike Mbeki at the time, though, Parliament still didn’t care: when NACOSA held a seminar later in 1996 to brief parliamentarians on the alleged AIDS crisis, only fourteen MPs pitched up.

In January 1997 Dlamini-Zuma told Mbeki that she’d been approached by the promoters of a locally developed drug they called Virodene P058, based on a chemical called dimethylformamide, claiming that skin patches impregnated with it had helped AIDS sufferers. Mbeki was interested. The originator of this idea, Pretoria cardiothoracic surgeon Carl Landuaer, backed by cardiology professor Dirk du Plessis of the University of Pretoria, were invited to present their claims directly to a meeting of Cabinet on the 22nd. People claiming to have been cured by Virodene appeared before it. After a lengthy and moving presentation, there was clapping and cheering.

Medicines Control Council president Peter Folb heard what was going down and marched in to put a stop to it. This was not how one goes about getting a drug approved. It was irregular. Worse still, as boss of the MCC for seventeen years, he’d been left out. Virodene’s pluggers should have applied directly to the proper licensing authorities. To him. They weren’t doing it the right way, the way GlaxoSmithKline gets its drugs approved, for example. Now there’s a model of probity to follow. In how to go about getting your prescription drugs licensed. ‘Ethicals’ they call them in the trade – AZT, Lotronex and Relenza, for instance. About all three we’re still to read. And are sure to be amazed. And afterwards even more by the company’s repeated protestations that it’s an ‘ethical’ company. Odd, it is. Because weapons and automobile manufacturers and the like don’t go on so. Shakespeare called it protesting too much. Especially since the lesson from the approval of GlaxoSmithKline’s aforesaid drugs is that you just do whatever it takes. As long as you get that official stamp. Best from the big guys first, the American FDA. Because once you’ve got it from them, you won’t have to worry about small fry like Peter Folb and his MCC. They’ll fall in line, no questions asked. Every time. But fair’s fair. It’s the way of the world in the drug business. All over.

On 21 November Folb put out a statement alleging that people had suffered ‘severe adverse toxic reactions’ to Virodene, and warning:

The MCC has serious concerns, based on the best available scientific knowledge and advice, that Virodene is unsafe and potentially dangerous to humans when given as a medicine for HIV infection and AIDS. Virodene has not been shown to be of any benefit for this purpose. … Virodene is an impure industrial solvent and toxic substance, used in the plastics industry, and it is quite inappropriate for medicinal use in humans in the form and manner in which it is being distributed.

Folb went on to threaten every kind of criminal and civil plague on anyone ignoring him. Folb’s statement was no more that the most ignorant and vulgar negative propaganda, but it was predicatably adopted by newspaper journalists as the scandalous truth. In fact, the compound has has long been known to have highly unusual chemical properties….

In a statement, ANC has no financial stake in Virodene, published in Mayibuye in March 1998, and in the Sunday newspapers on the 8th, under the title, The War on Virodene, repudiating false allegations made by the DA that the ANC stood to score financially from the approval of Virodene, Mbeki revealed that Folb and the MCC had eventually agreed to allow the drug to go to clinical trials, ‘but later changed their mind’, unmoved by the submission by the researchers of

at least four versions of their research proposal, the Protocol, in response to the critical appraisals of the MCC. As it became more and more difficult to understand the attitude adopted by the MCC, the Minister of Health and I held meetings with both the researchers and the Chairperson of the MCC, to help facilitate the resolution of any outstanding problems.

Mbeki explained the reason he and Dlamini-Zuma had intervened – in their respective leadership capacities on the Inter-Ministerial Committee on HIV/AIDS – in terms of the pressing need for a treatment solution to ‘the pressing crisis of an escalating pandemic of HIV/AIDS’ affecting ‘2,8 million infected South Africans’, and concerns that the disputes between the developers of the drug might lead to a situation where ‘the intellectual property represented by Virodene could fall into the hands of people who could shut down the research effort or sell Virodene at unaffordable prices, should it be licensed as efficacious medication’. He went on to list a number of estimable medical experts from Portugal, France, Great Britain, the Czech Republic and Canada, who’d examined the clinical trial protocol, and furnished unamimously favourable comments. But

Alas, … the MCC, still refuses to accept the application, despite its knowledge of the unanimous opinion of these “learned and highly qualified professionals” [as one expert described them], and whose credentials it is perfectly aware of. To confirm its determined stance against Virodene, and contrary to previous practice, the MCC has, with powers to decide who shall live or die, also denied dying AIDS sufferers the possibility of “mercy treatment” to which they are morally entitled. I, and many others, will not rest until Virodene’s efficacy or otherwise is established scientifically.

But Peter Folb and his MCC were just as adamant that Virodene wasn’t going to be tested in any kind of approved trial under any circumstances. Mbeki could jump in the lake.

Asked why the government had got involved in the Virodene licensing bid, ANC Secretary-General Kgalema Motlanthe explained: ‘Because this is a major issue, it confronts all of humanity. If society is on the brink of a major breakthrough on the scourge of AIDS, [there should be the] will and readiness to bring this work to a conclusion.’ The MCC was ‘playing God,’ he said. ‘Given the devastating effects of AIDS, the research must be brought to its logical conclusions.’ The researchers were being ‘hounded like criminals’, he noted, referring to Mbeki’s revelation that the MCC had conducted midnight raids on the researchers’ homes, ostensibly looking for evidence of wrongdoing. But finding nothing. ‘The rationale of the MCC should be questioned,’ he suggested. ‘I surmise that the MCC is driven by other interests than concern for proper control of medicines.’ To which Folb responded: ‘This is not something which a responsible person should be hinting at. He should be called on to clarify his statements, which are seriously damaging and utterly untrue.’

The AIDS establishment saw funny psychological reasons motivating Mbeki and Dlamini-Zuma’s concern to see Virodene tried out. ‘There was this sense that this drug would be the thing that offset the perception ... of Africans as substandard and less than capable,’ explained Quarraisha Karim sweetly. ‘All eyes were upon [the ANC] and the expectations were very high and they were really trying to find their feet but they didn’t want to exercise caution. This was driven by this need to show the world: “Yes, Africans can do this. We can do this. Virodene became our redemption.”’ Their redemption. Her husband Salim Karim voiced similar thoughts: the Cabinet imagined that its discovery of Virodene would somehow give the new government a boost in the same way that Chris Barnard’s world-first successful human heart transplant had been a winner for the old order, he thought.

Medical academics and professionals rallied to support Folb and his MCC. On 23 March the heads of medical schools at the universities of Cape Town, Stellenbosch, Natal, Witwatersrand and MEDUNSA protested at what they described as Mbeki’s political interference, and called for a commission of inquiry: ‘This council [the MCC] has an admirable record in its dealing with many complex issues over many decades. Its concern for the health of individuals and the health of the public is beyond question and it has served the South African public with the highest degree of integrity under the leadership of its chairman, Professor Peter Folb.’ Folb agreed; his council ‘must be left to do its work according to proper standards that will offer reasonable prospects to patients and prevent their being exploited’. So did the Medical Association of South Africa: the politicians should butt out, they said, because they were undermining the autonomy of the MCC:

Medicine is not an exact science and over the years the practice of finding scientifically and ethically justifiable answers in the quest for curing diseases has assured patients of our first obligation: to do no harm.’ There was a way to find out if a drug such as Virodene worked, the doctors said: ‘This can be achieved by way of acceptable scientific protocols, entrenching ethical principles. It is important not to raise expectations that may not be fulfilled, especially when people living with Aids are particularly vulnerable to the sort of harm that follows on grave disappointment.

But unlike the clubby doctors, Mbeki and Dlamini-Zuma were thoroughly unimpressed by Folb’s showing in the affair, and began doubting his competence and the health of his organization generally. An independent panel of top-drawer overseas experts was hired to assess the MCC’s performance under his leadership. This was no hatchet job: Graham Dukes, Emeritus Professor of Drug Policy Studies at the University of Groningen in The Netherlands was actually a friend of Folb’s, who had invited him to contribute two chapters to, and edit a section of, the 13th edition of the standard reference Meyler’s Side Effects of Drugs that he had edited in 1996. Dukes was assisted by Dr Suzanne Hill of the University of Newcastle, New South Wales, Australia.

Dukes and Hill were appalled by what they found – bearing out Mbeki and Dlamini-Zuma’s worst suspicions. Their report released on 24 March 1998 recommended that ‘the present MCC should cease to exist’ immediately, and urged the ‘suspension of [its] work’ on the spot. Folb’s head rolled soon thereafter: he was notified that his contract, up for renewal in April, wouldn’t be. His deputy, and the MCC Registrar got the chop too, in circumstances a labour tribunal later declared unfair, but by then Helen Rees had taken over, with Peter Eagles, a pharmacology professor at the University of the Western Cape, as deputy president. Precious Matsotso was appointed new Registrar.

I met and had dinner with Carl Landauer at his invitation in late 2005. I was curious to find out why he imagined the administration of the diethyformamide might have a therapeutic action when administered to AIDS patients. Though instinctively averse to the use of synthetic chemicals in medicine, as a general principle, I already knew that dimethylformamide is a reducing agent that counteracts the damaging effects of cellular oxidation – the real cause of AIDS. (We’ll get there later.) Landauer promptly confirmed that this was exactly the pharmacological action intended; it nothing to do with any ‘antiretroviral’ action. As for the virus: well, what virus? With that he had me listening. He whipped out a pen and paper and began explaining with series of molecular schematics and other notes and diagrams that diethylformamide is a thoroughly researched compound long known to chemists for its singular, most unusual properties, which inter alia make it ideal for infusing into tissues destined for transplant, preserving them without harming them.

Landauer impressed me at our meeting as a genuine, selfless pioneer of a novel treatment modality, thoroughly frustrated by the usual medical prejudice against novelty and the institutional inertia that he’d run into, about which he told me the whole story: his contacts with Mbeki and government, the entire fascinating history from start to finish. At the end of which, it was not difficult for me to understand why he had impressed Mbeki and how it came to be that government had come to associate itself so closely with Landauer’s appeal for his invention to be tried out in formal controlled clinical experiments. But happy dealing AIDS drugs, the medical establishment wanted none of it.

Towards the end of Mandela’s tenure, Mbeki increasingly took command. By 1997, still pepped by Cameron’s AIDS talk early the previous year, Mbeki had become concerned about Mandela’s blasé attitude to AIDS and he worried that the Department of Health would not be able to manage the threatened crisis alone. His first step in November was to establish a Ministerial Task Force on AIDS, whose monthly meetings he chaired. Tshabalala-Msimang was appointed to head its secretariat, and it promptly got to setting battle plans.

Mbeki was surprisingly silent about AIDS in his closing speech at the ANC’s 50th National Conference in Mafikeng on 20 December, on succeeding Mandela as party president, but the conference did resolve that since AIDS would ‘massively impact on the economy, will impact socially with more orphans and the loss of breadwinners, and on the health service with additional new users’, the education campaign to prevent it from spreading should ‘be led by the President of our organisation who must direct that the NEC, Branches, the Youth League, the Women’s League throughout our Provinces … place the campaign against AIDS on their day to day agendas’. The nine-point programme included included the party’s resolution that ‘The message about Aids awareness be included in political speeches of our entire leadership, with a pledge to fight the disease; The ANC co-operates with all organisations, groups, individuals, and agencies engaged in the campaign.’

‘It frightens me and makes me feel anguished inside that we’re losing a population and nobody seems to be disturbed,’ said Virology Professor Alan Smith at the University of Natal’s medical school in the March 1998 issue of African Business. ‘We’re going to depopulate an entire continent.’ But in his landmark African Renaissance speech given at the United Nations University in Tokyo on 9 April, Mbeki, now formally leading the country’s forces, emphasized the government’s resolve to fight what was making Professor Smith frightened: ‘We must take decisive steps to challenge the spread of HIV/AIDS, of which Africa accounts for two thirds of the world total of those infected. Our government has taken the necessary decisions directed at launching and sustaining a big campaign to confront this scourge.’

At a conference on the ethics of vaccine testing in South Africa, held in Durban in the first week of September that year and attended by about a hundred scientists, researchers, Health Department officials and NGOs, the scale of the ‘national emergency’ facing the country, to quote AIDS Law Project director Mark Heywood, was repeatedly emphasized: South Africa was said to have fifty thousand new HIV infections a month, seventy more every hour. It was noted that UNAIDS had warned in January that by June almost three million South Africans would be HIV-positive, and that the infection rate had leapt by seven-hundred thousand in 1997 alone. Referring to news that Mbeki was planning to launch a major AIDS awareness campaign, Heywood warned: ‘If South Africa wants to lead an African renaissance, it is not going to succeed with half its school-going population and twenty-five percent of its teachers HIV-positive and with the lowered morale that goes with one in every five adults having HIV or AIDS.’ And Mbeki was ‘going to have to go much further than investing in public awareness’, Heywood counselled; drugs were what we needed. But Peter Busse, founding director of the National Association of People Living With AIDS (NAPWA) took a different line. Conceding that AIDS drugs were very expensive, he urged that in countries unable to afford them the First World should put up cash for vaccine research instead. Words that would lead to a fateful rebellion in NAPWA’s ranks.

Even the tax collectors were scared: on 3 September, while the conference was still on the go, the fiscus released a press statement warning that up to thirty-five per cent of South Africans could be dead from AIDS within a decade. To educate civil servants about the danger, the Cabinet had resolved that the Department of Health should allocate funds to each and every government department, including the Revenue Service, to pay for an internal AIDS awareness campaign ‘to combat Aids and protect [government] employees and their families’.

Shortly after the vaccine conference ended, Mbeki rose to the sombre occasion, appearing at a press conference on 11 September, along with several Cabinet ministers, to announce the launch of the government’s Beyond Awareness campaign to about two hundred political and social leaders from just about every walk. But the name of the campaign notwithstanding, none of its R80 million budget was for the drugs that the activists craved; prioritised instead were ‘primary prevention’ strategies. Welfare Minister Geraldine Fraser-Moleketi explained the thinking behind this: only the development of a vaccine could provide a long-term solution to the epidemic in the country. Dlamini-Zuma suggested that in view of the role that that the country’s youth had played in resisting apartheid, they should adopt the fight against AIDS as ‘the new struggle’. Both Mbeki and Dlamini-Zuma stressed that AIDS was draining the economy, and said it would only get worse as the country’s estimated three million HIV-positive people began falling sick.

On 9 October Mbeki brought more hands on deck by establishing the ‘Partnership Against AIDS’, a ‘broad-based and multi-sectoral’ co-operative, made up of representatives from several government departments and private sector players with an annual budget of R80 million. Grandly launched it was too – at a soirée thrown at the Presidential guesthouse for eight hundred people. In so doing, Mbeki was addressing AIDS as the national emergency that local and foreign ‘AIDS experts’ and activists had sold it as. He never doubted them for a moment. On the contrary, he was never seen out without a red AIDS solidarity ribbon on his lapel. To show how much he cared. In fact he led the fashion, the badge on his coat presaged by the remarkably similar ‘narrow scarlet sash, emblem of the Junior Anti-Sex League’ in George Orwell’s 1984, the ‘aggressive symbol of chastity’; and again the bloody symbol glinted on his coat as Mbeki appeared on national television that day to warn that a deadly new sex plague was suddenly upon us. Why, the Department of Health’s Health Sector Strategic Framework 1999-2004 called for the government to ‘Declare HIV/AIDS a national emergency, if not a global emergency’. It was all very alarming.

Mbeki’s special television address to the nation to tell South Africans that a deadly new germ, although invisible, was actually everywhere had the unintended consequence of whipping up a maelstrom of plague hysteria in some parts – with tragic results. Whereas the theme of Mbeki’s speech had been the importance of sexual restraint for our national salvation, Mandela went further three weeks later. Delivering the keynote address on World AIDS Day on 1 December at a meeting in Matubabatuba in KwaZulu-Natal, attended by UN-AIDS boss Peter Piot, he urged:

It is time to break the silence. That is why we are here today as political leaders, following the lead given by Deputy President Thabo Mbeki. … We want our communities to be able to say to our country: Come and witness the reality of AIDS; see the devastation in our community; see the fresh graves; see the courage of those who live with the infection and of the children who have lost their parents. … It is the silence that leads us, when we see all the signs in our friend’s face, to speak of anything else rather than ask, ‘Do you have AIDS? How can we help?’ It is the silence that hangs over our cemeteries when we bury loved ones knowing they died of AIDS, but not speaking of it. It is the silence that is letting this disease sweep through our country, adding 1 500 people each day to more than 3 million already infected.

When NAPWA fieldworker Gugu Dlamini took Mandela’s advice and courageously broke the silence by announcing that she was HIV-positive during a radio programme on the same day, her neighbours in KwaMancinza near Durban were horrified. Alarm spread as the news of the demon among them did, and two weeks later, having decided that the threat needed a decisive fix, they proceeded at night in a posse to her home where they beat and stoned her to death. ‘It is a terrible story,’ Mbeki commented when he heard this. ‘We have to treat people who have HIV with care and support, and not as if they have an illness that is evil. This is a message that needs to be spread to as many people as possible.’ AIDS, he emphasized, was one of his greatest concerns for the future of our country.

And without the special medicine so many of us were going to die, said NAPWA member Zackie Achmat, at the public launch of the group’s special project that he’d conceived, the AIDS Treatment Action Campaign. Gathered on the steps of St George’s Cathedral in Cape Town on International Human Rights Day, 10 December 1998, he and a dozen other protesters fasted for the day and collected about a thousand signatures to demand that the government develop a programme to provide ‘AIDS medication’ to the sufferers:

The Treatment Action Campaign calls on the Minister of Health, Dr. Zuma and Trevor Manuel, the Minister of Finance to meet immediately with the National Association of Persons Living with HIV/AIDS (NAPWA) and HIV/AIDS NGOs to plan for resources to introduce free AZT for pregnant mothers with HIV/AIDS. The TAC also calls on the government to develop a comprehensive and affordable treatment plan for all people living with HIV/AIDS.

People like his gay friend Simon Nkoli, who’d just died an AIDS martyr on 30 November – having taken AZT alone and in combination with other AIDS drugs on and off since 1988, courtesy of friends abroad who’d been sending them over, one parcel after another, until he finally keeled over.

Achmat was no newcomer to the political scene, but a seasoned agitator from his teens during the late apartheid era. A founder member of the National Coalition for Gay and Lesbian Equality (NCGLE), he succeeded Cameron as director of the AIDS Law Project in 1994 and ran it for three years before Heywood took over in 1997. In October the following year, as leader of the NCGLE, Achmat demonstrated his political brio in getting buggery decriminalized by the Constitutional Court (on the same day, coincidentally, that Mbeki announced the Partnership Against AIDS on TV); and with this behind him Achmat knew he was born to lead. And that the country’s top judges in this newly established forum, eager to demonstrate how progressive they were, could be relied on to help him ram his next agenda through. By now Achmat’s ambitions had drawn him to another gay group, a special little sect of the chosen: the National Association of People Living with AIDS (later to transmogrify into a massive African heterosexual organization). There he’d find his road to really big fame. A month after winning his gay rights in court, he was on the steps of the Church with his supporters, demanding AZT for mothers and their unborn babies, and for HIV-positive people generally. But he would not take it himself, he told journalist William Gumede a week later: ‘On principle, I won’t take ARVs until they are freely available to the poorest.’

Mbeki, meanwhile, was busy leading the government’s fight against AIDS in his own way. Welfare and Population Development Minister Geraldine Fraser-Moleketi had come up with the idea that a good way for her ‘Women in Partnership Against AIDS’ to draw attention to how women were specially victimized by AIDS would be to have a railway train chuffing around around the country and providing mobile conference facilities for po-faced women to talk all day about how violent men are and how they just forced themselves on their women as they felt like it. The railway parastatal Spoornet ageed to go along with her scheme, and provided a train for it, throwing in a hundred million rand to fight AIDS too.

On 4 March 1999 Mbeki launched the Vusa-ifizwe (‘On the Right Track’) AIDS train at Pietersburg in the company of several top politicians, including Dlamini-Zuma and Mineral and Energy Affairs Minister Penuell Maduna. In his speech Mbeki delivered a stern admonition for his brothers, remarking on their poor turnout at the launch and how they needed to get more involved in AIDS awareness and prevention campaigns. ‘Woman are particularly vulnerable to this disease and to society’s reaction. We need to stand up and support their fight,’ he said. In her address Dlamini-Zuma provided frightening statistics: a fifth of women attending antenatal clinics were HIV-positive; 3.6 million South Africans had the deadly virus; and in KwaZulu-Natal almost a third of people living there were infected. ‘We have to begin encouraging women to break the silence and raise society’s levels of awareness. We need to demystify the taboos, expose the violence and propagate the hard facts about the impact of HIV/AIDS on women and children.’ After all was said and done, Northern Province Premier Ngoako Ramatlhodi (later to follow Mbeki’s intellectual flip-flop on AIDS) performed the customary AIDS ritual by lighting a candle.

On 17 March Achmat wrote to Dlamini-Zuma to ‘request an urgent meeting with yourself, the Minister of Finance and other HIV/AIDS NGOs to discuss and plan the implementation of free AZT and formula feeding for pregnant mothers with HIV/AIDS, and to explore other affordable treatment options. As partners in the fight against AIDS, we urge you to meet with us to explore alternative solutions that are fair and equitable to all South Africans.’

On Human Rights Day (the South African one) on the 21st , Achmat again led his supporters in bravely skipping lunch to raise the moral pressure on Dlamini-Zuma to change her mind about giving pregnant women AZT. Four days later, inflamed with righteousness outrage, Achmat and members of his NAPWA-TAC barged into her office at Parliament to press their demand – an ‘informal meeting’, they called it, at which she agreed to treat with them and fixed a date.

Before it arrived Dlamini-Zuma caused an uproar by announcing on 17 April that along with the Health Ministers of Zambia and Zimbabwe she intended making AIDS a notifiable disease, requiring doctors to tell intimate partners and families if their loved ones lit up the HIV test: ‘We want to know who is dying of AIDS, and relatives and partners must be notified. It is time we treated AIDS as a public health issue like tuberculosis. We don’t go about treating that with secrecy.’ But this common sense was opaque to the AIDS activists. Why should the partner or family of a person carrying a deadly unseen plague have to be told? It was ‘outrageous’, said NAPWA’s Peter Busse. It was ‘reinforcing oppression of women and undermining everything AIDS activists are trying to do’, said Heywood. In the event, Dlamini-Zuma decided not to push it.

Achmat and fellow NAPWA-TAC members met Dlamini-Zuma to discuss their demands on 30 April, after which a joint statement was released agreeing that reasonably priced AIDS drugs were a human right, and that the Minister would stipulate an affordable price for AZT to give pregnant women for the ‘prevention of mother-to-child transmission’. ‘If you want to fight for affordable treatment, then I will be with you all the way,’ she added. But it was not only AZT that Achmat was after; ‘pressure on’ formula milk producers ‘such as Nestlé’ to provide it cheaply was to be a key objective too. So on top of this profoundly toxic drug, Achmat wanted doctors pushing Nestlé factory milk on African mothers too. For a replay of the criminal Third World milk powder catastrophe. Jesus wept. Even Coovadia dimly remembered it, commenting later: ‘Formula food is a killer. It doesn’t provide babies with the protection against disease that breastmilk does. If it’s mixed with contaminated water, babies can die of diarrhoea or pneumonia. … I believe government is being badly informed by poor science. It shouldn’t be providing the formula.’ The WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality agreed, reporting in Lancet in February 2000 that giving formula milk to babies in ‘less developed countries’ trebled to quadrupled their death rate. Achmat hadn’t heard.

The next meeting with Achmat and his group was on 29 September – exactly a month before Mbeki’s stunning about-turn on AZT in Parliament. By now, though, lots had changed. Disagreement within NAPWA over Achmat’s demand that his drugs project be prioritised led him to walk out and set up the TAC as an independent group. Mbeki had succeeded Mandela as President, and soon condoms, which Mbeki thought the answer, because the experts said so, were everywhere: according to an article by Myer et al. in AIDS (15(6):789-793) in April 2001, no less than 198 million of them were distributed that year, up from six million in 1994. Free dispensaries were set up in government buildings and in every hallway and public loo in the Union Buildings in Pretoria – and, to set a good example, even in Mbeki’s official residence, Tuinhuys, in Cape Town. Mbeki replaced Dlamini-Zuma with AIDS go-getter Tshabalala-Msimang as his Health Minister, moving the former up to Foreign Affairs. From the feedback Achmat would have got from AIDS Consortium director Morna Cornell, then also a TAC executive member, he had every reason to be optimistic about his prospects of pushing his TAC drug agenda past the eager new Minister. Cornell had commented that ‘recent meetings with Tshabalala-Msimang have shown that the department’s top priority is women and children, so I would think they would regard this as a really key issue. I just hope that we can now quickly see if this is applicable here. It certainly does seem to represent an unbelievable opportunity for our country to save lives.’ With AZT. Unbelievable.

But at the September meeting, also attended by her special advisor Roberts, Health Director General Ntsaluba, and a stand-in for HIV/AIDS and STD Directorate director Nono Similela, Tshabalala-Msimang was much less enthusiastic about giving pregnant women AIDS drugs than the TAC had expected. She expressed concern about the cost of providing AZT to expectant mothers, and about the safety and efficacy of nevirapine as an alternative, a drug that had just hit news. According to a TAC report on the meeting, ‘The Minister stated her awareness of TAC activities and welcomed a partnership with us on the issues of health care costs.’ Asked to ‘outline a practical programme on implementing prevention programmes on MTCT’, Tshabalala-Msimang responded cagily that the government was ‘committed to implementing the programme’ (to quote the report). But first, she said, the government has ‘agreed that the pilot programme should go ahead and that it should examine the efficacy of AZT and nevirapine’.

Nonetheless, despite this annoying talk of pilot programmes for pregnant women, instead of a general rollout that Achmat wanted, things remained sweet between Tshabalala-Msimang and his TAC. She wrote after the meeting:

I thank you very much for a very productive meeting on a number of indeed very emotional and sensitive areas in our work. Once more I want to assure you of our total commitment to a comprehensive rational response to the HIV/AIDS epidemic. In this context we will spare no effort in strengthening partnerships against HIV/AIDS. I am therefore happy that we could identify areas of cooperation and I hope we can develop a concrete plan in enhancing this working partnership and relationship. Once more, thank you very much for a constructive meeting. We will indeed follow up the recommendations that emanated from the meeting.

Within a couple of weeks, however, after reading Debating AZT, Mbeki and Tshabalala-Msimang would unequivocally reject the drug, and from then on it would be open hostilities and permanent war, with the TAC’s unending attacks on the government’s policy positions, and on the President and the Health Minister personally, unbroken by any Christmas armistices.

Mbeki spent November and December 1999 reading. And reading. Joel Netshitenzhe, director of government communications, confirmed that he had ‘read much literature on the issue of AIDS, including the literature of those who might not hold the conventional view. And the question he has posed from time to time is whether there has been sufficient interrogation of the issue. He merely says, “Instead of believing, be sure you have established the facts.” And I thought that would be a measure of a good President.’

He wasn’t the only one doing a big rethink about received wisdom on AIDS, and the articles of belief founding it – that Africa’s health problems originated from a virus (emerged from African jungles) to which Africans were especially susceptible, due to their exceptional fecundity; that the unseen infection could be determined with Western blood tests; and that only Western drugs could treat it. On 2 December Tshabalala-Msimang had a ninety-minute meeting with Geshekter, who convinced her that the new story of a sexually transmitted virus being to blame for the broken health of the poor in Africa wasn’t kosher, and that in reality there was nothing new happening: ‘a variety of old sicknesses have been reclassified’ as AIDS, and not only were the drugs very bad, the tests were useless too. Geshekter later described her as

thoroughly professional, calm, knowledgeable [and] well informed … She asked me basic questions. I tried to give basic answers. Anything I said I tried to back up with references or documentation. I wasn’t able on such short notice to bring a library full of material but I did my best. … We talked about the pharmaceutical issue about AZT and Glaxo-Wellcome. We talked about this ‘African sexual culture’ business, the definition of an AIDS case, difficulties with the ELISA test, the way the Western Blot gets read differently depending on which lab, on which continent and which technician is doing the reading. I was impressed by her. She was a model of professionalism, care, scrutiny and calm in the face of this gathering storm.

As the candle in Mbeki’s study burned low, the shimmering AIDS bubble – until then the very public object of his particular fascination – burst in front of him. He told his HIV/AIDS sceptic friend Sam Mhlongo, Head of Department and Professor of Primary Health Care and Family Medicine at Medical University of Southern Africa in Pretoria, who had also spent many years in English exile, that he rued having been so gullible in having uncritically believed all that the ‘AIDS experts’ had told him. Half a year earlier, at his inauguration as President on 16 June 1999, he’d been firm in the faith, piously sporting an AIDS ribbon for all the world to see and warning in his speech: ‘There can be no moment of relaxation while the number of those affected by HIV/AIDS continue to expand at an alarming pace.’ (Mandela, in contrast, wore no ribbon at the ceremony, and had nothing to say about AIDS.) In his address at the opening of Parliament nine days later Mbeki continued:

The government will also review all the work done so far to confront the scourge of HIV/AIDS with a view to the intensification of all efforts relating to this epidemic. Of critical importance will be that we take all necessary steps to ensure that the partnerships against HIV/AIDS that have been formed and the public educations we have been conducting do actually result in changing behaviour patterns, improve support to AIDS victims and orphans and speed up steps towards the development of a vaccine.

And four months later when he’d raised the toxicity of AZT in Parliament at the end of October, Mbeki was still talking the believer’s talk, was still full of holy fire, warning again that ‘we are confronted with the scourge of HIV/AIDS against which we must leave no stone unturned to save ourselves from the catastrophe which this disease poses’. Mbeki’s boilerplate statement on World AIDS Day, 1 December, evidently written well in advance, was a classic recitation of every cliché, every Western meme collectively making up the fearsome mythology of AIDS in Africa. It was a speech of which Achmat, Cameron and the whole gang of AIDS camp followers would have been proud:

People of South Africa, today we mark World AIDS Day. As South Africans, we participate in the World AIDS Day events as part of our ongoing support for the Partnership Against AIDS campaign. On this day, we must all join hands as people of South Africa and of the world against a silent killer that threatens our lives and the very fabric of our existence. On this day, we must use this opportunity to make our family, our friends, our neighbours and our fellow South Africans conscious of the dangers that HIV/AIDS poses to every single person in our country and to the health and future of our entire nation. We must urge all our youth to protect themselves at an early age and their loved ones against this disease by abstaining from sexual activity as much as possible by being faithful to their partners or by always using a condom if they are sexually active. To the youth of our country, we ask you, who are most vulnerable to this disease, to think about your future and the future of our children, before you become involved in a sexual relationship. To the men of our country, we ask you to use a condom if you engage in a sexual relationship which has the potential of exposing you, your partner or your wife to the danger of HIV/AIDS, for using a condom is a sign of respect to your partner, not a sign of mistrust. Together let us urge everyone in our nation to take responsibility for their own lives into their own hands in order to ensure that this killer disease is eradicated from our society. Every day we are burying more young people than ever before who have died because of AIDS. Every day a child suffers and has to learn to fend for him or herself when a parent dies as a result of this disease. Every day, when someone, who is infected, dies, we lose a lifetime of skills and experiences; we suffer a blow to our economy that we have only just begun to rebuild. I believe, therefore, that it is important for all of us to educate each other about the danger that HIV/AIDS poses to the socio-economic situation in our country. HIV/AIDS threatens to undermine our efforts to grow our economy and build a better life for all our people. It kills those on whom our society relies to provide income through agriculture, through mining, in the factories, those who run our schools and our hospitals, those who govern our towns and provinces. It worsens the poverty pervasive in our society when parents who are breadwinners die. People of our country, Every day, more people die as a result of AIDS in sub-Saharan Africa than anywhere else in the world. Thus, as we enter the next century, the challenge of HIV/AIDS is still with us and it is the task of our present generation of Africans to meet this challenge, by focusing on ways of preventing the spread of this disease and by providing care to those who are infected. There can be no talk of an African renaissance, if AIDS is at the door of our continent. We must recognise that the scourge of HIV/AIDS cannot be dealt with by one country alone. It requires a collective global effort. The challenge is to seek ways to minimise its effects, to prepare for its impact and to co-operate in the finding of long-term solutions. When the history of our time is written, let it record the collective efforts of our societies responding to a threat that put the future of entire nations in the balance. Let future generations judge us on the adequacy of our response. To overcome the challenge that this disease poses, every one of us must play an active part. If you are a member of a church or non-governmental organisation or a school that does not as yet have an HIV/AIDS programme, see to it that you come together to draw up such a programme. We must continue to break the silence and talk about this disease with openness. Those among us, who are infected, must be encouraged to tell others about their experiences. This will help to discourage the discrimination which they have at institutions and places of work. Rejection of those who are suffering is not acceptable; and we as a nation must offer all the support we can to people living with HIV/AIDS. People of South Africa, as we join hands in a Partnership Against AIDS, we must believe in our capacity to succeed in our struggle to stop the spread of this disease. We must build the Partnership Against AIDS so that it unites every community in our country into a dynamic force for changing people’s mindsets and behaviours. Government welcomes the initiatives that are being taken by the business community and the entire private sector, women’s groups, youth and student groups, the religious community, sporting organisations and the many non-governmental organisations to strengthen this partnership. As we join hands today, let us create a truly caring and humane partnership for health and prosperity for this will strengthen our efforts in shaping the next century as our African century. I thank you.

The first inkling of a shift in Mbeki’s perspective – from too much sex as the cause of AIDS, to too little good food – was apparent from a comment made during an interview by CNN a month later, on 3 January 2000. Addressing Africa’s crippling debt burden – repayment of which was consuming a quarter of its exports – he pressed: ‘Ways and means must be found to wipe out this debt as quickly as possible.’ The debt issue was closely linked to the AIDS pandemic, he said, and any programme to deal with it ‘has to be part of this integrated response to the challenge of poverty on the African continent’.

But as Mbeki’s faith was lapsing, the US was dangerously escalating the holy war: using his rotation as president of the UN Security Council in January, US ambassador Richard Holbrooke first declared ‘a month on Africa’, and then made AIDS the subject of the first Security Council meeting of the year, inviting US Vice President Al Gore to address it: ‘I came up with the idea that we should hold a special session of the Security Council on HIV/AIDS. I was told by everyone, including my own staff, “You can’t do this. It’s not done. It’s not in the U.N. charter.” And I said, “But AIDS is a security issue because it’s destroying the security, the stability of countries.”

Gore’s opening statement on 10 January went:

I call to order this first meeting of the United Nations Security Council in the 21st Century. … Today marks the first time, after more than 4,000 meetings stretching back more than half a century, that the Security Council will discuss a health issue as a security threat. We tend to think of a threat to security in terms of war and peace. Yet no one can doubt that the havoc wreaked and the toll exacted by HIV/AIDS do threaten our security. The heart of the security agenda is protecting lives – and we now know that the number of people who will die of AIDS in the first decade of the 21st Century will rival the number that died in all the wars in all the decades of the 20th Century. When 10 people in sub-Saharan Africa are infected every minute; when 11 million children have already become orphans, and many must be raised by other children; when a single disease threatens everything from economic strength to peacekeeping – we clearly face a security threat of the greatest magnitude. This historic session not only recognizes the real and present danger to world security posed by the AIDS pandemic – which I will discuss in further detail during my remarks as head of the US delegation – this meeting also begins a month-long focus by this Council on the special challenges confronting the continent of Africa.

And so on. Kofi Annan agreed: because AIDS was wiping out Africa’s civil servants, police and soldiers,

In already unstable societies, this cocktail of disasters is a sure recipe for more conflict. And conflict in turn provides fertile ground for further infections. The breakdown of health and education services, the obstruction of humanitarian assistance, the displacement of whole populations and a high infection rate among soldiers – as in other groups which move back and forth across the continent: all these ensure that the epidemic spreads ever further and faster.

When it was his turn to talk again, delivering ‘his remarks as head of the US delegation’, Gore contrived to whip the nigger back into line by commencing to quote Mbeki from back in the days when he was still a believer:

Mr Secretary General, Members of the Security Council, Distinguished Guests, and, in particular, Honored Delegates from the Nations of Africa: “HIV/AIDS is not someone else’s problem. It is my problem. It is your problem. By allowing it to spread, we face the danger that our youth will not reach adulthood. Their education will be wasted. The economy will shrink. There will be a large number of sick people whom the health will not be able to maintain.” Mr Secretary and Members of the Council: These are not my words. They were not uttered in the United States or the United Nations. They were spoken by my friend, President Thabo Mbeki of South Africa, as he declared South Africa’s Partnership Against AIDS more than a year ago. The same words should be spoken out not only in South Africa, not only in Africa, but all across the earth. In Africa, the scale of the crisis may be greater, the infrastructure weaker, and the people poorer, but the threat is real for every people and every nation, everywhere on earth. No border can keep AIDS out; it cuts across all the lines that divide us. We owe ourselves and each other the utmost commitment to act against AIDS on a global scale – and especially where the scourge is greatest.

AIDS is a global aggressor that must be defeated. As we enter the new millennium, Africa has crossed the first frontiers of momentous progress. Over the past decade, a rising wave of African nations has moved from dictatorship to democracy, embraced economic reform, opened markets, privatized enterprises, and stabilized currencies. More than half the nations of Africa now elect their own leaders – nearly four times the number ten years ago – and economic growth in sub-Saharan Africa has tripled, creating prospects for a higher quality of life across the continent. Tragically, this progress is imperiled, just as it is taking hold, by the spread of AIDS which now grips 20 million Africans. Fourteen million have already died – one quarter of them children. Each day in Africa, 11 000 more men, women, and children become HIV positive – more than half of them under the age of 25. For the nations of sub-Saharan Africa, AIDS is not just a humanitarian crisis. It is a security crisis – because it threatens not just individual citizens, but the very institutions that define and defend the character of a society.

This disease weakens workforces and saps economic strength. AIDS strikes at teachers, and denies education to their students. It strikes at the military, and subverts the forces of order and peacekeeping. The United States is profoundly moved by the toll AIDS takes in Africa. At the same time, we know that our own country has not achieved as much as we should or must in our own battle against AIDS. I am pleased that our Surgeon General is here today; his recent report tells us that we have not overcome the ignorance and indifference that lead to infection. We must continue to study the success of others, while we seek to share our progress with them. …Until we end the stigma of AIDS, we will never end the disease of AIDS. We also must do much more to provide basic care and treatment to the growing number of people who, thank God, are living, instead of dying, with HIV and AIDS. This requires affordable medicine, but also more than medicine; it requires that we train doctors, nurses, and home-care workers, that we develop clinics and community-based organizations to deliver care to those who need it. Today, fewer than 5 percent of those living with AIDS in Africa have access to even basic care. We know we can prolong life, reduce suffering, and allow mothers with AIDS to live longer with their children, if we offer treatment for opportunistic infections like tuberculosis and malaria. … Last year, I announced the largest-ever increase in the US commitment to international AIDS programs – $100 million to fight AIDS in Africa, India, and other areas. Today, I announce America’s decision to step up the battle. The budget the Clinton-Gore Administration will send to our Congress next month will include an additional increase of $100 million for a total of $325 million to fund our worldwide fight against AIDS. … Next July, the global community will gather in Durban, South Africa, for the 13th International AIDS Conference. … We will work with the organizers of the Durban Conference to advance this essential objective. It is essential, because how we speed the money, and how effectively we target it, not just how much we spend, will determine how many lives we save. AIDS is one of the most devastating threats ever to confront the world community. Many have called the battle against it a sacred crusade. The United Nations was created to stop wars. Now, we must wage an win a great and peaceful war of our time – the war against AIDS.

And on he spoke. Holbrooke explained after the meeting that what the US had in mind was that countries should ‘begin to redefine security as broader in the post-Cold War era than it used to be’. Which is exactly what happened three months later when Mbeki provoked a concrete response along these lines, by sending Clinton a threatening dissident manifesto in a diplomatic pouch – but we’re still coming to that.

UNAIDS executive director Peter Piot subsequently sized up international political reaction: ‘It was the first time that the Security Council debated on something that was not, let’s say, war and peace. … That was a breakthrough because it opened so many doors, and presidents, prime ministers say, “Oh, it was debated in the Security Council, this must be a serious problem,” which was ridiculous, but I literally got that kind of reaction.’

Mbeki’s next move was to prepare dossiers containing the leading scientific critiques of the HIV theory of AIDS, and the use of AZT to treat it, and to forward them in early January to four prominent South African scientists for comment. None, however, demonstrated the brains or the integrity to make a public break with their church and support him. What the storm over AZT had illuminated for Mbeki, and the stupid responses of the scientists that he’d approached, was how ignorant and lazy the featherbedded South African AIDS establishment was, and how incapable it had proved itself to be of thinking critically. Mbeki’s new disdain for it was made unmistakeably plain by his appointment, in December, of the South African National AIDS Council, comprising thirty-one members, including twelve Ministers, with the rest made up of private sector representatives involved in some way or another in AIDS. At its launch in mid-January 2000 SANAC’s chairperson Deputy President Jacob Zuma explained its composition: ‘Individuals, communities, national government and international organisations each have a key role to play.’ But not one of South Africa’s established ‘AIDS experts’ and activists was invited aboard to play it. Laurice Taitz complained in the Sunday Times on 23 January that

the AIDS Consortium – a network of 220 NGOs – was not invited to the launch, nor was it made aware of the appointed members. Not only is there a glaring absence of scientific and academic knowledge on the panel, but there are also no AIDS activists who have ever challenged the government on its AIDS policies. The Medical Research Council, the Medicines Control Council, pharmaceutical companies, doctors and specialists working with HIV/AIDS and leaders of community projects are also nowhere to be seen.

The Mail &Guardian reported an Uproar over Aids Council on the 28th, ‘the backdrop’ to which was the

long-running conflict between Aids experts and the government, fuelled recently by the government’s controversial rejection of the anti-retroviral drug AZT despite significant evidence that it is effective in preventing the transmission of the HIV virus in pregnant women to their unborn fetuses. The rubbishing of AZT has been spearheaded by President Thabo Mbeki on the basis of subsequently questioned research discrediting the drug and highlighting its toxicity.

Unlike the Partnership Against AIDS, SANAC was launched unceremoniously – in a small basement room below the Union Buildings, attended by only a few of the appointees, a handful of government officials and some journalists. Significantly, none of the five technical task teams appointed to assist SANAC in the formulation of policy recommendations were briefed to advise it concerning the use of antiretroviral drugs. The modest launch was in keeping with the perfunctory do held to mark the first anniversary of the Partnership Against AIDS on 9 October 1999, with the birthday bash taking the meagre form of a press conference in altogether less salubrious surroundings than the one in which Mbeki had launched it – a cramped studio in the South African Broadcasting Corporation’s Johannesburg HQ. With better things to do, and real national challenges to address, Mbeki appears to have grown tired of listening to his partners’ yakking and turned the show over to his deputy Zuma.

As the scientific foundations of the HIV/AIDS model crumbled the closer he examined them, Mbeki saw the African AIDS paradigm for what it was: a business with a scarcely believable gaping hole in its middle, driven ideologically by a reclothed body of very ugly and very ancient white assumptions and beliefs about Africans. This appreciation aroused an imperative that he’d articulated with remarkable prescience in his African Renaissance Statement made at Gallagher Estate in Midrand on 13 August 1998 and broadcast in part on national television: Africa ‘can and must be its own liberator from the condition which seeks to describe our continent and our people as the poverty-stricken and disease-ridden primitives in a world riding the crest of a wave of progress and human upliftment’.

The apocalyptic vision of Africa presented by the AIDS construct, which was being pressed with a disconcertingly familiar missionary vim, was fundamentally antithetical to Mbeki’s own vision for social and ideological transformation in the country. And if fellowship was Africa’s paramount value, here was a new imported system of beliefs to putrefy it – isolating, terrifying, alienating, mortifying. Who better then to share his ideological and scientific insights with than William Makgoba, then president of the Medical Research Council? A regular guest at Mbeki’s home, Makgoba was the editor of African Renaissance (Mafube, 1999), a compendium of optimistic essays for which he, Mbeki, had just written the foreword. Here, Mbeki assumed, was an African scientist with the same vision for Africans who’d finally recovered command of their own destiny after centuries of Western colonial servitude and political and psychological oppression.

Poring over his scientific papers in the small hours one morning in early January 2000, and staggered by the enormity of what he was on to, Mbeki gave Makgoba a ring. It was to be a most disappointing conversation. An article in New York Times on 8 July, Dissent on Aids by South Africa’s President: Thoughtfulness or Folly, in which Mbeki’s midnight call to Makgoba was reported, provides an idea of the lines along which their midnight exchange went: ‘Prominent doctors accused Mr. Mbeki of dabbling in pseudo-science while people were dying.’ This was Makgoba’s standard label for any criticism of AIDS orthodoxy, which, he told Mbeki, was ‘not worth exploring’. As it quickly became apparent to Mbeki that he was talking to a scientific moron, he said cheerio, and let Makgoba return to his dreams. But from then on, it was bitter mutual contempt across an unbridgeable rift. Mbeki kept his new opinion of Makgoba to himself, but Makgoba was less circumspect, telling Science reporter Jon Cohen in June: ‘When politicians want to really interrupt science in a manner that distorts it, I can only think of the history of Nazism. Every time this has happened, it’s preluded disaster, regimes have collapsed, and people have died.’ Makgoba confirmed to Cohen in April that Mbeki had sent him about fifteen hundred pages of scientific papers critiquing the HIV-CD4 cell-AIDS model. ‘It’s pure rubbish,’ he said. ‘They never provided any data and, at the same time, they are taking things out of context.’ He said he’d told Mbeki this in a letter offering counter-arguments in favour of the orthodox viral model of AIDS. He should stop this nonsense, he’d advised: ‘His credibility as an African leader may suffer from this.’

On emerging from a meeting in the second week of January, Californian pharmaceutical biochemist David Rasnick received an astonishing message: someone from the office of the South African President had just phoned to say that Mbeki wanted to speak to him. ‘I didn’t believe it at first,’ he told the Chicago Tribune. ‘I didn’t know Presidents just called out of the blue like that.’ Rasnick was president at the time of an international association of scientists, clinicians and other concerned people, whose object was told in their name: the Group for the Reappraisal of HIV/AIDS Hypothesis. Following a second missed call, Mbeki’s office sent Rasnick a telefax on the 19th, posing some basic questions about the HIV/AIDS model in South Africa:

What means and methods are used in the Public Health system to test the ‘HIV status’ of individuals? What definition is used, again in the Public Health system, to classify a person as being afflicted with AIDS? Of the people determined to have died of AIDS, what ‘opportunistic disease’ was identified as having been the immediate cause of death? Has any research been done on the health profiles on the population where allegedly it has been found that there are large numbers of ‘HIV positive people’ (e.g. in KZN)? Has any research been done on ‘HIV positive’ infants, children and orphans with regard to their health profiles, and those of their mothers’ families? On what do we base statistics we publish occasionally on the incidence of HIV and AIDS, and how do we arrive at the projection?

It was apparent from the way the questions were framed was that Mbeki knew the answers already: HIV antibody tests were completely useless; AIDS as a medical diagnostic construct was all but meaningless; AIDS was just a range of ancient diseases renamed; in Africa AIDS was the lot of the poor; and the statistics were junk. And, of course, the broken health of Africans had nothing to do with loving too much.

Two days later, at a time pre-arranged with one of Mbeki’s aides, Rasnick’s cell-phone rang. ‘A voice came on the line and said it was Thabo Mbeki,’ Rasnick told the Tribune. Mbeki quizzed him for about fifteen minutes concerning his collaboration with Duesberg in his biology laboratory at UC Berkeley. ‘He was checking me out, seeing if I was legitimate. I suppose I passed his test, because he asked me for my personal support for his anti-AIDS efforts and I gave it to him.’ Rasnick related further to the New York Times:

He wanted our views, and we gave them to him. He had read everything we had written, everything that was available on the Internet. He knows there are some serious questions out there. I think he’s courageous. You start looking like a lunatic if you question the AIDS axioms. Knowing this in advance, he put his neck out there anyway. He wants to have a free and public hearing about all things related to AIDS.

He wanted US President Bill Clinton, UK Prime Minister Tony Blair and German Chancellor Gerhard Schroeder joining in too, he told Rasnick, who told Now magazine in Toronto in turn on 9 March, adding: ‘Mbeki has a good sense of humour and a quick laugh. He’s read extensively. He asked me if I would personally support his efforts in all this stuff that has to do with AZT and AIDS. … South Africa may be the place where this whole craziness comes to an end. It’s no messier than bringing down apartheid peacefully. I can’t think of a better-positioned person, as a head of state, in the entire world.’

Rasnick’s reply to Mbeki’s questionnaire, drawn in collaboration with Geshekter, summarised some problems with the HIV/AIDS hypothesis, but was rather hammed – wrong in parts and missing the big issues. All pointed out thereafter in a clarifying memorandum sent to Mbeki in mid-March, drawn by an obscure bio-physicist, of whom hardly anyone had ever heard, other than readers of rarified, specialist scientific and medical journals: Eleni Papadopulos-Eleopulos.

Along with a group of collaborating scientists – chiefly consultant emergency physician Valendar Turner, her fellow senior medical physicists Barry Page and David Causer, pathology professor John Papadimitriou and visiting Colombian research biologist Helman Alfonso – her Perth Group (since expanded, with the writer sometimes aboard) had been posing radical challenges to Robert Gallo’s retroviral theory of AIDS in various specialist journals from the beginning – frequently after a summary bouncing first by the scientific oafs at the door of Nature. Because please. You can’t talk this way. You’d make us look ridiculous. We’d have to eat humble pie. Be reasonable. You’re asking too much. As you chip away, speaking politely always, keeping your voice down, with none of the temper of the orthodoxy’s defenders. We can’t fault a cool word of what you write, but you’re just much too hot for us.

Strikingly diminutive in shoes, but mammoth in print, Papadopulos-Eleopulos had jumped ship from nuclear physics to biology after being hired in the seventies by the Department of Medical Physics at the Royal Perth Hospital in Australia to calibrate its radiotherapy gear. She proceeded to teach herself molecular biology from scratch, not from the textbooks but from original papers – her vast collection of which dates back to the beginning of the 20th century. (We speak of mountainous stack after stack; I have a snapshot.) By the end of the decade the autodidact in biophysics had conceived and experimentally demonstrated an epochal new model of cellular functioning: her theory that cells are primarily driven by cyclical oscillations of oxidation and reduction, governing cell processes as varied as the uptake of nutrients to locomotion and cellular division. Published in the Journal of Theoretical Biology in 1982 under the modest title, A Mitotic Theory, Papadopulos-Eleopulos’s redox model has since been adopted and propounded by none other than Luc Montagnier of the Pasteur Institute in Paris, supposedly the discoverer of HIV. This was way beyond the stuff of any PhD, but in any event Papadopulos-Eleopulos wasn’t bothered with claiming such conventional honours. In fact, in common with AIDS dissident Walter Gilbert, also a nuclear physicist, with a chair in molecular biology at Harvard and winner of the Nobel Prize for chemistry in 1980 for his invention of DNA sequencing technology, she holds no degree in biology at all. A point taken against her in her absence by Duesberg at a three-day dissident medical conference in Naples in early July 2003. To which Mhlongo retorted in her defence: ‘Be careful. Next they’ll be saying you’re not a doctor.’

The Perth Group’s missive straightening out Rasnick and Geshekter’s reply to Mbeki’s questions was sent to him privately, and was copied on to a select few AIDS dissident scientists and activists, so it didn’t reach the newspapers, but it highlighted a tension, right from the start of the South African AIDS controversy, as uneasy as the division between the Charterists and the Africanists in the ANC during the struggle, and it would surface again at the second meeting of Mbeki’s International AIDS Advisory Panel in July 2000. It has to do with the question: What do we actually mean by ‘HIV’ and ‘HIV-positive’? Infected by a virus as the ‘AIDS experts’ claim – but a harmless passenger as the American dissidents argue? Or something quite different, as the Australians contend? Rasnick was understandably put out by the Perth Group’s theft of his thunder. But from that point on, Mbeki only had eyes for Eleni. Courted in secret. Not even the other dissident scientists in the know. Right under their noses.

Mbeki liked Turner’s suggestion of a face-off between orthodox and dissident scientists, and in February he asked Tshabalala-Msimang to convene a bipartisan panel to look into ‘everything about AIDS’, from the drugs to ‘whether there’s this thing called AIDS, what it is, whether HIV leads to AIDS, whether there is something called HIV, for example. All these questions.’ It was evident from this that he was already onto the HIV isolation problem, the little-known black hole in the middle of the HIV theory of AIDS. On 28 February 2000 Tshabalala-Msimang’s special advisor Roberts formally announced on her behalf: ‘We are looking into the feasibility of getting an international expert panel to look into AIDS in Africa and the way forward. It will be internationally representative and made up of experts from the US, Europe and Africa.’ Deputy President Zuma explained on national radio that the panel would ‘look at these issues to get rid of misinterpretations and misrepresentations or differing opinions. If there are differing opinions they must be scientifically investigated so we can get at the truth.’ As Newsday reported it in the US on the 29th, under the title Added Foe in Aids War: Skeptics, its brief would be ‘to review evidence that HIV causes AIDS and allegations that the AIDS drug AZT is poisonous’ – given that ‘Dr. Peter Duesberg, a professor in the molecular biology department of the University of California at Berkeley, and his followers ... insist that HIV is a harmless virus and AIDS a nonexistent disease’ and ‘skeptics argue that AZT is a poison; AIDS, they insist, is actually caused by the drug used in its treatment. South African skeptic Anthony Brink of Pietermaritzburg, an attorney, insisted that “no one has ever been cured by AZT, but it sells like hotcakes all the same ... and it reaps profits counted in billions.”’

The Church of AIDS filled the newspapers with cries of protest and derision. The convention of the expert panel was ‘a justification for the immoral, unscientific and unlawful decision to withhold AZT or nevirapine from pregnant women’, accused the TAC. Nonsense, responded Tshabalala-Msimang on 2 March: ‘I hope that the work of the panel will demonstrate that we have no hidden agendas.’ The purpose of convening the panel was ‘to explore all aspects of the challenge of developing prevention and treatment strategies [for AIDS] that are appropriate to the African reality’. Who would be on the panel, she didn’t say: ‘My department is talking to a wide range of specialists to see who is willing and available to participate.’ She ducked answering whether Duesberg would be part of it: ‘My personal view is that those with more extreme views are unlikely to participate because we are looking for a consensus view.’ But she was open to suggestions as to who should be invited, she said. After debating their views at their meeting and thereafter on the Internet for a couple of months, the government wanted the panellists to ‘thrash out a consensus recommendation to the department’, she said. Challenged on the government’s decision not to supply antiretroviral drugs to pregnant women, she defended it saying it was taken ‘in the light of the best available evidence and the special social and economic circumstances in our country. I still think it’s the right decision.’

In a letter dated 2 March, addressed to fellow dissident scientists but which fell into the media’s hands, Rasnick revealed Mbeki’s call to him and what had been discussed between them:

Dear everyone, I am now free to divulge this information. Wednesday, January 19, 2000, Jacques Human in South African President Thabo Mbeki’s office faxed me 8 questions that the President sent to Health Minister Manto Tshabalala-Msimang. Mbeki wanted me to respond to the questions and answers. I asked Professor Charles Geshekter, PhD, to join me in responding to those questions. We sent our response to Mbeki’s office Thursday, January 20. Friday, January 21, I talked with President Mbeki for perhaps 10 min on the phone. The President and I had a very nice conversation. He asked me if I would support his efforts regarding AZT and AIDS. I made a personal commitment to support Mbeki and I also committed Rethinking AIDS: the Group for the Scientific Reappraisal, and I committed the International Coalition for Medical Justice (ICMJ) to support his efforts. Mbeki is good friends with Clinton, the Prime Minister of England, and the German Chancellor. He told me that he is going to write these heads of state and ask them to join his efforts to bring about an international discussion on AIDS and the anti-HIV therapies sometime in the spring, well before the International AIDS Conference in July. Mbeki wants to provide a public forum where the leading proponents of the HIV hypothesis and its leading critics can present the evidence for and against the following popular beliefs: 1. AIDS is contagious. 2. AIDS is sexually transmitted. 3. HIV causes AIDS. 4. The anti-HIV drugs promote life and health. (Below is what Charlie Geshekter and I sent to President Mbeki’s office.) [etc.]

Roberts’s announcement of Mbeki’s AIDS Panel plans and Rasnick’s disclosure about Mbeki’s communication with him whipped up a conflagration hotter than Hades. Tshabalala-Msimang attended and spoke at a gala dinner convened by NAPWA on 9 March, in the middle of a three-day ‘Break the Silence!’ conference ‘organised under the auspices of the Durban 2000 Conference’, which is to say paid for the pharmaceutical industry. The TAC and other groups attended too. Throughout the event Tshabalala-Msimang was harassed by about thirty demonstrators waving placards demanding ‘AZT/Nevirapine’ for pregnant mothers, and during her speech was constantly booed from the floor. Reporting the event afterwards, Achmat complained: ‘She angered almost every person by refusing to take questions and to stay for dinner.’ Was anyone really surprised? When it was his turn to speak Cameron pontificated: ‘It simply does not seem that the government can get it right on AIDS. … There are too many lives, too much happiness, too much human prosperity at stake for flirtation with dangerous and wayward theories.’ Too much happiness? Human prosperity? His? Being on to a good thing. As an AIDS superstar – pocketing $10 000 in December that year on receiving the Kaiser Family Foundation-sponsored Nelson Mandela Award for Health and Human Rights. And a ticket to a seat on the Supreme Court of Appeal.

The day after Rasnick’s disclosure of Mbeki’s contact with him, spokesman Parks Mankahlana declined to confirm it: ‘The President would be disappointed if people he has spoken to would want to use the contact with him to justify whatever view they may hold.’ Rasnick explained later, just as the first line of his letter indicated, that he’d understood there to be no objection to his mentioning that Mbeki had conferred with him; but a statement by KwaZulu-Natal Health MEC and ANC NEC member Zweli Mhkize, formally released by the Government Communication and Information Service on 13 April, appeared to convey Mbeki’s distinct displeasure: ‘It was indeed a privilege for Mr David Rasnick to discuss with the President of South Africa. But for him to publicise such a private discussion is the most discourteous abuse of a rare privilege, it is most distasteful and unacceptable.’ Whether Mbeki actually saw Mkhize’s statement, and gave it the nod before it was issued, is doubtful from Mkhize’s ignorant assertion, typical of uncritical medical thinking and out of line with Mbeki’s own view, that the toxicity of AZT ‘was another matter that has been misinterpreted’, since ‘few drugs have no side effects’. Cost, he said, not toxicity, was the issue. His maybe, but certainly not Mbeki’s.

Roberts remarked on the furious reaction to the announcement of the AIDS Panel in a post on the internet forum AF-AIDS a month later:

If the panel had met and reached preposterous conclusions then I would understand a negative reaction. But why now? Why is it considered impossible that the panel may come up with suggestions that will be helpful in the battle against AIDS in Africa? Rather than rejection and speculation would it not be better to work to get a useful result from this panel? I say this as I believe that I too would have concerns if I believed all the speculation that I have read in the South African press. … Responding from my personal perspective, the press in South Africa has, in the main, inaccurately represented my views on the question of AIDS in Africa and attributed to me some absurd positions. So it is possible that equally ludicrous positions may also have been attributed unfairly to others. Some of these ridiculous reports in the press have been used critically against me, for example, by Judge Cameron and others without validating the truth of any of these statements with me. I know that it is always easier to speculate and attribute a position and then attack it, but how this benefits the battle against AIDS eludes me.

You misunderstand, Ian. If you got into this thinking it was about science. Least of all in the florid imaginings of Edwin Cameron. Who gets so angry when you hint, as Mbeki does, that the miniature demons possessing him are all in his head. And then scowling like hanging Judge Danforth in Arthur Miller’s dramatization of the Salem witchcraft delusion, The Crucible: ‘You must understand, sir, a person is either with this court or he must be counted against it, there be no road between.’

Cameron responded to the announcements with a direct approach to Mbeki: he wrote him a letter asking him in letter not to flirt with ‘dangerous and wayward theories’ anymore (he likes that phrase) and begging him to please provide AZT to HIV-positive pregnant women; it’s the right thing to do. He packed his epistle with a moral and medical punch from the heavyweight division, with cosignatories Anglican Archbishop Njongonkulu Ndungane and Methodist Church primate Bishop Mvume Dandala speaking for God, and University of Natal Professor of HIV/AIDS Research Hoosen Jerry Coovadia for the AIDS doctors. A phalanx of eminences from both the ecclesiastical and temporal worlds. But Mbeki was unmoved. On 15 March Cameron was sitting in his chambers tinkling on his next coruscant oration when his fax machine buzzed out a sixteen-page reply. Citing a slew of studies on AZT’s foetal toxicity that I’d collated in Debating AZT, Mbeki declined Cameron’s entreaty with a pointed rebuff, reciting his dull buzzwords repeatedly in volley of delicious sarcasms:

I am taken aback by the determination of many people in our country to sacrifice all intellectual integrity to act as salespersons of the product of one pharmaceutical company [AZT manufacturer GlaxoSmithKline.] … I am also amazed at how many people, who claim to be scientists, are determined that scientific discourse and inquiry should cease, because ‘most of the world’ is of one mind … The debate we need is not with me, who is not a scientist, or my office, but the scientists who present ‘scientific’ arguments contrary to the ‘scientific’ view expressed by ‘most of the world’ … By resort to the use of the modern magic wand at the disposal of modern propaganda machines, an entire regiment of eminent ‘dissident’ scientists is wiped out from the public view, leaving a solitary Peter Duesberg alone on the battlefield, insanely tilting at the windmills. … It is clear from your letter that you believe that we should ignore or merely note these findings [the recent AZT foetal toxicity reports] because of the current ‘consensus amongst responsible and authoritative scientific leaders’ as well as ‘the available evidence’. Undoubtedly, such ‘consensus’ and ‘available evidence’ also existed on the use of thalidomide … Faced with the findings indicated in this letter, I am afraid that my own conscience would not allow that I respond only to the ‘consensus’ with which you are in agreement.’ Mbeki concluded with a reference to his decision to form an international expert panel ‘to discuss all HIV/AIDS matters that are in dispute’, and expressed the hope that ‘you will agree with me that such a meeting should be inclusive of all scientific views and not only those representative of the ‘consensus’ to which you refer. I fully recognise that I have much to learn and must be ready to admit and correct whatever mistakes I might make as a result of not heeding the advice that ‘a little learning is a dangerous thing’.

Cameron received Mbeki’s answer as a slap in the face. His ‘heart sank’, he said. The lapsed disciple forsaking the prophet. Peter denying Jesus. (The allusion is not extravagant; the judge, we’re still to read in wonder, suffers under the delusion that his true métier is to be a seer in all this.) Whereas he’d captured Mbeki’s imagination with his sex plague fantasy at their meeting in February 1996, and had him spell-bound for the next four years, it was clear from the letter that Mbeki now scorned him for his missionary sermons to the natives, expounding their imminent doom if they didn’t quit screwing around so much, as was their special wont. What gave Mbeki’s reply its special sting was the fact that not only did it show up Cameron’s Holy Eucharist as cheap rotgut, it was outing Cameron as an ignorant dupe, in line after referenced line – chapter and verse, page after page. The shoe was now on the other foot. Mbeki was tutoring the naïf, not in pipedreams, not in anodyne human rights waffle like Cameron’s National Charter for People living with HIV and AIDS, but in the brutal and most unpleasant facts. About the horrendously noxious chemical. For Cameron it was all too much. Having to think deeply. Revisit his certainties. Make a public U-turn. He read the letter trembling ‘with a sense of fear and dismay’. With the shame and humiliation. Of the outing. His burning faith oppugned. With fact and reason. He resolved to take his revenge, and he would do so over the years to come at every opportunity with the kind of cold, unflinching resolution for which offended women are classically famous – in gales of obloquy, badmouthing Mbeki in the foulest imaginable way to anyone who’d listen.

Coovadia (Cameron’s joint prize-winner of the Nelson Mandela Award for Health and Human Rights) publicly reacted to the AIDS Panel announcement by stating that it was time for scientists to take off their thinking caps and put on their helmets instead; there was a war to be fought: ‘There are 1 700 new infections every day in South Africa, 60 000 children die every year and 4,2 million South Africans are currently infected with HIV. We can’t have an academic debate while people are dying.’ We can’t afford shiny white Mercedes Benz motorcars without the help of such prize money either. Or twelve room mansions overlooking the sea. On our puny academic salaries. Handsomely supplemented by our executive vice-presidency fees of international AIDS project management companies such as Axios. Mary Crewe, director of the Centre for the Study of AIDS at Pretoria University, agreed with him: ‘We don’t have the luxury of this debate.’ In fact there wasn’t one, said Lynn Morris, a vaccine researcher at South Africa’s National Institute of Virology: ‘There is no debate among scientists. HIV causes AIDS. The evidence is overwhelming and conclusive.’ Clive Evian, a professional consultant ‘AIDS expert’, said angrily: ‘I think it’s about arrogance, it’s about baggage with the pharmaceutical industry and, most of all, it’s about delaying dealing with the issue.’ The envisaged panel was a ‘waste of money. … We need the President and Health Minister to kick out the pseudo-scientific dissidents who talk nonsense.’ Pseudo-scientific nonsense-talking dissidents like Nobel laureates Walter Gilbert and Kary Mullis – among the most distinguished and accomplished biologists of our time. Scientific democrat Glenda Gray’s opinion was that ‘If we are still querying in the 20th century whether HIV causes AIDS, then this means the country is in serious denial about the HIV/Aids epidemic. … Although it’s very important to determine innovative strategies for combating AIDS, engaging with fringe groups is not the way forward. These people should never have been given a platform. … [Questioning AIDS orthodoxy] is exactly what I would have expected from the apartheid government, not [Mbeki]. You just don’t expect someone with Mbeki’s credentials to do something that is so confounding.’ Ashraf Grimwood, chairman of the National AIDS Convention of South Africa shuddered: ‘I started feeling a very strange plot was afoot.’ The MRC’s Salim Karim was perplexed: ‘The President’s talk on World AIDS Day was excellent – and he writes his own speeches. He clearly understands this epidemic. So I don’t know. It’s not denial; it’s more complicated than that.’ As for him: ‘I have no doubt that HIV causes AIDS.’ At first AIDS acitivist and AZT promoter Charlene Smith feigned indifference: ‘Mbeki’s panel? Who the hell cares? Then she got characteristically hot and bothered: ‘We’re dying down here. Play all the intellectual games you want on the Internet, but we’re dying down here.’ And I don’t mean whites like me. Who know better than Mbeki does.

Makgoba felt

truly embarrassed for my government. I don’t think anyone knows where this thinking is coming from. It makes us look absolutely lost. … The scientists of South Africa have been providing this information [on antiretroviral drugs] for years. The longer we delay, the worse the situation becomes. The irony of this is: How can you replace the orthodoxy of the West with the unorthodoxy of the West and think that you are making progress?

Mbeki’s contacts with the AIDS dissidents were a ‘national scandal’, he said. ‘AIDS dissidents were failures in their own countries’ and South Africa was becoming ‘a fertile ground for the types of pseudo-science often embraced by politicians’. Worthless was Mbeki’s ‘politically motivated suggestion, in the absence of scientific evidence, that malnutrition and poverty cause AIDS in Africa’. The dissidents were ‘a small group of people who spend an enormous amount of time making sure their message will have an impact. When you see it for the first time, and if you are not experienced, you are likely to be seduced by it.’ The questions Mbeki was raising were ‘trivial’ and ‘mind-boggling’, he said; they turned the issue of whether HIV causes AIDS into a ‘political rather than scientific’ issue. And ‘if politicians are seeking consensus among scientists, that’s the wrong approach. One of the things that distinguishes politics from science is that in science we never seek consensus ... in science you are either right or wrong.’ And, as he thought he’d emphasize at the end of the Panel’s first day, ‘science is closed on these questions’. Mbeki’s intervention was dangerous, he warned: ‘Whenever politics takes centre stage, manipulates science for its ends, opts for the wrong scientific advice, or erodes the independence and rigour of the scientific methods in any country, the consequences have been dire.’ But imagine the trouble we’d be in had Mbeki contented himself with being advised by slobs like him, having regard to the former’s complaint in the Sunday Times two months earlier on 6 February that Makgoba and his fellow ‘AIDS experts’, such as Coovadia and Karim, are too lazy to read their medical journals – hence their foolish public statements that there was nothing to worry about; there were no recent research reports in the medical press about AZT’s extreme toxicity. Right after a whole flood of them. Really grim ones. Makgoba went on:

The current political and scientific furore in South Africa, fuelled largely by the dissident’s theories on HIV/AIDS and the seeming support of Mr Mbeki … is undermining the constructive public health messages this government has put in place. It is sending mixed messages to all those who have dedicated themselves to the alleviation and eradcation of this epidemic and is having a negative impact on the morale of affected patients and families. The undermining of scientists and the scientific method is especially dangerous in a developing country still in the process of establishing a strong scientific research base. Furthermore, it amy erode investor confidence, with dire economic consequences. We present South Africans cannot afford to make any more mistakes lest history judge us to have collaborated in one of the greatest crimes of our time.

Mamphela Ramphele supported Makgoba’s denunciation of Mbeki – more or less quoting him at a meeting in Johannesburg shortly afterwards: If the government entertained any of ‘this voodoo science, there’s a real danger people might say, “I don’t have to worry about condoms.” The disregard for the value of science is a worrying phenomenon that has crept into our new democracy.’ Mbeki’s position on AZT and soliciting of minority expert opinion on AIDS was ‘irresponsibility bordering on criminality’, she screeched. When Mbeki paid no attention to her ticking off for approaching AIDS with an open mind, and her insistence that we guys do it in a bag, she repeated her criminal charge in the first week of July in the US during an interview on the top-rated television news programme 60 Minutes.

It was difficult to imagine more vitriolic condemnation, but as Mhlongo pointed out to journalist Celia Farber:

There is no way this President will give in to attacks on him, because he is convinced, like he was in the struggle against apartheid, that there needs to be a debate. This is all related to apartheid, because the theories and practices of apartheid were not to be questioned. It was taken for granted. I grew up under apartheid. There were funerals every week because of the violence and the poverty of apartheid. There are many funerals still today, and I say that there is no evidence whatsoever that these people have died of AIDS. If you didn’t see poverty and malnutrition as the number-one cause of death in South Africa, I am prepared to close my bank account and give you all my money.

She asked him tongue in cheek: ‘How could there be all these media reports about the millions dying of AIDS in Africa? It can’t be a wholesale fabrication, can it? Don’t they say that AIDS affects the middle and upper classes, not just the poor?’ Mhlongo responded:

Look, there are no death certificates whatsoever. We have no references for anything. All you have is the media – television, radio and newspapers – agreeing on this. That stuff about the upper classes is really rubbish. I am so-called bourgeois, and I don’t see any of this among the middle class. It’s the poverty-stricken, unemployed, black South Africans who are dying, because of diseases related to poverty.

Once the AIDS Panel was set up, Makgoba, for his part, took a softer line than he had before – for a while anyway. Mbeki, he granted, is

a continuous learner. He wants to understand things. He’s basically a man who wants to exercise his power with knowledge derived from his own understanding of things. That sets him apart from Presidents in the Western world, where most people rely on being fed information from advisers. It means he doesn’t take accepted views easily. [Nonetheless,] my own view is that this process should never have been public. I am a scientist. I have been convinced by the evidence. There are politicians who are facing major policy changes and want to explore all possibilities. Indeed, I have to confess the President did consult me early in this matter. I told him what I’ve always told him. But the President felt it was necessary to consult these other people to see whether together we could resolve these differences. And I agreed to participate.

Minister in the Office of the Presidency, and personal confidant, Essop Pahad confirmed that Mbeki was the kind of guy who made up his own mind about stuff: ‘Fundamentally, he’s raising these issues because in South Africa, in our region, we have to find the necessary solutions to enable us to deal with this pandemic. And if he wants to understand something, he will not rely only on other people’s views. He wants to understand it for himself.’ Even if he came to unpopular conclusions; government spokesman Joel Netshitenzhe quoted Mbeki responding: ‘I didn’t go into this work, into this office, in search of popularity. If there are issues to be dealt with, they need to be pursued.’ Mbeki’s spokesman Parks Mankahlana explained:

The President speaks to all scientists and to everyone who believes he’s got something to contribute. Until all the questions that keep cropping up are answered, we are not going to be able to say to a person who disagrees with the conventional thinking, ‘You are wrong or right.’ [The President] has never said HIV doesn’t lead to AIDS. The fact of the matter is there is so much that is still unknown about HIV and AIDS. … All President Mbeki is saying is, ‘Let’s listen to everybody. Let’s not silence one group or another with hysterical declarations. To find a solution to this thing we have to look at all angles.’

The ANC’s Head of Presidency and Communications, Smuts Ngonyama, asked: ‘How can you have a situation where you must ban ideas? We are coming from a situation in this country where organizations were banned, newspapers were banned, people were banned. Are we returning to that stage now?’ Department of Health Director General Ayanda Ntsaluba correctly pointed out that in ‘a practical way, the debate within the ANC really does not affect what we are doing. I would have been more concerned if I got the impression that we were being diverted from the current program at government.’ ANC Secretary-General Kgalema Motlanthe later wondered: ‘If the debate over the cause of AIDS had been sorted out, why then did the dissidents and [orthodox] scientists in the newly constituted AIDS panel admit that they have come together to debate the issue for the very first time?’ Struggle activist and former political exile attorney Christine Qunta wrote supportively in Business Day on 19 May: ‘To shut out the views of scientists who do not agree with the majority, but whose theories can enhance opportunities for finding solutions to the Aids epidemic is surely out of place in the modern scientific community. Their views must be aired. … It was absolutely correct and essential for the President to seek out the views of all scientists who may help government to find answers to deal with the epidemic.’

On the other hand Saadiq Kariem, chairman of the ANC national health committee, was furious: ‘There’s a small minority of very senior people in the party who support the dissident view. … [They were] irresponsible … The implications of this are enormous and disastrous. People have already come to me and said, “If HIV doesn’t cause AIDS and AIDS isn’t sexually transmitted, why am I wearing a condom?”’ Sandy Kalyan, Democratic Alliance deputy spokesperson on AIDS, sang from the same hymn-book: Mbeki was ‘blatantly causing South Africa irrefutable [sic] harm in the eyes of the international scientific community by rehashing an old debate on the cause of AIDS’. The WHO should pay Mbeki a visit and put right ‘his strange approach to the South African AIDS crisis’. After which he should apologise to the local scientists he’d embarrassed, she said, ‘and especially to the 20 per cent of the South African population which is living with the HIV/AIDS virus’. Her boss, Tony Leon, judged the proposed International AIDS Advisory Panel ‘a waste of money, a waste of paper and a waste of words’. Treatment Action Campaign chief Zackie Achmat agreed: ‘The debates around the causality of AIDS and the toxicity of antiretrovirals are obscuring the real issue: drug-pricing policies that have left many essential meds unaffordable for the vast majority of South Africans with HIV. Rather than waste precious time reopening dead debates, the government should commit sufficient resources to addressing this crisis.’ Helen Schneider, director of the Centre for Health Policy at the University of the Witwatersrand, took a sympathetic view of Mbeki’s musing: ‘I think it’s completely explainable. There’s a very recent history of direct conspiracy against black people in this country.’ Besides which, ‘People can’t cope. What you’re seeing is this enormous struggle to come to terms with this problem.’ Unsuccessfully, in Mbeki’s case, hence his denialism. But it was kind of Helen to be so understanding. Of the traumatised natives. Having trouble thinking straight.

None too happy about the proposed AIDS Advisory Panel were the Holy Order’s foreign eminences either: ‘At first, we were thinking we would just ignore it, but now we think this confusion can really undermine all the efforts people have made to prevent this disease,’ said Awa Coll-Seck, director of the UN Department of AIDS Policy in Geneva. ‘People will reassure themselves, perhaps, that they can continue risky behaviour because HIV is not the real cause of AIDS. It’s becoming a real issue.’ Helene Gayle of the US Centers for Disease Control and Prevention denounced the sceptics, saying ‘there is no merit in questioning conventional wisdom’ about HIV. Mathilda Krim, founder of the immensely wealthy and hugely influential AIDS organization, the American Foundation for AIDS Research (amfAR), even asked Mbeki if she could fly over and talk some sense into him, but he declined to see her. Top ‘AIDS expert’ Mark Wainberg, president of the International AIDS Society, smouldered over Mbeki’s plans: ‘We often find that the ground is cut out from under our feet by people who should know better.’ And then he turned on Duesberg, the Great Satan, who was ‘contributing to the spread of HIV’ by claiming it to be a harmless passenger virus – for which guys like him should be criminally prosecuted, he said. Wainberg amplified this later in the year at the 13th International AIDS Conference in Durban in an interview for the film, AIDS in Africa, by Robin Scovill. His mouth turned down as if he’d been sucking on a lime, his eyes burning with intense anger, he charged: ‘Those who attempt to dispel the notion that HIV is the cause of AIDS are perpetrators of death. I would very much, for one, like to see the constitutions of the US and similar countries have some means in place that we can charge people who are responsible for endangering public health with endangerment, and bring them up on trial.’ And concerning Duesberg:

I think people like Peter Duesberg belong in jail. … It strikes me that someone who would perpetuate the notion that HIV is not the cause of AIDS is motivated by sentiments of pure evil, that such a person may perhaps really want millions of people in Africa and elsewhere in the world to become infected by this virus and go on to die of it, and who knows, maybe there’s a hidden agenda behind the thoughts of a madman. Maybe all psychopaths everywhere have ways of getting their views across; they are sometimes camouflaged in subterfuge. But I suggest to you that Peter Duesberg is probably currently the closest thing we have in this world to a scientific psychopath. And now this interview is finished, thanks.

Well howdy-doody. Or perhaps mazel tov. Hey, settle down, big macha, it isn’t Peter’s fault he’s a German. At a lunch table at the conference, a couple of paces from where I sat, I saw Wainberg flashing a Colgate smile as he glad-handed several dazzled women. The international AIDS hero. Who’d proposed four months earlier, to Mbeki’s astonishment, that troublemakers like me be arrested and imprisoned. As I watched him, chilled, that same favourite word of his came to mind in Hannah Arendt’s timeless summation of Adolf Eichman, huddled in his Jerusalem criminal court dock: ‘the banality of evil’.

The Aaron Diamond AIDS Research Center’s John Moore said he was ‘flabbergasted’ by the AIDS Panel announcement: ‘Mbeki has given lifeblood to a dead cause.’ But he wasn’t going to take it lying down; he’d be approaching ‘very serious levels in the US government ... because [Mbeki] needs to get proper advice, from his peers. To see these questions resurging in a country where the AIDS problem is so much more serious [than in the US] is shocking and frightening; and to see the president of a nation taking this seriously is a very shocking thing.’ Mbeki’s call for a ‘re-examination’ of the infectious AIDS model was ‘tantamount to Holocaust denial because the implications are so serious’. Seth Berkley, head of the New York-based International AIDS Vaccine Initiative agreed: people entertaining doubts about HIV as the cause of AIDS were like ‘those that believe that the Holocaust did not occur’. Moore continued: ‘You should not try to steer government policy on a path that could lead to the genocide of a nation.’ As for Mbeki and Tshabalala-Msimang, ‘a charge of genocide would not be inappropriate ... Their efforts are already having a devastating negative effect on public health in South Africa [quite how he didn’t say], and the problems could well spread further if other nations are foolish enough to take a lead from the South African government.’ The journalist interviewing Moore was startled by the vehemence of his dogmatism. Didn’t Mbeki have the ‘democratic right’ to make an independent inquiry? Moore answered with more of the same: ‘It’s the South African government’s right to reinvent the wheel if they want, but these debates have been held and settled in America and Europe 10 years ago.’ Now if there’s one thing that ‘AIDS experts’ have in common with faithless lovers, it’s how readily lies spring to their lips. Because until something of a debate began in 2003 on the online letters page of the British Medical Journal there’d never been one worthy of the name. None of the published critiques have ever been answered.

‘AIDS experts’ charging doubters with Holocaust denial was a regular tactic to quash dissent from their doctrines. For instance, challenged by the Perth group in early 1999 in regard to his claims about the alleged isolation of HIV, Britain’s leading ‘AIDS expert’, Professor Robin Weiss of the Department of Immunology and Molecular Biology, Windeyer Institute, University College, London, evaded serious engagement on the issue, concluding: ‘There will always be a few people who cannot be convinced by the data before our eyes – or who emotionally wish to deny what the rest of us regard as facts. … In my view, to deny the existence of HIV is a bit like denying the Nazi holocaust. … This terminates our debate.’ The Perth Group shared this grossly unscientific talk with Rex Ranieri, a documentary filmmaker for TV Channel Nine in Australia. Ranieri urged Weiss to respond properly, but he carried on the same way as before:

If I were a radio or television producer, I think I might seek to explore a programme on latter day flat-earthers as a sociological phenomenon. What lies behind HIV and AIDS denial? Why do such people feel persecuted by scientific orthodoxy when in reality they are simply ignored? Why do quasi-fascist concepts keep slipping in, like the holy grail of [viral] ‘purification’? Doesn’t HIV denial resemble holocaust denial? First, I would take a vacation on the beach with the writings of two Italian Nobel Laureates who had suffered under fascism: Enrico Fermi the physicist who discovered nuclear fusion, and Primo Levi, the chemist who won the Nobel Prize for Literature, but later took his own life. These two thinkers would help me to place the issues of scientific controversy and society in proportion.

And that’s where Weiss ended, forgetting to append the second bit of personal counsel he had in mind for Ranieri when writing, ‘First’, before collapsing into incoherence and irrelevance.

Chekov recognised the style of the ‘AIDS experts’ a century earlier among medical professionals in Tsarist Russia, likening their ‘dullwittedness and tyranny’ to that of the secret police. But their ‘dullwittedness and tyranny’ had a natural appeal for Cameron: raised tentatively by him at the Durban AIDS Conference, genocide and Holocaust denial would develop into staple motifs in his attacks on Mbeki year after year. The Mail&Guardian’s too.

Rasnick wondered, ‘What’s behind all these shrill attacks on Mbeki?’, before solving his riddle himself: ‘It’s thousands of activists and scientists who fear they’re going to be out of a billion-dollar business.’ Duesberg seconded that: ‘I assume that the many beneficiaries of [the HIV/AIDS] hypothesis are now concerned that, for the first time, a head of state who is independent of the US government has called this unproductive and ... very detrimental hypothesis into question.’

In his fine analysis a year later of local media inventions of the Mbeki mystique, Bound by tradition: The world of Thabo Mbeki (UNISA, 2001), Lucky Mathebe defended Mbeki’s ‘unprecedented step ... of reopening the HIV/Aids debate’ in terms of his percipient central thesis that Mbeki ‘embodies pragmatism’. Having noted that he ‘shows an aversion to pure reason or ideology’ – of the Western ilk – Mathebe wrote:

In keeping with the traditional patterns of pragmatism, Mbeki needed all views, dominant or dissenting, to be subject to a careful and ongoing process of close scrutiny or examination. Like all pragmatists he does not believe in ‘dominant’ views and he maintains a stance against a priori or ideological positions. His pragmatism has motivated him to seek new insights on the epidemic. Because he is given to the view that the universe is not closed or complete, he felt it necessary to grant the dissidents or heretics a platform to play a meaningful role in the shaping of human affairs.

Just that point was made in a public statement in mid-March 2000 by Presidential spokesman Mankahlana, in defence of Mbeki’s decision to ‘reinvigorate the debate’, as Mbeki put it, by convening his multilateral advisory panel on AIDS:

Let’s not obsess with this petty foolishness. AZT is not a cure for AIDS, and besides, it’s unaffordable. … Why are the critics of Mbeki creating the impression that [AZT is an effective treatment for AIDS] when they know it isn’t? In fact it is Mbeki’s critics who are in denial about HIV/AIDS because they create a false sense of hope that a certain drug will intervene in the problem. This is not the case. … What is important is that here we have a disease that there is no cure for. … That is why we are putting an international panel together to re-evaluate what we know, and which is clearly not complete, and therefore not the answer. … The President is saying let us all work together on this. And yes, there is going to continue to be confusion, but the person who’s going to shut us up is the person who finds a cure. The President doesn’t belong to any faction. … This panel must strive to give answers to all the unknowns. It must attempt to unravel all the ‘mysteries’, including what the profit-takers cannot tell us.

On the way, Mankahlana hit out at ‘the machinations of the profiteering pharmaceutical companies’, evidently citing from Mbeki’s table-talk:

Sure, the shareholders of GlaxoWellcome will rejoice to hear that the South African government has decided to supply AZT to pregnant women who are HIV-positive. The source of their joy will not be concern for those people’s health, but about profits and shareholder value. … Like the marauders of the military-industrial complex who propagate fear to increase their profits, the profit-takers who are benefiting from the scourge of HIV/AIDS will disappear to the affluent beaches of the world to enjoy wealth accumulated from a humankind ravaged by a dreaded disease. And we will continue to die from AIDS.

Back in the UK, the company’s executive director for Africa, James Cochran, naturally didn’t see it this way. In his view, ‘blaming the pharmaceutical industry for failure to arrest the current AIDS epidemic in Africa is convenient but simplistic. … The real barriers to access to treatment are lack of education, medical infrastructure and political will.’ Especially political will – as was evident from the government’s failure to take up its offer of AZT at a a quarter of its usual cost, an offer the government had spurned, he said.

As we read Mankahlana nailing the drug company, we were, for the most part, listening to his master’s voice: acid comments uttered privately without diplomatic sweetening. About an industry Mbeki had long-appreciated has immense clout: When during a visit to Vice President Al Gore on 5 August 1997 the latter pointed out, ‘You know Thabo, the American pharmaceutical industry exerts an influential voice in political circles’, Mbeki retorted: ‘Yes, all over the world.’ But evident from Mankahlana’s language was that he was personally still in thrall of the newspaper story that AIDS was a new dread disease ‘ravaging’ the country, and that he hadn’t himself arrived at the radical insights of his principal. And as it turned out, Mankahlana, unlike Mbeki, wasn’t personally on top of the AZT toxicity literature either. His misapprehensions about HIV and AIDS, and his ignorance concerning the toxicity of AZT, would cost him his own life seven months later – taken by the very drug he was deprecating as ineffective.

Mankahlana responded further to all the outrage in a statement Building a Monument to Intolerance, published in abdridged form by the Mail&Guardian on the 31st, under the title What the president said:

The Presidency spent considerable time the past week searching frantically for a passage in the President’s speeches which said an HIV-positive condition does not lead to Aids. Neither his private correspondence nor a reconstruction of all the discussions with either his ministers or any other authority on the question of HIV and Aids could produce any evidence of this. So the President has never said that HIV does not cause Aids. … It turns out the President’s cardinal sin was making contact with someone by the name of David Rasnick who does not share the commonly held view that HIV leads to Aids. It is said that it is wrong for him to talk to such people. They are even called dissidents. If he spoke to these people he would undermine the work done over the many years and he would cause South Africans and other people who live with HIV and Aids to lower their guard. … Assailants of the President therefore argue that the President must not question the accepted hypothesis on HIV/AIDS. He must then give AZT to HIV-positive pregnant women and those who have been victims of rape. He must tell his people to use condoms and practice safe sex. He must not listen to anyone who disagrees with the accepted line of thinking and the problem of HIV and Aids will come to an end. … Mbeki’s dilemma is compounded by the fact that he does not have the option to dispense AZT to people because it is simply unaffordable. Not only is AZT not a cure for HIV/AIDS, but also it has been proven to be ineffective unless it is used together with other drugs. This regime costs at least R4 000,00 a month. Given that the government will not afford the cocktails that are prescribed for the treatment of HIV/AIDS, our response to the pandemic must be the distribution of condoms and an unwavering belief that HIV is the sole cause of AIDS. This approach says we must sit back and do nothing about HIV and AIDS. It says that the problem is beyond our comprehension and therefore impossible to resolve. We definitely cannot accept this approach. Mbeki says this approach is inadequate. We cannot be content with knowing what the cause of the illness is. We must eradicate the sickness from the face of the earth. Because there is no cure for HIV/ AIDS and because people continue to die from AIDS the search for a solution must continue. This is all President Thabo Mbeki is advocating. Humanity is faced with a difficult problem that in the remarkable advances that have been made in science and technology notwithstanding, we are faced with a complex disease that is threatening to destroy the whole of humanity. The propensity to self-destruct and search for non-existent adversaries is common when people find themselves under siege. In any case why are we told a lie that AZT is a panacea to the problem of AIDS. It simply is not. And why are critics of Mbeki creating the impression that it is when they know it isn’t? In fact it is Mbeki’s critics that are in denial about HIV/AIDS because they advocate a false sense of hope that a certain drug will intervene in the problem. This is not the case. There is a raging debate in scientific circles that antibiotics are harmful to health. We have been using these wonder drugs for decades. Many can rightfully claim their livelihood to these drugs. And yet no one is accusing those who initiated these questions about antibiotics of being ‘scientifically naive and foolish’ … But then why is it that what we know about HIV and AIDS should not be questioned, the glaring inadequacies in humanity’s response to the problem notwithstanding? … The search for an answer to the problem of HIV/AIDS must be re-invigorated. That is why we are putting an international panel together to re-evaluate what we know and which is clearly not complete and therefore not the answer. … Frankly we cannot satisfy ourselves with the definition that the foreskins of the Zulu are the explanation for the rapid spread of the disease in one section of the country. … Government is strong in its resolve that we cannot confine our response to the problem of HIV/AIDS to an injunction not to speak to David Rasnick or telling people how to think. Whether we speak to Rasnick or not, whether there are thought police to monitor what others think, human beings will continue to die from AIDS. A disturbing trend in the response to the current debate has been the rabid intolerance to different viewpoints that has been displayed in the South African media. One prominent commentator even brandished the President a criminal because he spoke to Rasnick and also because he dared think beyond what is accepted wisdom. Surely we do not want to return to the days of Stoffel Botha and the total onslaught. As far as we know all efforts to prescribe how other people should think have failed all over the world, both under capitalism and erstwhile socialism. Even dictatorships and fascism failed to suppress the freedom of the human mind to wonder in search of solutions to the intractable problems that face us. Government advocates safe sex and the use of condoms as one of the elementary responses to the problem of HIV / AIDS. The President is going to continue to mobilise public awareness about the dreadful nature of the disease. Furthermore President Mbeki is going to intensify the fight for the end of discrimination against and exploitation of people who live with HIV/AIDS, both by insurance and medical schemes and the pharmaceutical giants who are the sole beneficiaries in the dogged defence of AZT by large sections of the media. Yes they buy a lot of advertising space and are therefore a strong ally of publishing and broadcasting houses, to the detriment of the millions that live with HIV and AIDS.

All of which sounded perfectly reasonable, who’d disagree? But disagree the drug fans did. The Mail&Guardian’s mystified editorial, What’s behind Mbeki’s crusade?, in the same issue, portrayed perfectly the general attitude in the suburbs to Mbeki’s initiatives. Its tone was classic white South African liberal (‘You can have the afternoon off, Gertie’) – moralistic and condescending:

There is nothing inherently wrong in trying to keep open the debate about HIV/Aids … But engaging in this kind of investigation can be highly problematic if you are Thabo Mbeki, president of South Africa. … he has at times behaved like someone trying to be the Boy’s Own basement lab hero of Aids science. He has allowed his attention to be diverted into abstruse debates on immunology and related science. He seems to have become the international political patron of views on HIV/Aids which seriously undermine the deployment in this country of best available methods based on the best available science for treating HIV/Aids and related conditions. In the process, the nation’s attempts to deal with this national health crisis have been plunged into confusion. … It is small wonder that scientists, diplomats and politicians, even in Mbeki’s own party, are asking whether Mbeki’s usually astute judgment has completely deserted him. His behaviour has also led to unhelpful speculation about why he is so strangely exercised by the issue. Even if the largely discredited dissident views to which he wishes to give so much air are eventually proved to have been right, this will not compensate for the ground that is being lost right now in our fight against what best science sees fit to call HIV/Aids. … We and other critics of the president’s approach to HIV/Aids would deny no one – not even crackpots [this writer, see below] – the right to challenge conventional wisdom. The issue for us is that Mbeki is missing his vocation completely if he seeks to revise scientific knowledge instead of expediting policy in the way he was elected to do. … Why has Mbeki embarked on this stubborn, silent crusade? There are no obvious reasons, no reports of African National Congress branches rising up and demanding that the president personally push the case for the earth being flat in the world of Aids science. … The dismay over Mbeki’s actions crosses the nation’s traditional fracture lines, with Mamphela Ramphele and Malegapuru Makgoba, among the most prominent of the black scientists and doctors, as desperate for a government turnaround as any white health worker. … No one disputes Mbeki’s good intentions. He clearly understands the extent of the Aids epidemic, and the social and political problems it poses. If he were not deeply concerned by the Aids problem, it is highly unlikely he would have become so deeply embroiled in it. What is unclear is his judgment on this matter – and his unwillingness to confine himself to the job he was elected to do and to restrict his forays into the intricacies of specialised subjects to the taking of best available advice.

Unable to shut down Mbeki’s plans for his proposed International AIDS Panel by shouting, the ‘AIDS experts’ now took to sulking. On 4 April the Independent Online reported that ‘furious’ about Mbeki’s contact with the ‘renegade’ experts – ‘dissident David Rasnick, in particular’ – as well as ‘the government’s refusal to provide pregnant women with the anti-Aids drug AZT’, a number of English ‘AIDS experts’ as well as ‘several US organisations and companies’ – were threatening to boycott the 13th International AIDS Conference in Durban in July. But Tshabalala-Msimang dismissed their moans: ‘We’re known for talking to everybody. It will be strange to exclude certain people because their views do not agree with the established views.’

Amazed by the virulence of the personalised criticism he was drawing, Mbeki wrote confidential letters to Bill Clinton, Tony Blair, Gerard Schroeder, Kofi Annan and other world leaders on 3 April, dispatched in secure diplomatic bags, conveying his scepticism of the First World AIDS model and approach, and deploring his critics’ ‘orchestrated campaign of condemnation’. But having posed the first political challenge to the sanctity of HIV/AIDS science – breaching its moat and battering its gate – it really ought not to have surprised him when its guardians responded from the parapets with an unrelenting torrent of burning oil, slingshots and poisoned arrows.

I am honoured to convey to you the compliments of our government as well as my own, and to inform you about some work we are doing to respond to the HIV/AIDS epidemic. As you are aware, international organizations such as UNAIDS have been reporting that Sub-Saharan Africa accounts for two-thirds of the world incidence of HIV/AIDS. These reports indicate that our own country is among the worst affected. Responding to these reports, in 1998, our government decided radically to step up its own efforts to combat AIDS, this fight having, up to this point, been left largely to our Ministry and Department of Health. Among other things, we set up a Ministerial Task Force against HIV/AIDS chaired by the Deputy President of the Republic, which position I was privileged to occupy at the time. Our current Deputy President, the Hon. Jacob Zuma, now leads this Task Force. We also established Partnerships against AIDS, with many major sectors of our society including the youth, women, business, labour unions and the religious communities. We have now also established a National AIDS Council, again chaired by the Deputy President and bringing together the government and civil society. An important part of the campaign that we are conducting seeks to encourage safe sex and the use of condoms. At the same time, as an essential part of our campaign against HIV and AIDS, we are working to ensure that we focus properly and urgently on the elimination of poverty among the millions of our people. Similarly, we are doing everything we can, within our very limited possibilities, to provide the necessary medicaments and care to deal with what are described as ‘opportunistic diseases’ that attach to acquired immune deficiency. As a government and a people, we are trying to organize ourselves to ensure that we take care of the children affected and orphaned to AIDS. We work also to ensure that no section of our society, whether public or private discriminates against people suffering from HIV/AIDS. In our current budget, we have included a dedicated fund to finance our activities against HIV/AIDS. This is in addition to funds that the central government departments as well as the provincial and local administrations will spend on this campaign. We have also contributed to our Medical Research Council such funds as we can, for the development of an AIDS vaccine. Demands are being made within the country for the public health system to provide anti-retroviral drugs for various indications, including mother-to-child transmission. We are discussing this matter, among others with our statutory licensing authority for medicines and drugs, the Medicines Control Council (MCC). Toward the end of last year, speaking in our national parliament, I said that I had asked our Minister of Health to look into various controversies taking place among scientists on HIV and AIDS and the toxicity of a particular anti-retroviral drug. In response to this, among other things, the Minister is working to put together an international panel of scientists to discuss all these issues in as transparent a setting as possible. As you know, AIDS in the United States and other developed Western countries has remained largely confined to a section of the male homosexual population. For example, the cumulative heterosexual contact, US percentage for AIDS cases among adults/adolescents, through June 1999 is given as 10 percent. (HIV/AIDS Surveillance Report: Midyear edition. Vol 11, No 1, 1999. US Department of Health and Human Services). The cumulative absolute total for this age group is reported as being 702,748. US AIDS deaths for the period January 1996 to June 1997 were stated by the US CDC as amounting to 32,750. (Trends in the HIV and AIDS Epidemic: 1998. CDC). On May 13, 1999, a SAFA-AFP report datelined Paris stated that 1998 UNAIDS and WHO reports had said that AIDS was responsible for one death in five in Africa, or about two million people. It quoted a Dr. Awa Coll Seck of UNAIDS as saying that there are 23 million carriers in Africa of HIV. This SAFA-AFP report quotes Dr. Coll Seck as saying: ‘In Southern Africa, the prevalence of the (HIV) infection has increased so much in five years that this region could, if the epidemic continues to spread at this rate, see its life expectancy decline to 47 by 2005.’ (Interestingly, the five years to which Dr. Coll Seck refers coincide closely with the period since our liberation from apartheid, white minority rule in 1994). The report went on to say that almost 1,500 people are infected in South Africa every day and that, at that point, the equivalent of 3.8 million people in our country carried the virus. Again as you are aware, whereas in the West HIV/AIDS is said to be largely homosexually transmitted, it is reported that in Africa, including our country, it is transmitted heterosexually. Accordingly, as Africans, we have to deal with this uniquely African catastrophe that: * contrary to the West, HIV and AIDS in Africa is heterosexually transmitted; * contrary to the West, where relatively few people have died from AIDS, itself a matter of serious concern, millions are said to have died in Africa; and, * contrary to the West, where AIDS deaths are declining, even greater numbers of Africans are destined to die. It is obvious that whatever lessons we have to and may draw from the West about the grave issue of HIV/AIDS, a simple superimposition of Western experience on African reality would be absurd and illogical. Such proceeding would constitute a criminal betrayal of our responsibility to our own people. It was for this reason that I spoke as I did in our parliament, in the manner in which I have indicated. I am convinced that our urgent task is to respond to the specific threat that faces us as Africans. We will not eschew this obligation in favour of the comfort of the recitation of a catechism that may very well be a correct response to the specific manifestation of AIDS in the West. We will not, ourselves, condemn our own people to death by giving up the search for specific and targeted responses to the specifically African incidence of HIV/AIDS. I make these comments because our search for these specific and targeted responses is being stridently condemned by some in our country and the rest of the world as constituting a criminal abandonment of the fight against HIV/AIDS. Some elements of this orchestrated campaign of condemnation worry me very deeply. It is suggested, for instance, that there are some scientists who are ‘dangerous and discredited’ with whom nobody, including ourselves, should communicate or interact. In an earlier period in human history, these would be heretics that would be burnt at the stake! Not long ago, in our own country, people were killed, tortured, imprisoned and prohibited from being quoted in private and in public because the established authority believed that their views were dangerous and discredited. We are now being asked to do precisely the same thing that the racist apartheid tyranny we opposed did, because, it is said, there exists a scientific view that is supported by the majority, against which dissent is prohibited. The scientists we are supposed to put into scientific quarantine include Nobel Prize Winners, Members of Academies of Science and Emeritus Professors of various disciplines of medicine! Scientists, in the name of science, are demanding that we should cooperate with them to freeze scientific discourse on HIV/AIDS at the specific point this discourse had reached in the West in 1984. People who otherwise would fight very hard to defend the critically important rights of freedom of thought and speech occupy, with regard to the HIV/AIDS issue, the frontline in the campaign of intellectual intimidation and terrorism which argues that the only freedom we have is to agree with what they decree to be established scientific truths. Some agitate for these extraordinary propositions with a religious fervour born by a degree of fanaticism, which is truly frightening. The day may not be far off when we will, once again, see books burnt and their authors immolated by fire by those who believe that they have a duty to conduct a holy crusade against the infidels. It is most strange that all of us seem ready to serve the cause of the fanatics by deciding to stand and wait. It may be that these comments are extravagant. If they are, it is because in the very recent past, we had to fix our own eyes on the very face of tyranny. I am greatly encouraged that all of us, as Africans, can count on your unwavering support in the common fight to save our continent and its peoples from death from AIDS. Please accept, Your Excellency, the assurance of my response.

THABO MBEKI

Mbeki disclosed the purpose of his letter during a television interview by Joan Shenton, slotted into the MNet television programme Carte Blanche on 16 April, in the course of which he justified his order that the safety of AZT be investigated – for pregnant women especially:

J S: Last year you were reported in Parliament as being concerned about giving AZT to pregnant mothers. Why were you concerned?

MBEKI: Well, because lots of questions had been raised about the toxicity of the drug, which is very serious. We as the government have the responsibility to determine matters of public health, and therefore we can take decisions that impact directly on human beings, and it seemed to me that doubts had been raised about the toxicity and the efficacy of AZT and other drugs, so it was necessary to go into these matters. It wouldn’t sit easily on one’s conscience that you had been warned and there could be danger, but nevertheless you went ahead and said let’s dispense these drugs.

J S: Some AIDS doctors say the evidence is overwhelming that AIDS exists and AZT is of benefit. What is your comment on that?

MBEKI: I say why don’t we bring all points of view. Sit around a table and discuss this evidence, and produce evidence as it may be, and let’s see what the outcome is, which is why we are having this international panel which we are all talking about. They may very well be correct, but I think if they are correct and they are convinced they are correct, it would be a good thing to demonstrate to those who are wrong, that they are wrong.

J S: People say you are not keen on giving AZT to pregnant women because it is too expensive and in some ways you are seen as penny-pinching. What do you reply to that?

MBEKI: That surely must be a concern to anyone who decides this drug must be given to stop transmissions, again from mother to child, which is extremely costly and must be taken into account. But we also need in that context to answer the particular questions of toxic effect of this drug. If you sit in a position where decisions that you take would have a serious effect on people, you can’t ignore a lot of experience around the world which says this drug has these negative effects.

J S: Why have you been so outspoken recently about greed and the pharmaceutical companies?

MBEKI: I think a lot of the discussion that needs to take place about the health and treatment of people does seem to be driven by profit. We’ve had a long wrangle with the pharmaceutical industry about parallel imports, and what we were saying is we want to make medicines and drugs as affordable as a possible to what is largely a poor population. We need to find these medicines that are properly controlled, properly tested, the genuine product and no counterfeits.

J S: In the press you are exhorted to confine yourself to the job to which you were elected, and leave specific subjects to the taking of best available advice.

MBEKI: I don’t imagine Heads of Government would ever be able to say I’m not an economist therefore I can’t take decisions on matters of the economy; I’m not a soldier I can’t take decisions on matters of defence; I’m not an educationist so I can’t take decisions about education. I don’t particularly see why health should be treated as a specialist thing and the President of a country can’t take Health decision. I think it would be a dereliction of duty if we were to say as far as health issues are concerned we will leave it to doctors and scientists, or as far as education is concerned we will leave it to educationists and pedagogues. I think the argument is absurd actually.

J S: How do you feel about the reaction of your country’s leading virologists and intellectuals to your position?

MBEKI: I get a sense that we’ve all been educated into one school of thought. I’m not surprised at all to find among the overwhelming majority of scientists, are people who would hold one particular view because that’s all they’re exposed to. This other point of view, which is quite frightening, this alternative view in a sense has been blacked out. It must not be heard, it must not be seen, that’s the demand now. Why is Thabo Mbeki talking to discredited scientists, giving them legitimacy. It’s very worrying at this time in the world that any point of view should be prohibited, that’s banned, there are heretics that should be burned at the stake. And it’s all said in the name of science and health. It can’t be right.

J S: Now it has been said that the pharmaceutical industry is more powerful than government. Are you going to take this debate to other world leaders like President Clinton, Prime Minister Blair or the Prime Minister of India, who has expressed support for an investigation into these issues, as you are?

MBEKI: Certainly I want to raise the matter with politicians around the world, at least get them to understand the truth about this issue, not what they might see on television or read in newspapers. And we were very glad to see India get themselves involved in this issue. The concern around probable questions, which in a sense have been hidden, will grow around the world and the matter is critical, the reason we are doing all this is so we can respond correctly to what is reported to be a major catastrophe on the African continent. We have to respond correctly and urgently. And you can’t respond correctly by closing your eyes and ears to any scientific view that is produced. A matter that seems to be very clear in terms of the alternative view, is what do you expect to happen in Africa with regard to immune systems, where people are poor, subject to repeat infections and all of that. Surely you would expect their immune systems to collapse. I have no doubt that is happening. But then to attach such important defence to a virus produces restrictions and what we are disappointed about as an Africa government is that it seems incorrect to respond to this AIDS challenge within a narrow band. If we only said safe sex, use a condom, we won’t stop the spread of AIDS in this country.

But in hoping to enlighten ‘politicians around the world’, assist them ‘to understand the truth about this issue’, and alert them to the fact that serious questions about AIDS orthodoxy were being neglected or suppressed by the media, and that the orthodoxy was itself a product of media fanfare around AIDS, Mbeki had miscalculated. From a mistaken premise. That the most powerful politician in the world, Bill Clinton, was a decent sort. Clinton was taken aback. The Third World rebel wasn’t playing ball. Disregarding the fact that Mbeki’s letter to him was a private communication, Clinton contrived – in an outrageous breach of basic personal etiquette – to neutralise the threat it posed to his country’s AIDS project by dint of a tactical leak to the Washington Post. The Post published it on 18 April, covered by a blistering editorial, accusing Mbeki of having taken a ‘further step down a path that will make the scourge of AIDS worse’, that he ‘unaccountably continues to embrace and legitimize absolute misinformation about the causes and treatment of AIDS’, and that he ‘continues to evade the reality’ of it. Worst of all he had convened an international panel of experts including ‘dissidents’ who claim AIDS ‘is a result of malnutrition rather than infection by HIV’. The panel was ‘ludicrous waste of precious time, and a cruel hoax on his suffering people’. With one in ten of his country infected, South Africa is ‘in the midst of a medical holocaust. … No serious medical scientist doubts the causal link between HIV and AIDS. And no serious political leader should either.’

Clinton’s aides burnished the innuendo that Mbeki was nuts by feeding the Post the transparently false claim that the administration had initially endeavoured to keep the discreditable letter quiet. The Henry J Kaiser Foundation faithfully repeated this in its Daily HIV/AIDS Report the next day: ‘After receiving the letter, the Clinton administration tried to limit its distribution.’ Thinking we were stupid. And as gullible as the Washington Post’s former local correspondent Allister Sparks. Who gobbled it down without stopping to chew. In his book Beyond the miracle he parrots:

The White House was so astonished at this equating of criticism of the dissidents with apartheid tyranny [in fact Mbeki’s complaint concerned censorship not criticism] that it ran a check to see whether the letter was a hoax. It then tried to keep the letter under wraps to avoid embarrassing Mbeki, but the letter was leaked and there was an avalanche of adverse publicity in the US and elsewhere. I happened to be in Washington at the time ... and everywhere I went people would question me about Mbeki. ‘What gives with your new President?’ they would ask. ‘Is he crazy?’

They might have asked Sparks instead: Are you as big a sucker for planted misinformation as the rest of us? Because it should have been perfectly obvious that the letter, personally addressed and securely couriered, could never have been leaked to the press without Clinton’s express assent. And that the private communication would have remained ‘under wraps’ in perpetuity without it.

A negative front-page report in the Washington Post duly followed on the 19th, S. African President Escalates AIDS Feud:

At loggerheads for months with his own medical establishment over the pandemic that is killing millions of South Africans, Mbeki has now raised the dispute to the international arena with a passionate defense of his approach to the crisis in a letter dispatched this month by diplomatic pouch to President Clinton and other heads of state. … Several Clinton administration officials and foreign diplomats expressed dismay at Mbeki’s decision to intensify what they see as a diversionary dispute and to bring it to a potentially volatile international forum.

The report explained the reason for the worry:

Mbeki’s words resonate widely because his nation’s new democracy and advanced industry make it a natural leader on the continent, a status acknowledged in its selection as host of this year’s international conference on AIDS. So stunned were some officials by the letter’s tone and timing – during final preparations for July’s conference in Durban – that at least two of them, according to diplomatic sources, felt obliged to check whether it was genuine.

Most troubling to the Americans was Mbeki’s impregnable logic; the Post quoted Assistant Secretary of State Susan Rice: ‘It was clearly impassioned in parts, but I thought much of its substance was quite logical and quite compelling.’

But Makgoba disagreed: ‘I think the letter was emotional and irrational. This man will regret this in his later years. He displays things he doesn’t understand. … I think we are just creating [an image of] ourselves as an embarrassment to the world. The scientific evidence about these issues is so clear that one is really surprised that we spend so much time and energy having a heated argument about something that is very straightforward.’ The effect, he said, was that Mbeki and his government were undermining South Africa’s efforts to fight the epidemic. But Mankahlana countered that Mbeki was simply looking at all views: ‘The problem that the scientific world has is this: It has to do with human arrogance.’

Duesburg was pleased: ‘I think after this letter, I have to go [to the AIDS Panel meeting]. It’s getting hot again, just like in the old days, thanks to Mbeki. I’m surprised that there’s a place left on this planet where you can ask commonsensical questions.’

On the same day that the Washington Post was discrediting Mbeki at the bidding of the Clinton administration, his deputy Zuma spoke in his defence during a parliamentary debate, emphasizing that ‘At no point has the President said that he challenges the view that HIV causes AIDS, or the contrary. All we are saying is that the issues must be debated and all views are considered. We should not, and we will not leave any stone unturned, even if this means including the view of the so-called dissidents. … No scientists had a monopoly on all knowledge about AIDS.’ In a positive reference to the breakaway dissident chapter of the AIDS activist organisation ACT UP in San Francisco, Zuma compared the group’s contention that HIV is harmless with Galileo’s critique of the geocentric theory of planetary motion. So more was the pity that Coovadia had cancelled ACT UP SF’s booth at the AIDS Conference in July; Zuma read from their letter of complaint to Mbeki about this: ‘For the past decade in San Francisco we have witnessed the destruction of human life caused by AIDS drugs. We hoped that by exhibiting at the conference, we could warn participants to prevent a similar catastrophe occurring in their countries.’

Coovadia had put his foot down: their ‘attendance will detract from the ethos and principles of the conference,’ he said. Their ‘support for the “Duesberg theory”, which is inaccurate and harmful and has constantly been discredited in the scientific community … can only harm efforts at HIV openness, cause tremendous confusion among people at risk and undermine much needed prevention efforts’. The South African Medical Association spoke the same way in its journal the SAMJ in May: ‘Whilst SAMA welcomes any debate on health it is obliged to point out that the view HIV may not cause AIDS has been thoroughly discredited by several recent scientific studies. [An entirely false statement.] This view is dangerous and its propagation may lead to cases of AIDS that may have otherwise been prevented.’

On the 20th, a day after the Washington Post’s attack on him, the South African Press Association wired Mbeki’s response, conveyed by his spokesman Mankahlana, to calls that he go for an HIV test: ‘The President is not prepared to engage in trivia; he has got more important things to worry about than testing for HIV/AIDS. Those who want to go and test for HIV/AIDS must do so.’

After contemptuously leaking Mbeki’s private letter to him to the press, Clinton promptly made plain his low opinion of it by announcing a ‘Marshall Plan for AIDS’. A bill went through the House on 15 April directing the Treasury to see to the establishment of a trust fund to be administered by the World Bank to collect public and private funds to combat AIDS in Africa. The bill authorized an annual US contribution of $100 for five years. ‘The survival of the continent is at stake,’ said Democratic Party Representative Barbara Lee for California. ‘AIDS is decimating the continent and leaving behind millions of orphans in its wake.’ ‘… no issue in the world is more consequential,’ said Jim Leach, Democratic Representative for Iowa.

Things took a serious turn two weeks later when on 29 April Clinton formally declared AIDS abroad – in Southern Africa particularly – a threat to US national security. A National Intelligence Estimate prepared in January, on which the White House claimed to have relied – strategically declassified and posted on the CIA’s website – claimed that it was the consensus of government analysts that a quarter of Southern Africa’s population would die of AIDS and that the numbers would rise for a decade, causing ‘a demographic catastrophe’, and creating an ‘orphan cohort unable to cope and vulnerable to exploitation and radicalization’. The Estimate warned that ‘state failure in partial democracies’ would be the result. Since there aren’t any true democracies in Africa. As AIDS killed off Africa’s people ‘revolutionary wars, ethnic wars, genocides and disruptive regime transitions’ would follow. ABC’s World News quoted administration officials the following day. The ‘global death rate from HIV/AIDS is so overwhelming, the spread of infection so rapid and the consequences to national security so dire ... that the United States must in effect declare war on the disease’.

And it was more than big talk: Clinton established an ‘interagency working group to develop a series of expanded initiatives to drive the international efforts’ to fight it. By making this declaration, Clinton was bringing the National Security Council into the game. Which is no joke. Mhlongo told me how he later got a visit at his MEDUNSA office by a pair of CIA spooks (in transparent poses), questioning him inter alia about what they suggested were Mbeki’s mental problems.

Sandra Thurman, director for the White House Office of National AIDS Policy, told Associated Press: ‘We have to respond to this because we’ve never seen a crisis like HIV and AIDS globally. We’re beginning to understand that this epidemic not only has health implications, but has implications as a fundamental development issue, an economic issue and a stability and security issue. With the logistical expertise that the national security community brings, with the diplomatic expertise that is necessary to sort of pave the road for leaders around the world to respond to this epidemic, this gives us a whole new ability to respond to AIDS like we would respond to any other international threat.’

As it made AIDS in Africa the new threat to American security for its spooks to deal with, the White House announced that it would seek $254 million from Congress to fight AIDS in Africa, double the steady $120 million annual allocation that had been spent over the preceding seven years.

Taking Clinton’s lead, the World Bank declared AIDS in Africa its ‘No. 1 priority’ in the same month, a move predicted by its president James Wolfensohn’s speech before the UN Security Council on 10 January, in which he announced that AIDS had become its ‘central development issue. … Many of us used to think of AIDS as a health issue. We were wrong. AIDS can no longer be confined to the health or social sector portfolios. AIDS is turning back the clock on development.’ Swayed by his pitch, the UN Security Council followed suit in May by declaring AIDS a ‘global security issue’.

The political implications of Mbeki’s appeal for a panopoly of views about AIDS to be heard and considered had become enormous. South Africa’s freedom to make its own policy was being cramped by decrees passed overseas, whose writ extended into our country, with millions of dollars allocated to carrying them out. The pressure on Mbeki to conform to the party line and to desist from subverting the orthodox virus/chemotherapy consensus was intense. He was becoming a threat to the safety of the world. And who needs reminding what happened to Patrice Lumumba in newly independent Congo shortly after Eisenhower passed that very judgement upon him? After which, it emerged during the Church hearings in the Senate in 1975, the CIA was only too quick to oblige.

The American administration’s beliefs that South Africa was the rotting pit of venereal disease among blacks that the ‘AIDS experts’ were claiming it was, and that Mbeki’s scepticism presented a serious stumbling block to American plans to cure the epidemic, was demonstrated by the first order of business of US Secretary of State Colin Powell on a state visit to South Africa a year later, in the third week of May 2001. Within hours of his arrival he paid a visit to an AIDS clinic for a photo-shoot. Asked by a journalist whether he’d talked to Mbeki, he clenched his jaw and answered only that he was ‘doing everything possible’ to combat AIDS. Two years later he’d be declaring AIDS the world’s worst crisis, a ‘weapon of mass destruction’.

The Mail&Guardian published an opinion piece on 1 May 2000, Mbeki’s Aids letter defies belief, by some tired former pathology professor, one Michael Berger. Trading on his fading papers to sound authoritative, because it was quite evident that he hadn’t actually taken the trouble, as Mbeki had, to read into the matters about which he spoke, his article celebrated that characteristic old South African English attitude, with a veneer of reason covering snarling chauvinistic disdain. Compensating for his astigmatic inability to see what troubled Mbeki about AIDS ideologically, over and above the fact that the science was bad, Berger resorted to a series of banal, unexamined ex cathedra assertions, before sticking the knife in about his unhealthy ‘cast of mind’. He opened by asking,

what does one make of Mbeki’s implicit denial of the relevance of Western science and Western solutions? Does it imply a belief that the West’s view of Aids in Africa represents a racist attempt to “smear” African morals and culture? There is, indeed, a body of opinion, small and fringe though it may be, which claims that the current scientific view on the origin and spread of Aids in Africa is an attempt to portray Africans as immoral and addicted to sexual excess. By calling into doubt the central tenet of the current belief on the origins of Aids, namely, that it is a viral infection spread mainly by sexual contact, Mbeki is tacitly denying what he may see as a Western conspiracy against his continent. It seems to me impossible to reach a single conclusion; the letter admits of so many interpretations. Possibly, it doesn’t matter and the president’s motivations and reasons for writing in this vein were mixed. Whatever the full answer, the letter is deeply disturbing. It demonstrates a capacity for justifying the most unreasonable of positions by a brew of implausible appeals to populist sentiments and prejudices. It suggests a racial-based perspective, not uncoloured by paranoia. It is quite possible that overseas investors will see a link between Robert Mugabe’s cynical pre-election end-game to the north of us and the kind of imagery employed by Mbeki in his letter. But, more importantly, the mode of discourse reflected in Mbeki’s letter is no stranger to South Africa. Sober, reality-based assessment is cast aside in favour of ideologically driven rhetoric – as if the intensity of verbalised belief can supersede objective fact and rational argument and displace any unwelcome, internal doubts. And so it can in a limited sense, but at a great price to a vulnerable society which harbours such modes of thinking. It is not a great step from the limited issue of Aids to the wider political playing field. Surely the stakes are too high, for our country and Africa as a whole, for us to afford such propensities in ourselves or in our political leaders?

Princeton University demographer Robert Shell, then at Rhodes, picked up Berger’s basic implication and put it expressly later in the year, on 4 October: ‘The ANC must find a way to get Mbeki to resign. As far as HIV researchers are concerned, we would like him to go.’ Stefan Vella, Wainberg’s successor as president of the International AIDS Society, was reported on the radio asserting at the opening of the 14th International AIDS Conference in Barcelona on 8 July 2002 that recalcitrant political leaders not cooperating in implementing AIDS treatment programmes – he meant Mbeki – should be sacked. It was amazing. Like the Vatican in the old days vetting the appointment of kings and queens, the AIDS theocracy today decides who’s fit to govern. Depending on their beliefs.

On 7 May 2000 the Sunday Independent climbed into Mbeki about his letter too. On the basis of a series of false historical assertions (commonly called lies), liberal journalists Jeremy Gordin and Adele Sulcas rejected his appeal to his fellow heads of state for an open intellectual and scientific environment in which to address AIDS:

HIV/AIDS is not a freedom of speech issue. It is about scientifically verifiable facts. … What’s more, the various controversies taking place among scientists on HIV/AIDS ... took place six and ten years ago. The dissident scientists were not ... burnt at the stake or even silenced. In fact, they were initially paid a great deal of attention. But then they were proved to be unsound by contrary evidence and have remained silent ever since, until you [Mbeki], among others, recently provided them with a new forum.

Contrasting with all the incensed ‘AIDS experts’, GlaxoSmithKline, with the most on the line, preferred, for the public record, to keep things sweet. After meeting Mbeki in the UK in early May in the company of about fifty other business executives, its English chairman Sir Richard Sykes expressed his company’s sympathy for the laggard slow to get the hang of the game, and hoped that once he’d recovered from his perplexity, he might rejoin the team:

One could say most of the world recognises that HIV causes AIDS, and that treating people with drugs which are trying to keep it under control is a way forward. The President is trying to understand that, and we in the pharmaceutical industry hope he will come to that conclusion as he has these discussions, and hopefully we could move forward to deal with the situation. We believe that what he is trying to do is to get a clear understanding himself, so that when he gets that understanding, he will then say: ‘Okay, this is the problem, this is the cause and this is the way forward, and we are going to work in collaboration with others to try to deal with this important issue for South Africa.

By buying our drugs. Billions worth. Finally understanding. Moving forward.

The wonder of it was why there was so little Western interest in the content of the African politician’s dare concerning the safety and use of AZT, having regard to the published literature in the scientific and medical press to which he had called attention, and the obvious trouble with the HIV theory of AIDS model in the face of the glaring epidemiological discrepancies that he’d traced with some sarcasm in his confidential letter. There was lots of flash and noise in the responses, but nobody actually addressed the awkward points he was raising. Because he’s African? In a private note, a correspondent of mine in the US, Aiden Gregg, highlighted a revealing fact trite among social science researchers:

I agree with your description of the motives that impel orthodox AIDS scientists not to subject their research assumptions to rigorous standards of scrutiny. But what is interesting is that these motives do not seem to be operating at a wholly conscious level. It’s not often the case, I suggest, that mainstreamers plan their evasiveness in advance; rather it spontaneously emerges in the absence of any principled commitment to investigating the basis of HIV-skeptical position with thoroughness and even-handedness. Regrettably, people in a position of privilege and prestige don’t see the need even to ‘entertain’ radical proposals. One interesting parallel here is the social psychological research that shows that high-status individuals rely more on stereotypes in understanding the behavior of low-status people, whereas low-status individuals are more likely to use individuating information to understand the behavior of high-status people. Higher status means lower accountability, and lower accountability means there is less need to think deeply about an issue. It’s all about increasing accountability to compel intellectual engagement.

Engagement for starters perhaps with Brewer, Gisselquist and others – all basically AIDS orthodox – who, in the March 2003 issue of the International Journal of STD and AIDS, comprehensively reviewed and analysed the literature cited in support of the almost universally accepted theory that sex is the vector of HIV transmission in Africa, and found Mounting anomalies in the epidemiology of AIDS in Africa: Cry the beloved paradigm:

There is substantial dissonance between much of the epidemiologic evidence and the current orthodoxy that nearly all of the HIV burden in sub-Saharan Africa can be accounted for by heterosexual transmission and the sexual behaviour of Africans. … We propose that the existing data can no longer be reconciled with the received wisdom about the exceptional role of sex in the African AIDS epidemic. … Dispassionate assessment of our conclusions admittedly depends on a willing suspension of disbelief, since the current paradigm is deeply embedded.

Time and the BBC picked up the piece, and the Canadian Mail and Globe editorialised it, but between the ‘AIDS experts’ and journalists in South Africa, with everything to lose, it passed without a mention.

An article by Jon Cohen in Science at the end of April 2000, South Africa’s New Enemy criticised Mbeki for ‘publicly questioning whether HIV is the cause of the AIDS epidemic that is ravaging his nation’. It quoted his spokesman making an unfortunate statement – quite at odds with Mbeki’s own grip of the science and the fallacies of AIDS orthodoxy – that was seized upon and widely condemned by Mbeki’s detractors:

Parks Mankahlana, Mbeki’s spokesperson, confirms a widespread rumor that providing treatment to infected pregnant women worries the government because of the number of surviving orphans this policy would create. ‘A country like ours has to deal with that,’ insists Mankahlana. ‘That mother is going to die, and that HIV-negative child will be an orphan. That child must be brought up. Who’s going to bring the child up? It’s the state, the state. That’s resources, you see?’

But of course this was not how Mbeki saw it at all. He’d seen right through the ‘HIV-positive means you’re going to get AIDS and die’ myth, this business model of the pharmaceutical industry running the medical industrial complex.

Unable to stop the enquiry into their dark arts – whether in truth they were a deadly scam – South Africa’s AIDS mandarins snarled in the run-up to the first AIDS Panel meeting. ‘AIDS is ravaging this country, not only by consuming those who are in their most productive years, but ravaging it because of the drain it’s going to place on our economy.’ Mbeki’s open-ended approach to AIDS was ‘going to damn the next generation. …I think the President and this country will be judged by history for this folly,’ said Slim Karim. But he’d take part in the AIDS Panel meetings ‘to assist South Africa in coming out of this mess’. The one Mbeki had led the country into. Coovadia shook his head; Mbeki’s convention of his AIDS Panel ‘shows that politicians have a fundamental lack of understanding how science works’. University of the Witwatersrand Medical School Bioethics Professor Udo Schuklenk dismissed the dissidents as ‘a remote minority, a small sect’. Couldn’t these unbelievers see that HIV-fighting ‘drugs have been developed that keep people with AIDS alive, that give them a perfectly good quality of life, that bring them back to productive working lives’?

CHAPTER

Following Tshabalala-Msimang’s introductory address, Mbeki’s opening speech at the first meeting of his Presidential Advisory Panel on AIDS at the Sheraton Hotel in Pretoria on 6 May 2000 was extraordinary for its penetrating clarity, his common-sense bucking against AIDS orthodoxy where it so obviously took off from the facts, and his self-effacing ironic humour in typecasting himself as a fool for questioning it. I’ll admit that as I listened to him speak a few metres away, I lost control of my sluices:

I am indeed, very, very pleased that we have arrived at this moment and would like to welcome Stephen Owen [the moderator] and other distinguished people from outside our country, as well as the scientists from within our own country who are here. Welcome to what for us is a very important initiative. I am going to read a few lines from a poem by an Irish poet [and rebel], Patrick Pearce [just before the English shot him]. It will indicate some of what has been going through my mind over the last few months. The poem is entitled, ‘The Fool’ and it says: ‘Since the wise men have not spoken, I speak but I’m only a fool; A fool that hath loved his folly, Yea, more than the wise men their books or their counting houses or their quiet homes, Or their fame in men’s mouths; A fool that in all his days hath never done a prudent thing, ... I have squandered the splendid years that the Lord God gave to my youth in attempting impossible things, deeming them alone worth the toil. Was it folly or grace?’ I have asked myself that question many times over the last few months: whether the matters that were raised were as a result of folly or grace. You will remember the letter we sent inviting you to this meeting. It included a quotation from a report by the WHO on the global situation of the HIV/AIDS pandemic. It said that of the 5.6 million people infected with HIV in 1999, 3.8 million lived in Sub-Saharan Africa, the hardest hit region. There were an estimated 2.2 million HIV/AIDS deaths in the region during 1999, being 85% of the global total, even though only one-tenth of the world population lives in Sub-Saharan Africa. In addition, the report said there are now more women than men among the 22.3 million adults and one million children estimated to be living with HIV/AIDS in Sub-Saharan Africa. It was this situation, communicated to us by organisations such as the WHO and UN AIDS, which clearly said that here we have a problem to which we have to respond with the greatest seriousness. And, of course, among the Sub-Saharan Africans are the South African Africans, with millions of people said also to be HIV positive and also many people dying from AIDS. The Minister has indicated our response to this, so I won’t go over that ground. But it is important, I think, to bear it in mind because some have put out the notion that our asking certain questions in order to understand better and therefore be able to respond better, constituted an abandonment of the fight against AIDS. What the Minister has said indicates what we have indeed done. There are other things she didn’t mention including the allocation of dedicated funds in our annual budget specifically to address this issue. That is from the point of view of the national government, in addition to what other layers of government are doing. We believe that that response is important, and it is being carried out in an aggressive way, in a sustained way, and in a comprehensive way so that we do indeed respond to the picture that is painted by these figures. It was because it seemed that the problem was so big, if these reports were correct, that I personally wanted to understand this matter better. Now as I’ve said, I’m only a fool and I faced this difficult problem of reading all these complicated things that you scientists write about, in this language I don’t understand. So I ploughed through lots and lots of documentation, with dictionaries all around me in case there were words that seemed difficult to understand. I would phone the Minister of Health and say, ‘Minister, what does this word mean?’ And she would explain. I am somewhat embarrassed to say that I 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. We responded with that part of the response the Minister was talking about – public awareness campaigns, encouraging safe sex, use of condoms, all of those things. But as one read on, one noted that we had never said anything in all of this public awareness campaign, that people need to practice safe sex and use condoms in order to stop the other sexually transmitted diseases – syphilis, gonorrhoea and so on – as though these did not really matter. What mattered was this virus. As one read all of these things, one discovered what, as far as I know, was the first report published in our medical journals in this country about the incidence of HIV among our people in this part of the world. It was published in the South African Medical Journal in 1985. Among other things, that article said that groups at high risk of developing the acquired immune deficiency syndrome – AIDS – in the United States and Europe include homosexual and bi-sexual males; those who abuse intravenous drugs and haemophiliacs. The article further says that AIDS has been reported in Central Africa. However, homosexuality, drug addiction or blood transfusion have not been reported as risk factors in these patients. It has therefore been suggested that the agent causing AIDS is endemic in Central Africa. However, our preliminary data show that although individuals with antibodies directed against HIV are to be found in South Africa, these positive individuals only come from a high-risk group comprising male homosexuals. Individuals who did not belong to any of the known high risks groups did not have HIV antibodies. Our data, says the article, therefore suggests that the agent implicated in the causation is not endemic in Southern Africa. That was in 1985. And of course all of the other documentation that I’ve seen suggests that what was reported here in 1985 to be the risk group in this part of the world, remained the risk group in the United States and Western Europe with a preponderance of these infections being among homosexuals and therefore by homosexual transmission, as it is said, of the virus. But according to these reports, clearly something changed here. In a period of maybe five, six, seven years after 1985, when it was said that such transmission in this region was not endemic in Southern Africa, there were high rates of heterosexual transmission. Now as I was saying, being a fool I couldn’t answer this question about what happened between 1985 and the early 1990s. The situation has not changed in the United States up to today, nor in Western Europe with regard to homosexual transmission. But here it changed very radically in a short period of time and increased very radically in a short period of time. Why? This is obviously not an idle question for us because it bears very directly on this question: How should we respond? There has been this change, for reasons I can’t explain but you, as scientists, surely would be able to explain. Why this change? What therefore is our most appropriate response? And so we started communicating with some of the people in this room, to ask what is the cause? There is a whole variety of issues that the Minister of Health has just said she will not comment upon, which also I will not comment upon because they are very much part of the subject of your discussions. We were looking for answers because all of the information that has been communicated points to the reality that we are faced with a catastrophe, and you can’t respond to a catastrophe merely by saying I will do what is routine. You have to respond to a catastrophe in a way that recognises that you are facing a catastrophe. And here we are talking about people – it is not death of animal stock or something like that, but people. Millions and millions of people. Somewhat of a storm broke out around this question, which in truth took me by surprise. There is an approach which asks why is this President of South Africa trying to give legitimacy to discredited scientists, because after all, all the questions of science concerning this matter had been resolved by the year 1984. I don’t know of any science that gets resolved in that manner with a cut-off year beyond which science does not develop any further. It sounds like a biblical absolute truth and I do not imagine that science consists of biblical absolute truths. There was this very strong response saying: don’t do this. I have seen even in the last few days, a scientist who I’m quite certain is eminent [Mark Wainberg, president of the International AIDS Society] who said that perhaps the best thing to do is that we should lock up some of these dissidents in jail and that would shut them up. It is a very peculiar response but it seemed to me to suggest that it must surely be because people are exceedingly worried by the fact that large numbers of people are dying. In that context any suggestion whatsoever that dealing with this is being postponed because somebody is busy looking at some obscure scientific theory, is seen as a betrayal of people. Perhaps that is why you had that kind of response which sought to say: let us freeze scientific discourse at a particular point; and let those who do not agree with the mainstream be isolated and not spoken to. Indeed it seems to be implied that one of the important measures to judge whether a scientific view is correct is to count numbers: how many scientists are on this side of the issue and how many are on the other – if the majority are on this side, then this must be correct. In the end, what I’m saying is that as Africans we want to respond to HIV/AIDS in a manner that is effective, a manner that does indeed address the fact of these millions of lives that are threatened. As I noted, the WHO says that in Sub-Saharan Africa, 2 million people died in 1999 alone. It is truly our hope that this process will help us to get to some of the answers, so that as public representatives we are able to elaborate and help implement policies that are properly focused, and that actually have an effect. I’m quite certain that given the people who are participating in this panel, we will get to these answers. And so you see why I’ve been thinking over this matter over the last few months that perhaps I should have allowed the wise men to speak. Indeed when eminent scientists said: ‘You have spoken out of turn,’ it was difficult not to think that one was indeed a fool. But I am no longer so sure about that, given that so many eminent people responded to the invitation of a fool to come to this important meeting. Welcome and best wishes. Thank you very much.

Who dropped the ball I don’t know, but vital to the plan for the conference of orthodox and dissident scientists that Turner had proposed was the adjudication of the issues being raised by the dissidents – as essential as baking powder in the birthday cake. But there was none. In Turner’s correspondence with Allen, he’d emphasized the need for an adjudicator to try the rival cases, and proposed ten scientists from each camp, including Nobel laureates, to present them. A clue to the reason why no such adjudicating board was appointed lies in the fact that, as Tshabalala-Msimang pointed out when the decision to convene the panel was announced, she expected the ‘top scientists’ on the panel to arrive at a consensus. But it was entirely unrealistic, as events were to show, to expect that professionally and financially invested ‘AIDS experts’ could be persuaded to surrender their dogmas by way of reasoned debate. Presiding at the AIDS Panel meetings instead, we got an ever-smiling law professor from Canada, Stephen Owen of the Institute for Dispute Resolution at the University of Victoria, British Columbia, keeping things polite and Canadian. That was it. The result was that the controversy was left in the air. Entirely defeating the purpose. Turner described the lost opportunity as ‘a great pity’. Putting it mildly. On a personal note, I was so dismayed by this basic blunder that I decided against attending. An invitation to dinner with the dissidents changed my mind. I drove up on Friday 5 May 2000, and was glad I did. The reception I got all round gave me an instant recharge. As did the camaraderie and opportunities to strategise and philosophize day and night over the rest of the weekend. And likewise at the second meeting in July, which I attended as an accredited observer.

It was fortunate that Owen wasn’t asked to decide anything. Because it was quickly obvious that he didn’t know what was going on, that he’d arrived with a complete misconception of the colloquium’s purpose, that he lacked any appreciation of the basic scientific issues being raised, and that his head was filled with the drama painted in the newspapers, which he’d never paused to question. As revealed by his statements to the press after the first day: ‘So far there has been abundant evidence of a connection between HIV and AIDS but how direct the connection is, is not known. [Despite the disagreements between the orthodoxy and the dissidents] there is an awareness of the critical need for action. We cannot simply wait. There is a recognition among both sides that they have to act on the best evidence.’ The kind of mindless talk lawyers get paid for. Smiling. Sitting with Mbeki after the second meeting, he advised him (to quote an orthodox panellist in the Mail&Guardian on 8 September) ‘to push forward with the five-year plan, to say he had now heard all sides, that the government would be doing everything including the use of ARVs, and that he would advise Mbeki to look into parallel importation and compulsory licensing’. Never mind that the fundamental causation dispute remained unresolved.

Mbeki’s convention of orthodox and heterodox medical and scientific experts to debate their disagreements about the cause and treatment of AIDS was spurned by the former. With the notable exception of Robert Gallo, who stayed away to evade Duesberg’s embarrassing questions, they came, but they wouldn’t answer the dissidents’ challenges. So as the debating chamber it was intended to be, the exercise was largely a flop, an unrequited offer to engage, a one-way flow of ideas. Coovadia commented spot-on: ‘I knew we would learn nothing from them. We were talking past each other. It was as absurd as talking between people who believe in God and those who don’t.’ Yes it was. The orthodoxy would not or could not talk to the problems raised by the dissidents, both at the meetings and in a closed Internet forum. It was all soapbox grandstanding. For instance, in his response to Duesberg’s point that nothing happens in cell cultures purportedly inoculated with HIV, I watched Clifford Lane, deputy director of the US National Institute for Allergy and Infectious Diseases (NIAID), and co-author, with director Anthony Fauci, of the AIDS chapter in Harrison’s Internal Medicine, swaggering like John Wayne, although himself built like a mosquito: ‘Come over to my lab and I’ll show you HIV burning its way through CD4 cells.’ Overlooking that HIV expert Simon Wain-Hobson of the Pasteur Institute in Paris had already conceded years earlier in Nature in January 1995: ‘An intrinsic cytopathic effect of the virus is no longer credible’; that Luc Montagnier of the same place, now generally credited with having first ‘discovered HIV’, has long asserted that HIV needs ‘co-factors’ to do its harm; and that HIV is supposed to be a lentivirus, dormant for years. (A new model proposing HIV to be hyperactive from the onset of infection quickly collapsed under orthodox criticism.)

A year and a half after Lane’s macho talk in Johannesburg, Gallo was in India attending an AIDS conference. Interviewed by the Indian Express on 19 December 2001, he was asked first off: ‘What’s your current research about?’ He admitted in roundabout style that two decades after alleging that he’d discovered the cause of AIDS, he still lacked a basic model of pathogenesis: ‘I and my team of scientists are trying to find out how HIV causes AIDS and devise better ways to treat it’ – signalling his own appreciation that this idea of his that HIV kills CD4 cells and then leads to the onset of any one of about thirty opportunistic illnesses, is insupportable. And that the drugs have way outlived their shelf-life. An article in Nature Medicine in July 2003, HIV-1 pathogenesis, by Mario Stevenson, confirmed that nobody really knows how or why HIV causes illness: ‘Despite considerable advances in HIV science in the past 20 years, the reason why HIV-1 infection is pathogenic is still debated and the goal of eradicating HIV-1 infection remains elusive.’

A surprise last-minute arrival at the first panel meeting raised a few eyebrows: four American ‘AIDS experts’ pitched up unannounced to listen in quietly on the last day of the meeting – all suitably dark-faced to kind of blend in with the locals. Word was that Clinton had asked Mbeki if he might send some of his people over. ‘That’s the United States AIDS forces coming in,’ remarked Duesberg laconically. ‘It seemed like they were there to observe,’ said Rasnick. Evidently Clinton was rattled by what Mbeki was doing, the threat he was posing, the trouble he was causing.

Mandela, for one, initially stood apart from the general condemnation of his successor. During a trip to the US in mid-May, a group of university students in New York asked his opinion of Mbeki’s conduct in enquiring about the safety of AZT and in convening his AIDS Panel. He answered that Mbeki had ‘done his homework before going public’. Such kind words would soon dry up.

On the 21st Clinton formally received Mbeki at the White House on his first official visit to the US. Mbeki asked Clinton for US support, ‘whatever our differences’ concerning his government’s approach to AIDS in South Africa – whatever Clinton’s appalling recent discourtesy to him. But the Americans had only one thing on their minds: unblocking the drug pipe, as their Surgeon General David Satcher announced in a press statement a couple of days later. US officials had questioned Mbeki about his position on AIDS, he said, and had ‘talked to’ him about his decision to deny AZT to pregnant women on the grounds of cost and toxicity. ‘We expressed concern about that. We’ve expressed our concern about babies born that could be saved.’ Zuma noticed: ‘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.’ Challenged regarding his position on AZT, Mbeki disputed that he’d ever made the categorical statement that it was ineffective: ‘I never said that. Pure invention. Pure invention.’ Indeed he hadn’t, his style in the controversy being to raise questions rather than assert positions.

Among those who’d taxed Mbeki on his fresh approach to AIDS while he was over in the US were Vice President Al Gore and Secretary of Health and Human Services Donna Shalala. The latter later recalled: ‘Thabo Mbeki – I do not believe he was in denial as much as he saw it as a conspiracy, a much more traditional African response. Both Vice President Gore and I argued with passion with him to move on this issue. And you know, we had polite responses. … He simply listened politely and basically said to us, “We understand what we need to do in our country,” and, “Thank you very much.”’ To Mbeki’s ‘more traditional African’ mind, AIDS was all a conspiracy, she thought.

The centrality in the AIDS controversy of the tussle over providing AZT to pregnant women was summed up in the title to Carol Paton’s report of the trip in the Sunday Times on 4 June: Glaring omission mars Mbeki’s defence to the Americans of his stance on AIDS. Mbeki gave a good account of his reservations about the conventional HIV/AIDS model and the drug approach to it, she wrote, and notwithstanding them, the government was running a large-scale awareness campaign in collaboration with ‘civil society’. She reported him explaining that the provision of AIDS drugs to all those infected, even were their cost to be cut by up to eighty-five per cent, would consume the entire health budget. And as the drug manufacturers themselves admitted, patients on such drugs needed constant monitoring, something for which the country lacked the infrastructure. Mbeki then raised again the unexplained paradox that, whereas in the West, AIDS was largely confined to gay men, in Africa it was a heterosexual affair. He said he was also puzzled why in 1985 South African ‘AIDS experts’ had claimed that there was no AIDS epidemic here, but that just five years later they were saying that the disease was completely out of control.

South Africa’s most eminent liberal journalist and former newspaper editor, Allister Sparks, happened to be in Washington when Mbeki flew in, all wound up by the story that his colleagues had turned out concerning the home ‘country riven by ... the terrible unmanageable HIV/AIDS pandemic’, as he described it in Beyond the Miracle, ‘which had swelled into a massive epidemic in South Africa on a scale that threatened the whole future of the country’. His knickers in an awful knot over Mbeki’s AIDS doubts, especially his recent letter conveying them, Sparks considered that Mbeki had foolishly created ‘a situation that cried out for damage control’, and that he, Sparks, was just the man to fix it. So the bull-frog of South African journalism hopped over to see South African ambassador Sheila Sisulu, to burp out his proposal that Mbeki come over to the National Press Club’s Washington auditorium to ‘clarify his position. … He would be able to reach the whole world at once and put the issue to rest with a simple statement that could go something like: “Of course I believe HIV causes AIDS, but in South Africa we have some special circumstances which I will now tell you about…”’ But Sparks’s hopeful mission was answered with no more than a biscuit and a cup of tea and an explanation of Mbeki’s position on AIDS that confused him even further.

As it turned out, Mbeki had his own plans to clear the air. Since the Washington Post had given him a pounding after Clinton leaked his letter, he agreed to an interview by its correspondents in South Africa two weeks before his trip. ‘It seems to me that everybody in government should try to understand this thing as thoroughly as possible so that we can respond to this issue. There are real, genuine scientific questions recognized by scientists that need to be resolved,’ he told them. But Mbeki’s careful elucidation of the reasons for his questioning stance in relation to AIDS orthodoxy fell on deaf ears. Asked whether the country could afford his cautious, questioning approach when activists were claiming that about one-and-a-half thousand South Africans were being infected daily, he retorted impatiently: ‘How is that figure derived? Do you know? I don’t know.’ The Washington Post certainly wasn’t interested in ‘understanding this thing as thoroughly as possible’ – even less Mbeki’s assertion that there were unresolved ‘scientific questions’, with its implication that American scientists had it all fucked up. On 16 May, about a week ahead of his visit, the newspaper criticized him again in Mbeki vs. AIDS Experts: S. African’s Radical Views on Epidemic Baffle Allies:

In a country with one of the world’s fastest-spreading AIDS epidemics, the restlessly curious Mbeki has repeatedly ignored medical consensus and shrugged off price discounts offered by pharmaceutical companies, steadfastly refusing to distribute antiretroviral medicines, such as AZT, to South Africans infected with the AIDS virus, HIV. … [Mbeki] is revisiting a question that most medical experts had considered long closed: Does HIV cause AIDS? In doing so, he has alienated and mystified a broad range of political allies, advisers and even friends who held him in high regard.

The piece closed with an effulgent offering from the director of the Paediatric AIDS Unit at Johannesburg’s Chris Hani-Baragwanath Hospital, Glenda Gray: ‘“We have 600,000 children admissions each year. … Forty percent of those children are HIV positive. We’re spending a lot of time and resources every day dealing with something that is almost preventable.” She paused. “If they’re not going to provide us with AZT,” she said, “then the best thing that the government can do is to ask us to strangle them all at birth.” Yes dear.

After seeing the Washington Post hash it, Mbeki tried explaining his case to the newspaper again, this time briefing its editors at a meeting over lunch. But, as they told Sparks, they were left as ‘baffled and critical’ as before by his ‘convoluted and obscure’ explanation of his approach. Mbeki had yet another go at explaining his position on the television programme NewsHour with Jim Lehrer. Asked, ‘You have said you were mischaracterized in some of the comments you said about the relationship between HIV and AIDS … Exactly where do you stand?’, Mbeki replied:

Well, yes. I don’t know where these reports came from that we are taking a position saying there is no connection between HIV and AIDS. I never said it. At the beginning of this month, the month of May ... a group of scientists came to South Africa representing the different points of view with regard to these matters. One of the results of which was that the Centers for Disease Control would host a process ... so that they can work out these matters that are outstanding with regard to HIV/AIDS, because we need more information so that we can act more vigorously and more effectively.

Without quoting him to enable readers to decide for themselves, Sparks condemned Mbeki’s direct answer in his book as ‘evasive’, even as he conceded elsewhere: ‘A close scrutiny of all Mbeki’s speeches on the subject shows that he has never denied that HIV causes AIDS.’

Although Paton reported that ‘By the middle of his US tour, sentiment in the media showed signs of becoming more even’, the Mail&Guardian played up the negative press that Mbeki drew in an article the week after the Washington Post piece, quoting a particularly insulting charge, and falsely claiming it was typical: ‘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 – skilfully 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.”’ To which, editor Barrell added the thoughtful counsel: ‘Mbeki should step back, leave science to the scientists and – for God’s sake, Mr President – look after the politics.’

On the 25th, before leaving the US, Mbeki popped in to see Presidential candidate George Bush, then Governor of Texas, who received him at the Governor’s Mansion. They seemed to have hit it off on a personal level. Certainly Bush appears to have been mighty taken by Mbeki. When they met again at the White House a year and a month later, Bush, now in office, positively glowed with personal warmth at their press conference: ‘It is my honour to welcome President Mbeki to the Oval Office. It’s good to see you again, Sir. The last time we visited was in the Governor’s Mansion in Texas. … I’m so glad you’re here.’ It was the same press conference vibe again when Bush visited Mbeki on 9 July 2003:

Mr President, thanks. Gosh, we’re honoured to be here. Thank you for your wonderful hospitality. … I appreciate our strong relationship – and it is a vital relationship. Mr President, I want to thank you very much for working hard to make it a vital and strong relationship. We’ve met quite a few times in the recent past, and every time we’ve met I’ve – I feel refreshed and appreciate very much your advice and counsel and your leadership. … I want to thank you for your friendship, appreciate the hospitality. It’s been a great honour to be in your country.

It was enough to put a tear in the eye. Then again, more seriously, Mbeki’s successful early courtship of Bush in anticipation of the latter’s presidency revealed his genius for long-term strategic scheming, because by concertedly establishing and nurturing a tight personal rapport with Bush, he pre-emptively neutralised the likelihood that, in asserting the interests of the Developing World against the First’s, he’d spark a full-bore US intelligence-orchestrated campaign to discredit him and bring him down. Hence his confidence in later openly deploring the imminent invasion of Iraq, and then after it, obliquely but unambiguously and sharply knocking the US in a plea for reform of the UN made in a speech to the General Assembly on 23 September 2003: for the UN to meet its challenges, all countries, both rich and poor, both the powerful and the disempowered, should commit themselves to act in a manner that recognised

none of us is an island, sufficient unto themselves. … What we have said today may not be heard because we do not have the strength to have our voice heard. Tomorrow we may be obliged to say – no more water, the fire next time. As the fires burn, the UN will die, consumed by the flames. … We must act together to say in our words and our actions, as countries and as the UN, there will be water next time not fire.

Tshabalala-Msimang delivered her Health Department’s Budget Speech for 2000/2001 on 6 June, and in it she raised her big concern:

As you will recall that in October last year whilst addressing the NCOP, the President raised some concerns about reported toxicity of the antiretrovirals. He then tasked me to investigate this matter. Flowing from that call, I requested the Medicines Control Council to do a risk benefit analysis particularly on AZT with priority given to its use in MTCT [during pregnancy]. A similar request was sent to the Cochrane collaboration centre located at the MRC. I have previously mentioned that the first reports of the MCC were unsatisfactory in that they did not address the fundamental questions I raised. In its final report the MCC concluded that it is of the view that the benefits of AZT use outweigh its risks in the case of MTCT. However the MCC also did point to the fact that the long term effects of AZT on the children exposed have not been established. Incidentally, a similar observation is made by the manufacturers of this product in the package insert. I believe we should reflect on the totality of this information as we grapple with the difficult decision on the options available to us on the pressing challenge of reducing MTCT. This is particularly so when some of the babies to be exposed (70 to 75%) would be uninfected without our intervention with these drugs. As previously indicated, we shall again consider all these factors together with the cost implications when we receive the report on the SAINT studies from our researchers in our next MINMEC [meeting with her provincial health ministers].

As the 13th International AIDS Conference in Durban in July 2000 approached, the Mail&Guardian berated Mbeki further. Two days before Mbeki opened the conference on the 9th, editor Barrell wrote a hoity-toity editorial entitled The death sentence has been brought back. As a vignette encompassing the ignorance, the mythmaking and the sentiment of the white liberal press around AIDS it was a beaut. It also bore out that old adage about failed and frustrated writers becoming journalists:

There is really no time left in which to dodge around the truth. South Africa has reimposed the death sentence. Once a world leader in judicial executions – until the moratorium of 1989 put a stop to hangings – the new South African government has brought back executive killing with a harsh vengeance. But this is not the execution of criminals, no mercifully ruptured neck. Those now condemned to die are the innocent: newborn babies who, by anti-retroviral drug intervention, could be saved from contracting the HIV from their infected mothers. The total number of babies consigned to this grotesque new ‘death row’ now exceeds 100 000; a figure which increases by about 2 500 a month. The lucky babies are already dead. Those who remain look forward to brief and wretched lives, to miserable and pitiful deaths. The life expectancy of a baby infected with the HIV can be as much as eight years. Some succumb much sooner, a quarter of their number die within 18 months. But they all eventually will die and their deaths are protracted and miserable. The emotional devastation to their parents and families can have no measure. Many babies will simply be abandoned. In the words of a paediatrician, working in a public hospital in Johannesburg: ‘A far more humane option would be to put these HIV-infected babies to a painless death as soon they were proved to be carrying the virus. To subject them to inevitable and such terrible suffering is beyond human belief.’ For the past four years the South African government health service has been steadfast in its refusal to sanction the use of appropriate drugs in these cases. It continues to do so in the face of overwhelming medical testimony. It dilly-dallies and it procrastinates, it obfuscates and it blatantly lies. This ‘policy’ is not only approved by the South African president, it is encouraged and amplified by him. It is pointless yet again to canvass the consummate futility of the South African government in its handling of the HIV pandemic. The invidious mismanagement is of record. Although the Deputy President, Jacob Zuma, recently claimed a 90% success in the ‘awareness campaign’, there are 1 700 new HIV infections a day – 200 higher than last year, and rising. South Africa has by far the worst record in Africa – if not the world. To call the government’s handling of the HIV/Aids crisis a disaster would be to praise it. The South African public health service caters to the poorest. Hence, the estimated 100 000 South African babies who have either already died or are in the awful process of doing so, are African. Any medical management which might reduce this inhuman statistic has been put on hold until such time as the health authorities yet again have patiently reassessed their policies, indulged in the luxuries of further debate, installed what new committees they deem, have sat around and worked out what new alibis they might propose for their almost utter lack of practical action. The high cost of anti-retroviral drug treatment is the excuse most usually flown in defence of the government’s refusal to save the lives of these babies. What brand of obscene bureaucratic diffidence states a ticket price for a life? ‘We’re sorry about your baby having to die. The cost of his life was just outside this year’s budget.’ Such cold indifference to human response is called the Nuremberg option. What is extraordinary is why the whole disgrace has yet to be brought before the South African Constitutional Court. The relevant clause in the Constitution includes the guarantees: Everyone has the right to have access to Health Care Services, including reproductive health care and no one may be refused emergency medical treatment. It can be argued that an unborn baby at risk of contracting the HIV is a medical emergency. As is now plain for all to see, President Mbeki and his advisers have painted themselves into a corner. There is no way out which will not result in major retractions by the president and his minions. What Mr Mbeki might try to remember, as he vacillates and coddles Irish martyr poetry, is that for each hour that he does nothing, another four black children struggle to draw breath, puke and ache, their skins festered, their mouths filled with ulcers, their bodies racked with disease – living skeletons as they approach a suffocating death. These are the children condemned who, by drug intervention, could have been saved from contracting the HIV. These are also the apparently acceptable price for the president’s face.

These are also the sapient insights of Mail&Guardian editor Howard Barrell, shared with the nation for Mbeki’s notice – all flowing from the universal supposition, preached by ‘AIDS experts’, that giving pregnant black women AZT saves their babies’ lives. Without which they soon leave for the next world in a spectacular show that the plague is upon them.This was the journalism of the liberal press at it moral zenith. In the purple style of Edgar Allen Poe, writing in The Masque of the Red Death in Tales of Mystery and Imagination:

The ‘Red Death’ had long devastated the country. No pestilence had ever been so fatal, or so hideous. Blood was its Avatar and its seal – the redness and the horror of blood. There were sharp pains, and sudden dizziness, and then profuse bleeding at the pores, with dissolution. The scarlet stains upon the body and especially on the face of the victim were the pest ban which shut him out from the aid and sympathy of his fellow-men. And the whole seizure, progress, and termination of the disease, were the incidents of half an hour.

Like The death sentence has been brought back, a thrilling read.

Rather than answering the challenges to their doctrines posed by the dissidents given a forum by Mbeki, and exposing themselves to the risk of ridicule and redundancy in their jobs, with the loss of power and privileges that would entail, activist medical clerics took to politics, by way of secret plotting in medieval style. They decided to publish a joint confession of faith by as many of the clergy as possible, and grandly too, in Nature, the world’s most haughty scientific journal, giving their ‘Durban Declaration’ the pomp of an encyclical, even though its plebeian expression and coarse conceptual shape created the impression that it was a first draft turned out in a hurry by someone other than a scientist. The idea was that by sheer weight of their numbers, the roar of their clamour would drown out the heretic voices. The Pasteur Institute’s Wain-Hobson in Paris recruited some cardinals and big orders to lend their names to the committee’s masthead to thunder nicely, and then circulated an email chain letter that read like this: ‘

The object is to get as many names of scientists and doctors to sign on. Names of signatories will appear on the Nature website. If you would like to sign on, we would be delighted. Send me an e-mail confirming this. To economize space on the website, we have to name people in a single line. Many of you will say that HIV/AIDS is not your area. However, over the years you have heard enough of the arguments to understand the association. Furthermore, many of you know well infectious diseases and understand Koch’s postulates. If you have colleagues in the laboratory or in the clinic who you feel would like to sign, please ask them. The more the better. However, please note that in order to be authoritative we feel it necessary to restrict the list to those with major University qualifications. Please do not ask students. Apologies for this. We would need email replies as soon as possible and before June 27. Finally please do not talk to reporters about the Durban Declaration until Nature publishes it. If you are asked by a member of the press, just say “I’d be pleased to talk to you about this, but I’m afraid I am not at liberty to do so at the moment”. Please could you point this out to others who wish to sign on. Many thanks, Simon Wain-Hobson on behalf of the organizing committee – The Durban Declaration.

The preamble to the Durban Declaration, published on 6 July, read:

The declaration ... was stimulated by the current controversy in South Africa about whether HIV is the cause of AIDS. This has caused massive consternation among all scientists, doctors and many others in the international community who treat AIDS patients or who work on AIDS in other ways. There is widespread anxiety that denying or doubting the cause of AIDS will cost countless lives if blood screening, use of condoms, and methods to prevent mother-to-child transmission of the virus are not implemented or, worse, even abandoned. The declaration has been signed by over 5,000 people, including Nobel prizewinners, directors of leading research institutions, scientific academies and medical societies, notably the US National Academy of Sciences, the US Institute of Medicine, Max Planck institutes, the European Molecular Biology Organization, the Pasteur Institute in Paris, the Royal Society of London, the AIDS Society of India and the National Institute of Virology in South Africa. In addition, thousands of individual scientists and doctors have signed, including many from the countries bearing the greatest burden of the epidemic. Signatories are of MD, PhD level or equivalent, although scientists working for commercial companies were asked not to sign. The Durban Declaration has an organizing committee of over 250 members from over 50 countries.

The Durban Declaration comprised seven articles of belief – basically that HIV causes AIDS, the tests are good, you’ll die without the drugs, and so on, ludicrously inadequately referenced, and warning again, ‘It is unfortunate that a few vocal people continue to deny the evidence. This position will cost countless lives.’ (‘The New York Times Declaration’, published on 9 July by the same crowd, made the same claim in its subtitle: HIV causes AIDS. To argue otherwise costs lives.) But the conclusion of the Durban Declaration conceded, in effect, that to date the joint endeavours of the ‘AIDS experts’ all over the world had been perfectly futile. Their medicine hadn’t turned out any good, so the only thing for it was to stop the disease by non-medical interventions. By public health propaganda exhorting us all not to do it. But wear condoms, if we absolutely can’t help ourselves.

The inherently political rather than scientific character of the whole affair was given up by its propagandic language, along with a big, bright colour portrait of five happy black children, captioned: ‘Future orphans? The death toll from AIDS in Africa will be enormous unless action is taken now.’ But the point of the exercise was to swamp the dissidents by calling out a mob swelled by folk invited to sign up with no knowledge of the topic, all pointing to the authority of their eminences atop the list, and not wheedle for yet more government money. Responding to rumours about the document, Coovadia claimed confidentiality: ‘All I can say is that it … will be released at a time when it will get maximum publicity.’

Seeing it for the foolish, unscientific stunt it was, Mbeki let it be known through his spokesman: ‘If the drafters of the declaration expect to give it to the President, or the government, it will find its comfortable place among the dustbins of the office.’ Mbeki had only to say boo, and it crumpled up and died. (In fact there was a bit more to the statement than the bit quoted in the media, which left out that if the signatories thought they could bypass the AIDS Advisory Panel in this way, the declaration would be thrown out.) A press conference at the Durban AIDS Conference, at which the petition was to be formally presented, was cancelled. Mbeki had called it ridiculous, and that was the end of it. Because it was. Not only ridiculous, personally contemptuous: among the signatories were both local and foreign members of his AIDS Advisory Panel – announcing that it was a dangerous waste of time (‘a few vocal people continue to deny the evidence. This position will cost countless lives.’).

The Perth Group’s detailed rebuttal of the claims made in the Durban Declaration was rejected as usual by Nature – no room it said, but it subsequently published a brief letter. In a private note, Turner commented on the mark:

In many ways the Durban Declaration is reminiscent of the ‘Bishop’s licence’, the practice adopted by Pope Innocent VIII in the fifteenth century of declaring which authors may be read and which may not. The Bishop’s licence was the immediate forerunner of the Index Librorum Prohibitorum or ‘Guide to Prohibited Books’ drawn up by Pope Paul VI in 1557. Of course such attempts at censorship proved ineffective and if anything turned banned authors into ‘forbidden fruit’. But at least the Vatican had the decency to publish the names of the books along with their authors. The Durban Declaration made no such concession. Anyone seeking education or enlightenment could not claim any bounty from Nature. The shutters were down, the doors were bolted and no one was talking back.

It was a disgraceful episode but an instructive one. The rough weave of the language in which the declaration was set closely matched that of Wain-Hobson’s chain-letter, supporting my surmise that he’d knocked out the declaration too. Despite its striking crudity and its fundamentally unscientific character, the professional ‘AIDS expert’ had no difficulty garnering many thousands of open votes, and then publishing his dismal manifesto as a scientific statement in Nature. In sum, the Durban Declaration was another notable illustration of how mediocrity thrives in the AIDS era, and how AIDS has corrupted modern science. The pattern seems to be that dim men with bad ideas sold with lots of flash make the big deals.

CHAPTER

The 13th International AIDS Conference opened in Durban on Sunday evening, 9 July 2000. I was there. It was unbelievable. Even credulous AIDS-buff Robert Kirby was revolted, and said so in his TV column Channelvision in the Mail&Guardian the following week:

You would hope that after all the controversy, after all the monstrous, grotesque mismanagement by the South African government of the HIV/Aids scourge, after all the lies and the misdirection, the whole cruel disaster, someone with a little discretion, a soupçon of good taste and reserve, would have decided that enough was enough: that a serious international conference about one of mankind’s worst plagues should be afforded an equally serious opening formality.

But uh-uh:

It was about as inapposite and tasteless a display of garish effects as you could imagine. … [a] mega-kitsch display of Las Vegas bojo effects and gymnast-and-veil routines. This was the opening to an international science conference, not a soccer tournament. All it lacked was a fireworks display and some parachutists. Maudlin lyrics, no matter how dressed up and bellowed out they are, remain maudlin lyrics. Stunningly sentimental “poetry” mouthed in a trembling voice to subtle touch-screen graphics does not alter the flabby banality of its content. Whoever said that the disciplines of fascist display-art died with the führer was very wrong.

In a comment on its website, pro-AIDS drug activists in ACT UP New York concurred in Kirby’s pan of the show as

literally a made-for-television ‘Wonderful World of Color does AIDS’ telecast. The audience was ‘warmed-up’ by a television producer asking people to raise signs reading ACT UP (distributed as they entered the stadium) and pleading to everyone to shout out ‘ACT UP’ followed by a minute of silence. Then the telecast extravaganza began ‘live’ with music, dancing and drummers in traditional costumes on stage and suspended in the air in front of a huge chorus with a backdrop of projected images of children with AIDS. There were fireworks and fog machines and the opening address by the President of South Africa.

Followed by enormous red balloons released to bounce over the heads of the crowd. We all had such fun bumping them on. The only dampener on things was Mbeki’s opening address:

On behalf of our government and the people of South Africa, I am happy to welcome you to Durban and to our country. You are in Africa for the first time in the history of the International AIDS Conferences. We are pleased that you are here because we count you as a critical component part of the global forces mobilised to engage in the struggle against the AIDS epidemic confronting our Continent. The peoples of our Continent will therefore be closely interested in your work. They expect that out of this extraordinary gathering will come a message and a programme of action that will assist them to disperse the menacing and frightening clouds that hang over all of us as a result of the AIDS epidemic. You meet in a country to whose citizens freedom and democracy are but very new gifts. For us, freedom and democracy are only six years old. The certainty that we will achieve a better life for all our people, whatever the difficulties, is only half-a-dozen years old. Because the possibility to determine our own future together, both black and white, is such a fresh and vibrant reality, perhaps we often overestimate what can be achieved within each passing day. Perhaps, in thinking that your Conference will help us to overcome our problems as Africans, we overestimate what the 13th International AIDS Conference can do. Nevertheless, that over-estimation must also convey a message to you. That message is that we are a country and a Continent driven by hope, and not despair and resignation to a cruel fate. Those who have nothing would perish if the forces that govern our universe deprived them of the capacity to hope for a better tomorrow. Once more I welcome you all, delegates at the 13th International AIDS Conference, to Durban, to South Africa and to Africa, convinced that you would not have come here, unless you were to us, messengers of hope, deployed against the spectre of the death of millions from disease. You will spend a few days among a people that has a deep understanding of human and international solidarity. I am certain that there are many among you who joined in the international struggle for the destruction of the anti-human apartheid system. You are therefore as much midwives of the new, democratic, non-racial and non-sexist South Africa as are the millions of our people who fought for the emancipation of all humanity from the racist yoke of the apartheid crime against humanity. We welcome you warmly to South Africa also for this reason. Let me tell you a story that the World Health Organisation told the world in 1995. I will tell this story in the words used by the World Health Organisation. This is the story: ‘The world’s biggest killer and the greatest cause of ill-health and suffering across the globe is listed almost at the end of the International Classification of Diseases. It is given the code Z59.5: extreme poverty. Poverty is the main reason why babies are not vaccinated, why clean water and sanitation are not provided, why curative drugs and other treatments are unavailable and why mothers die in childbirth. It is the underlying cause of reduced life expectancy, handicap, disability and starvation. Poverty is a major contributor to mental illness, stress, suicide, family disintegration and substance abuse. Every year in the developing world 12,2 million children under 5 years die, most of them from causes which could be prevented for just a few US cents per child. They die largely because of world indifference, but most of all they are poor. Beneath the heartening facts about decreased mortality and increasing life expectancy, and many other undoubted health advances, lie unacceptable disparities in wealth. The gaps between rich and poor, between one population group and another, between ages and between sexes, are widening. For most people in the world today every step of life, from infancy to old age, is taken under the twin shadows of poverty and inequity, and under the double burden of suffering and disease. For many, the prospect of longer life may seem more like a punishment than a gift. Yet by the end the century we could be living in a world without poliomyelitis, a world without new cases of leprosy, a world without deaths from neonatal tetanus and measles. But today the money that some developing countries have to spend per person on health care over an entire year is just US $4 – less than the amount of small change carried in the pockets and purses of many people in the developed countries. A person in one of the least developed countries in the world has a life expectancy of 43 years according to 1993 calculations. A person in one of the most developed countries has a life expectancy of 78, a difference of more than a third of a century. This means a rich, healthy man can live twice as long as a poor, sick man. That inequity alone should stir the conscience of the world but in some of the poorest countries the life expectancy picture is getting worse. In five countries life expectancy at birth is expected to decrease by the year 2000, whereas everywhere else it is increasing. In the richest countries life expectancy in the year 2000 will reach 79 years. In some of the poorest it will go backwards to 42 years. Thus the gap continues to widen between rich and poor, and by the year 2000 at least 45 countries are expected to have a life expectancy at birth of under 60 years. In the space of a day passengers flying from Japan to Uganda leave the country with the world’s highest life expectancy – almost 79 years – and land in one with the world’s lowest – barely 42 years. A day away by plane, but half a lifetime’s difference on the ground. A flight between France and Cote d’lvoire takes only a few hours, but it spans almost 26 years of life expectancy. A short air trip between Florida in the USA and Haiti represents a life expectancy gap of over 19 years. HIV and AIDS are having a devastating effect on young people. In many countries in the developing world, up to two-thirds of all new infections are among people aged 15-24. Overall it is estimated that half the global HIV infections have been in people under 25 years with 60% of infections of females occurring by the age of 20. Thus the hopes and lives of a generation, the breadwinners, providers and parents of the future, are in jeopardy. Many of the most talented and industrious citizen, who could build a better world and shape the destinies of the countries they live in, face tragically early death as a result of HIV infection.’ (World Health Report 1995: Executive Summary WHO.) This is part of the story that the World Health Organisation told in its World Health Report in 1995. Five years later, the essential elements of this story have not changed. In some cases, the situation will have become worse. You will have noticed that when the WHO used air travel to illustrate the import of the message of the story it told, it spoke of a journey from Japan to Uganda, another from France to the Cote d’lvoire and yet another from the United States to Haiti. From developed Asia, Europe and North America, two of these journeys were to Africa and the third to the African Diaspora. Once again, I welcome you to Africa, recognising the fact that the majority of the delegates to the 13th International AIDS Conference come from outside our Continent. Because of your heavy programme and the limited time you will spend with us, what you will see of this city, and therefore of our country, is the more developed world of which the WHO spoke when it told the story of world health in 1995. You will not see the South African and African world of poverty of which the WHO spoke, in which AIDS thrives – a partner with poverty, suffering, social disadvantage and inequity. As an African, speaking at a Conference such as this, convened to discuss a grave human problem such as the acquired immune deficiency syndrome, I believe that we should speak to one another honestly and frankly, with sufficient tolerance to respect everybody’s point of view, with sufficient tolerance to allow all voices to be heard. Had we, as a people, turned our backs on these basic civilised precepts, we would never have achieved the much-acclaimed South African miracle of which all humanity is justly proud. Some in our common world consider the questions I and the rest of our government have raised around the HIV-AIDS issues, the subject of the Conference you are attending, as akin to grave criminal and genocidal misconduct. What I hear being said repeatedly, stridently, angrily, is: do not ask any questions! The particular twists of South African history and the will of the great majority of our people, freely expressed, have placed me in the situation in which I carry the title of President of the Republic of South Africa. As I sat in this position, I listened attentively to the story that was told by the World Health Organisation. What I heard as that story was told, was that extreme poverty is the world’s biggest killer and the greatest cause of ill health and suffering across the globe. As I listened longer, I heard stories being told about malaria, tuberculosis, hepatitis B, HIV-AIDS and other diseases. I heard also about micronutrient malnutrition, iodine and vitamin A deficiency. I heard of syphilis, gonorrhoea, genital herpes and other sexually transmitted diseases as well as teenage pregnancies. I also heard of cholera, respiratory infections, anaemia, bilharzia, river blindness, guinea worms and other illnesses with complicated Latin names. As I listened even longer to this tale of human woe, I heard the name recur with frightening frequency: Africa, Africa, Africa. And so, in the end, I came to the conclusion that as Africans we are confronted by a health crisis of enormous proportions. One of the consequences of this crisis is the deeply disturbing phenomenon of the collapse of immune systems among millions of our people, such that their bodies have no natural defence against attack by many viruses and bacteria. Clearly, if we, African countries, had the level of development to enable us to gather accurate statistics about our own countries, our morbidity and mortality figures would tell a story that would truly be too frightening to contemplate. As I listened and heard the whole story told about our own country, it seemed to me that we could not blame everything on a single virus. It seemed to me also that every living African, whether in good or ill health, is prey to many enemies of health that would interact one upon the other in many ways, within one human body. And thus I came to conclude that we have a desperate and pressing need to wage a war on all fronts to guarantee and realise the human right of all our people to good health. And so, being insufficiently educated, and therefore ill prepared to answer this question, I started to ask the question, expecting an answer from others: what is to be done, particularly about HIV-AIDS! One of the questions I have asked is: are safe sex, condoms and anti-retroviral drugs a sufficient response to the health catastrophe we face! I am pleased to inform you that some eminent scientists decided to respond to our humble request to use their expertise to provide us with answers to certain questions. Some of these have specialised on the issue of HIV-AIDS for many years and differed bitterly among themselves about various matters. Yet, they graciously agreed to join together to help us find answers to some outstanding questions. I thank them most sincerely for their positive response, inspired by a common resolve more effectively to confront the AIDS epidemic. They have agreed to report back by the end of this year having worked together, among other things, on the reliability of and the information communicated by our current HIV tests and the improvement of our disease surveillance system. We look forward to the results of this important work, which will help us to ensure that we achieve better results in terms of saving the lives of our people and improving the lives of millions. In the meantime, we will continue to intensify our own campaign against AIDS including: a sustained public awareness campaign encouraging safe sex and the use of condoms; a better focused programme targeted at the reduction and elimination of poverty and the improvement of the nutritional standards of our people; a concerted fight against the so-called opportunistic diseases, including TB and all sexually transmitted diseases; a humane response to people living with HIV and AIDS as well as the orphans in our society; contributing to the international effort to develop an AIDS vaccine, and; further research on anti-retroviral drugs. You will find all of this in our country’s AIDS action plan, which I hope has been or will be distributed among you. You will see from that plan, together with the work that has been going on, that there is no substance to the allegation that there is any hesitation on the part of our government to confront the challenge of HIV-AIDS. However, we remain convinced of the need for us better to understand the essence of what would constitute a comprehensive response in a context such as ours which is characterised by the high levels of poverty and disease to which I have referred. As I visit the areas of this city and country that most of you will not see because of your heavy programme and your time limitations, areas that are representative of the conditions of life of the overwhelming majority of the people of our common world, the story told by the World Health Organisation always forces itself back into my consciousness. The world’s biggest killer and the greatest cause of ill health and suffering across the globe, including South Africa, is extreme poverty. Is there not more that all of us should do together, assuming that in a world driven by a value system based on financial profit and individual material reward, the notion of human solidarity remains a valid precept governing human behaviour! On behalf of our government and people, I wish the 13th International AIDS Conference success, confident that you have come to these African shores as messengers of hope and hopeful that when you conclude your important work, we, as Africans, will be able to say that you who come to this city, which occupies a fond place in our hearts, came here because you care. Thank you for your attention.

Surprisingly, Makgoba said he liked Mbeki’s address: ‘Considering all we’ve gone through over the last few months, it’s an excellent speech. … He said all that could be said and I am quite happy with it. The President has given clear leadership.’ We were happy that you were happy, Willy; no one else was. Mbeki Makes Doctors Despair reported the London Guardian the following day, mangling what he’d said: ‘The scientific establishment was stunned yesterday by President Thabo Mbeki’s public rejection of the conventional wisdom that Aids, which is the leading cause of death in Africa, is caused by the virus HIV.’ It’s unlikely any of those stunned doctors attended the Conference on Primary Health Care, convened by the WHO at Alma-Ata in the USSR in 1978 – following which the Alma-Ata Declaration went: ‘The existing gross inequality particularly between developed and developing countries is politically, socially and economically unacceptable. … An acceptable level of health for all people of the world by the year 2000 can be attained through a fuller and better use of the world’s resources.’

After Mbeki’s address, Phil Wilson of the African-American Aids Initiative gnashed his teeth over unanswered prayers: ‘The house is on fire and Mr. Mbeki is sitting around trying to decide whether it was started by a match or a lighter. … He talks about a plan ... he doesn’t talk about action. I was hoping and praying he would find a way to gracefully back out of this madness.’ Professional Boston AIDS activist and journalist David Scondras, a member of the AIDS Panel, said Mbeki had broken his heart: ‘We all had high hopes. We gave him a beautiful opportunity to turn around and he didn’t.’ Oxford ‘AIDS expert’ Professor Roy Anderson spoke alike: ‘I was disappointed, to put it bluntly. It was an opportunity to concentrate on the main task … the main issue which in South Africa is an acute problem.’ So did conference chairman Coovadia:

What I’m sensing from people is an absolute sense of disappointment. ... Many people believed that the President would use the occasion to try to quell some of the disquiet around government’s position on HIV-AIDS. … There were great expectations that some of the disputes and the disquiet around the government’s position on HIV/AIDS and the dissidents and so on would be resolved and President Mbeki would employ the opportunity that was given to him to give a reappraisal of the position. People are now saying that they are really disappointed that it did not happen and instead we had another discussion about poverty which we already know is a fundamental problem in our society.

Kenneth Roth, executive director of Human Rights Watch, didn’t like Mbeki’s speech much either: ‘It is incumbent on him to give a clear message about the cause of AIDS. His job is not to orchestrate debate in a quiet college classroom. It is giving the best scientific information to the people in his country ... [He is] failing miserably.’ MRC AIDS research boss ‘Slim’ (obese actually) Karim was ‘disappointed that an opportunity was lost, both to set the record straight on the causation of AIDS, and to present a concrete plan to prevent mother to child transmission’. Mbeki’s agreement to speak at the opening of the conference had made him ‘very hopeful. I mean, I thought he needed 25 minutes because he needed to explain what had happened and he needed to mark out a new path. Only when he actually was 10 minutes into his speech, I realized he was not going to make any drastic new announcement.’Lynn Morris of the National Institute of Virology had the same thoughts: ‘This was a good opportunity for him to put a closure on the whole thing, and he didn’t.’ ‘Mbeki waffles on while Rome burns,’ thought Glenda Gray. Just as disappointed was Karim’s wife Quarraisha: ‘If only he said unequivocally that HIV causes AIDS and he made an announcement on reducing mother to child transmission, he would have seized the moral high ground. And he didn’t. And you look around, the strong statement that all the delegates here are making, and they continue to go against all of that!’ Professor Thomas Croates of the University of California had hard words: Mbeki’s position was ‘genocidal’, he said. In a report on 16 July, the Washington Post described how Lee Wildes, representing the American group AIDS Empowerment and Treatment International, ‘all but snarled into his microphone’. He seems to have hoped for a fix by the CIA, Lumamba-style: ‘You need to do something about Mbeki. I can’t even get a vitamin sent into this country.’

‘Comrades, today is a sad day for everyone!’ responded Achmat to Mbeki’s speech. And later: ‘There’s nothing in the world that can explain it. There is nothing in the world that can explain it. To find out that a government does not care about the lives of poor people and the lives of black people and are prepared to consign us to the graveyard was actually quite shocking.’ Top American AIDS boss Anthony Fauci of NIAID lamented: ‘He could have emerged as a spectacular leader of the whole African continent. He flubbed it.’ So the American government was going to have to take action – he made clear in an interview for the PBS Frontline television documentary The Age of AIDS, shown in the US on 30 and 31 May 2006. In view of Mbeki’s recalcitrance about towing the American line on AIDS, the Americans decided to use the TAC to carry out their foreign policy objectives, namely to get AIDS drugs flowing into South Africa and the rest of the Developing World: ‘You’re looking at it straight in the eye and you say, “What am I going to do?” And that was really crystallized by the activist movement that we saw in South Africa, and it was that impetus that led to the resolve to get treatment, care and prevention into the trenches in developing nations in whatever manner or form we can.’ Washing CIA money discretely through American corporate philanthropies to willing and cooperative dupes being the favoured way of going about such things.

At a demonstration for AIDS drugs outside the Durban City Hall, organised by the TAC for the start of the conference, the activists got Winnie Madikizela-Mandela over to say what she thought of Mbeki’s speech, and she didn’t let them down. His ANC government’s refusal to dish out the drugs was ‘a betrayal of our struggle for social justice’, she said.

AIDS exists! HIV causes AIDS! Like the spread of global parasitic imperialism, AIDS is roaming the world, attacking the poor and the marginalized. … In our beloved Africa, it has already cut a swath of destruction, swallowing up families and communities and villages. … We knew this was a plague and that it was moving south … yet we did nothing. We must take the responsibility for that failure. … Our failure to act has made us the murderers of our own people. Our government, for which so much blood was shed, has backed down and become an obedient servant of the multinational [drug companies]. … More than 1 600 people in South Africa become infected with HIV every day and

16 000 people die every year. The majority of the people dying are poor and black. This is a social holocaust.

Achmat picked up the theme: ‘AIDS is a holocaust against the poor and the responsibility lies with the drug companies who put profits before responsibilities. It’s wrong, immoral, unethical and unconstitutional not to provide those drugs.’ Newsday reported on 11 July:

After endless political nonsense from South Africans who should know better, it fell to Winnie Mandela to declare the brutal truth. … Yet South African President Thabo Mbeki not only refuses to acknowledge that HIV causes AIDS. His government is reluctant to fund programs that would offer cheap antiretroviral drugs to mothers – drugs that could sharply cut HIV transmission rates to their children.

In its report covering Mbeki’s speech the day before, Newsday noted: ‘In a long, dry speech delivered without interruption for applause or other response, Mbeki identified poverty as the culprit for his nation’s epidemic.’ Newsday’s opinion thereanent was captured in the title of the piece: Focus on Poverty, Not on HIV, AIDS: S. Africa leader’s speech frustrates delegates. No doubt it did, because unfortunately, as H L Mencken once pointed out, ‘What ails the truth is that it is mainly uncomfortable and often dull.’

The London Independent reported the City Hall demo and Mbeki’s address before it the next day, under the rousing heading, Durban Conference: Mbeki Accused Of ‘Betrayal’ Over Aids Treatment: Anti-Capitalist Rhetoric Deflects Spotlight From South African President’s ‘Mishandling’ Of Crisis In Disease-Ravaged Country – including the remarkable news that the ‘TAC has called for World Bank debt relief to be conditional on healthcare expansion in Third World countries’. Which is quite something to think about: the TAC urging the World Bank not to relax its choke-hold on any developing country reluctant to buy AIDS drugs – the only kind of ‘healthcare’ that the TAC is in business for. Suborning extortion you might call it.

But in urging this kind of blackmail of our government, Achmat and his friends in the Bush administration see eye to eye: US Treasury Secretary Paul O’ Neil came on an AIDS tour of the country with Irish singer Bono of the rock group U2 the following year. Who cried for the cameras during a visit to Glenda Gray’s Paediatric AIDS Unit at Chris Hani-Baragwanath Hospital – as the front-page headline of the Daily Dispatch reported on 25 May 2002: Emotional Bono visits Aids mothers. He was understandably upset, having been told that the bouncing babies, apparently fine, were actually infected by a terrible virus and weren’t going to live long. ‘The Secretary will be able to send one message back to the President. This is an emergency what we have seen today,’ he wept. ‘Astounded’ by the prioritisation of prevention programmes over drug purchases in the disbursement of foreign aid funds, O’ Neill responded: ‘There is something wrong when the system does not take care of the here and now. … We, the world, have got to deal with this problem. … This is do-able.’ The report concluded: ‘O’ Neil, who has long criticised the misuse of foreign aid by recipient countries, said he wanted re-evaluations of where US foreign assistance was being spent as well as an increase in that assistance.’ To control domestic health policy with his country’s money.

Following Mbeki’s Sunday night opening address, Cameron presented the first Jonathan Mann Memorial Lecture at the conference the next day. The Deafening Silence Of Aids portended the empty bombast to follow, with the claim in the noisy title quickly conceded as false by Cameron himself: ‘Nor has there been silence, as the title of my lecture suggests. Indeed, there has been a cacophony of task groups, workshops, committees, councils, policies, drafts, proposals, statements, and pledges.’ So why then claim there is one? For theatrical effect? To tally with the conference slogan, ‘Break the Silence’? To Break the Wind?

Cameron’s speech was decorated with limp rococo flourishes such as:

UNAIDS careerist, the late Jonathan Mann’s ‘statement cannot be accepted without nuance, since in Africa it is relative mobility and affluence that have placed people at risk of exposure to HIV. [Hey, that’s like a totally amazing new insight, Judge, but what are you actually trying to tell us? That blacks have all got AIDS because they’re rich? And swarm around the continent screwing everyone. Unlike American and European heterosexuals on their own turf. And suddenly in the last decade or so. If not, what?] But Mann’s analysis here had led him to a more fundamental and general insight – one that formed the focus of his future work and advocacy. This was his realisation that health and human rights are not opposing [had anyone said they were?], but are complementary approaches to what he called “the central problem of defining and advancing human well-being”. [Wow, a brilliant, deeply thought-provoking new formulation of an ancient problem of philosophy.] … But the demography of HIV has been overlain by a shift even more momentous and one that in its nature is optimistic. [Old AIDS drugs, useless alone, work near miracles combined. In their very nature.] AIDS can now be compared with other chronic conditions which on appropriate treatment, and with proper care, can in the long term be subjected to successful medical management. [As long as you don’t mind croaking first of the toxicity of your care.] Amongst the public at large, the result has been that fear, prejudice and stigma associated with AIDS have lessened. [Is there maybe a study to refer us to, bearing this out? Or are you just talking pretty?] And persons living with HIV/AIDS have suffered less within themselves [is there another way to suffer?] and in their working and social environments. In short, the new combination drug treatments are not a miracle. But in their physiological and social effects they come very close to being miraculous.

Although like a hillbilly Baptist, Cameron might feel full of holy vitality after drinking his poison (arsenic tonics were once ubiquitously prescribed and enjoyed well into the 20th century), the mounting literature on the inefficacy and deadly toxicity of AIDS drugs would lead the ‘AIDS experts’ to announce an embarrassing retreat from them just a few months later. Their physiological effects on Cameron we’ll read about later.

Amidst the poverty of Africa, I stand before you because I am able to purchase health and vigour. I am here because I can pay for life itself. To me this seems a shocking and monstrous iniquity of very considerable proportions – that, simply because of relative affluence, I should be living when others have died; that I should remain fit and healthy when illness and death beset millions of others.

That phrase again: ‘relative affluence’ – presumably different from the ‘relative ... affluence’ of Africans that puts them at risk of AIDS. But strangely enough, straight affluent whites have been virtually untouched by the scourge.

Without a scruple for the impropriety of his doing so, the appellate judge then abused the occasion as a senior member of the judiciary to criticise the executive’s AIDS policy insultingly, demean the President as a silly crank, praise the government’s opponents in the TAC and outline the shape of the policies that his brethren would later force the government to adopt:

In my own country, a government that in its commitment to human rights and democracy has been a shining example to Africa and the world has at almost every conceivable turn mismanaged the epidemic. So grievous has governmental ineptitude been that South Africa has since 1998 had the fastest-growing HIV epidemic in the world. It currently has one of the world’s highest prevalences. ... A basic and affordable humane intervention would be a national programme to limit mother-to-child transmission of HIV through administration of short courses of anti-retroviral medication. [The humane effect on babies of a short course of AZT we read in Debating AZT; the latest studies are reviewed in Poisoning our Children. The effects of nevirapine you can read in The trouble with nevirapine.] Research has shown this will be cost-effective in South Africa. Such a programme, if implemented, would have signalled our government’s appreciation of the larger problem, and its resolve to address it. To the millions of South Africans living with HIV, it would have created a ray of light. [GlaxoSmithKline also bills AZT as ‘A Ray of Hope’.] It would have promised the possibility of increasingly constructive interventions for all with HIV, including enhanced access to drug therapies. To our shame, our country has not yet come so far as even to commit itself to implementing such a programme. The result, every month, is that five thousand babies are born, unnecessarily and avoidably, with HIV. Their lives involve preventable infections, preventable suffering, and preventable death.

I just make up my numbers as I go. As a religious type I also believe, like everyone else, that HIV-positive means disease and suffering and death around the corner. Unless I purchase the indulgences sold by the pharmaceutical industry.

Cameron then attacked Mbeki as a born fool:

In our national struggle to come to grips with the epidemic, perhaps the most intractably puzzling episode has been our President’s flirtation with those who in the face of all reason and evidence have sought to dispute the aetiology of AIDS. This has shaken almost everyone responsible for engaging the epidemic. It has created an air of unbelief amongst scientists, confusion among those at risk of HIV, and consternation amongst AIDS workers.

Not just a stupid fool, a criminally negligent one:

One of the continent’s foremost intellectuals, Dr Mamphela Ramphele, has described the official sanction given to scepticism about the cause of AIDS as ‘irresponsibility that borders on criminality’. If this aberrant and distressing interlude has delayed the implementation of life-saving measures to halt the spread of HIV and to curtail its effects, then history will not judge this pronouncement too harsh. I cannot believe that our President’s address at the opening last night has done enough to alleviate the concerns.

The judge pressed for the government to take the TAC on board in formulating policy:

At the launch of the International Partnership Against AIDS in Africa in December 1999, UN Secretary General Kofi Annan made an important acknowledgement. He stated: ‘Our response so far has failed Africa.’ The scale of the crisis, he said, required ‘a comprehensive and coordinated strategy’ between governments, inter-governmental bodies, community groups, science and private corporations. … There has also been the principled trumpet of treatment activism. In America, brave activists changed the course of Presidential politics by challenging Vice-President Gore’s stand on drug pricing and trade protection. Their actions paved the way for subsequent revisions of President Clinton’s approach to the drug pricing issue. In my own country, a small and under-resourced group of activists in the Treatment Action Campaign, under the leadership of Zackie Achmat, has emerged. In the face of considerable isolation and hostility, they have succeeded in re-ordering our national debate about AIDS. And they have focussed national attention on the imperative issues of poverty, collective action and drug access. In doing so they have energised a dispirited PWA movement with the dignity of self-assertion, and renewed within it the faith that by action we can secure justice. [By scoring drugs. After coming out of the closet.] What has been a story of grievous mismanagement, we have failed to construct the sort of inclusive alliance under governmental leadership that has been indispensable to AIDS prevention programmes. We know that that should have happened and it has not happened, it should have happened under governmental leadership, including the AIDS NGOs which have done magnificent work under difficult circumstances instead of which they have felt alienated and ostracised by government.

Listening to Cameron’s wussy speech was to picture his brothers in the judiciary wincing, but apparently not; his criticism of the government’s AIDS policies, his own policy demands, his praise for the TAC and his urging that the government should collaborate with it and take its cues in formulating policy all prefigured exactly the High and Constitutional Courts’ prescriptions to the government in the subsequent nevirapine case.

Folk won to Cameron’s gloomy superstitions and as ardent with zeal for them were ‘the continent’s foremost intellectuals … principled … brave … a perceptive man of principle’. But against anyone offside, or merely unconvinced and unmoved by his ridiculous fire and brimstone sermonizing, Cameron concluded by levelling the basest and coarsest of moral accusations, charging complicity in the crimes of the century. Whipping out memories of apartheid and the Holocaust to drive his case home, the trick went down a treat:

Those of us who live affluent lives, well-attended by medical care and treatment, should not ask how Germans or white South Africans could tolerate living in proximity to moral evil. We do so ourselves today, in proximity to the impending illness and death of many millions of people with AIDS. This will happen, unless we change the present government ineptitude and corporate blocking. Available treatments are denied to those who need them for the sake of aggregating corporate wealth for shareholders who by African standards are already unimaginably affluent. That cannot be right, and it cannot be allowed to happen. No more than Germans in the Nazi era, nor more than white South Africans during apartheid, can we at this Conference say that we bear no responsibility for 30 million people in resource-poor countries who face death from AIDS unless medical care and treatment is made accessible to them. The world has become a single sphere, in which communication, finance, trade and travel occur within a single entity. How we live our lives affects how others live theirs. We cannot wall off the plight of those whose lives are proximate to our own. That is Mann’s call – the clarity of his call – his legacy to the world of AIDS policy; and it is the challenge of his memory to this Conference today.

AIDS drugs for Africa. Cameron got a rapturous ovation. They stood clapping and cheering forever, applauding what Science writer Jon Cohen called ‘one of the most remarkable acts of activism I’ve seen in twelve years of covering AIDS’.

But Tshabalala-Msimang was unimpressed by reports of his speech: ‘We reject the notion that simply defines the adequacy of national responses to the provision of antiretroviral drugs. We are unapologetic about the fact that the focus on primary prevention remains the core of our programme.’

The juxtaposition of Cameron’s address right after Mbeki’s highlighted the marked intellectual disparity between the two men, and a paradoxical one it was too. Whereas Mbeki the politician spoke in the exacting, empirical manner of a careful judge reviewing the hard facts, the judge conversely employed the language and alarmist devices of a vulgar politician, making one recklessly unsubstantiated morbid declamation after another, intended to appal and cow. It might have been trimmed in Crimplene ruffles, but it was a tip-truck load of pretentious waffle no less, spiked with the wild, hateful charges that having regard to the policy it had set on AIDS, the new ANC government was scarcely different from the criminal regimes of the apartheid and Nazi states, with the result that our country faced imminent collapse thanks to its incompetence and callous indifference. In talking this way Cameron bought straight into white stereotypical perceptions about African government identified by Mbeki on BBC television during an interview by Tim Sebastian on 6 August 2001: ‘There is a view among some people that there must be a collapse, there must be a cataclysm, it’s not quite possible that you could have a black government managing a sophisticated country and economy like this.’ Orwell nicely explained the vacuousness of Cameron’s speech by noting in his essay Politics and the English Language, written in 1946, that ‘the slovenliness of our language makes it easier for us to have foolish thoughts’. The intriguing thing about Cameron’s foolish thoughts, showcased in his talk, was that, as George W Bush’s are, they were so rousing for the mob listening, generated such éclat and were so very politically effective. Whereas, contrariwise, Mbeki’s sober calls to the facts and to reason went off like Guy Fawkes in the rain.

Another difference between the two speeches, the two minds, was that in counterpoint to that typical white liberal pessimism with which Cameron’s talk was freighted, an orgiastic celebration of doom and gloom (such as gives the Mail&Guardian its modern odour), Mbeki was at pains to emphasize characteristic African hopefulness. The gist of the passage to which I allude bears repeating:

The peoples of our Continent ... expect that out of this extraordinary gathering will come a message and a programme of action that will assist them to disperse the menacing and frightening clouds that hang over all of us as a result of the AIDS epidemic. … we are a country and a Continent driven by hope, and not despair and resignation to a cruel fate. Those who have nothing would perish if the forces that govern our universe deprived them of the capacity to hope for a better tomorrow

– the American forces that Cameron was proselytising for, dealing certain, early, painful death to millions of African poor. Without the pharmaceutical industry’s cut-price beneficence to head off the imminent African calamity. In so speaking Mbeki was repudiating those morose new conceptions being imposed from without on African people, with the help of guys like Cameron, that a brand-new virus was suddenly about, predominantly among white gay men in the US and Europe, but everywhere among black heterosexuals in Africa. A plague coming down from the dark north. Spread by loving. Most signally down here too, just in time to spoil our hopes for our revolution. Ideas comfortably at home in First World Christian cultures, especially American, but horribly alien in the optimistic, indigenous cultures of Africa. Alien to anyone, like Mbeki, who turned the TV off long enough to ponder them.

Cameron’s speech may have been all piss and wind, but it contained a twinkling clue. Speaking generally, psychologist Rollo May described his sort: ‘People who claim to be absolutely convinced that their stand is the only right one are dangerous. Such conviction is the essence not only of dogmatism, but of its more destructive cousin, fanaticism. It blocks off the user from learning new truth, and it is a dead giveaway of unconscious doubt.’ The temper of Cameron’s talk is well explicated by post-modernist philosopher Jean Francois Lyotard’s conception of ‘metanarratives’ – authoritarian grand theories, whose fired-up subscribers, be they religious or political, always lay claim to be the sole custodians of truth, and intolerantly deny all and any alternatives.

As Cameron was speaking, and the Durban AIDS Conference hummed along, Mbeki was flying to faraway Togo, on much more important business: attending the annual Organisation of African Unity summit, where he again defended his decision to open the AIDS debate to dissident contributions on the basis that it was a free speech issue, with special significance given the country’s apartheid past: ‘Exclusion of ideas, simply because they are different from mine, I don’t think is very healthy. In our own case, just in terms of the political transition in South Africa, we would not have achieved what we achieved if we had excluded certain views.’

Views like those of the country’s national Minister of Health: Incredibly, Coovadia and Karim refused Tshabalala-Msimang’s request to address the final plenary session of the conference to set straight what she felt had been the misreprentation of the government’s position. Here were the cardinals flexing their muscles, showing who were in charge. And it wasn’t the country’s elected representatives.

Not only were Mbeki’s public doubts about their doctrines ‘extremely belittling’ to him ‘as a scientist involved in AIDS research’, said Professor Greg Hussey, head of paediatric infectious diseases at UCT, later on; much more importantly than that, he was threatening their money. This was of course emotionally distressing, he said; it ‘sits at the back of your mind and it complicates the way you react with the health department. It is extremely wearying and is upsetting to have to contend with what the minister, what the department is going to say. You are wary, especially with international grants, that they [the department] are going to say no.’ Ian Sanne, head of the Infectious Diseases Unit of the University of the Witwatersrand, explained similarly:

Research is becoming less competitive for international funding because of the government’s stance. Scientists recognise that research needs to be conducted in collaboration with the Department of Health. But this needs to be a joint effort. No one in the Department of Health wants to approve a research agenda in a timeous fashion, in part because they are scared for their own careers. We are being asked to identify research questions in a resource poor setting, but then we have problems accessing international funding when our government is not going to implement the research.’ And it was important for guys like him to get that money from pharmaceutical companies to do drug experiments on Africans, he said, because without AIDS drugs ‘this disease is universally fatal. There’s no reason we should not be using everything at our disposal to fight it and give people the chance to live as full a lifetime as is possible.

Fight it with deadly poisonous drugs. Guaranteeing a short one.

When the week’s business at the conference was done, Mandela delivered the closing speech. No longer tactfully deferential to his successor as President, he immediately took to chastising Mbeki like a child for the trouble he had caused concerning ‘one of the greatest threats humankind has faced. … It is never my custom to use words lightly. If twenty-seven years in prison have done anything to us, it was to use the silence of solitude to make us understand how precious words are and how real speech is in its impact upon the way people live and die.’ It was a clever start, implying superior wisdom and moral authority. His negative insinuations he now spelt out:

If by way of introduction I stress the importance of the way we speak, it is also because so much unnecessary attention around this conference had been directed towards a dispute that is unintentionally distracting from the real life and death issues we are confronted with as a country, a region, a continent and a world. I do not know nearly enough about science and its methodologies or about the politics of science and scientific practice to even wish to start contributing to the debate that has been raging on the perimeters of this conference. I am, however, old enough and have gone through sufficient conflicts and disputes in my life-time to know that in all disputes a point is arrived at where no party, no matter how right or wrong it might have been at the start of that dispute, will any longer be totally in the right or totally in the wrong. Such a point, I believe, has been reached in this debate. The President of this country is a man of great intellect who takes scientific thinking very seriously and he leads a government that I know to be committed to those principles of science and reason. The scientific community of this country, I also know, holds dearly to the principle of freedom of scientific enquiry, unencumbered by undue political interference in and direction of science. Now, however, the ordinary people of the continent and the world – and particularly the poor who on our continent will again carry a disproportionate burden of this scourge – would, if anybody cared to ask their opinion, wish that the dispute about the primacy of politics or science be put on the backburner and that we proceed to address the needs and concerns of those suffering and dying. And this can only be done in partnership. I come from a long tradition of collective leadership, consultative decision-making and joint action towards the common good. We have to overcome much that many thought insurmountable through an adherence to those practices. In the face of the grave threat posed by HIV/AIDS, we have to rise above our differences and combine our efforts to save our people. History will judge us harshly if we fail to do so now, and right now. Let us not equivocate: a tragedy of unprecedented proportions is unfolding in Africa. AIDS today in Africa is claiming more lives than the sum total of all wars, famines and floods, and the ravages of such deadly diseases as malaria. It is devastating families and communities, overwhelming and depleting health care services; and robbing schools of both students and teachers. Business has suffered, or will suffer, losses of personnel, productivity and profits; economic growth is being undermined and scarce development resources have to be diverted to deal with the consequences of the pandemic. HIV/AIDS is having a devastating impact on families, communities, societies and economies. Decades have been chopped from life expectancy and young child mortality is expected to more than double in the most severely affected countries of Africa. AIDS is clearly a disaster, effectively wiping out the development gains of the past decades and sabotaging the future. Earlier this week we were shocked to learn that within South Africa one in two, that is half, of our young people will die of AIDS. The most frightening thing is that all of these infections, which statistics tell us about, and the attendant human suffering, could have been, can be, prevented. Something must be done as a matter of the greatest urgency. And with nearly two decades of dealing with the epidemic, we now do have some experience of what works.

Since the government already had an extensive AIDS awareness and prevention programme in operation based on the infectious AIDS model, Mandela could have been referring to only one thing – Mbeki’s reluctance to deal AIDS drugs: ‘He will, with me, be the first to concede that much more remains to be done. I do not doubt for one moment that he will proceed to tackle this task with the resolve and dedication he is known for.’ For the rest, Mandela’s speech was a predictable string of the usual exhortations: we ‘must’ this, we ‘need’ that,

to fight this war. … The challenge is to move from rhetoric to action and action at an unprecedented intensity and scale. … Promoting abstinence, safe sex and the use of condoms and ensuring the early treatment of sexually transmitted diseases are some of the steps needed and about which there can be no dispute. Ensuring that people have access to voluntary HIV counselling and testing services and introducing measures to reduce mother-to-child transmission have been proven to be essential in the fight against AIDS. … Partnership with the international community is vital. A constant theme in all our messages has been that in this globalised world, we have indeed again become the keepers of our brother and sister. That cannot be more graphically the case than in the common fight against HIV/AIDS.

Coovadia was thrilled: ‘You cannot imagine how your speech is music to our ears. It has answered so many spoken and unspoken questions.’ Even the bit about globalisation being all about looking after each other. We thought you were supposed to be the expert, Jerry. With all the answers. To Mbeki’s questions.

Mandela, it was clear, had moved from agnostic to passionate convert – ‘shocked’ by the latest report from UN-AIDS claiming that twenty per cent of (black) South Africans were infected, that half of all (black) fifteen-year-olds would eventually die of AIDS, and that ‘With a total of 4.2 million infected [black] people, South Africa has the largest number of people living with HIV-Aids in the world.’ The Mail&Guardian and the rest of the country’s newspapers published these factoids with wide eyes. Mbeki on the other hand dismissed them out of hand as ‘hysterical estimates’. Which of course is what they were. Shaking his head as he read Mandela’s speech. With pity. At his predecessor’s gullibility, for a start. His naivety. Looking past the surface gleam of Mandela’s sweetly reasoned appeal and into the game being played. The game to which the old man was perfectly oblivious. Because Mandela’s speech certainly wasn’t getting in the way of business. It’s precisely what distinguished it from the one given by Mbeki – a savvy leader of the emerging world, alive to the fact that AIDS, essentially, is a neo-colonialist project. Pusch Commey described him well in the London-published New African in September 2000 as a ‘political grandmaster who has thought 20 moves into the global chess game of richman/poorman, plunderer/victim’, of whom ‘Africa can indeed be proud’. Who’d recognised ‘African AIDS’ as the latest front for the conduct of the North’s global trade offensive against the South, and who had ‘dared to threaten the very foundation upon which is built a huge Aids edifice that feeds on the virus. Pharmaceutical companies, Aids researchers, the medical establishment, microbiologists, NGOs, entrepreneurs, you name it. And which replicates as fast as the virus itself as sufficient panic is created to force governments and institutions to fork out more and more cash.’

Borrowed cash. Vice-president of the World Bank for the African region, Callisto Madavo, announced during the Durban AIDS Conference that the bank had allocated $500 million to fund HIV-AIDS programmes in Africa. He said the money would be made available for borrowing from the International Development Association, the bank’s ‘soft-loan window’. Karen Bennett, a conference spokesperson, said she was pleased: ‘The world is finally recognising that this is where the centre of the epidemic now is.’ The First World, perhaps. But not the South African government, which said no thanks to the offered loans. The US Export-Import Bank tried its luck too, touting loans at seven per cent, the commercial interest rate, to twenty-four sub-Saharan countries for the purchase of AIDS drugs. But on 24 August, the International Herald Tribune lamented: ‘The US offer of $1 billion in annual loans to finance the purchase of anti-Aids drugs in sub-Saharan Africa has been rejected by South Africa, one of the countries most devastated by the disease, health officials said.’ Oddly enough, there were no other takers either.

In the manner of a dinner guest who’d drunk too much and spoken alike, and was phoning to propitiate the host the next day, Cameron apologised for the excesses of his remonstrances to the government a day after the conference ended, and agreed with Mbeki that poverty played a crucial role in what the ‘AIDS experts’ were calling AIDS in the country. Speaking at a forum hosted at the University of the Witwatersrand, he said, ‘Poverty is a determinant of who falls ill with AIDS, but there is also a virological component – this is what wasn’t said in [Mbeki’s] speech five days ago.’ This was a strange concession for Cameron to make if one assumes that a senior judge picks his words with care, because the ordinary dictionary meaning of a ‘determinant’ is akin to what we lawyers call a sine qua non. An absolutely necessary precursor. You have to be poor before the virus can get you, in other words. But that’s certainly not what he meant. Actually he was just blabbering. As usual. It’s what having the virus does to you. Cameron liked Mandela’s speech, though: the Independent Online reported on 15 July 2000 that he’d praised it for setting ‘the tone for action against HIV/Aids by unequivocally stating the immediate need for the use of drugs to prevent mother-to-child transmission of HIV’. Just as Cameron had already unequivocally stated it. The immediate need. For drugs.

A week later an editorial in the Mail&Guardian repeated its charge that Mbeki and his Ministers were murderers, nay, genocidal killers now, for turning their porcine noses up at the use of AZT in government hospital maternity wards, and warned that

if our government any longer hesitates and prevaricates on the issue of providing anti-retrovirals to HIV-positive pregnant women, it should not be surprised to hear charges of genocide directed at it. For to fail to act right now against the HIV/Aids pandemic on the basis of best-available science and with all the resources we can muster will have genocidal results. Whether that outcome is the result of malevolence, of incompetence, of panic-induced denial, or of pig-headed obduracy among senior members of the government will scarcely matter. For they will have been warned often enough. Yes, history will then judge them harshly, as former president Nelson Mandela said in a closing speech to the World Aids Conference in Durban last week. But, before history has its turn, the rest of us will have a go at them – and our judgment will not be generous. A failure to act now is genocide. President Thabo Mbeki and his entire government must either get their act together in combating the HIV/Aids catastrophe – now – or get out of government.

It was all getting rather ridiculous.

Of course the commentary in the liberal press was deeply insulting. But much more than personally so: Mbeki picked up the white supremacism inhering in the general cultural disdain of the English world behind it. DA leader Tony Leon’s remarks at a party meeting in Stanger, near Durban on 25 July were the last straw:

Not all news has been good news for South Africa. The president has done considerable damage to his government’s – and his own – reputation. His mishandling of the Zimbabwe crisis and HIV/AIDS policy are two cases in point. President Mbeki’s speeches convey a paradoxical suspicion of developed nations, yet a sense of entitlement – that they somehow ‘owe us’. There is also a near-obsession about finding ‘African solutions’ to every problem – even if this means flouting scientific facts about AIDS in favour of snake-oil cures and quackery.

It was low. But then so is Tony Leon. Who in the mid-70s had written for the apartheid army journal Paratus that the illegal invasion of Angola was ‘one of many splendid tasks of the army’, and who’d described the apartheid military as this ‘giant helping hand’. Brigadier-General Bosman complimented him sarcastically in the Gauteng Provincial Legislature on 9 November 1998:

Mr Speaker, I wonder if the honourable member is aware of the fact that while I was in the Defence Force, I had a very talented young man who did his national service indirectly under my command. He was very talented, sir, because he was a journalist with Paratus, one of the better journalists, and he was one of the best propaganda writers for the Defence Force at the time. As a matter of fact, Mr Speaker, he was very effective … He was very talented with his writing on the total onslaught and that man, sir, was Mr Tony Leon. Thank you, sir.

The talented apartheid propagandist’s remarks were low because the truth of it was that Mbeki had pertinently deplored entitlement attitudes on more than one occasion in his speeches – for instance, urging ‘our abandonment of the concept of the Deliverer with the corollary of the Entitled Recipient’ at a fundraising dinner for the University of Transkei held in Johannesburg on 30 April 1998, and then on 3 June calling in Parliament for an end ‘to the abuse of freedom in the name of entitlement, said to arise naturally from our having been the victims of apartheid’. And his position in relation to the West was infinitely more sophisticated than Leon’s gross caricature – racist generalising, all of it. Leon’s gloating over Mbeki’s involvement with Virodene poked at a sore, and his implication that Mbeki was ‘flouting scientific facts’ in condemning AZT and in doubting the rest of AIDS medicine rubbed salt in it. Because whatever Virodene’s merits or otherwise, AZT was certainly useless, and deadly poisonous too. Whites like Leon ignorantly backed AZT for no other reason than that it was produced and had been marketed successfully by one of the biggest and most profitable corporations on the planet. By whites. Mbeki had been universally castigated for rejecting it – his position deprecated patronisingly by Mary Crewe, head of the Centre for the Study of AIDS at the University of Pretoria: ‘I find it fascinating that Mbeki keeps talking about how the solutions have to come from the ‘African people’ and not from foreign experts, but the South African people want AZT for pregnant women. They also want rape prophylaxis and more funding for treatment of people with AIDS. At what point do you accept what the people are asking for?’ At what point do you buy what the pharmaceutical industry is selling? At what point do you wonder whether ‘the people are asking for’ drugs? Just because the TAC and the newspapers say they are.

Reading Leon’s speech, Mbeki was livid. And retaliated early the following month.

On 11 August Mbeki delivered the second Oliver Tambo Memorial Lecture in Johannesburg, entitled Where are they now? – where, after liberation, are the black intellectuals and the black bourgeoisie in the struggle for national transformation? – Mbeki reproved the country’s ‘native petite bourgeoisie, with the native intelligentsia in its midst, that, in pursuit of well-being that has no object beyond itself, commits itself to be the foot-lickers of those who will secure the personal well-being of its members’. Then he turned on Leon:

The white politician makes bold to speak openly of his disdain and contempt for African solutions to the challenges that face the peoples of our continent. According to him – who is a politician who practices his craft on the African continent – these solutions, because they are African, could not but consist of pagan, savage, superstitious and unscientific responses typical of the African people, described by the white politician as a resort ‘to snake-oil cures and quackery’.

Mbeki’s assumption that by ‘snake-oil cures’ he was referring to African traditional medicine was wrong, said Leon six days later: addressing business leaders in Johannesburg he said that in speaking about snake-oil he was alluding to Virodene, and the quackery he had in mind was Duesberg’s dissident views.) Leon was enunciating a millennium-old racism, said Mbeki: ‘This racism has defined us who are African and black as primitive, pagan, slaves to the most irrational superstitions and inherently prone to brute violence. It has left us with the legacy that compels us to fight, in a continuing and difficult struggle, for the transformation of ours into a non-racial society.’ Mbeki pointed out that the range of crimes against humanity historically perpetrated by Europeans against Africans would never have occurred unless the former knew as a ‘matter of fact’ that the latter were less human than themselves, and closed by noting: ‘Our white politician would not have made the statements he reportedly made, unless he knew it as a matter of fact that African solutions amounted to no more than snake-oil cures and quackery.’ He then moved on, but not before a final bite: he wasn’t going to devote his lecture to ‘the arrogance and racism of those who have convinced themselves they are superior’, but rather to those who have suffered under it.

And still are. Citing a stack of illustrative personal experiences reaching back to her schooldays in a mixed-race school in former Rhodesia, Thandi Chiweshe found Racism is still alive and kicking in a lengthy, articulate and painfully frank opinion piece published in the Zimbabwe Independent two days after Mbeki’s lecture:

over the last few months, living as I currently do in South Africa, I cannot help but become not just dismayed but angry. In this country you live and breathe race and racism. It is omnipresent wherever you are. … Following the events in Zimbabwe in the last few months, there has been a flurry of reports and analysis that seeks to say that racism is now a non-issue. This is the case in South Africa but also in Zimbabwe. In South Africa, this was brought on by the events in Zimbabwe and the recently held national conference on racism. Indeed nobody in their right mind would ever support Bob and his band of marauders. Yet at the same time there is a high level of dishonesty that currently pervades our public discourse on racism at a national, regional and international level. This is the dishonesty that says racism is the figment of the bad politician’s imagination. That before Bob and company resurrected it, racism was dead and buried in Zimbabwe and we were all living happily in harmony. This refrain has also been picked up in South Africa and other places and now we have a whole international choir that sings, “racism is dead”. Well, for me as a young, short, fat black woman, it is very much alive and doing quite well by all accounts. In fact, it never really died, it just mutated. … By denying that racism is real and that it is still exercised in various places we are actually making it grow bigger and much more dangerous. As black people, by buying into this denial we have become complicit in its growth and therefore in our own continued marginalisation and domination. … Our problems with HIV/Aids are now being explained in terms of our sexual depravity by some. In development circles we hear often enough about how our cultures are the key problem and that nothing can be done about those (read: strange/barbaric/weird so we can’t really be bothered to even understand those). In South Africa, when President Mbeki dares raise racism, he is told, not too kindly, that he should worry more about delivering to the people that voted him into power. There is a denial that the very same problems that he is supposed to address were a direct result of colonialism, apartheid and the current economic order. But he dare not talk about that or he will become racist himself. … Indeed, racism today is not as pedestrian and as explicit as it was in 1940 … it has a newer set of legs, and it has become more sophisticated. Yet many of us continue to experience racism in its very pedestrian forms. This is what makes us unable to give it its rightful name and consequently unable to devise strategies to deal with it.

Leon responded to Mbeki’s attack on him in the media the following day. He would take ‘great pleasure’, he announced, in submitting the text of Mbeki’s speech to the forthcoming conference on racism being convened by the Human Rights Commission. Mbeki, he said, was intolerant of political opposition: ‘His only response to opposition is an attempt to either co-opt it, silence it or demonise it.’ Lacking the heft to fell Mbeki fair and square, Leon aimed his punches on the eyebrow cut:

President Mbeki must now explain to South Africa and the world why it is that he has as recently as two years ago championed the totally disreputable and now medically, scientifically and legally discredited and now outlawed, so-called miracle Aids cure Virodene. He squandered his prestige on what might rightfully be called a form of quackery, and now takes issue with me because I dare to mention this blindingly self-evident fact. Since everyone who ever disagrees with President Mbeki and his government is a racist or an alleged self-hating black, I presume that Thabo Mbeki’s views on this matter are so discredited and frankly disreputable as to not require too much serious attention. If President Mbeki spent more time where I do – among the people in their communities – he would know that the truth of the matter is that he has wasted precious time and huge resources of state on prosecuting politically correct solutions and often eccentric viewpoints at the expense of real and sustained delivery and help to the mass of our people. President Mbeki is busy perfecting tactics which turn questions of fact into questions of motive and which malign genuine constitutional opponents of his government with the most dangerous racial stereotyping which has no place in a modern democracy in Africa, or anywhere else in the world for that matter.

But Mbeki’s charges of racism had nothing to do with racially stereotyping his opponents – since it’s racists who negatively agglomerate those whom they physically or psychologically oppress, not the other way round. Nor was it the kind of gross racism seeing a black man refused a table in a restaurant or slighted by a white clerk in a government office. The racism that Mbeki discerned in his white liberal critics’ attacks on him was much more insidious, precisely because, like a permanent smell coming up through the floorboards, it was so subtle, so ineffable. The kind that drives liberals like Tony Leon, Howard Barrell and David Beresford apoplectic if he mentions it. They grew up in the house with it so don’t notice it. When, through his spokesman, Mbeki spoke of the ‘institutional racism’ of the Mail&Guardian in that newspaper on 17 December 2000, he was referring to a mindset, founded by what one might call the West is best assumption. If the West offered AZT, it must be bloody marvellous. If Western experts said blacks were dying in heaps from a new disease they got on account of their extraordinary promiscuity, it must be true. For Mbeki, an African, to dispute this Western wisdom was not merely incomprehensibly unreceptive, it evidenced mental problems. Putting him beyond the pale. A moral, intellectual and political outlaw. With any strike to destroy him and his reputation sanctioned, however base, however extreme. There was certainly no need to seriously entertain what he was saying. Such as that there was a ‘large volume of scientific evidence alleging that, among other things, the toxicity of this drug [AZT] is such that it is in fact a danger to health’; ‘When you are dealing with a virus and you … put [AZT] into the human body, whatever antiviral agent comes into this particular cell, it has to … produce phosphorous particles [i.e. be triphosphorylated], which are the things that have an impact on the virus [but] science isn’t even agreed upon that question. Does such phosphorylation take place?’; and that ‘scientists don’t know what they are looking for when testing for HIV’. The point comes home when one ponders how completely different international reaction would have been had Tony Blair been doing the talking.

Referring to ‘the racist stereotypes that are part of our daily menu of information and perception, and the formation of popular consciousness’, Mbeki raised these themes again in his Letter from the President in ANC Today on 30 May 2003, concerning speculation and insinuations in the media about high-level corruption in the arms deal, implicitly smearing him too: ‘... the threat is made that a “shadow of allegations might engulf” these “highest reaches of government” ... which means the President.’ He began by referring to liberal media opposition to the investigation by the Human Rights Commission of a complaint by the Black Lawyers Association and Black Accountants Association in November 1998 about endemic racism in the white-controlled media:

The ANC made its own submission to the hearings. One of the critical issues it raised was the role of the intensely negative, highly offensive and deeply entrenched stereotype of Africans among some in our country, which makes it inevitable that much reporting in our country would be racist. The ANC made the point that this stereotype necessarily dictated that some in our country would proceed from the position that our government was corrupt as alleged, unless it proved itself to be innocent. Among other things, it cited the instance of an article in a weekly journal [the Mail&Guardian], in which the journalist concerned gratuitously accused the writer of this Letter of dictatorial tendencies. The ANC explained the circumstances surrounding the writing and publication of this article, which were relevant to the subject of the hearings. This matter having been contested and subsequently taken to court by the journal concerned, the judge found in favour of the ANC. Needless to say, the determination made by the courts did not get the public exposure that the resort to these courts by this journal had evoked. The false allegation of wrong doing by the ANC was what was vigorously implanted in the public mind. To the contrary, the rejection of this allegation by the courts, and therefore the independent judicial assertion of the truth about this matter, was assiduously hidden from the public. Had this truth been communicated as openly as it should have been, it would have undermined the racist stereotype of Africans, and demonstrated the correctness of the decision of the HRC to hold its hearings. It was therefore not in the interests of some in our country, who believe in the stereotype, that this truth should be widely known. The same stereotypical conviction about our government being corrupt, unless it proves itself innocent, has re-surfaced with regard to the defence procurement decided by our government in 2000.

In the opening lines of his Letter, Mbeki yet again employed that favourite phrase, ‘as a matter of fact’, always used ironically to debunk the particular ‘fact’ in question subscribed to by his ‘civilised’ white liberal opponents:

In the Biblical Gospel according to St Matthew, it is said that Jesus Christ saw Simon Peter and his brother Andrew fishing in the Sea of Galilee. And He said to them: ‘Follow Me, and I will make you fishers of men.’ Perhaps taking a cue from this, some in our country have appointed themselves as ‘fishers of corrupt men’. Our governance system is the sea in which they have chosen to exercise their craft. From everything they say, it is clear that they know it as a matter of fact that they are bound to return from their fishing expeditions with huge catches of corrupt men (and women).

Mbeki indicated later on the sort of folk who know all they know ‘as a matter of fact’:

As an important part of the struggle to realise this objective [‘of building a truly people-centred society’], we should not, and will not abandon the offensive to defeat the insulting campaigns further to entrench a stereotype that has, for centuries, sought to portray Africans as a people that is corrupt, given to telling lies, prone to theft and self-enrichment by immoral means, a people that is otherwise contemptible in the eyes of the ‘civilised’. We must expect that, as usual, our opponents will accuse us of ‘playing the race card’, to stop us confronting the challenge of racism.

An aspect of Leon’s response to Mbeki’s attack that warrants note is his accusation that Mbeki was intolerant of opposition, maligning and demonising his opponents. It really sounded rather like the bully crying, the pot calling the kettle black, considering the slanderous treatment Mbeki was receiving for his public musings about the integrity of AIDS medicine – evincing the moral: Never disagree with a liberal who concerns himself with the welfare of the natives. For the rest, Leon’s talk was cheap propaganda. From the politician with the amusing fantasy that, in contradistinction to Mbeki, he’s a man of the people, ‘the people in their communities’. Whose idea of the ‘facts’ is what GlaxoSmithKline’s directors fed him. A couple of doctors in attendance, maybe. Followed by pink salmon and the best wines ordered up and enjoyed in the boardroom afterwards. All downed with lots of clubby pinstriped bonhomie.

The London press picked up the stridency of the Mail&Guardian’s editorials, with the result that much the same vituperative tone coloured contemporaneous articles in the English papers. Writing in the Observer on 20 August, the Mail&Guardian’s David Beresford reported the TAC’s announcement that it was off to court in an article entitled Mbeki ‘lets Aids babies die in pain’: ‘Campaigners against Aids in South Africa will start legal proceedings this week to force the government to save thousands of babies from painful and lingering deaths.’ Beresford knifed Mbeki on the way:

A Sussex University economics graduate, seen during the years of struggle against apartheid as the ANC’s arch-diplomat, Mbeki was widely regarded as sophisticated and cosmopolitan. Time and experience now offer, however, another perspective – of a man whose sensitivity on race points to a previously undiscovered psychological trauma which, while deserving of sympathy, makes him among the politicians least qualified to heal past wounds.

The Times made a similar charge on the 23rd: ‘Mbeki is suffering from a gargantuan persecution complex … [he is] acting like a nutter.’ The Independent spoke the same way the next day: ‘There is also growing disquiet within the ANC over Mr Mbeki’s judgement, which, senior members say, is damaging the party.’ Helen Suzman Foundation director RW Johnson put his boot in too, slandering Mbeki in the Spectator on the 26th: ‘Crudely put, many now believe that Mbeki is no longer playing with a full pack – that he’s off his rocker. … he may really be suffering the nervous breakdown that some suspect. … A Russian friend said to me, “It’s strange about Mbeki. In Russia it generally takes about five years for our presidents to go mad. He’s done it in one.”’ (But it’s not only Mbeki that Johnson despises, it’s African leadership generally – evidenced in his preceding proposal in the Daily Telegraph on 22 May that Africa be ‘recolonised’.) In a piece entitled Mbeki ‘Enemy of the people’ on the 27th, the Times buffed its earlier smear:

Nelson Mandela was always going to be a hard act to follow ... If the man to do it was [Mbeki], it seemed just an eccentric part of the new Pretoria politics. That was before President Thabo Mbeki declared himself a medical expert who understood his country’s Aids epidemic better than the global authorities. As a result, only legal action may force his government to admit that relatively cheap drugs given to pregnant women could prevent thousands of babies being fatally infected. Mbeki’s denial of the accepted facts about Aids is combined with an arrogant belief that what Africa needs is money, not the white man’s medicine. In his inauguration speech, Mbeki claimed that his people were no longer ‘the children of the abyss’. It would be a cruel irony if he proved to be the man to lead them into it.

The conservative Daily Telegraph climbed in too, repeating the Times’s charge that Mbeki ‘eccentric’ over his approach to AIDS and ‘hypersensitive’ to criticism for smarting at the aggression of his critics.

Visiting the city in the final week of September, Mbeki’s Minister in the Office of the Presidency, Essop Pahad, deplored the London press’s ‘persistent, poisonous attacks’, and wrote a reply to Johnson’s insults in the Spectator on the 30th, in which he took him to task for his ‘arm’s-length psychoanalysis of a president whom he has never so much as met’ (in fact he he did once) and for ‘alleging that the leader of Africa’s most secure democracy’ was insane. Back home, Pahad protested further to the Sunday Independent:

The far-reaching nature of the personal attacks on the president is staggering and incredible. If similar remarks were made against a prominent British leader, under the protection of organisations bearing the name of prominent and respected persons of equivalent calibre to Helen Suzman, there would be a major uproar. In some cases these personal attacks also originate in the South African press and this is also unacceptable.

Approached for comment, Suzman, who thought Johnson’s attack on Mbeki ‘good in parts’ but ‘over the top’ in others, was not so concerned about the unapproved loan of her foundation’s name to Johnson’s article; ‘What I worry about more is a president’s office that is unable to deal with criticism.’ Jeremy Gordin, then managing editor of the Sunday Independent, couldn’t see why Pahad should have been so upset; on the same day that Pahad’s indignant objection appeared in the Spectator, he reported the hoo-ha in the Star under the heading, ‘Mad’ Mbeki reports set Pahad ranting. Gordin quoted author Ronald Suresh Roberts suggesting that for Johnson, ‘Aids is just another occasion for Africa-bashing, another platform from which to confuse South Africa’s friends and damage South Africa’s influential push for a global economic new deal.’ But indeed it was: AIDS, and the lapse in Mbeki’s ardour for the ideology he’d deconstructed, had become a club with which to beat him down, discredit him, and undermine his drive to reorder international economic relations.

The American press also proposed that Mbeki was round the bend. ‘Under pressure to spend millions to prescribe AZT, President Mbeki indulges flat-earthers’, was Time’s response in April 2000 to Mbeki’s defence of his decision to invite ‘dissidents’ aboard his AIDS Panel; his ‘misplaced trust of medical authority’ threatened countless lives; without the drugs, a quarter of South Africa’s population would be dead by 2010. In South Africa’s Leader Flunks AIDS Lesson on 11 July, Newsday asked, ‘Has Mbeki lost his mind? That sounds like a decent question to most Americans. Until Mbeki pried open all the old questions about HIV, the issue was widely viewed as the obsession of a few tireless cranks.’ At best, in the American view, on the issue of AIDS Mbeki had become separated from all judgment. On 21 January 2002 the New Republic was still asserting:

To American eyes, Thabo Mbeki is a contradiction. Throughout his political career, he’s been known as a pro-Western moderate. … And yet on AIDS, he spews Afrocentric nonsense – denying that Western science can help his people, claiming that racists are exaggerating the scope of the disease, and flirting with homegrown quack cures. A recent New York Times editorial remarked, ‘It is hard to understand how Mr. Mbeki ... can be so irresponsible about AIDS.’

The attacks on Mbeki in the US press would be revived in April, May and September 2003.

As the English and US press were going at banjaxing his reputation like buggery, Mbeki took some low kicks locally from Mondli Makhanya in an opinion piece in the Sunday Times on 24 September. It was intriguing as an instance of a tame black journalist writing to sound like a white liberal, bloated with power afforded him at last, with his piece containing the same sort of air, logical fissures and analytic superficiality. (The docile native’s toadying to the liberal press bosses by posturing against Mbeki was rewarded two years later with the editorship of the Mail&Guardian after Barrell went back to England, and thereafter the Sunday Times.) Makhanya began with an approving description of a witty address Mbeki had given as Presidential candidate in June the year before, delivered, like his others on the pre-election campaign trail, almost exclusively in the country’s vernacular languages:

By election-campaign standards, too, the metamorphosis was a masterstroke: the bookish intellectual was now connecting with the urban proletariat and being embraced by them as one of their own. Even the sceptics in the international and local media were bowled over by the new Mbeki. Reams were written about Mbeki the thinker, Mbeki the hands-on manager, Mbeki the nuts-and-bolts man and Mbeki the man of the people. The business community, jittery about the post-Nelson Mandela era, perked up and began singing his praises. … The man of the people is no more. The thinker and orator whom many were in awe of no longer exists.

And why? Why he’s no longer a man of the people, orator, thinker? Because he was doing his own investigating, thinking, and drawing his own disconcerting conclusions:

The foreign media, who had raved about the Sussex University graduate who would lead Africa out of its malaise, now deride him. His noble efforts to fight Africa’s battles on the international stage have been completely overshadowed by a ridiculous controversy over his doubt about the link between HIV and AIDS. Mbeki has become his own worst enemy. A hallmark of the Mbeki presidency has been what can only be described as an intellectual superiority complex. Behaving almost like a benevolent dictator, Mbeki has nursed the notion that he knows what is right for South Africa to such an extent that no amount of lobbying and public pressure can divert him from a chosen path. … At the moment, Mbeki finds himself caught up in an unnecessary controversy that has done his presidency and South Africa immense harm. Only a few in his trusted inner circle can honestly claim to understand why he is flying in the face of irrefutable science and reopening the debate on the link between HIV and AIDS. So dismissive of public opinion has Mbeki been that he has been unwilling to bow to pressure from churches, trade unions, the non-governmental sector and the health profession. Few democratically elected presidents would risk the unpopularity that comes with having the moral and intellectual opinion of the country turned against them. Yet Mbeki, one of the most astute modern politicians, has done exactly that. So what is it about Mbeki that compels him to behave in a way that not only undermines his presidency, but also damages South Africa’s reputation as one of the few African countries run by sane men? The answer is that Mbeki is a starkly different ANC president from those who came before him. The ANC he leads is also very different to the one led by his predecessors. His intellectual superiority complex and the consequent individualist style with which he runs the ANC sets him apart from his predecessors.

Mbeki was establishing a ‘personality cult’, Makhanya wrote:

If the ANC is to reverse this trend, it should be in the area of HIV/AIDS that it intervenes to remind Mbeki that it is sometimes possible for him to be wrong and for others to be right. … The ANC’s willingness, or its lack thereof, to break ranks with Mbeki on this question will determine just how serious it is about accountability. As for Mbeki, his response to popular opinion will reveal whether his vision of a new Africa led by people who do not see themselves as demigods is real or whether it is just a sexy catch phrase he dreamt up one boring Sunday afternoon at Sussex University. He can still rebuild the image he enjoyed in June 1999 and set himself back on track to leave the legacy he wants. All he has to do is pull out the Thabo Mbeki who inspired the thousands who gathered at FNB Stadium on May 30 last year. He needs to reconnect with the people he governs.

He needs to abandon his insights, principles and convictions, and throw his lot in with the media-formed popular consensus. Like a sheep. Like Makhanya the lickspittle. Anxious to keep on the right side of whites, first and foremost. To stay in their good books. And get their jobs.

Writing in the October issue of New African, editor Baffour Ankomah attributed the murderous intensity of the English newspapers’ character attacks on Mbeki, incited by the local Mail&Guardian, to the fact that

In 15 months as president, Mbeki has proved beyond doubt that he is nobody’s errand boy. Recently, the powers that be wanted him to deliver the head of Zimbabwe’s Robert Mugabe on a silver plate. He refused. His unusual display of African presidential confidence is causing ripples abroad, especially in Britain, where he has become the target of crude headlines in recent days. The aim is to give him a bad name so they can hang him.

Ankomah warned of what had befallen other ‘progressive leaders’ such as Lumumba and Nkrumah, ‘cut down’ for their independent vision:

Forty years ago, Nkrumah was called a ‘megalomaniac’ (mad, in short) for preaching African unity, and wanting to industrialise Ghana as a model for the new Africa of those days. His government was overthrown. His projects were called “white elephants”. Yet, today, Nkrumah’s 11-point African Union programme (published in 1963) [the subject of Mbeki’s university master’s degree thesis] has been adopted and implemented almost wholesale by the European Union. The West continues to think for Africa. An African leader with an independent opinion suggesting an African solution must be daft.

The trouble with Mbeki’s open doubts about the HIV-AIDS model went beyond irritating evidence of a non-compliant, independent African vision and will. He was implicitly calling into question the integrity of Western commercial medicine. At its best. Because if virologists were its revered and mystical Jesuits, retrovirologists claimed mastery of even darker arts. It might chop and change chaotically (we’ll see), but the HIV theory of AIDS and the aggressive chemical approach to its management was allopathic medicine at its most sophisticated, most confident. And Mbeki was implying it was all bull. (Later on in this book, we’ll be touching on how medicine has succeeded the Church as a primary source of vital beliefs in Western culture.) Mbeki was defiantly holding out against them. He wasn’t paying due obeisance to the new Baal. The fury he generated was accordingly deadly. Hence the charges of genocide – treated at Nuremburg by hanging; of lunacy – treated by psychiatrists by inflicting brain damage, by knife, chemicals or electricity; and for perceived unfitness to rule, there was the Patrice Lumumba option.

A further reason for the rancour generated by Mbeki’s impugnation of AZT in particular was that subconsciously in the collective mind of his white critics, the drug represents a concrete token of an idealised notion of progressive Western medical science – looming like a rampart against a deeply rooted perception of retrograde African ignorance, in a country where Africans have worryingly taken charge. The drug has become politically fetishized – the weapon doctors wield to fight this horrible disease that only blacks seem to get, together with a few white homosexuals. Hence the pre-eminence of the AIDS drug issue in the white-run media. South African black critics hammered Mbeki over AZT and similar drugs for a related reason; allegiance to the drug cause put them in line with modernity. It’s a psychologically comfortable place. The whole of the white world nods to denote its favour. Nobody noticed that Mbeki’s African, pragmatic, open-ended approach to AIDS medicine coincides with Western scientific philosophy at its best, articulated so well by Sir Carl Popper, for instance. And summed up in one sentence by Albert Einstein: ‘The important thing is never to stop questioning.’

Disgusted by the viciousness of the attacks on Mbeki, a dozen prominent black business people, professionals and academics led by attorney Christine Qunta placed a full-page 1000-word protest that she drafted in the Sunday Times on 6 May 2001, noting that ‘Not during the worst days of apartheid, or even when the revelations of the Truth Commission showed the full horror of the human rights abuses committed under the political leadership of a succession of apartheid rulers … have apartheid politicians been singled out for such contempt, such open hatred, such unfair reporting as has the President.’

The bitter acridity of newspaper copy about the AIDS treatment and causation controversies also flowed from journalists’ offended self-perceptions. Mathebe deftly mapped this in the final chapter of Bound by tradition: The world of Thabo Mbeki, explaining ‘Mbeki’s unpopularity by reference to the fact that he is given to intellectual deliberation, which the modern journalist sees as his or her province or exclusive domain’. But here was a man who clearly thought for himself, and worse: he thought he knew better. Than white journalists. And not only do journalists rate themselves as thinkers, they’re crusaders for truth too; Mathebe cites an observation by a French commentator, Mogin, that ‘it is media people who most often think they embody the challenge to the status quo’, and who imagine themselves to be ‘“naturally” progressive because they daily hold history at the end of their pen’. And that because they wield power, politicians are morally suspect, and their statements and actions probably dissimulation. The violence of journalists’ language in assailing Mbeki was amplified by their inflamed self-opinion as ‘the custodians of moral virtue’, as Mathebe put it. Hence the intolerant, hateful and destructive gales of cant in their judgments condemning him. Simply for pointing out the existence of an alarming corpus of literature on the extreme toxicity of AZT. And for acknowledging that a controversy existed about the cause of AIDS – started by Duesberg, no less, one of the world’s most prominent retrovirologists. It got journalists into a moral fever, unequalled in the history of their business. As they went about GlaxoSmithKline’s. Really, it was to puke over.

Another element accounting for the dull reception liberal journalists have given Mbeki’s thoughts on AIDS is that they are simply not listening to him generally; they find no sympathy with his drive to vindicate African dignity, because in their cosy conclaves what he’s saying doesn’t reach their souls. To them it’s just posturing and prattle, like any other politician’s. And not glowing with a complex set of African attitudes, values and approaches, quite distinct from European and American ones – brought into hard focus by AIDS and highlighting their profound differences. The chasm between the progressive and liberal agendas too. And where Mbeki’s statements on AIDS are pained and uncomfortable, implying the persistence of white racist thinking after the revolution, to liberal journalists they make no sense at all.

Arthur Miller explained the hot reception of Mbeki’s challenges in the introduction he wrote to his Collected Plays, written in 1957 and included in Death of a Salesman: Text and Criticism edited by Gerald Weales (Penguin Books, 1996):

At first blush a new idea appears to be very close to insanity because to be new it must reverse important basic beliefs and assumptions which, in turn, have been institutionalized and are administered by one or another kind of priesthood with a vested interest in the old idea. … The polemical method, as well as the scientific exposition, the parable, or the ethical teaching, all depend upon a process which, in effect, says, ‘What you believe is wrong for these reasons; what the truth is is as follows.’ Tremendous energy must go into destroying the validity of the ancient proposition, and destroying it from an absolutely opposite viewpoint. An idea, if it is really new, is a genuine humiliation for the majority of the people; it is an affront not only to their sensibilities but to their deepest convictions. It offends against the things they worship, whether God or science or money.

Throughout the controversy at its hottest, the Mail&Guardian reworked the lines of its editorials and articles week after week, but its song remained the same, and it provided a vivid instance of what Herbert Marcuse captured in the title of his oft-quoted essay, Repressive Tolerance – his deconstruction of the sham claim of advanced liberal societies to abide dissent. George Orwell made the same point in his intended preface to Animal Farm (only published decades later, because it was not on to talk that way), explaining how in such societies, as opposed to dictatorships,

Unpopular ideas can be silenced, and inconvenient facts kept dark, without any need for any official ban. … At any given moment there is an orthodoxy, a body of ideas of which it is assumed that all right-thinking people will accept without question. It is not exactly forbidden to say this, that or the other, but it is ‘not done’ to say it. … Anyone who challenges the prevailing orthodoxy finds himself silenced with surprising effectiveness. A genuinely unfashionable opinion is almost never given a fair hearing, either in the popular press or in the high-brow periodicals.

Nearly all other newspapers took the Mail&Guardian’s lead, both in South Africa, in England and elsewhere. This was the newspaper to heed, its credibility perfected as a brave anti-apartheid firebrand. (None other than Mbeki himself had gone out soliciting legal defence funding for it when its reporting during the late apartheid era repeatedly landed it in court.) The result was the consolidation of an almost unanimous international public consensus, particularly keen in white liberal circles, that African babies – not white, Indian, or ‘coloured’ – were being infected with a deadly virus by their mothers, and were dying in droves, suffering horrible lingering deaths. Because Mbeki’s government wouldn’t come to their rescue. With AZT. And that Mbeki himself was sad, bad and mad. The last bastion of unelected state power, the predominantly white courts, would have to save the South African black populace from the demented ogre. The heartless dictator. The useless, stupid kaffir.

CHAPTER

September 2000 was a dizzy month in the South African AIDS controversy. It began with Mbeki explaining his reservations about the monocausal viral model of acquired immune deficiency – the propensity to fall sick, in plain speech – in an interview in Time on the 4th:

Now, if you go through the literature, ordinary standard literature available in medical schools, there will be a whole variety of things that can cause the immune system to collapse. Endemic poverty, the impact of nutrition, contaminated water, all of these things, will result in immune deficiency. If you take the African continent you add to that things like repetitive infections of malaria, ordinary STDs [sexually transmitted diseases] – syphilis, gonorrhoea etc. All of these will result in immune deficiency. Now it is perfectly possible that among those things is a particular virus. But the notion that immune deficiency is only acquired from a single virus cannot be sustained. The problem is that once you say immune deficiency is acquired from that virus your response will be anti-retroviral drugs. But if you say the reason we are getting collapsed immune systems is a whole variety of reasons, including the poverty question which is very critical, then you have a more comprehensive response to the health condition of a person. … I am saying that you cannot attribute immune deficiency solely and exclusively to a virus.

Asked, ‘Would you acknowledge that HIV is a causal factor in AIDS?’ Mbeki replied:

I am saying sure, no problem at all, there may very well be a virus. But there is a lot of debate among scientists, which is why we said let all these different factions come together. Let’s all get together ourselves and sort out this question. There cannot be any dispute about all these other things which result in immune deficiency. It’s in the medical school textbooks at university. So one of the first things they are going to try to answer is, when you take a person’s blood and measure it, what are you measuring? Are you measuring a virus or what? For what has been said is that these tests are measuring HIV. But what are these tests really measuring? The scientists are not agreed among themselves that what they are measuring is a virus. They are measuring the response of the immune system to something attacking it. But TB [tuberculosis], for example, destroys the immune system and at a certain point if you have TB you will test HIV positive because the immune system is fighting the TB. Then you will go further to say TB is an opportunistic disease of AIDS whereas in fact TB is the thing that destroyed the immune system in the first place. But if you come to the conclusion that the only thing that destroys immune systems is HIV then your only response is to give them anti-retroviral drugs. There’s no point in attending to this TB business because that’s just an opportunistic disease. What is fundamental is the AIDS. So much so that even in everyday language AIDS is said to be a disease. It’s no such thing. AIDS is a syndrome. It’s a whole variety of diseases which affect a person because something negative has happened to the immune system. If the scientists come back and say this virus is part of the variety of things from which people acquire immune deficiency, I have no problem with that. But to say this is the sole cause therefore the only response to it is anti-retroviral drugs, I am saying we’ll never be able to solve the AIDS problem.

Peter Bruce commented in an editorial in Business Day on the 12th:

President Thabo Mbeki has once again brought ridicule on himself and his country by repeating his eccentric views on HIV/AIDS. … His view, unacceptable to all but a handful of crank scientists, has desperate consequences for South Africans’ health. It implies that the HIV virus is but one minor cause among many, hence discouraging the single-most important preventive measure needed to turn the pandemic around, namely, a change in the sexual behaviour through which the deadly virus is transmitted

– black sexual behaviour, he implied, having regard to the virtual absence of ‘AIDS’ among the other race groups in South Africa, white particularly.

Mbeki’s remarks were ‘clearly nonsense’, commented Southern African HIV-AIDS Clinicians Society president Desmond Martin. Although, yes, ‘False positive tests do occur with antibody testing in patients with TB. But confirmatory testing rules out this false test.’ (Really?) And yes, ‘TB does cause some – and I’d stress some – immunosuppression. But to say it “destroys” the immune system is wrong.’ To say that when you don’t have enough proper food to eat and your health collapses and you are over-run by colonising TB bacilli is wrong. Martin went on: the statement that ‘the test is meaningless … coming from a highly respected source … put our education campaigns back,’ he complained; they are ‘being disbelieved’. Children are responding to safe sex programmes with derision, he said. We don’t like our youngsters discovering sex, he meant.

Adding its voice to the storm over Mbeki’s statements in the Time interview, the communists came out in support of the capitalists of the medical industrial complex. The SACP referred to general secretary Blade Nzimande’s appeal to Mbeki in April: ‘Comrade President, let us not cheat ourselves. We know that AIDS kills, and that AIDS is caused by the HIV virus.’ We know it because it’s what doctors say, and as communists we prefer modern scientific doctors to backward unscientific priests when it comes to explaining life.

The day after publication of the Time interview, there was another, in a rather more modest forum, the Johannesburg studios of Radio 702, where a crass sports jock called John Robbie interviewed Tshabalala-Msimang. When he addressed her by her first name, and she objected, he contemptuously persisted – ‘behaving like the “baas” talking to the “maid”’, chided Business Day afterwards. He tried forcing a statement from her concerning whether she believed HIV caused AIDS, but she would not be compelled: ‘You will not pressurise me to answer that.’ To which he responded, ‘Go away. I cannot take that rubbish any longer. Can you believe it? ... I have never in my life heard such rubbish.’ Similar contempt was expressed on a Capetalk 576 community radio billboard in Rondebosch, Cape Town in 2002: ‘Why did the chicken cross the road? Chicken? There’s no proof that there’s a chicken to begin with – Health Minister.’

Unwittingly, like a child with matches, Robbie had ignited an inquisition into the beliefs of members of government concerning AIDS – entailing the requirement that they make public avowals of subscription to the dominant creed. Education Minister Kader Asmal was examined next. But at a media conference on the 12th, he refused to be ‘pushed into a corner over the issue’. This gave the Mail&Guardian an idea. Not content to report the news, it decided to make it, by submitting a questionnaire to each of the Cabinet’s twenty-seven members, inquiring whether they believed HIV caused AIDS. And published what responses it drew later in the month.

The 16th was the start of Cosatu’s annual four-day conference. About a week in advance of it, a white paper concerning AIDS policy, prepared for tabling and discussion at the conference, was tactically leaked to the Mail&Guardian, and the weekly duly obliged with an article about it on the 8th: Cosatu: End scientific speculation on HIV/Aids. The policy paper called on the government to do just that, and to turn its attention instead to supplying cheap AIDS drugs – especially to rape victims and HIV-positive women, something that was ‘morally and medically right’. Cosatu president Willie Madisha was approached for comment: ‘We believe that indeed HIV causes AIDS and that is not disputable. All this talk and debate about the cause of AIDS prevents people from trying to deal with the problem.’ We believe.

The AIDS controversy was hardly a shop floor issue, but the unionists, I suggest, seized it for its practical political value. When the Tripartite Alliance between the ANC, the Communist party and Cosatu was formed ahead of the first democratic election of 1994, Cosatu had wielded considerable clout within it, but its influence over ANC policy since had been in steady free fall. I surmise that AIDS presented to Cosatu as a politically useful issue with which to leverage itself within the axis and to pressurise the ANC in government in an attempt to arrest its slide from power-player to minor participant in the alliance. And perhaps juggle for a position closer to the heart of the masses than the ANC. Caring. Unlike the ANC. But the credulity of Cosatu’s leadership concerning the racist AIDS scare and its decision to support the TAC agenda might have had the opposite effect and have exacerbated the erosion of union power and influence within the alliance. Because by indulging in such foolish populist talk, and by throwing in its lot with the TAC, Cosatu’s voice has become more difficult to take seriously by Mbeki and his senior ministers and aides.

And then there was the money in it. In 2002 the investment arm of Cosatu-affiliated CEPPWAWU bought stock in local drug manufacturer Aspen in a black empowerment deal. Announcing an increase in revenues of forty-one per cent in August that year, the company press release quoted CEO Stephen Saad: ‘Aspen’s strategic approach towards providing quality affordable generic antiretrovirals for HIV/AIDS sufferers has progressed significantly, firmly positioning us to deliver on this initiative in the foreseeable future.’ Nothing strange for Cosatu getting involved in the business with disease: in July 1997 its investment arm Kopano ka Matla had already bought into Netcare, a private hospital company. Along with thirty thousand black doctors making up the South African Medical and Dental Practitioners. All enjoying the profits together. And hopelessly compromising Cosatu’s voice in health policy, especially concerning the provision of AIDS drugs. We lawyers call this a conflict of interest.

At about the same time as the rigged Cosatu press-leak, a nine-page document drawn by the deputy chairperson of the ANC’s national health committee, Confidence Moloko, helped by committee secretary Saadiq Kariem, was delivered to the Cape Times. It asserted: ‘... we do not have the luxury of fiddling whilst the masses are dying. … We have identified the cause [of AIDS]. The infectious agent is HIV, which is a retrovirus. The predominant scientific view that HIV causes Aids is the view that the ANC, its leadership and its membership has to publicly express.’ Tshabalala-Msimang was annoyed about not having been consulted. Understandably, since she chairs the committee – an advisory body formed in 1990 to report to ANC Secretary-General Kgalema Motlanthe. Not circulate rearguard broadsides. She accordingly demanded that the document be withdrawn. A member of the committee speaking anonymously explained why it had refused: ‘This is a moral stand that we need to take.’ Against the government’s immorality. In a statement on the 13th the ANC emphasized that the document was a discussion paper that did not reflect the views of the party. Indeed, speaking for the ANC, Smuts Ngonyama noted that ‘It wasn’t even a subcommittee document, it was one man’s opinion on the subject.’ Moloko admitted as much: ‘This is a confidential discussion document intended to stimulate debate within the organisation. … We hope this will raise the level of debate.’ Hardly: it simply recited and urged the conventional wisdom, in a fifth column manoeuvre by medical doctors in the ANC. ‘There is nothing secretive about it but it is only intended for people in the ANC. We are not ready to release it to the public yet.’ Yet it was deliberately leaked to a white conservative newspaper. Very likely by Kariem. There were no ‘holy cows’ in the ANC, Moloko added, and the debate about Mbeki’s position on AIDS demonstrated this. That wasn’t the point. The doctors were subverting Mbeki. Their first loyalty to the medical-industrial complex. They were playing into the hands of his detractors. So that in reporting the matter, the Independent Online could claim on the 13th: ‘The document ... reflects dissatisfaction in the ruling party about Mbeki’s ambiguous statements on the disease that affects over four-million South Africans.’

According to a report in the Mail&Guardian on 13 December 2002, Moloko and Kariem had not been forgiven for their treachery more than two years later, with Tshabalala-Msimang allegedly moving to block their accreditation applications to prevent their attendance at the ANC’s annual national conference set to start the following week.

On 15 September the Mail&Guardian backed the two discussion papers’ calls with one of its own in its inspiring Just say yes, Mr President editorial:

President Thabo Mbeki either gets his act together on HIV/Aids very soon or he places his presidency at risk. We South Africans are losing the battle against this disease. This is, in no small measure, the result of the refusal by Mbeki to accept the guidance of best science. That refusal is irrational and perverse. More than four million South Africans are infected with HIV. These four million-odd South Africans will die as a result. Families and communities across the country are being decimated. More South Africans are being infected with HIV – at the rate of one a minute. Worse, the rate at which South Africans are being infected is rising. Worse still, the African National Congress – the first party to be democratically elected in our country – has allowed this rate of infection to continue to rise every year since it came to power. … It is not too late for Mbeki to change the growing perception of him as an extremely intelligent man, but one whose intellect contains islands of irrationality that are impervious to reason, who has difficulty in conceding an error of judgement, and who prefers verbal play to the practical tasks at hand. An encouraging start would be for Mbeki to say as little as this: ‘Deficiency in immune systems is due to more than just HIV. But we have to recognise that there has been a huge increase in the number of illnesses and deaths among our adults and children. What we know is that there is a new virus and that it is, primarily, causing this increase in deaths.’ Just say it, Mr President.

Just say it like Gerhart Hauptman, the 1912 Nobel Prize winner for literature, declaring his support for the Nazi regime in 1933 in an article he published under the title: ‘I say yes!’

On the same day that the Mail&Guardian was enjoining Mbeki to just embrace the faith, PAC health secretary Costa Gazi made a call at the same level, demanding Mbeki make a public apology for his stance on AIDS. And he should also take responsibility for the tens of thousands of children’s lives that have been unnecessarily lost because of his policies, he said.

The following day, on the 16th, Mbeki attended the first day of Cosatu’s annual congress. Union boss Madisha opened by repeating what he’d said earlier in the month:

We need to put the current controversies behind us and develop strategies to obtain cheap drugs, either through hard negotiations with producers or through parallel importation of generics and compulsory licensing. For Cosatu the link between HIV and AIDS is irrefutable, and any other approach is unscientific and, unfortunately, likely to confuse people. The current debate on the causal link between HIV and AIDS is confusing. As a result, it can undermine the message that all South Africans must take precautions to avoid infection. Government’s unwillingness to provide anti-retrovirals, particularly to prevent mother-to-child transmission, is unfortunate. Concerns around cost are understandable but often exaggerated. In any case, they cannot be used to deny treatment for the millions of victims. This is tantamount to condemning HIV/AIDS victims to early deaths.

Alert to how AIDS was being worked by his opponents not only as a cudgel to discredit him personally, along with his vision for radical national transformation, but also as a wedge to separate him from his allies, Mbeki answered elliptically:

In trying to define a role for the trade union movement, we must never forget that there are forces for change, and then there are reactionary forces bent on retaining at all cost the privileges and power acquired under apartheid. They want us to become a house divided against itself, concentrating on a campaign to destroy one another. Those [the ‘beneficiaries of our racist past’] who want to set the national agenda in their own interest want us to forget about 84 percent of these killer diseases [‘heart disease’ and ‘malaria’, for example, as he would explain in Parliament later in the month] and concentrate on the remaining 16 percent. We must not allow ourselves to be misled.

(Apropos of heart disease, Mbeki laughs privately that coronary thrombosis among whites, no matter how many it takes under, doesn’t draw any media interest, because, unlike black AIDS, it’s a ‘first class disease’.) He urged the Tripartite Alliance to ‘intensify the struggle against racism’. But the subtlety of Mbeki’s answer to Madisha was lost on SACP general-secretary Blade Nzimande. Asked by the media to comment, he went for the lazy sound-byte: His party ‘accepts the view of the scientific community that the HI virus causes AIDS’, he said. ‘We need to fight against HIV-AIDS with the same intensity as we struggled against the criminal apartheid system.’ We need to fight it with condoms and drugs.

On the 19th, having just refused to distance herself from Mbeki’s open, questioning stance at a parliamentary media briefing a couple of days earlier, and unwilling to answer yes or no to journalists’ questions about HIV as the cause of AIDS, Tshabalala-Msimang attended a meeting of the parliamentary Health Committee. A group of about fifty TAC members in ‘H.I.V. positive’ tee-shirts led by Achmat gatecrashed the meeting to show their ‘dismay and anger’ at the government’s AIDS stance. After the manner of Hare Krishna devotees, they sat murmuring ‘Just say yes, just say yes’ throughout her address. On the steps of Parliament afterwards, as journalists hovered, having been called out to cover the staged event, they pressed their plea on her again. Achmat put it to her that she’d accepted HIV caused AIDS in the past, and she should now say so publicly. Her answer was that she’d ‘never said HIV did not cause AIDS’. The government’s stance was causing confusion, someone cheeped. She retorted: ‘Who is causing confusion? I say one and the same thing all the time and you refuse to listen. In rural areas where I operate, people are not confused.’ Recognising where that was going, Achmat countered that while poverty helped to spread HIV, it did not cause AIDS.

The London Observer reported the upshot of the Mail&Guardian’s poll of Cabinet members’ beliefs on the same day. Silent or evasive, most wouldn’t play. Labour Minister Membathisi Mdladlana answered, ‘Yes, of course HIV causes AIDS.’ Another report included his rider that ‘poverty also damages the immune system’. Finance Minister Trevor Manuel uttered cagily: he did not want to get into the subject, he said, but he understood ‘there is evidence to suggest’ HIV caused AIDS. But equally there was also evidence that other factors, such as poverty, ‘accelerate’ the conditions associated with the disease: ‘Bodies that are weaker are more susceptible to that condition.’ Public Enterprises Minister Jeff Radebe appears to have had a surprise in store for reporters on the 14th, but they didn’t ask him: ‘I was waiting for the HIV and AIDS question, but you disappointed me,’ he said with a smile. (‘We support the President,’ he said two weeks later.) Tshabalala-Msimang’s office responded on her behalf: ‘The minister is working on the assumption that there is acquired immune deficiency. There is a variety of things that causes the collapse of the immune system and it cannot be attributed solely and exclusively to the virus.’

At separate media briefings on the 19th, the Inkatha Freedom Party’s Ben Ngubane, Minister of Arts, Culture, Science and Technology, and Correctional Services Minister Ben Skosana both agreed HIV causes AIDS, but defended what they described as ‘the government’s decision to enquire into other factors escalating the epidemic’. Ngubane had a curious comment though: ‘The link between HIV and Aids is indisputable. The current debate is at a much bigger level, about the nature of investigation in laboratories.’ The value of the tests on which the whole show was being staged? The link between a meaningless test result and ancient diseases?

The Panafrican News Agency wired a report on the 20th, Furore Over Government’s AIDS View Continues:

As the government continues to prevaricate on HIV/AIDS and the nation becomes more desperate, Archbishop Njongonkulu Ndungane on Wednesday called on all religious leaders and organised society – including the unions – to take the initiative. ‘We need an urgent strategic planning meeting of all interested parties so as to develop a plan of action and we need to move fast. We believe that history will measure this country’s slow response to the pandemic in human, not in statistical terms, and that the inherent injustices will be judged as serious a crime against humanity as apartheid,’ he said. [And history will tell how AIDS revitalised the South African Anglican Church.] Ndungane said the government’s stubborn refusal to work within scientifically accepted parameters is the greatest existing threat to the political and economic stability of the region. ‘It impacts on the entire global family and entrenches the insidious effects of poverty, which is the greatest known form of violence. What is becoming increasingly clear is the futility of looking to government for a solution. At the very least, we need to apply pressure on our political leaders to change this situation,’ he added.

In a private note Gerrit Brand, a theologian with a PhD from Utrecht, pertinently explained South African Christian enthusiasm for AIDS from two tacks:

The Church was very active in the struggle against apartheid and found its whole meaning in that stance for a long time. When apartheid was gone, the Church was suddenly left with a feeling of disorientation. The abnormality of apartheid had become normal to it, and so it couldn’t cope with a more normal situation. In this sense there was a sort of nostalgia for apartheid, for some great evil against which the Church could once again take a principled stand. This is what caught both Tutu and Ndungane in the end. Among white Christians, especially in the NG Kerk, who had supported apartheid, the need for a new struggle was even stronger because it would afford them the chance to redeem themselves by, this time around, joining in the struggle with no holds barred. So, interestingly, AIDS has become the absolute top priority of the NG Kerk. It is terribly sad to witness how so many people’s sincere wish finally to do something good is ravishing their immunity to the ideology of AIDS.

And terribly sad it was to see that most heroic of anti-apartheid clerics the late Beyers Naude sipping cocktails with AIDS Law Project director and TAC national treasurer Mark Heywood on 14 October 2003 at Monte Casino in Johannesburg, where the AIDS documentary A Closer Walk had its premier screening. Director Robert Bilheimer, nominated for an Oscar for his 1989 film about Naude, told the audience that nothing less than ‘igniting a revolution’ was his intention in making the film: ‘Its time for the people to take control ... Kennedy once spokes of a ripple effect. We are all here tonight and this is where the ripple begins. ... When you have people in the back doing something ... then you can be damn well sure leaders in the front will take notice.’ Revolutionary people in the back like Heywood. Useless leaders in the front like Mbeki.

In Parliament, on the same day that PANA published Ndungane’s excoriations, Tony Leon pressed Mbeki for a personal affirmation of orthodox belief. He answered: ‘The programme of the government in this country is based on this thesis that HIV causes AIDS and everything in the programme says that.’ They liked that bit. But hated the next: ‘AIDS stands for Acquired Immune Deficiency Syndrome,’ but ‘A virus cannot cause a syndrome. A virus can cause a disease, and AIDS is not a disease, it is a syndrome.’ A syndrome that includes ‘twenty nine diseases’. Questions about HIV and AIDS had been raised by ‘very eminent scientists’, and while he had ‘no problem’ with the argument that HIV contributed to the collapse of the immune system, other factors such as malnutrition and malaria were also involved. All these had to be studied so that ‘we can respond to them all and be more effective’. Reiterating his point in his April letter to Clinton, Blair, Annan and others that ‘Reciting comfortable catechisms on AIDS is not good enough’, Mbeki commented. ‘The basic problem is that many people don’t want to study these questions. They are perfectly happy to repeat what is said to be the conventional wisdom.’ He then raised a crucial issue: ‘When somebody is tested, HIV positive or negative, what is being measured? … What do HIV tests measure?’ An advisory panel established to research the link between HIV and AIDS would report back by the end of the year, he said. And as for nevirapine for HIV-positive pregnant women, tests were continuing in South Africa, and anyway, he said, it hadn’t been approved anywhere else in the world for that indication.

Leon responded that Mbeki had ‘snatched confusion from the jaws of clarity’. New National Party AIDS spokesman Kobus Gous said that whoever had advised Mbeki that a virus could not cause a syndrome should ‘be fired’. Heywood pronounced Mbeki’s exposition ‘devious and dishonest’. Barney Pityana, then chairman of the Human Rights Commission, said his HRC was considering legal action in the light of a number of complaints by AIDS sufferers claiming that their constitutional right to be provided with potentially life-saving drugs was being denied by the government.

As Cameron put it later on in the PBS Frontline television documentary The Age of AIDS screened in the US on 30 and 31 May 2006 : ‘It was clear from his speech that he’d had access to denialist literature on AIDS, denialist literature that queried whether HIV was, in fact, a virally caused condition, and that queried, most significantly, whether the anti-retroviral drugs were of any use in treating what the denialists claim is an environmental and social condition, not a viral condition.’ To which Glenda Gray added, ‘What we had was a president who was a dissident. We had lackeys in the health department that would do anything that their master said, and even if it meant not giving women interventions to save their children’s lives.’ You see, they’re all savages.

The following day, on the 21st, journalists tried pinning down Public Works Minister Stella Sigcau on the AIDS causation issue at a media briefing. She wriggled: poverty relief was her concern, she said, and since poverty made people susceptible to disease, the government should focus on ensuring people emerge from it. And later in the day, the last day of Cosatu’s national congress, more than two thousand delegates adopted a unanimous resolution urging the government to end its speculations about the cause of AIDS, give attention to AIDS orphans, and to provide AIDS drugs to HIV-positive pregnant women and rape victims. The resolution called on the government to approach the pandemic as a ‘national disaster requiring extraordinary measures’. Cosatu congress closes with Aids crusade reported the Independent Online next day, with Madisha appealing to the union to ‘mobilise our family and friends, the bosses and even the government to ensure that we act as a unified people to defeat this scourge. What would be the use of all our resolutions if we were to pass them and then have to listen to the agony of our fellow South Africans, our mothers and fathers, brothers and sisters and children, who are dying as we speak.’ Cosatu was well and truly onside. The TAC’s. The pharmaceutical industry’s.

As Mbeki was sceptically summing up for the ANC what was going down between Cosatu, the TAC and the drug corporations, his predecessor was declaring himself a believer. Interviewed by the Daily News on the same day, Mandela said he shared the ‘dominant opinion which prevails throughout the world’, and would only give it up if it was shown ‘conclusively that that view is wrong’. But, he said,

I am not a specialist; I’m not a doctor. It is known that in medicine there will be a particular viewpoint, which is embraced by experts throughout the world. But some research then shows that that view requires qualification, sometimes to be abandoned altogether. … [Mbeki] has said that government action is based upon the fact that HIV causes AIDS, but he himself as an individual has got certain reservations. … I would like to be very careful in saying so and so is right and so and so is wrong. … I would like to be careful, because [for] people in our positions, when you take a stand, you might find that established principles are undermined, sometimes without scientific backing, and so I would like to be very careful.

For all the soft soap, Mandela’s implication was obvious: Mbeki was undermining good science without good reason, so it followed that he must deservedly ‘now and again ... come under severe criticism’. But he respected him nonetheless, he said. ‘We are very, very close indeed.’ Not really, truth to tell.

The annual three-day conference of the National Executive Committee of the ANC began on Friday the 29th. The political dynamics of the AIDS controversy got a close look and featured in its report released early the following month. The Mail&Guardian endeavoured to dictate the agenda on the front page of its Just say yes, Mr President issue, charging: ‘The vast majority of scientists are in agreement that HIV causes Aids. South Africa is gripped by a catastrophe that is killing millions of our people. The government’s questioning of the link between HIV and AIDS is crippling the campaign to combat the scourge’ – but the newspaper would be rebuffed by the NEC in its closing statement. Making ironic use of the Mail&Guardian’s apocalyptic imagery to justify his consideration of politically incorrect perspectives, Mbeki answered the accusation in the Star on 10 October, feigning humble ignorance along with pretended awe: ‘I personally want to understand this matter better … We are looking for answers because all the information shows that in reality we are faced with a catastrophe and you can’t respond by merely saying “I will do what is routine”. We need to respond in a way that recognises that it is a catastrophe.’

September ended on a happy note. Achmat was awarded a ‘Spirit of Hope Award’ from the SA NGO Coalition for his ‘special contribution’ to civil society.

From the AIDS storm pelting Mbeki and Tshabalala-Msimang, October offered no respite. The month began with a statement by the South African Medical Association, reported on the 2nd, deprecating the confusion Mbeki was causing. And not only about whether HIV caused AIDS; SAMA was concerned at the ‘growing number of people now questioning the existence of HIV’. Like the Devil. Chairman Zolile Mlisana commented:

The point we want to raise is that at this point in time there shouldn’t really be discussion about whether HIV causes AIDS. It was SAMA’s responsibility to end [it]. … Whether HIV causes Aids or not is not a matter of speculation, it’s a question of scientific fact. As professionals and scientists we want to make that statement very clear. It’s our responsibility to do so. … HIV does cause AIDS. It is not a matter of political opinion. … President Mbeki is wrong if he implies doubt about HIV causing AIDS.

All the same, he was a ‘sound and highly intelligent man. … Perhaps he has not consulted enough, or has somehow undermined that consultation process.’ But he wasn’t all wrong: ‘Especially in the cases of medical disasters and epidemics it is important to note and emphasise that these are not arrested by the administration of medicines, but by social re-engineering, prevention, and public health measures. The president is right if he is attempting to force us to consider more than just the virus and administration of medicines on the issue of HIV/AIDS.’

The next day, following the conclusion of its meeting, the ANC NEC issued its closing statement. It mentioned the ‘massive propaganda onslaught against the ANC, its President and its government on fundamental questions facing the country’ – and one would think Mbeki was Mobuto or Bokassa the way he was being attacked; it regretted ‘the practice of Alliance partners of debating matters central to the transformation of our country in the media, rather than engaging with each other in a comradely manner and in appropriate fora’; and it ‘reaffirmed its policy and programmes on HIV/AIDS [‘based on the thesis that HIV causes AIDS’] as articulated by the President and carried out through the structures of the movement and those of government’. After reviewing them, it concluded:

The NEC lends its full support to the initiatives of the government to support further scientific enquiry into this very complex pandemic and towards efforts to find a cure. In this context, we should refuse to surrender to populism, dogma and sales pitches of some pharmaceutical companies and their agents. Fighting the HIV/AIDS pandemic is a national priority. As the movement that embodies the aspirations and hopes of our people, the ANC, its members and cadres should not allow themselves to be distracted from pursuing the programme to turn around the tide of the pandemic with vigour, commitment and dedication. Neither should we pander to the agenda of those whose occupation it is to extract the most sensational sound byte. In the final analysis, our responsibility is to the mass of our people.

At the Pretoria Sakekamer’s annual dinner on the 4th, Leon said Mbeki’s ‘brand of pronouncements to the ANC caucus [a week earlier] does violence to the facts. … Aside from the diversionary nature of his contribution in the AIDS debate, President Mbeki has done great damage to South Africa as an investment destination.’ His ‘effective declaration of war on the international drugs and pharmaceutical companies was a case in point’. He should ‘make love, not war’ on international investors. ‘President Mbeki should stop surfing the Internet on immunology and start fixating on improving investment flows into South Africa. In short, government should stop blaming and start delivering. They should prioritise, rigorously, not politicise endlessly.’ There was another scolding for Mbeki earlier in the day: Makgoba told a meeting at Rhodes University that South Africa couldn’t ‘afford any more mixed messages and blunders’ in its fight against AIDS. We – he meant Mbeki – had to make careful ‘political and scientific choices’ or history would record collaboration in the ‘greatest genocide of our time’. South Africa would still be facing ‘the explosive and unrelenting HIV/AIDS epidemic’ when the dissident scientists that he’d invited to the country had gone home.

Government spokesman Joel Netshitenzhe announced the following day that starting the day after, an ad campaign would be running for two weeks on the premise that HIV causes AIDS. Mbeki had been fully consulted, and it had ‘his seal of approval. … The current debate might have introduced doubt about the government’s position on AIDS. This campaign is about reinforcing government’s stance on the matter.’ He said the focus of the advertisements would be on promoting the ABC programme: ‘abstinence from sex, being faithful to one partner, and condom use’.

As he spoke, journalists were studying a bundle of correspondence released to them on the same day. It was the full exchange between Mbeki and Leon over AZT for rape, excerpts of which had been published in the Sunday Times in July, and they contained enough acid to strip paint.

Leon:

You have misrepresented your opponents, twisted their words and tried to impose your own meaning on what they said, all in an attempt to blindside your critics. I cannot judge whether this is merely a cynical attempt to silence debate, or whether you really believe that anyone who criticises you or your government is (by definition) a racist. … I would far rather, Mr President, that you and I should work together on this supreme crisis facing our country ... I would be only too happy to stand on the same platform with you to back a campaign for the eradication of sexually transmitted diseases whose prevalence does so much to help spread HIV/Aids. I am not interested in whether my [largely white] supporters or yours [largely black] suffer more from STDs [sexually transmitted diseases] ... We both want the best for our country and for all our countrymen and women. I will be only too happy to meet you at your earliest convenience to discuss how we may work together to dramatise that this is a crisis for all of us, that death and disease know no distinction of politics, creed or race.

Mbeki answered:

I also note that you make no comment whatsoever against the gravely insulting statement made by Charlene Smith about rape being ‘endemic’ in African culture. Rather, you attach footnotes to your letter, which, by trying to talk the rape figures upwards, seek to imply that she may, after all, be right. My attention has also been drawn to Ms Smith’s denial, in a recent publication, of ever having written the passage I quoted in my letter to you. In the event that you did not understand its true import, let me cite it once again. ‘Here, (in South Africa), (AIDS) is spread primarily by heterosexual sex spurred by men’s attitude towards women. We won’t end this epidemic until we understand the role of tradition and religion and of a culture in which rape is endemic and has become a prime means of transmitting the disease, to young women as well as children.’ The article in which this appears is subtitled ‘Their Deaths, His Doubts, My Fears’. It appears in the Washington Post edition of June 4, 2000. Datelined Johannesburg, the newspaper says it is ‘By Charlene Smith’, described by the newspaper as ‘a South African journalist who writes about HIV, (who) will speak at the International AIDS Conference in Durban in July.’ Since she denies having made this nakedly racist statement, which you seek to justify in your footnotes, time will tell who between her and the Washington Post is prone to the shameless propagation of unembellished untruths. The racist stereotype of Africans that many South Africans carry in their heads has nothing to do with ‘civil society’. The subterfuge of seeking to hide behind the skirts of ‘civil society’ will not pass. Your comments suggest that you are not aware of the fact that the figures published about the incidence of HIV in our country and the rest of our continent are estimates. Mathematicians and statisticians have questioned the reliability of these estimates and the correctness of making extrapolations, in our country, from information gathered among pregnant black (African) women at antenatal clinics, using highly questionable mathematical models. To understand the extraordinary distortion this creates, please try to get figures about the incidence of HIV-AIDS among the white population of our country! I am certain you will find the search very frustrating and the result very illuminating! But, of course, I am likely to be quite wrong in assuming that a person as well informed as you are about HIV-AIDS does not already have this information. You may also be unaware of the desperate attempt made by some scientists in the past to blame HIV-AIDS on Africans, even at the time when the USA was the epicentre of reported deaths from AIDS. To me as an African, it is both interesting and disturbing that the signatories of the so-called ‘Durban Declaration’ return to the thesis about the alleged original transmission of HIV ‘from (African) animals to humans’, given what science has said about AIDS during the last two decades. I accept that it may be that you do not understand the significance of this and the message it communicates to Africans, hence your queer observation that I seek to silence our critics, without responding to their arguments. … Possibly we do originate from different planets with radically different value systems.

It seems clear that you are determined that neither established fact, nor anything else whatsoever, will deter you from pursuing your set goal of ensuring that rape victims use AZT ... I still find it completely unacceptable that the leader of the opposition should, in a democracy, blatantly urge defiance of the law. … You would do well to listen to those who have been and continue to be victims of the most virulent racism. Difficult as it may be, the least you might try to do is to fight against the tendency to hold in contempt those whom white South Africa has held in and treated with contempt for many centuries, even if you do not quite understand everything they mean when they speak. … You state that the appearance of the president and the leader of the official opposition on the same stage, campaigning on the same health issue, would make ‘a very great public impact.’ You may very well be correct. But I can also imagine how many people there would be, at home and abroad, who would ask ... why does the elected president not have sufficient courage to discharge his responsibilities about the health challenge we face, without requiring that the leader of the official opposition should hold his hand? … You are entirely wrong to claim ... that ‘death and disease know no distinction of politics, creed or race.’ Perhaps this illustrates graphically the point that we do, indeed, occupy different planets. Contrary to what you say, even a child, from among the black communities, knows that our own ‘burden of disease’ coincides with the racial divisions in our country.

In this regard, you might care to consider what it is that distinguishes Africa from the United States, as a consequence of which millions in sub-Saharan Africa allegedly become HIV positive as a result of heterosexual sexual intercourse, while, to all intents and purposes, there is a zero possibility of this happening in the US. I imagine that all manufacturers of antiretroviral drugs pay great attention to the very false figures about the incidence of rape in our country, that are regularly peddled by those who seem so determined to project a negative image of our country. The hysterical estimates of the incidence of HIV in our country and sub-Saharan Africa made by some international organisations, coupled with the earlier wild and insulting claims about the African and Haitian origins of HIV, powerfully reinforce these dangerous and firmly-entrenched prejudices. None of this bodes well for a rational discussion of HIV-AIDS and an effective response to this matter, including the use of anti-retroviral drugs.

I trust that our discussion about AZT and rape will convince you that despite the fervent reiteration of various assertions, supported by many scientists, medical people and NGOs, about the existence of some unchallengeable and immutable truths about HIV-AIDS, as public representatives we have no right to be proponents and blind defenders of dogma. Whatever the intensity of the campaign to oblige us to think and act differently on the HIVAIDS issue, the instinctive human desire in the face of such a barrage, to obtain social approval by succumbing to massive and orchestrated pressure, will not lead us to become proponents and blind defenders of dogma. The cost of AIDS in human lives is too high to allow that we become blind defenders of the faith. Once again, I would like to suggest that you inform yourself as extensively as possible about the AIDS epidemic. Again, for this purpose, I would like to recommend that you access the Internet. On the various websites, you will find an enormous volume of literature, including CDC, WHO and UNAIDS documents, editions of various highly respected science journals as well as ‘dissident’ articles. I believe that it is imperative that all our public representatives should base whatever they say and do on the HIV-AIDS matter, on the truth and not necessarily on the comfort of fitting themselves into the framework of whatever might be considered to be ‘established majority scientific opinion’.

But it was all lost on Leon: ‘I do not think that politicians are under any “moral obligation” (in fact quite the opposite) to claim the right to deliver final judgement on questions of scientific fact. It is a totalitarian principle that political leadership is somehow on a higher plane to technical expertise and is thus entitled to override the autonomy of all institutions in society.’

Mbeki replied:

Let me assure you that as long as I have to occupy a decision-making position within out politics, so long will I take such decisions as may be necessary and morally defensible, whatever institution makes recommendations according to its mandate and possibilities. The idea that, as the executive, we should not take decisions we can defend, simply because views have been expressed by scientist-economists, scientist-agriculturists, scientist-environmentalists, scientist-pedagogues, scientist-soldiers, scientist-health workers, scientist-communicators etc, is absurd in the extreme. It is sad that you feel compelled to sink to such absurdity, simply to promote the sale of AZT. ... I think that it is dangerous that any of our public representatives and political parties should allow themselves to be used as marketing agents of particular products and companies, including drugs, medicines and pharmaceutical companies. … In my letter of July 1, 2000 I took issue with you about the matter of double standards. In one instance this related to the matter of the rule of law, about which you campaigned with regard to the land question in Zimbabwe. In this regard, you accuse me of making ‘a nonsensical comparison’. Since the issue of the rule of law is a matter of principle, I believe that it is fundamentally incorrect to argue, as you did, that AZT should be prescribed for rape, despite the fact that the existing legal procedures had not been followed enabling this drug to be registered and legally dispensed for this purpose. Strangely, you, the Leader of the Official Opposition, argue that my insistence on the observance of the rule of law is nonsensical. Whereas you would not accept what I said in the National Assembly about the fact that Glaxo Wellcome neither asserted the anti-HIV efficacy of AZT in cases of rape and had not applied for its licensing for such a situation, I trust you now accept the truthfulness of these statements, since they have been confirmed by representatives of the company. After all, relative to them, you do not occupy the position of ‘an effective opposition’. Whatever your personal views, I trust that, as Leader of the Official Opposition, you will understand and accept the proposition that it is incorrect to argue for the observance of the rule of law in Zimbabwe and to categorise its observance as ‘irrelevant’ and ‘nonsensical’ in South Africa when AZT is affected. What I have said in this and the previous letter about the efficacy of AZT in rape cases does not constitute a ‘personal opinion’, as you assert. Unless they indicate otherwise, I would also assume that the manufacturers of AZT, Glaxo Wellcome, do not consider what I have said about what the CDC says about AZT and AIDS as constituting a ‘personal opinion’. If there were any dispute about this, I would be very willing to ask the CDC whether it has changed its mind since 1998. On this matter, our government will therefore continue to act in a manner that is consistent with available scientific evidence. I have a political obligation to ensure that this happens, regardless of your own personal opinions. I am certain that, as government, we are perfectly aware of the interests of the people we represent. We will continue to do everything we can to ensure that these interests are addressed, naturally within the context of the constraints imposed on us by the stubborn legacy of colonialism and apartheid. That legacy includes the persistence of racist ideas in the minds and the psychology of many of our people and others elsewhere in the world. I spend the amount of time and effort I do on the issue of AIDS because as a government we have to do everything necessary to deal with this syndrome and the destructive health crisis in our country and the rest of Africa. None of this constitutes ‘shadows’, as you allege, which allegation might be informed by the fact that throughout their lives the majority of those you represent have had the ‘good fortune’ of being perhaps unwilling beneficiaries of racist practice and recipients of supremacist racist prejudice, and ideology. I must also make the point that the formulation of correct policies and programmes makes it imperative that, as government, we proceed from the most accurate information we can access. We will therefore always seek to obtain the accurate figures about such matters as rape and AIDS so that we adopt correct policies with regard to these important challenges. We do not have the luxury to play political games with information, merely to advance party-political objectives. As a government, we will not abdicate our responsibility to work for the health of all our people, leaving this matter exclusively to ‘the physician and the patients’, as you suggest. I may have no medical expertise, but I have grave doubts that the fact of being the largest opposition party means that you are best placed to advise our government about the medical decisions it should take. All of us have a moral obligation not to do anything we believe to be fundamentally wrong. This applies as much to Presidents as it does to Ministers who might feel that decisions of the President or the Cabinet are wrong. No amount of pressure, however virulent, strident and sustained, will persuade me to betray this principle. If nothing else, this is what many of us have learnt from a very long history of struggle by our people from liberation from oppression, contempt and lies. I believe that common courtesy required that you inform me that you intended to release our correspondence to the media, as I would if I were handing this letter to the media. The only thing we had agreed was the principle that the National Assembly and the general public should have access to the communications between us. But, again, possibly we do originate from different planets with radically different value systems. Yours sincerely Thabo Mbeki.

Mbeki’s repeated reference to ‘radically different value systems’ rings, at first blush, of rhetorical conceit. But to appreciate that there’s much more to it is to get the full chill of the icy slight. As Mathebe elucidates it in Bound By Tradition: The World of Thabo Mbeki, Mbeki’s estimation of pragmatism and inclusivity in his hierarchy of values over characteristically Judeo-Christian tendencies to ideology and narrow constructions of truth in human affairs mark his outlook as traditionally African. And fundamentally distinct from Leon’s characteristically judgmental and intolerant European one.

As I read their exchange, I sensed in Leon’s manoeuvring that extra effort that lawyers sometimes put into a bad case that they’re committed to pressing. Because the client is watching. It was clearly exemplified by the following morsel:

You dismiss Charlene Smith’s defence of herself in the Mail&Guardian and once again re-quote her as saying in The Washington Post (June 4): “Here [in South Africa, AIDS] is spread primarily by heterosexual sex – spurred by men’s attitudes towards women. We won’t end this epidemic until we understand the role of tradition and religion – and of a culture in which rape is endemic and has become a prime means of transmitting the disease to young women as well as children.” You claim that his is a “nakedly racist statement.” Yet nowhere in this quote does Charlene Smith make a racial distinction between black, coloured, Indian or white South Africans. You are reading into the statement a racial intention that is by no means evident.

The reek of Leon’s white liberal hypocrisy burned our eyes. At so many levels. There is no common South African culture; it is tremendously variegated. The only rape that hits the liberal papers is black on white or child – burnishing Smith’s stereotype. In an article we’re still to treat, liberal journalist William Saunderson-Meyer was rather more frank in laying out his prejudices: ‘South Africa has the world’s highest incidence of child abuse and rape. [Like South Africa has the world’s highest HIV infection rate.] Uniquely, this is the only country where the two outrages are combined in that savage speciality, the rape of babies in the belief that it will cure Aids. … Of course, it is politically embarrassing that this is almost exclusively a black South African practice.’

Is it? And Cameron, we’ll later read with astonishment, openly blames the ‘AIDS epidemic’ on ‘sexual practice among African men’ – on their ‘promiscuity’. There is no AIDS seen among whites, ‘coloured’ or Indian people in South Africa on any significant scale, and when ‘AIDS experts’ talk about the ‘AIDS epidemic’, they always mean among blacks. Even if they don’t say so. In claiming that the rape of young women and children is ‘endemic’, thanks to ‘the role of tradition and religion’, Smith certainly wasn’t intending to include Jewish ‘tradition and religion’, WASP ‘culture’ in the KwaZulu-Natal Midlands, and so on. Leon was transparently dissembling in suggesting otherwise. But I’m a liberal. Race doesn’t matter to me. I don’t see it. For as long as I’m boss of the show.

Mbeki was too quick for the debating crook:

All rape is reprehensible. I was as distressed when I heard about Ms Smith’s rape as happens whenever I hear of any incidence of rape. Accordingly and unreservedly, I sympathise with her. In Ms Smith’s case, I immediately spoke to the then minister of safety and security to take all necessary measures to ensure that the culprit was apprehended and charged. The minister kept me informed about this matter constantly, relating even to the means the [police] used to identify the culprit. I know that none of this could ever undo the grave harm and damage done to Ms Smith. Over this specific incident I have no influence. I, like other people, did what I had the power to do. I have not sought to vilify Ms Smith. But neither do I accept that her terrible and unacceptable ordeal gives her licence to propagate racism, as I am convinced her published Washington Post comments do.

Outclassed and against the ropes, Leon slipped in an unrelated whinge as a decoy: ‘... you have treated me, as elected leader of the opposition, with basic discourtesy since June 1999. … you might wish to reflect on the fact that you have never once issued an invitation to the opposition to discuss matters of common concern to the country. It is only when the opposition has sought a meeting with government that same has been acceded to.’ (Leon’s public grievance over this would repeatedly break out like a cold sore.) Mbeki saw the trick and snapped back: ‘The broad issue you raise about how the president of the republic and the leader of the official opposition should relate to each other is completely irrelevant to the matter we have been discussing.’ But not before explaining: ‘I think you have made your point about your importance when, in the National Assembly, to depart from the physical position occupied by FW de Klerk, the first democratically elected leader of the official opposition, you moved from the bench opposite the deputy president’s to the bench opposite the president’s bench.’ The better to keep an eye on the boy.

Mbeki had more to say in his ZK Mathews Memorial Lecture at Fort Hare a year later, evidently perceiving Leon to represent the stereotypical facile political operator, his vulgar domineering and arrogant manner an anathema to him, all the more offensive for its chrome-plate of quasi-reason: ‘This white politician, who practises his craft on the African continent ...’

Leon has never deigned to learn the correct pronunciation of Mbeki’s name, a reminder whenever he utters it of his personal distance from and lack of sympathy with African culture. He Anglicises it, so instead of ‘Tuh-bor Mbeh-gie’, we hear ‘Tar-bow Mbe-kee’. Talk about ‘basic discourtesy’. But then Leon hadn’t even thought of that. And Leon seems to derive a particular satisfaction from calling that mispronounced first name along with the second when dressing him down. As he might his garden boy, who’s just pulled the seedlings out with the weeds. Now look here, Tarbow – in the style of certain snooty circles among the Natal English, whose pointed Anglicising of vernacular names is considered a mark not of ignorance but of social distinction. It was clear that in their debate over AZT for rape, Leon could not countenance the possibility that he might be wrong. As even GlaxoSmithKline later pointed out. And that Mbeki, a confident black man, might know better than he did. Than the smug South African white man.

On the day that the full correspondence between Mbeki and Leon was released, the Mail&Guardian claimed Mbeki fingers the CIA in Aids conspiracy ‘to promote the view that HIV causes AIDS ... in what was described as a “rambling” address’ to the ANC caucus meeting (the one mentioned by Leon two days earlier).

Mbeki reportedly noted this a week later. Some anonymous ‘outraged’ ANC MPs told the Mail&Guardian afterwards that he’d said at an ANC caucus meeting on the 28th that the TAC had ‘infiltrated’ the unions to widen the call on the government to buy AIDS drugs. He allegedly repeated that HIV had never been satisfactorily isolated, and said that the pharmaceutical companies promote the HIV theory of AIDS because they make huge profits out of AIDS drugs. What’s more, they said, he’d alleged that the CIA was ‘working covertly alongside the big US pharmaceutical manufacturers to undermine him because, by questioning the link between HIV and AIDS, he is thought to pose a risk to the profits of drug companies making anti-retroviral treatments’. This story took off like a rocket on the newswires, and was splashed all over the world’s newspapers. Mbeki’s office declined to confirm or deny the reports, explaining that discussions at caucus meetings were ‘not intended for public consumption’. Achmat’s response was to protest; he didn’t want to fight with Mbeki, but it was time he called off his AIDS

side-show … Those of us who have HIV cannot afford to die in silence while our disease is denied a name by our government. We believe it was wrong for radio talk show host John Robbie to tell Health Minister Manto Tshabalala-Msimang to ‘get off my show’. It was disrespectful. But the greater disrespect is shown to the poor and black people of this country by our government. We are dying in large numbers and the President won’t acknowledge that we are dying of HIV/AIDS.

He won’t just say it.

Later, on 6 August 2001, Mbeki was asked about the allegations during an interview by Tim Sebastian on BBC HARDtalk:

TS: You were quoted last year in relation to the AIDS policy in South Africa, as saying that the CIA was working covertly with American drug companies to discredit you.

MBEKI: Never said any such thing.

TS: Never said it?

MBEKI: Never, ever said such a thing.

TS: It was wrongly reported?

MBEKI: I don’t know where they got it from, it’s completely wrong. It was not even from the point of view of inference; I hadn’t said anything that relates to that matter at all.

TS: And you were quoted at a meeting last Autumn of 200 ANC MPs and Cabinet Ministers as saying that criticism of your AIDS policy was a foretaste of foreign attempts to undermine your government to protect the existing balance of economic power. Is this mischief making?

MBEKI: Absolutely.

TS: You never said this?

MBEKI: Absolutely, yes. That’s part of what I was saying earlier about the press here. I have absolutely no problem with the press criticising policies and the things that we do, the things that we say, but you then find that kind of thing happens. It’s pure invention.

The media’s representation of Mbeki as a paranoid lunatic was useful as a psychological trick: it justifies normal thinking. Suggesting that Mbeki is certifiable puts him into a medical category, to be boxed off as one of them, not one of us. Safe, no longer threatening. It’s much easier to call a man mentally sick for talking differently than do the hard work of trying to figure him out. And taking what he says seriously into account. Especially when his talk involves an upsetting challenge. And you don’t have to be an Einstein, sitting thinking while processing boring patent application files (having been refused enrolment for a postgraduate science degree – not clever enough) and discovering it’s all wrong, as Nobel laureate Albert Szent-Gyorgyi observed, by a process of ‘seeing what everybody has seen and thinking what nobody has thought’. Because it’s surely perfectly obvious that the ‘everyone’s at risk’ dogma of ‘AIDS experts’ finds no match in the real world. And that claims of a ‘33.5 per cent’ HIV infection rate among blacks in KwaZulu-Natal (according to the Department of Health’s 2002 figures), but ‘negligible’ and ‘less than one in a thousand’ among whites (according to the Natal Blood Transfusion Service, in my private communications with it) are manifestly risible. But the former is repeatedly printed in the white liberal media all the same.

There was some fuss around 9 October as Mbeki’s liberal critics in journalism tried to get a fire going over the discovery that parliamentarians qualified for antiretroviral drug cover in terms of their official medical aid schemes. The Star attacked him with a headline: Hypocrite. Ever hungry for negative copy with which to bash Mbeki, the London papers followed. Mbeki allows anti-Aids drug for elite, was how the London Times worked it that day: ‘Mr Mbeki’s government was accused of blatant hypocrisy.’ The empty story petered out. For all his faults, Mbeki hadn’t been in charge of drawing the parliamentary medical aid scheme’s rules.

The 10th saw a formal parliamentary debate about AIDS. Leon sued for peace. But on his terms – offensively, insultingly, presumptuously, à la Tony Leon, vintage edition. With Mbeki having rejected his request to join a shared platform for the fight against AIDS, as revealed in their just-released correspondence, Leon now called for the formation of a ‘mighty coalition’ of celebrities from politics, sport, glamour, business and civil society, relying on ‘the best wisdom that science has to offer’. The jeering from ANC benches drowned him out. (I can just imagine: professionals, intellectuals and politicos among blacks to whom I talk all think he’s ridiculous, a figure of fun.) Speaking later on the same day at the launch of his party’s AIDS policy programme in nearby Khayelitsha, Leon promised that all metropolitan councils falling under his party’s control would be offering AZT to rape victims and HIV-positive women.

The time has come to declare a truce on this issue, to stop acting against the people’s best interests and for South Africa to take a united stand in the fight against AIDS. … I think we’ve won the war with the President on AIDS, but the problem is it’s a war without victors or victory because the people are dying. … Fifteen hundred South Africans every day are being diagnosed as being contaminated with this terrible virus. … And we have started doing it today. HIV does cause AIDS, finished and klaar, case closed. … While President Thabo Mbeki continues to confuse the issue with his misguided state of denial about the exact cause of HIV/AIDS, the Western Cape government has taken the bull by the horns. The Western Cape is the only province in South Africa where AZT is officially administered to HIV-positive expectant mothers. … Of all countries, South Africa has proved to be the most susceptible to infection and one of the most impotent in response [due to Mbeki’s] misplaced intellectual arrogance.

The base politician to the last. Talking such talk, no wonder Mbeki scorns him.

Archbishop Ndungane went for a public HIV test the next day. He was the first of his priesthood to do this; an Anglican synod in September had unanimously resolved that all bishops would submit to HIV tests in the hope that the rest of the clergy would follow. It was a publicity stunt, they admitted in as many words at the time, because they’d been moved by the concerns of some that the Church had not been seen to be in the frontlines in the fight against AIDS. ‘We hope, by setting an example, to encourage others to be tested ... [because] early detection helps.’ You die, he could have added. ‘As community leaders, we also hope to remove the stigma attached to HIV/AIDS.’

The Washington Post ran another derisive piece about Mbeki on the day, captured in gist and tone in a concluding comment by Wits bioethics professor Udo Schuklenk: ‘The President has dug a huge hole for himself. Unfortunately, he’s sacrificed the lives of babies all for some misguided notion of solidarity.’

The day after that, on the 12th, Rob Dorrington, a professor of actuarial studies at the University of Cape Town, told a meeting of insurance assessors that ‘South Africa has all the ingredients to make sure the HIV and AIDS pandemic will be the most explosive of any country in the world. … About 45 percent of adults will become infected with HIV unless there are significant changes in South Africa.’ With a pitch and a vision like that, Rob, you should have stuck to selling insurance.

ANC Head of Presidency and Communications Smuts Ngonyama disclosed on the 16th that Mbeki had decided to scale down his participation in the public discourse about AIDS. But he was not backing off, he said; he would still be involved in public debate. This had been decided at a recent ANC NEC meeting – at which he persisted in questioning the HIV theory of AIDS on the basis that ‘a virus cannot cause a syndrome’, and again asserted poverty and malnutrition to be the principal causes of broken health in Africa. Ngonyama said a committee of members of the Cabinet, led by Deputy President Zuma would lead the debate on the causation question, and would be tabling a report.

Mbeki’s defiant rejection of the HIV theory of AIDS, was again in evidence in a remark Ngonyama made to journalist William Gumede on 16 July the following year: ‘It’s based on a scientific assumption, and like all assumptions it can be disproved.’ And that his withdrawal had been a party decision, rather than his own, appeared from a letter to Business Day a bit earlier: on 18 August Essop Pahad had referred to ‘the collaborative debate and decision-making in the African National Congress, where even Mbeki can find himself having to accept the collegiate view on events’. Pahad’s next line indicated the subject to which he was referring: ‘On  AIDS , it has been emphasised time and again that, far from having a flirtation with dissidents, the president appointed an expert panel and awaits the response prior to making decisions.’ And as for the suggestion that Mbeki was a tyrant closing down all controversion: ‘Far from a climate of trepidation, there is in the presidency a remarkable degree of openness to debate. In fact, it was the presidents willingness to debate the  AIDS  issue that led to such a fuss.’

The London Guardian claimed Mbeki’s Aids stance cuts poll ratings on 20 October, reporting ‘a large and sudden fall in public support almost certainly attributable to his controversial stance on the cause of Aids’, with the rest of the article making a song and dance about it. But an article in the London Independent the next day, bristling with even more animosity, contradicted that claim amidst all its poisonous froth:

Central to his popularity decline is rising unemployment but also, many believe, his loss of stature internationally. [He has] made himself a laughing stock for suggesting that HIV may not lead to Aids. A US diplomat said: ‘In Washington, jaws are on the floor at some of the stuff he has said or is supposed to have said about Aids. Recently, when the White House has raised the issue in phone calls, Mbeki’s aides have changed the subject.’ European governments are equally at a loss; one diplomat, referring to President Mbeki as ‘Stalinist’, went as far as to suggest he had used his unorthodox views on Aids to test the loyalty of his entourage. … There has been no apology from President Mbeki’s office for the months of confusion he has sown in a country where panic and prejudice have taken hold. Ten per cent of the population is HIV positive. Indeed, given his lack of leadership and the lack of government medication or advice, it is no wonder that men in the KwaZulu-Natal and Mpumalanga provinces follow their mates’ advice and ‘cure’ themselves by raping virgins. On Monday, because he could not bring himself to say sorry, President Mbeki made known that he would no longer speak about Aids and that he had appointed a committee to replace himself in the ‘debate’ on the causal relationship between HIV and Aids.

A concurrent article in the London Times, however, laid bare the AIDS-obsessed dishonesty of the Guardian’s and Independent’s writers:

The issues which concerned more than 10 per cent of South Africa’s 42 million population included job creation (76 per cent), crime levels (60 per cent), inadequate housing (25 per cent), education standards (13 per cent), HIV-Aids (13 per cent), health (12 per cent), poverty (11 per cent), and corruption (10 per cent). This is the first time that more than 10 per cent of the population have identified HIV-Aids as an issue of significant concern. Critics of the Government’s position on HIV-Aids insist, however, that it is woefully inadequate in a country where more than one in ten people is estimated to have been infected by the disease.

In other words the South African public couldn’t be bothered. Enough for the English liberals.

Ngonyama stirred things up on the 23rd by condemning the Western Cape DA’s programme to supply AZT. ‘We find it quite outrageous that this issue ... can be exploited for political grandstanding. [People] are being used as guinea pigs and conned into using dangerous and toxic drugs that are detrimental to their own health. … [It was] reminiscent of the biological warfare of the apartheid era.’ Again the London papers published reports about this to make the ANC look bad. Médecins Sans Frontières, the Treatment Action Campaign, Life Line, and Rape Crisis, among others, were upset and responded in a joint statement: ‘To suggest that the programme bears any resemblance to biological warfare is a grotesque distortion of the truth. What is truly obscene are the efforts of all politicians to use the lives of people with HIV and Aids as political pawns to score points with voters. … No experimental drugs are used. The pilot project uses only one anti-retroviral drug – AZT – which has been conclusively proven safe and effective.’

But on the 24th Tshabalala-Msimang announced the government’s new guidelines for the treatment of HIV-positive people, and they left AZT clean out: ‘There is a narrow view again that continues to associate prevention of mother to child transmission of HIV with the use of antiretrovirals only. … We know they are toxic. … We know there are other medical interventions. … At no time has South Africa said it will never use anti-retrovirals, but there are [cost] constraints.’

And then suddenly, on the 26th, Parks Mankahlana, Mbeki’s spokesman, and previously Mandela’s too, was announced dead at thirty-six. Killed, it later emerged, by the ‘conclusively proven safe and effective’ drug. It was severe anaemia, said his family. Which Sigma’s AZT label warned about: ‘Target organ(s): Blood Bone Marrow.’ GlaxoSmithKline’s package insert too: ‘AZT ... MAY BE ASSOCIATED WITH HEMATOLOGIC TOXICITY INCLUDING ... SEVERE ANEMIA.’ A condition that increases risk of early death by thirty to ninety times, reported Mocraft et al. in AIDS in 1999 in Anaemia is an independent predictive marker for clinical prognosis in HIV-infected patients from across Europe: ‘Patients with mild or severe anaemia were significantly more likely to have taken zidovudine [AZT] at some stage. ... In addition, patients with anaemia, mild or severe, were much more likely to have been diagnosed with AIDS.’ One can imagine Mbeki’s emotional reaction to his death. Someone so close, poisoned by the very chemical that he’d warned the world against almost exactly a year earlier, and for which he’d paid such an enormous political price – with just about everyone calling him a meddling, ignorant, cyber-surfing fool, who’d ‘made himself a laughing stock’, as the London Times described him, repeating the Independent’s insult, five days before his spokesman died.

At Mankahlana’s funeral Peter Mokaba said: ‘The media has disappointed us and I do not know how they are going to repair the damage. A comrade passes away, a comrade who served them well … and they want us to bury him with diminished status.’

CHAPTER

Speaking at the launch of the South African Mayors’ Chapter on HIV/AIDS in Durban on 7 November, part of the UN Development Programme-sponsored Alliance of Mayors and Municipal Leaders on HIV/AIDS in Africa, Tshabalala-Msimang again expressed her antipathy towards AIDS drugs – and those promoting them. As to the impression they were engendering, that the government’s AIDS programme would founder unless it provided AZT and nevirapine in the health system, she said: ‘Today I want to dispel this myth, because it is absolutely not true. The pharmaceutical industry and those who have a vested interest in the drug industry fuel this propaganda.’ She pointed out that ‘without necessarily implementing a large scale anti-retroviral programme, many poor countries, including Uganda and countries within the Southern African Development Community, had ‘implemented basic public awareness programmes, and the treatment of opportunistic diseases successfully addressed the disease’. (The ANC Youth League sized the TAC up in the same way about a year and a half later: in Pagad and TAC: Two Sides of the Same Coin in the Sowetan on 22 April 2003, spokeman Khulekani Ntshangase wrote spot-on that the TAC was ‘a pressure group whose salaries are paid by Americans. This is a conglomeration of drug-dealers who serve as marketing agents of toxic drugs.’)

As late as November, Essop Pahad still hadn’t covered the intellectual distance that Mbeki had in seeing right through the AIDS scare. Responding to an editorial in the Financial Mail three weeks earlier under the fantastic title, Until Mbeki believes, Aids will thrive, the President’s closest confidant wrote a surprisingly sloppy response on the 10th, referring to the ‘unexpected cataclysm’ – as if there really was something new on the go – and asking the magazine’s editor: ‘… accepting that HIV/Aids is a catastrophe in waiting, what have you done for your country in fighting it? Will the newspapers stand aloof as the horror mounts? There are, admittedly, some efforts, which are commendable. I like the permanent red ribbon on the Sowetan, and some sustained and systematic campaigning in other papers.’ In Pahad’s invocation of the breathtaking imagery of the contemporary sex-plague folie there wasn’t any evidence of irony – with the result that he came through sounding as silly as Charlene Smith.

To Tshabalala-Msimang’s slight on the drug agenda, the South African Paediatric Association responded with an emotive public statement on the 21st: ‘For too long now we have remained silent and almost sidelined from the issues we deal with on a daily basis. It is us, and not the politicians and policy-makers who care for the ever-increasing numbers of sick children with HIV/AIDS each day. We insist that the health ministry accepts its responsibility in helping to prevent innocent newborns acquiring the disease from their mothers.’ In other words buy the drugs. Pretending to know what they were talking about, like patent lawyers holding forth on the law of the sea, the paediatricians lined up behind the WHO’s conclusions announced the month before that transplacental genotoxic and carcinogenic cell-poisons are safe and effective during pregnancy, to prevent mothers from making their babies sick by nurturing them in their wombs, and by feeding them after birth the natural way as the Lord intended.

The paediatricians were a bit late. A month after their statement, and a little over a year after Mbeki voiced his concerns about the toxicity of AZT in Parliament, and had been attacked ferociously from just about every quarter for doing so, New Scientist reported on 16 December 2000, under the headline, No More Cocktails, that: ‘Four years of “hit hard, hit early” HIV treatment may be on the way out in the US, as evidence mounts of the drugs’ serious side effects. AIDS experts in the US are about to complete a humiliating U-turn when the Department of Health and Human Services launches its revised HIV treatment guidelines in January.’ The language couldn’t have been stronger in a popular science magazine characterised by its allegiance to the commercialised scientific establishment.

As leading US AIDS journalist Laurie Garrett put it in Newsday on 17 January 2001, ‘Instead of telling American physicians to “hit early, hit hard”, a policy in effect since 1996 that calls for giving HIV-positive patients powerful drug cocktails before the patients actually experience any symptoms of illness, the new National Institutes of Health guidelines will call for caution and delay in treatment.’ She mentioned an epiphany arrived at by ‘prominent AIDS physician’ Charles Carpenter of Brown University, a member of the AIDS advisory committee to the NIH, which he shared with the Royal Society of Medicine in London in a speech he had given in December: ‘In retrospect, we now realize the risk of drug toxicity is greatly enhanced by taking these drugs early.’ Which your regular guy might suppose means that the sooner you start taking your poison, the sooner you flake. NIAID’s Anthony Fauci, one of the Co-Chairs of the panel convened to review the official treatment regime, agreed, more or less, that not only is the medicine dangerous, it doesn’t even work: ‘It’s clear we’re not going to eradicate the virus with the drugs we have now. And we’re starting to see a greater and greater realization of the accumulation of toxic side effects.’ It’s sinking in at last.

Garrett then dashed off a litany of some of them: ‘death of hip bone tissue, increase in blood cholesterol levels, neuropathy or loss of nerve sensations, kidney failure, radical alterations of liver metabolism, diabetes, skin rashes, pancreas failure, severe anemia, liver dysfunctions so acute as to require transplants and near-instantaneous death due to buildup of lactic acid.’ With this degree of toxicity, who needs to blame a crafty mutating virus lurking in all sorts of hide-away places? But dully she did: ‘Most [people on the drugs] are overcome by drug-resistant forms of the virus.’

Breaking the news on 4 February, Lawrence Altman on the New York Times quoted Fauci: ‘We are adopting a significantly more conservative recommendation profile’ – the idea being, as Altman paraphrased him, to allow ‘the virus to remain in the body longer in return for sparing the patient the drug toxicities’.

The Americans released their HIV Treatment Guidelines Updated for Adults and Adolescents the next day. They were a remarkable vindication of Mbeki’s position. In fact his parliamentary fiat at the end of 1999 that AZT’s safety be investigated, and his and Tshabalala-Msimang’s persistence in publicly stating that the drug was dangerously toxic, possibly precipitated them. Because until then, outside of highly specialised, relatively obscure scientific journals, mention of AZT by ‘AIDS experts’ had invariably been accompanied by singing and dancing. Even as they reported chilling toxic effects. Like Mbeki’s political intervention concerning AZT, the new treatment guidelines were the fruit of another initiative from outside the cloister. Galvanised, I venture, by the attention that Mbeki had very publicly drawn to the toxicity of AZT in 1999, the Henry J Kaiser Foundation convened an official panel in the US the following year to review David Ho’s universally accepted treatment model, namely, promptly administered big doses of AZT and its ilk for the HIV-diagnosed. The accumulated toxicity data on the deadly consequences of that approach had piled too high to disregard any longer.

In a write-up of the 9th Annual Retrovirus Conference in 2002 in the AIDS Reader, Jeffrey Laurence spelt out the reason for the rethink as being ‘the side effects of all HAART regimens and the limited evidence of survival benefit for initiating therapy in asymptomatic persons even at relatively low CD4 cell counts … Much of this is being driven by some prominent cardiovascular, endocrine, and bone metabolism effects of HAART.’

Fauci explained the reason for the turnaround in his characteristically clueless manner:

We are very concerned about a number of toxicities associated with the long-term use of anti-retroviral drugs. Particularly alarming is the alteration of fat metabolism that can emerge during treatment. We are seeing an increasing number of patients with dangerously high levels of cholesterol and triglycerides. The good news is that new anti-HIV treatments have dramatically improved the quality of life for many patients, and the incidence of AIDS and AIDS-related deaths has dramatically decreased. The bad news is that we now must find ways to deal with unanticipated toxicities, including the potential for premature coronary disease.

Only a country with the sense of humour to elect Ronald Reagan and the Bush dynasty to the Oval Office could have got an idiot like this to run their AIDS research operation as director of the National Institute of Allergy and Infectious Diseases. On second thoughts, he’s their ideal man. Inasmuch as clowns suit circuses. The grave toxicity of ‘antiretroviral’ drugs is not apparent only after ‘long-term use’. As scores of published papers reviewed in Debating AZT make clear. Certainly, normal fat deposits melting away, sometimes showing up in permanent hard humps on the neck or in swollen abdomens, are graphic pointers to the drugs’ serious metabolic toxicities. As confirmed by the laboratory markers Fauci mentioned. But also causing massive unseen damage to blood, organs and tissues – under the skin. For Fauci to suggest as he does that deadly toxins like AZT make you feel better and bestow a radiant quality of life on you that you never had before, is proof that what counts for thinking with this guy is remembering what he read on the billboard. That AZT prevents AIDS and gives you a better crack at living than dying. Fauci’s expression ‘unanticipated toxicities’ would have you think that they weren’t apparent right from the beginning. They were. What has been happening is that reports of new toxicities are coming in to worsen the picture. Such as the latest: osteonecrosis (bone-death), newly noticed. He skipped that one.

Mbeki’s reaction to the big news about the ‘significantly more conservative’ treatment approach, as Fauci called it, was to send a note to Tshabalala-Msimang asking: ‘Have we looked at the radically revised guidelines the US government issued at the beginning of the year about treatment with antiretroviral drugs, where they have said that these drugs are becoming as dangerous to health as the thing they are supposed to treat?’

The fundamental turnabout in AIDS treatment policy by the ‘AIDS experts’ – accurately described as a ‘sea change’ by Mark Harrington, senior policy director of the New York-based Treatment Action Group – ought to have been a clue to the mess the science was in, but the FDA evidently missed it. Garrett reported that in the light of these radical treatment policy reversals, the FDA was considering not tightening but relaxing drug-testing requirements in order to get new AIDS drugs onto the market: ‘That makes activists like Harrington and Gregg Gonsalves, policy analyst for Gay Men’s Health Crisis in New York City, angry.’

Now anger is a tediously familiar emotion to which AIDS activists resort, and the media loves to report, whenever they can’t get their druthers. You should have seen Professor Alan Whiteside and professional Boston AIDS activist David Scondras at the second meeting of Mbeki’s AIDS Panel in Johannesburg in July 2000, doing comic impersonations of Kruschev pounding the table with his shoe. As we watched in vicarious embarrassment. Or Charlene Smith hissing on the television show, Carte Blanche, on 7 November 1999: ‘I’d like to know where President Mbeki got the information in his speech. Last year government spent R54 million treating prisoners who had AIDS related illnesses in private hospitals. And yet they are denying women and children who are often gang raped – a brutal violation to any woman. And these women are denied the opportunity to save their lives with this drug. How dare Mbeki!’ Dare I give her the answer? The sight and sound of this woman fulminating is to bring Shakespeare to mind always: ‘A woman moved is like a fountain troubled: muddy, unseemly, thick, and bereft of beauty.’ Saving the lives of rape victims with AZT is a subject for later.

Zackie Achmat even makes being angry an essential part of his movement’s profession of faith. The Treatment Action Campaign Pledge reads:

I am scared and I fear tomorrow, because my friends, my family members, my schoolmates and colleagues, and even I may have HIV/AIDS. I do not have enough knowledge about treatment and care. I want to learn more. I care about my life and the lives of my friends. I am angry. Millions of people have HIV/AIDS and they will die for no reason other than the fact that treatment costs are too high. I will use my anger, fear, knowledge, emotions, and care to win affordable treatment and care for people with HIV/AIDS.

And so forth. The sort of infantile cant that only an NGO person who’s never had a real job could spew without laughing. But Cameron apparently thinks the TAC pledge just spiffing: ‘For four million South Africans living with HIV who have no present access to treatment, the TAC has offered a focus for their activism, a channel for their energy, and an outlet for well-justified anger about the awesome spread of HIV infection.’ An outlet for all their hysterical excitement too – noted by Constitutional Court Justice Sandile Ngcobo in his judgment for some plaintiff discriminated against in his mention of ‘the devastating effects of HIV infection [reported in the newspapers, but not by statisticians] and the widespread lack of knowledge about it have produced a deep anxiety and considerable hysteria.’ You’re on the money there, Judge. With respect. How angry Cameron himself can get, when you have a laugh on him, we’ll later see.

But to return to the angry yank activists, anyone will allow that they were justifiably pissed off for once. A couple of weeks earlier, on 20 December 2000, the Los Angeles Times had run a string of articles telling how the already lax drug approval regime in the US – extant since the Reagan presidency, when the FDA buckled under intense political pressure to approve AZT – had led to the passage of seven major new drugs, all of which were subsequently pulled after proving to be lethally toxic. And told of other dangerous drugs still selling. Bang-on target, Gonsalves complained: ‘I would argue that the drug companies and the Food and Drug Administration have been negligent, retrospectively, in not conducting or requiring long-term studies of the effects of these drugs so we can answer basic questions like these about their use. Thousands of patients like me don’t have the data to make an informed decision about when to use these agents, and the drug companies are laughing all the way to the bank.’ You betcha, Greg.

According to an Economist report at the time, The World in 2001, the pharmaceutical industry was already turning over $350 billion annually, typically enjoying profit margins of over thirty-five per cent, growing by 10 per cent a year. (Without indicating its source, Médecins Sans Frontières claimed it’s a paltry $117 billion.) Of that sum, according to a Reuters report on 7 October 200, the global AIDS drug market is worth $4 billion, and that it’s dominated by GlaxoSmithKline, the world’s biggest-selling pharmaceutical manufacturing corporation. That’s about thirty-eight per cent of the market, said the UK Financial Times on 21 August 2000, worth £982 million out of total group sales of £8.5 billion. IMS Health, a US drug marketing-research firm, reported that total sales of AZT, 3TC (a similar drug), and Combivir (a combination of the two) topped $1.1 billion worldwide in 2000.

No slouch when it comes to peddling its wares, GlaxoSmithKline told us in its published financial reports that it spent $4.7 billion on marketing them all in 2000. Combined with ‘administrative costs’ that figure comprised 37.2 per cent of its revenues. That’s about three times what it spent on research: 13.9 per cent. (And three times in percentage terms what that famously aggressive marketer Microsoft allocates to pushing its buggy codes.) But after manufacturing costs and these outlays, it still succeeded in pocketing a phenomenal 27.8 per cent of its revenues as profit – a relatively modest return in the pharmaceutical sector, the most lucrative legal enterprise on earth at the time. (Commercial banking has since pushed up to number place.)

US consumer lobby Public Citizen reported on 18 April 2002 that whereas the profits of America’s top 500 companies, as rated by Fortune magazine, had declined by 53 per cent in 2001 over the year before, the second sharpest drop in nearly fifty years according to an analysis by that journal, the country’s top ten drug companies had upped theirs by 33 per cent: 18.5 cents for every $1 of sales, eight times higher than the average profits of the 490 top companies in their wake, ahead of second-place banks, which made just 13.5 per cent. And pulling a return of 16.5 per cent on assets, nearly six times the average of the other losers.

Those maimed and killed by AIDS drugs have at last been noticed by British doctors too. With the deadly toxicity of AZT and its relatives dawning on them finally, like surgeons having second thoughts about the long-established benefits of drilling holes in their patients’ heads, bleeding them, burning them, and administering mercury and arsenic, English AIDS activist Edward King reported in his piece, British Physicians Contemplate Even Longer Deferral of Antiretroviral Therapy in Medscape (online) on 30 May 2001 that ‘The initiation of antiretroviral therapy may be delayed even longer than advised by current [recently revised American] recommendations, according to draft guidelines currently being considered by the British HIV Association (BHIVA).’ But dismayed by the independent line, ‘prominent US physicians expressed concern at the British proposal’, with David Hardy, associate professor of clinical medicine at the University of California, Los Angeles, spluttering hilariously that he thought the British proposals ‘premature and perhaps too avant-garde’. Just as long as we don’t jazz them up too much, Dave. But the Poms have a friend in veteran American ‘AIDS expert’, Jay Levy, Director of the Laboratory for Tumor and AIDS Virus Research at the University of California at San Francisco. In his article, The Big Question Now in Anti-HIV Therapy – When?, written for the San Francisco Chronicle on 23 February 2001, he predicted ‘future recommendations that will raise the threshold even higher before beginning current anti-HIV therapies’, having regard inter alia to ‘toxicity which may lead to damage of the pancreas, heart, kidney or brain’.

It was a black Monday for GlaxoSmithKline’s English board when it heard of the official American misgivings about the toxicity of its AIDS drugs. On 11 February 2001 the London Independent on Sunday reported HIV rethink to hit drug sales: Glaxo faces lower profits as doctors decide to alter treatment for patients. The numbers told why: ‘GlaxoSmithKline, which derives a massive 7 per cent of pharmaceutical sales from HIV and Aids drugs, could be particularly hard hit by the new recommendation.’ The company feigned indifference: ‘... it does not believe revenues will be hard hit.’ But that didn’t fool the accountants: ‘... experts are not convinced. “You’ve got to see this development as a big risk,” said one Wall Street analyst. “The company ... thought it could rely on doctors starting the treatment early on. The prescriptions to new patients represent about a third of the sales for these drugs; strip that out and you are going to find profits cut.”’

Hats off to the African National Congress for its statement about the Americans’ revised treatment recommendations. An extensive discussion comprising one thousand six hundred words in its mouthpiece, ANC Today, on 20 April 2001 put our local ‘AIDS experts’ to shame. After reciting the salient articles of the new guidelines, it quoted John Bartlett MD, of Johns Hopkins University Medical Centre and co-chair of the panel that produced them, saying in a state of evident deep confusion: ‘The updated guidelines recognise that we do not yet have the data we need to make definitive recommendations about the optimal time to start treatment. We highlight the uncertainty, allow for flexibility, encourage an individualised approach to treatment, and, at the same time, try to provide guidance.’ Amounting to: Ease up, guys, not so fast anymore. And your guess is as good as mine. We’ll do this thing together. We’ll experiment. On you. And if smoke comes out your ears, we’ll try another one. It was quite a shift from what he said in the New York Times on 6 April 1993: ‘... if somebody asked me, is it better to start early or late on AZT, I’d say there are some compelling reasons to start early’ – hot after the Concorde Coordinating Committee’s letter to Lancet, urgently anticipating its full report, alerting doctors to the fact that the drug had been found to be useless for asymptomatic HIV-positive people.

The ANC press release commented on the new guidelines it quoted:

The reader should bear in mind that these guidelines were drawn up by US scientists, based on US experience. Nevertheless their applicability extends beyond the US, in as much as the drugs used in the US are the same as those used in the rest of the world, including South Africa. The reader should also note that the US scientists take great care to emphasise that not enough is known about HIV/AIDS for them to set guidelines without qualifying these with many observations intended to introduce as much ‘flexibility’ as possible. Accordingly, they advise that everything is relative and provisional and requires specific responses to each individual patient, under the supervision of experts on the use of anti-retroviral drugs. Furthermore, they advise a comprehensive diagnostic approach for each patient to establish the overall health status of each patient including sustained hi-tech medical, psychological, social and nutritional support for each patient. In sum, the US scientists argue that the certainties about HIV/AIDS that are trotted out in our country everyday rest on a very shaky scientific basis. They further assert that the use of anti-retroviral drugs requires the very sophisticated medical supervision that the US as a highly developed country has, but which we do not have, as a developing country. They further warn that the ‘alarming’ toxicity of these drugs is such that they cause both known and as yet unknown diseases. As has been publicly stated by both Drs Robert Gallo and John G. Bartlett of the US, under certain circumstances these drugs may create more problems than they solve. The problem with all this is that it refers to questions of life and death for individual human beings. Such a situation does not admit of inhuman games or clever intellectual point scoring. It also does not allow for the propagation of unscientific slogans that the time for scientific inquiry is over. The uncertainties admitted and explained in the Guidelines and the New York Times and Business Week articles mean that further and urgent scientific work and debate is required to confront the serious problem of AIDS. We can only hope that our government and the scientists concerned with AIDS do everything in their power to speed up the experiments explained in the report of the Presidential Panel. In the meantime, this we must say, that it is time that our scientific establishment stops treating the issue of HIV/AIDS as a political issue rather than a medical/scientific matter. Morality and human decency dictates that all our scientists should adopt this position and refuse to join in the propagation of lies.

On 12 May 2001 the British Medical Journal reported an FDA warning to manufacturers of AIDS drugs in view of their persistence in marketing them with the same old happy spin, as if nothing had changed:

The US Food and Drug Administration (FDA) has issued a warning letter to manufacturers of AIDS drugs cautioning them to tone down the optimistic tenor of their antiretroviral ... billboard and magazine ... drug advertisements. Thomas Abrams, director of the FDA’s division of drug marketing, advertising, and communications said that current antiretroviral advertisements directed at consumers are misleading as they fail to depict the limitations of AIDS drugs and also feature healthy looking people … sexy and athletic models in the prime of health who were climbing mountains, sailing boats, and riding bikes. These are pursuits which are quite difficult for people with HIV infection, who have to take drugs several times a day that have debilitating side effects … The advertisements therefore violate the Federal Food and Drug Act.

About which ANC Today had this to say the following week: ‘Most unfortunately, there is little chance that the politicians, corporate, medical, non-governmental and media people in our country, who are involved in a campaign that is not different from the one which the US FDA seeks to prohibit, in the public health interest, will listen and respond to the message of the US FDA. In the consequence, innocent people in our country will continue to suffer, even to the point of death, thanks, in part, to the wilful behaviour of these fellow South Africans.’

Predictably, following the US health officials’ change of mind about the safety of AIDS drugs like AZT and its relatives, ‘AIDS experts’ have started publishing papers finding that it does no harm to begin them much later. Doctrinaire by the day, fickle by the week. In December 2001, in Proceedings of the National Academy of Sciences, Dybul et al. came up with another idea to reduce poisoning, and save money too. Take the drugs a week on, a week off. This would cost less and reduce side effects, they said. As if it needed saying. They even gave it a fancy name: ‘structured intermittent therapy’. Patients fared well according to viral load and cell counts, these ‘AIDS experts’ reported. But on no account start exploring unsupervised whether reducing the number of poisonous pills swallowed yet further might make you feel even better: ‘It is important to stress, however, that the results of randomized, controlled clinical trials – currently under way – are needed to prove the benefits of this experimental approach before it can be recommended to patients outside the setting of a controlled clinical trial. Don’t try this at home!’ In the AIDS age, feeling better is misleading. We’ll tell you if you are getting better or not. Because if we’re not in charge of your health, who’ll pay our mortgages?

CHAPTER

Following the big antiretroviral turn-around in the US and in Britain, the next act in the South African AZT drama was the crucifixion of an African child, played out slowly in the media to the exquisite delectation of the AIDS activists. The decline and demise of their stolen mascot, little Xolani Nkosi, was celebrated as a concrete illustration somehow of what was wrong with government AIDS policy, specifically its reluctance to hand out AZT. That Nkosi Johnson, as the white media better knew him, died on ample supplies of the very drugs for which they were agitating completely passed them by – as it did Blade Nzimande, general-secretary of the South African Communist Party: ‘Nkosi’s life, struggle and contribution remind all of us that the majority of the four million people living with HIV/AIDS in our country have little or no access to information about prevention, good public health services, and affordable treatment.’

Word that he was ailing in January 2001 sparked an orgy of self-congratulatory commiserations. Everyone wanted a piece of the action, to be anointed with a bit of the dying boy’s blood, like Jesse Jackson daubing his shirt with Martin Luther King’s gore after his assassination in order to book himself a spot in the historical picture record. Everybody was very publicly there, physically at his bedside, in spirit pouring out their hearts in letters from all over the world, or wailing in the media. The Internet news forum AF-AIDS announced, ‘Nkosi Johnson, the brave 11-year old, who stood up at the opening plenary of the Durban 2000 conference to disclose his status and to speak to the international crowd, is currently very ill. The [forum moderators] would like to extend their support to the family of Nkosi, and to recognize the inspiration that Nkosi is to many activists.’

In fact he didn’t ‘disclose his status’ there at all; his story was already three years old, having hit the headlines in 1997 when he was battling to get into a school that had rejected him because he was HIV-positive. (The gay-lib agenda, to whose service the HIV-AIDS construct was pressed early on – disastrously, in the result – is given away by this endless cliché stream: disclosing his HIV status, breaking the silence, fighting the stigma. As in coming out.) But we still get the strangest primeval kick out of watching someone being separated for a ritual decease, hence the frisson folk get enunciating the expression ‘HIV status’. Signalling bravery at the stake. With the longer it taking the more gratifying it being. Just as the longer the ceremonial bull slaughter takes, and the louder the beast bellows in dismay, the more propitious the whole affair is read to be. As with the lynching of the Galilean. Even the ritualised expulsions in the Survivor, Big Brother and Weakest Link television shows faintly echo this old thrill. And how and why a child without any say over his own life should be an ‘inspiration’ to activists is beyond comprehension, except to excite their common mawkish sentimentality. After all, his only claim to fame was that the ‘AIDS experts’ had marked him for death, like a trussed goat on the roof of a bus headed home to take part in the wrong side of a traditional feast. Predicting that he wouldn’t last more than nine months, Xolani proved them wrong, to their disappointment, and kept them waiting a further decade. Think what a flop the show would have been had he made a perfect recovery and gone back to school.

On 9 January 2001 the Panafrican News Agency was pleased to report Messages of Support Pour in for Dying AIDS Activist. Activist? It told that ‘The HIV-virus he has carried since birth has now spread to his brain, causing permanent brain damage [and the loss of] his sight in both eyes.’ Two days earlier we’d heard from the Star that Youngest AIDS hero’s work drawing to a close in an article mentioning that a

tube is attached to his nose to feed him his diet of baby food, juice, and hot water … His medication is also taken this way, with tablets crushed into the juice. On Sunday, South Africa’s youngest Aids activist woke for half an hour. Mostly he has slept since he collapsed while being bathed last weekend, after which he was rushed to Coronation hospital in Johannesburg. Doctors have discovered that Nkosi, 11, who was struck by three severe seizures on Saturday and Sunday, has brain damage after they found a layer of damaged tissue. Gail Johnson of Melville, Nkosi’s foster mother, who adopted him when he was two, said: ‘The doctors said the damage was due to long-term degeneration, but they said it was not the seizures which caused the brain damage but just the progression of Aids.’

But that conclusion is insupportable in view of what his doctor, Ashraf Coovadia, told Susanna Loof of Associated Press, quoted in her piece, Child AIDS Activist Seriously Ill, on 6 January 2001: ‘Tests performed on Nkosi Johnson ruled out opportunistic infections, such as meningitis, as the cause for the worsening of his condition … The boy has lost a lot of weight and is being tube-fed because he can’t chew and swallow properly. His eyes are staring blankly and it is impossible to say whether he is aware of his surroundings.’

For the rest, Loof’s article was a rich serving of maudlin dross:

Johnson has been lauded for being open about his HIV-status in a country where people who are suspected of carrying the virus often are shunned by their families and chased away from their communities. … Nkosi Johnson became internationally known as an AIDS activist when he delivered a speech in August as part of the opening ceremony for the 13th International AIDS Conference, held in Durban. He called on the South African government to provide HIV-positive pregnant women with antiretroviral drugs to prevent transmission during childbirth.

Of course, the child hadn’t made any choice about ‘being open about his HIV-status’, nor was he any ‘activist’; this was all part of a sick but lucrative melodrama in which he’d been assigned the role of dead man walking – indeed he was carted around on display and made to shake a tin cup for his guardian: ‘Johnson and his foster mother last year travelled to the United States to raise AIDS awareness and money for Nkosi’s Haven, a Johannesburg shelter that provides care for HIV-positive mothers and their children.’

The PANA report mentioned that ‘a parade of friends, family and media’ had been to visit the child, including ‘friends such as Judge Edwin Cameron and Zackie Achmat [who stopped] by to lend support’. Friends? Puhleeze. About the only famous fairy not fluttering in was Michael Jackson. Praise be to the Almighty that the boy didn’t get a friendly visit from him too. As he lay there, paying the price for his father’s mortal sin. Loving his mother. Without a condom. They call it ‘unsafe sex’. Spreading germs. The sins of the father being visited on the son, in the best of biblical tradition. Being the unspoken take of the dew-eyed bedside AIDS gang pulling in to touch the Belsen bones of their fading relic. Visiting divines, smiling kindly, like priests at a burning. Murmuring sympathies, until doctor says that’s enough now.

The Mail&Guardian’s Belinda Beresford just revelled in it on 12 January in her piece, Half of nothing and still fighting:

They come to praise him. [Like the Magi.] And to mourn ... the skeletal 11-year-old child lying unmoving in his bed … But now the virus has attacked his brain, causing Aids-related dementia. [Like ‘tertiary’ syphilis. Except we know now it was actually the medicine: mercury arsenic and bismuth.] Although there is still hope [of tapping the tale for more copy], the politicians, media and friends flooding his house make it clear they are attending a deathwatch. Already the little boy ... has brain damage. When a caregiver lifts him up, his long, bony limbs trail uselessly across the bed [thanks to AZT-induced mitochondrial myopathy (muscle rot), discussed in Debating AZT]. He can communicate by squeezing his hands or moving his eyes and some of his facial muscles. A tube going down his nose is used to provide him with nutrients every two hours as he’s incapable of eating. He wears a baby’s nappy. … Aids physicians say that he’s almost certainly going to die, whether it be in a few hours or a few weeks. … last year an American woman offered to pay for the treatment, and Nkosi started undergoing triple therapy in June. He stopped the treatment a few weeks ago, saying that he didn’t feel better [of course], but was persuaded by his doctors to start again with just two of the drugs [they’re clever]. He continues to receive his anti-retroviral therapy, passed through the naso-gastric tube into his stomach. Since an essential part of his immune system is gone [his lymphocytes wiped out, as the literature on AZT predicts], such treatment is the only thing that provides hope of survival, by dampening down the virus and its attacks on Nkosi’s brain. … [The child’s doctor, Ashraf] Coovadia is adamant that Nkosi’s condition is not caused by anti-retroviral drugs: ‘I can say unreservedly that the condition he’s in now is in no way the result of anti-retroviral therapy.’ Dr Shaun Conway of the International Association of Physicians in Aids Care agrees: Nkosi’s dementia comes not from the drugs he has been taking but from a body that has run out of resources.

We couldn’t help noticing how the doctors rushed to tender not guilty pleas to murdering the boy even before the charge had been laid. As if they knew. But were helpless to desist from their grandly ordained crime. In a danse macabre. This is nothing new. Doctors have killed their patients with violent treatments (letting blood, drilling scalps, burning, purging, poisoning) for centuries – treatments that just a moment’s intellection ought to have revealed to be useless and deadly. As an advocate I’ve seen this kind of suspended judgment in terrible murder and robbery cases, with apparently good men drawn into plots to do evil things, as if the more wicked the suggestion, the greater its allure. Like giving a child AZT. Piped in even, when he can no longer swallow it.

Concerning Xolani’s ‘dementia’, Debating AZT canvassed several reports in the medical literature concerning the drug’s neurotoxicity. Some more pertinent data were published by Neuenburg et al. in the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology in October 2002 – foreshadowed in the title: HIV-Related Neuropathology, 1985 to 1999: Rising Prevalence of HIV Encephalopathy in the Era of Highly Active Antiretroviral Therapy. As Reuters Health reported it, ‘The prevalence of HIV encephalopathy increased over time ... to 59.5% in the 1996-1999 period. … In a multivariate model, HIV therapy was estimated to double the risk of HIV-related encephalopathy.’

The remainder of Beresford’s article was the literary equivalent of that ubiquitous little crying boy poster sold by OK Bazaars. In an editorial covering Beresford’s piece, Nkosi shows the way, Mail&Guardian editor Howard Barrell drooled: ‘The touch of a king was once believed to cure illness. It appears that many of our politicians believe the touch of a dying child might work similar miracles for them, to judge by their rush to be linked to Nkosi Johnson as he dies slowly of HIV/Aids. … The home in Johannesburg where he is dying is besieged by well-wishers. It also plays host to a herd of politicians and other hand-wringers.’ But Barrell then criticised Mbeki’s ‘snub’ of the boy’s alleged request for a meeting. Not wanting to be part of the ‘rush’. To join the ‘hand-wringers’. But who can blame him for not being interested in a lecture from the child along the lines of his coached Durban AIDS Conference speech:

I just wish the government can start giving AZT to pregnant HIV mothers to help stop the virus being passed on to their babies. Babies are dying very quickly and I know one little abandoned baby came to stay with us and his name was Micky. He couldn’t breathe, he couldn’t eat and he was so sick, and my mummy, Gail, had to phone welfare to have him admitted to a hospital and he died. But he was such a cute little baby and I think the government must start doing it because I don’t want babies to die.

Barrell proposed: ‘Perhaps this was what Mbeki could not bring himself to hear: his government gently lambasted by a child for its equivocation and delay in responding to a pandemic that affects mainly the poor and black population, a disproportionate number of them women.’ Barrell missed the fact that the boy was already moribund and couldn’t speak. And so couldn’t have requested a visit. Visiting, Barrell wrote, would be

a gesture Mbeki finds it difficult to make. For how could he make it with any sincerity without renouncing the nonsense he has been content to talk about HIV and Aids? His review of the year 2000 was equally inadequate. He could not bring himself, in his New Year address to the country, to acknowledge the massive crisis HIV/Aids is visiting upon us all. … The final report of the multimillion-rand presidential Aids advisory panel is still not out. Insiders say that the report is delayed by the difficulty in reconciling two opposing sets of views of factions of mainstream scientists and the dissidents. While we wait for this and our president to assume his full responsibilities, Aids dissidents spread additional confusion; as Nkosi’s health declines, so too does our view of the president; and more Nkosis are born and die. For how long will we tolerate this leaderless state of affairs?

Until journalists like you wake up and get a grip, Uncle.

In his explanation of the workings of political kitch in The Unbearable Lightness of Being (Harper and Row Publishers, Inc., 1984), Milan Kundera provides a better account of Mbeki’s aversion to joining the ‘rush’ to exploit the photo opportunity:

When the heart speaks, the mind finds it indecent to object. In the realm of kitsch, the dictatorship of the heart reigns supreme. The feeling induced by kitsch must be the kind the multitudes can share. … Kitsch causes two tears to flow in quick succession. The first tear says: How nice to see children running on the grass! The second tear says: How nice to be moved together with all mankind, by children running on the grass. It is the second tear that makes kitsch kitsch. The brotherhood of man will be possible only on a base of kitsch. And no one knows this better than politicians. Whenever a camera is in the offing, they immediately run to the nearest child, lift it in the air, kiss it on the cheek. Kitsch is the aesthetic ideal of all politicians and all political parties and movements. But whenever a single political movement corners power, we find ourselves in the realm of totalitarian kitsch. When I say ‘totalitarian’, what I mean is that everything that infringes on kitsch must be banished for life: every display of individualism (because a deviation from the collective is a spit in the eye of the smiling brotherhood); every doubt … In the realm of totalitarian kitsch, all answers are given in advance and preclude any questions. It follows then that the true opponent of totalitarian kitsch is the person who asks questions.

Is it really any surprise that Mbeki wanted nothing to do with this bleeding cabaret, and why the AIDS crowd harried him over it?

The Citizen managing editor Martin Williams took a dim view of the Nkosi Johnson affair for reasons quite distinct from Barrell’s in an editorial he wrote on 16 January entitled Exploiting little Nkosi:

Xolani Nkosi (that is his legally correct appellation) must be the most exploited child in South Africa. The parade of leeches trying to associate themselves with his plight, either by visiting him, or invoking his name in emotive statements about Aids, is truly nauseating. Some politicians had the gall to issue media notices in advance, advising when they would be at Nkosi Johnson’s side, obviously hoping to be photographed. Their motive was plain, to extract sympathetic publicity by linking their profiles to the suffering of an 11-year-old boy whose deteriorating condition had attracted headlines. There was also a cheap attempt to embarrass Thabo Mbeki by saying Nkosi’s fervent wish was to speak to the President, to ask why he walked out during the boy’s address at the Aids 2000 conference in Durban last year. Mbeki could, arguably, have played to the baying gallery of Aids activists and other critics, who are making capital out of Nkosi’s tragic situation. But it is doubtful whether even a quiet, pre-emptive visit would have silenced them. I have no insight into Mbeki’s views on Nkosi, although those in the know say the President is heartbroken. Dissidents in general have been respectfully restrained about what’s happening to the brave little chap but there is a view that he is being killed by drugs. He did not develop any opportunistic infections. People who saw him after the Aids conference said his orange-tinged hair suggested malnourishment; he was not eating well, and at one point was ingesting eight different types of medication. In a recent US television documentary Nkosi told Christine Maggiore that he had been ‘taking medicines’ for eight years. His caretaker, Gail Johnson, said he had been on a combination of AZT, 3TC and Nevirapine since December 1999. Before that he was apparently using Bactrim for about four years. AZT, as Citizen readers know by now, was designed specifically to kill cells. It is the subject of a book, Debating AZT, by Anthony Brink, which is currently on sale. Nevirapine, too, is not without detractors. Over the festive season the American Centers for Disease Control issued a warning after 22 health workers using the treatment developed serious side effects. If it’s dangerous for adults there is a reasonable assumption that children would also be at risk. Therefore, the notion that Nkosi’s condition is being made worse by drugs in not at all implausible. Which would mean he is being killed by misguided kindness and publicity.

The Democratic Alliance’s ‘deputy spokesperson on HIV/AIDS’, Sandy Kalyan, elbowing her way up the ladder of important political offices, reacted with outrage to Williams’s editorial in a letter:

I am shocked and alarmed that supposedly reputable journalists like Martin Williams can propagate the idea that Nkosi Johnson is being harmed by the medication he is taking for HIV rather than HIV itself. Any paediatrician in a state hospital would tell you, Mr Williams, that 10 years ago the death of a patient was exceptional – now, they see more children dying than surviving. And rest assured, Mr Williams, only the most exceptional state hospital patient even knows that antiretrovirals exist. On the other hand, HIV-positive children in the first world are living for longer and longer because there is more and more knowledge about how to use antiretrovirals most effectively. It is a pity you seem not to have heard Nkosi’s doctors attributing his collapse not to the drugs, but to the fact that he started on them too late. The general consensus among doctors all around the world is that antiretrovirals do cause some serious side effects, and need to be carefully monitored. But they are also now keeping alive, indefinitely, people who would previously have died within a year or eighteen months of infection. They are also preventing HIV-infected mothers like Nkosi’s mother from passing the virus on to their children. Every society needs its renegades those who refuse to follow the conventional line. But those who still argue that the world is flat, despite overwhelming evidence to the contrary, just look ridiculous. The evidence supporting the link between HIV and Aids is so strong that one cannot argue convincingly or honestly against it. I am not sure what your agenda is in propagating views that are plainly wrong Mr Williams, but please bear in mind the possible consequences of publishing opinions which may well lead to people’s deaths.

Mrs Pumpkin Pips MP would do well to a take a few deep breaths, light a joss-stick and have a nice cup of ginger tea while meditating on the reminder by early AZT clinical trials overseer Professor Anthony Pinching at the 12th International AIDS Conference in Geneva in 1998 that ‘The side effects of AZT can be indistinguishable from the symptoms of AIDS’, and calmly revisit the ugly case that Williams makes.

Debating AZT took us on a pretty thorough journey through the toxicity literature on AZT – how AZT kills nerve, muscle and all other cells, and it detailed how epidemiological investigations have found that the wasting, nerve and brain damage suffered by the child invariably occur among AZT-treated HIV-positives only, and not the untreated. A paper I omitted from Debating AZT by Poznansky et al. in the British Medical Journal in 1995, HIV positive patients first presenting with an AIDS defining illness: characteristics and survival, reported that ‘wasting syndrome [occurs] almost exclusively’ among AZT-treated patients, confirming what Coker et al. had reported in AIDS in 1991: ‘A clinically significant myopathy that precedes the development of zidovudine associated mitochondrial myopathy has been a rarity in our experience.’ And Dalakas et al. noted the year before that in the New England Journal of Medicine: ‘Before 1986, when zidovudine (formerly called azidothymidine) was introduced, the number of patients with HIV-associated myopathy was small, and myopathy was considered a rare complication of HIV infection.’

A report by Langston et al. in Paediatrics in February 2001, Human Immunodeficiency Virus-Related Mortality in Infants and Children […], documented the changing causes of death among HIV-positive children as they got older. The paper said nothing about the treatment that they were on, but we can guess in the light of what Poznansky, Coker, Dalakas and their colleagues noticed, and what Langston and associates found among the children in the study: ‘Children with HIV who survive longer are less likely to die of pulmonary disease or infection and more likely to die of cardiac causes or with wasting syndrome.’ That is, of cell poisoning, not infectious disease. The children would have been receiving the best of American medicine: antiretroviral therapy. Indeed, there’s little doubt that they were: Reporting the Incidence of cardiac abnormalities in children with human immunodeficiency virus infection: The prospective P2C2 HIV study in the same journal in September 2002, Starc et al. found that ‘During 5 years of follow-up, cardiac dysfunction occurred in 18% to 39% of HIV-infected children and was associated with an increased risk of death.’ A covering editorial commented: ‘Further investigation of the best strategies to monitor and treat cardiac disease in HIV-infected children in the era of protease inhibitors now seems warranted.’ Protease Inhibitors are always used in combination with AZT-class drugs. Which so weaken cardiac muscle that the children’s hearts soon give in. In anywhere between eighteen and thirty-nine per cent of cases. Do you still tip your hat to ‘AIDS experts’? Unable to give up their pills.

In their paper The AIDS dilemma: drug diseases blamed on a passenger virus, published in Genetica in 1998, Duesberg and Rasnick made the riveting point that it was in 1987, the year that AZT was introduced to the market as an AIDS drug, that an epidemic of dementia and wasting among HIV-positives led the Centers for Disease Control to add those maladies to their list of ‘AIDS-defining’ illnesses. So doctors take us around another circle. Putting Xolani under – dolefully regretting that his neurotoxic and myopathic medicine sadly wasn’t able to prevent the onset of his AIDS brain damage, his AIDS blindness, his AIDS paralysis and his AIDS withering away to a skeleton.

Without drawing the obvious conclusion suggested by their data, a recent paper further evidences the damage that AZT and similar drugs do to optical nerves. Like Xolani’s. A Retinal nerve fiber layer evaluation in human immunodeficiency virus-positive patients by Plummer et al., published in February 2001 in the American Journal of Ophthalmology, found that ‘HIV-positive patients without CMV retinitis showed significant differences from HIV-negative normal controls in a number of measures of the retinal nerve fiber layer. This indicated a loss of retinal ganglion cells in HIV-positive patients without retinitis.’ They concluded: ‘Significant thinning of the retinal nerve fiber layer occurs in HIV-positive patients without infectious retinopathy.’ Which doesn’t tie in too well with the current model that HIV-positive people going blind in the care of their doctors do so because of cytomegalovirus infection. More like those expensive medicines. If Plummer and his colleagues had kept in mind the elementary principle that in nature the exception breaks the rule, that is, the anomaly destroys the hypothesis, they would have realised that their findings mark the end of the viral (cytomegalovirus) theory of blindness among AZT-treated AIDS patients. But for doctors, like goats driven to bitter grasses, to consider the prospect that the medicine itself is causing the malady is understandably entirely unappealing.

Steven Swindells’s report of the child’s death for Reuters on 1 June mentioned that before he died he had become completely incontinent and weighed less than 10kg. Swindells offered a plastic flowers eulogy: ‘He took his message of safe-sex and advocacy of anti-AIDS drugs across the country and abroad at a time when government policy towards the disease was thrown into disarray after Mandela’s successor, President Thabo Mbeki, questioned the link between HIV and AIDS and the safety of AIDS drugs.’ But the tiny waif hardly had any convictions of his own to sell. About safe sex and great pharmaceutical drugs. Under the absurd subheading, Nkosi Clashed With Mbeki, Swindells wrote: ‘Nkosi shot to world attention when he made an emotional appeal at the opening of the world’s biggest AIDS conference in Durban last year. Sharing the same platform as Mbeki, Nkosi won hearts with his appeal for compassion for AIDS victims, safe-sex and drugs such as AZT which can prevent the transmission of the virus from pregnant mothers to their babies.’ I watched. The boy was staged like a Dickensian circus freak. Hearing him reading the fake lines drawn by his handlers, calling for AZT for pregnant women, was revolting and distressing beyond words. It’s true. I lost it. That crazy guy pacing up and down the aisles with his hands in the air shouting at the sordid spectacle was me.

Ascribing a direct role to the media in Nkosi’s death, Fintan Dunne in Ireland had some pained words in White Medicine, Black Death for Nkosi, on his website. Implying that sentimentalism comes cheap and easy, he pointed to the gagging schlock turned out by journalists covering the boy’s demise in place of ‘healthy journalistic scepticism’. They might have raised their eyebrows at the fact that the boy was well when his white foster mother started feeding him ‘up to twenty five’ pills a day, including ‘toxic chemotherapy’, because he had been diagnosed HIV-positive, and assumed to be on his way to an AIDS death. Her relationship with him was, Dunne suggested,

a microcosm of the white relationship with Africa: well-intentioned but misinformed. … Nkosi was adopted by White culture. That was the beginning of the end … Had the orphaned Nkosi lived in a black community he might never have been medicated, or may have been treated with the traditional herbal medicine that in many Western eyes is the work of untutored savages. Our white culture has a different religion. White-coated doctors are our priesthood. Bodily immortality is the promise. Drugs are our sacred food from the holy of holies, even if side-effects and misdiagnosis are now killing millions in standard clinical practice – let alone in experimental areas like Aids. One of the many drugs administered to Nkosi was AZT. The bottle it comes in carries a skull and crossbones [when supplied to research laboratories]. The Physician’s Desk Reference has warned doctors that AZT can cause illness indistinguishable from Aids. … In truth, White Medicine has been killing Nkosi with misguided therapy, based on a bad diagnosis. Yet it is a profitable error. It sells lots of expensive drugs. Pretending all is well keeps doctors in social standing. In short, white medicine has sacrificed Nkosi. That’s entertainment. An Emergency Room drama. … Meanwhile, Western media describe Nkosi as dying from the Aids virus and castigate South African president Thabo Mbeki for daring to question the value of the magic White drugs.

Dunne described the popular emotionalism about Nkosi’s illness, particularly in the media, as a form of

sentimental fascism. … The dictator cries when the pretty girls hand him flowers. The fascist is always sentimental. The same tears flow for the fatherland. Tears flow as old rebel songs ring out to the clink of beer glasses. Their measure is the depth of personal denial and social schizophrenia. The killing goes hand in hand. The path to the graveyard is unimpeded by the tears and is well worn. Ask the Irish. Or ask Nkosi the Aids puppet. A pretty boy with a bunch of Aids flowers wheeled out for the great dictators at the 2000 Durban Aids conference. Satisfying the needs of our sentimental cult of gallant victimhood.

Gail Johnson’s notions about HIV and AIDS and the drugs were all informed by the media. A story Celia Farber has described as having been ‘botched virtually beyond repair’. But it’s a ‘profitable dereliction of duty’, Dunne noted, because ‘Sentiment sells newspapers and it does not hinder pharmaceutical advertising. In short, the white media is sacrificing Nkosi. That’s entertainment too. … History is written by Victors. They will write that they could not save Nkosi. Truth is authored by Time. It will write that they killed him. With sentimental fascism.’ Cameron was later to provide an example of it in his familiar muddled chat about Xolani’s death: ‘Ultimately through the grief and anger we must feel hope. It’s a challenge bigger than apartheid. … It’s a challenge to us all in South Africa – white, black, male, female, whatever you are.’ (Autistic, blind, spastic or gay.) A general observation made by Charles Darwin would have better fitted the occasion: ‘Wherever the European hath trod, death seems to follow the aboriginal.’

TIME took a swing at Mbeki in reporting Xolani’s death on 1 June: AIDS Orphan’s Preventable Death Challenges Those Left Behind: South Africa’s AIDS ‘celebrity’ Nkosi Johnson raised the profile of his country’s neglected sufferers. From the title alone, you get the picture. At a memorial service in St George’s Cathedral a week later, Achmat picked up the theme and warned from the pulpit: ‘To everyone in our government, we are saying please listen to us, because our anger will boil over. Our anger will boil over if this does not happen. We cannot let our people continue to die. We cannot let ourselves continue to die.’ Moreover we enjoy being angry, and we like talking about dying all the time; it makes us feel empowered. Why, everybody listens to us when we do. Just like they are listening to me now. The dean of St Georges, the Reverend Rowan Smith, said he wanted to weep when he heard Tshabalala-Msimang say in Parliament that she had no plans to make AIDS drugs available. Her remark that AZT didn’t cure AIDS came very close to the callousness of apartheid Minister of Justice Jimmy Kruger when he stated that Steve Biko’s death left him cold, he said. ‘To those thousands who have been using the drug that must have been a blow deep down in the stomach.’

Castro Hlongwane, Caravans, Cats, Geese, Foot and Mouth and Statistics: HIV/Aids and the struggle for the Humanisation of the African, a discussion document debated by the Tripartite Alliance in March 2002, which we’ll discuss later on in detail, charged bitterly that Xolani had been ‘forced to consume’ antiretroviral drugs and that they had killed him: ‘He was reborn as a creature of the imagination and the resources of white South Africa. The world decided to accord him the status of a hero, the new Hector Peterson murdered not by the apartheid regime, but by our country’s democratic government.’ On 23 March 2002 Die Burger reported Gail Johnson’s response (I translate from the Afrikaans report): ‘Nkosi [she can’t even get his name right, and uses the child’s surname – not the one given to him by his mother] was never forced to take antiretroviral drugs. A woman in America offered them. I took him to a paediatrician who told him how they worked and what the side effects are. [As if the child would have been able to comprehend, and make a choice of his own. Then she changes her story:] I told him and it was his choice to take them. [Not hers, as foster mother. She passes the buck to the child. For causing his death.] He only took the drugs for three months in 2000 [a month’s course of AZT and 3TC spread over two was enough to kill the adult James Hayman], when he was already too sick for them to have an effect. [So why give them then?] The drugs had absolutely nothing to do with his death.’ We’ll be the judge of that, madam. Especially in the light of how you laboured your account of how the toxicities of the drugs were explained to the child, before he died on them. And the fact that Alive and Well founder Christine Maggiore from Los Angeles recorded the boy on video telling her how you’d been drugging him from infancy. And that he particularly hated taking AZT, which you forced him to resume when he secretly tried to stop: ‘I’m taking AZT. I’m taking the cocktail. The bitter one I don’t like is AZT. There’re other pills. I don’t really know the names.’ Asked by Maggiore, ‘Do you ever not take the pills and not tell anyone?’, he replied, ‘I used to do that but my mom [Johnson] caught me.’

In an especially putrid instance of AIDS journalism-kitsch, In memory of Nkosi, published by Health-e on 28 November 2002, Anso Thom confirmed that before killing him off with AZT, Johnson and the doctors had been poisoning him with heaps of other drugs:

The scene played itself out three times a day. Nkosi would stand there, a glass of coke in one hand and a pile of pills and potions on the kitchen table in front of him. … that day Nkosi put on a brave face. ‘Tonight we’ll go and have those prawns,’ he announced once while trying to swallow the handful of tablets. He would stand there for about three minutes, glass in his slim hand, eyes shut tightly as he tried to coax his frail body into accepting the pills, some of them vitamins, some of them larger and too dry and bulky to swallow. … After he left we found an assortment of pills scattered under his bed. We realised then that he had not been taking all his medication and we knew that this was one of the many signs that he was ready to give up. He was tired.

He was being poly-medicated to death.

But Xolani did not avoid the drugs because he ‘was ready to give up’ as Thom put it in her koeksuster offering; he did so because he knew they were killing him. For her film, Maggiore also interviewed Winstone Zulu, a Zambian AIDS activist and orthodox member of the AIDS Panel: ‘I wasn’t compliant all the time because the drugs are difficult to take, you know, they make you sick. But in public I was compliant’ – not wanting to discourage others, he explained. ‘I wasn’t taking them all the time. Sometimes I skipped a whole week. … Every time I took the drugs I felt much closer to death than if I didn’t take them.’ Just as Xolani felt. Xolani died somewhat like a third-degree burn victim, only burned on the inside, and declining slowly, agonisingly, humiliatingly, horribly. All thanks to GlaxoSmithKline, whose drug has ‘extended and improved the quality of life of millions of people living with HIV/AIDS around the globe’. A lie exposed in March 2001: Reporting The use of highly active antiretroviral therapy (HAART) in patients with advanced HIV infection: Impact on medical, palliative care, and quality of life outcomes in the Journal of Pain Symptom Management, Bechtl et al. confirmed (per AIDS Weekly synopsis) that ‘HAART treatment does not appear to have significant benefits for the mental health of HIV patients; patients did not report a quality of life improvement after HAART; this was true even when the treatment regimen was clinically successful’. Not surprisingly, since ‘treatment failure, either intolerance or death, occurred in up to 40% of the patients studied’.

Thom dribbled on in her article: ‘Now, more than a year after his death we remember the little boy, wise beyond his years. A fighter, a survivor, a practical joker, a politician, a son, a friend and an awkward teenager. … Like Hector Peterson and Baby Tsepang, we can only hope, that like them, his suffering and bravery was not in vain. Lala Ngoxolo (rest in peace), Xolani Nkosi Johnson. Umzabalazo Usaqhubeka! (the struggle continues).’ Do you also write for Mills and Boon? In between ‘Talk To Your Maid’ Zulu classes over at the tech?

Had he been listening, Xolani wouldn’t have been able to understand Thom’s nauseatingly pretentious salutations – he couldn’t even speak his own language, thanks to Johnson’s removal of the child from his people. SABC Africa screened a television documentary about him in mid-2003, featuring a clip in which he referred to the country’s vernacular tongues as ‘those black languages’, and stated wretchedly: ‘I wish I was white, white people don’t die of AIDS.’ After a visit from his blood relatives had saddened him, Johnson stared deep into his eyes and asked: ‘Is it those people talking about your mommy who made you sad? Do you feel like they should all just go away?’ He wasn’t doing well, she said to the journalists: ‘He looks like someone on chemotherapy.’ Notwithstanding her observation that he was obviously being poisoned by the medicine she was feeding him, the film showed Johnson cajoling him to take it: ‘Life goes on. Medicine goes on.’ In fact she wanted him dead: she wished he had died earlier, she said, because ‘he was now beginning to understand about death’. Actually, his ‘understanding about death’ came from the fact that from the time Johnson took him, she’d been conducting a deathwatch, treating his arrival at the cemetery as long overdue. Because of a useless antibody test. And useless doctors. As a disgusted friend of mine voted after seeing the film: ‘That woman belongs in prison.’ Does anyone disagree?

In August 2000 Johnson had taken Xolani to see Professor Sam Mhlongo – a specialist in internal medicine, whose list of London medical qualifications and accreditations stretches longer than your arm. During their consultation at his home, Mhlongo strenuously warned her off AZT. But Johnson opted for the counsel of the white doctors. And Indians from the same academies. Who worship the same gods. And wage holy war against the same devils. Chemicals and germs. Because heedless of Mhlongo’s desperate advice given against all contemporary medical wisdom, she continued treating him with AZT and similar drugs.

For how long was Xolani poisoned before he died on 1 June 2001? The reports aren’t consistent. Gail Johnson claimed in Die Burger on 23 March 2002 that ‘He only took the drugs for three months in 2000.’ But it was much longer than that, according to Belinda Beresford writing in the Mail&Guardian on 12 January 2001, and after Xolani had become critically ill by this time the drugs the doctors continued piping the drugs in through his nose: ‘Nkosi started undergoing triple therapy in June. He stopped the treatment a few weeks ago, saying that he didn’t feel better, but was persuaded by his doctors to start again with just two of the drugs. He continues to receive his anti-retroviral therapy, passed through the naso-gastric tube into his stomach.’ No, it was before June 2000, according to Cameron in an interview by Tim Modise on SAfm radio on 18 July 2000: Johnson ‘told me last week in Durban that he had also started antiretroviral medication a few months ago and he’s on one of the protease inhibitors that I found uncomfortable. We spoke about possible [alternative] combinations for him. He’s in very loving hands and you can feel confident about that.’ It was even earlier than that according to Martin Williams, writing in the Citizen on 16 January 2001: ‘Gail Johnson … said he had been on a combination of AZT, 3TC and nevirapine since December 1999.’

April 2002 saw Xolani posthumously awarded the ‘Children’s Nobel Prize’ by a Swedish outfit, The Children’s World, funded by the Swedish International Development Cooperation Agency. Flying around peddling sentimental kitsch. And making people like Gail Johnson rich and famous. The award was presented by Queen Silvia. ‘I was overwhelmed,’ said Johnson. ‘Because of a little boy, I found myself in Sweden face to face with a queen. I had never imagined that.’ Of course it wasn’t ‘because of a little boy’. It was because she forced the medicine down when he tried giving it up. As determinedly as a breaking at the wheel by the Cape colonial authorities. Bone by bone. And killing him for real. Not like the cardboard effigies down at the indoor shooting range that Johnson blazes away at every week with her police reservist’s 9 mil Parabellum. Pretending, imagining it. Her jaw set with the satisfaction of it.

Jerry Coovadia, professor of ‘HIV-AIDS Research’ at the University of Natal and Chairman of the Durban AIDS conference, and Salim Abdool Karim, Deputy Vice-Chancellor of the same university, Scientific Programme Chair of the Durban conference and the MRC’s AIDS Research boss, wallowed in it like grunting hogs. Said Coovadia: ‘Nkosi is a worthy recipient of the Children’s Nobel Prize because of his magnificent contributions towards raising awareness of the terrible disaster of the HIV/AIDS pandemic. He lived through considerable difficulties as a child yet contributed more during his lifetime than many adults. Let us hope this award will rivet the world’s attention and help mobilize the action so long delayed that will prevent the birth of more Nkosis.’ Karim wasn’t going to be outdone in the manure: ‘This award is a great honour to Nkosi and everything he stood for. Nkosi was a beacon of hope. He gave all of us the inspiration to continue the struggle to address the global inequities that deprive the poor of life-saving HIV/AIDS treatments. The recognition that this prestigious award brings will ensure that his work continues.’

Neither Coovadia nor Karim, nor anyone else involved in killing Xolani Nkosi, or who enjoyed his death, journalists especially, seem to have known about the abortion of the AZT arm of a disastrous government-run study by Englwood et al. six years earlier. On 14 February 1995 the New York Times reported: AIDS drug AZT fails completely:

In a major surprise, the drug AZT – now the standard treatment for children infected by the AIDS virus – proved so ineffective in halting disease progression that federal officials have called off part of a large study involving it. AZT, or zidovudine, also had unexpectedly high rates of adverse side effects in children, like bleeding and biochemical abnormalities, officials said Monday. … Children receiving AZT alone had more rapid rates of disease progression, AIDS-related infections, impaired neurological development and death. The findings clearly caught health officials by surprise. AZT is widely considered the drug of choice in treating HIV-infected children and adults.

But the manufacturer paid no attention, continuing to market AZT for administration to children by advertising it in medical journals, highlighted by an image of three kids running hand in hand, a picture of happy vitality and financial prosperity: ‘Helping keep HIV disease at bay in children. Retrovir A world of antiretroviral experience. Generally well tolerated; Improved cognitive function; Survival rates similar to adults; Improvements in growth and well being.’ Under ‘Pediatrics’, persisted the company ‘Product Information’, ‘Retrovir is indicated for the HIV-infected children over 3 months of age who have HIV-related symptoms or who are asymptomatic with abnormal laboratory values indicating significant HIV-related immunosuppression. … The recommended dose in children 3 months to 12 years of age is 180 mg/m2 every 6 hours (720 mg/ m2 per day), not to exceed 200 mg every 6 hours [800 mg daily].’ GlaxoSmithKline currently suggests slightly differently: ‘Pediatrics: The recommended dose in pediatric patients 6 weeks to 12 years of age is 160 mg/m2 every 8 hours (480 mg/m2/day up to a maximum of 200 mg every 8 hours) in combination with other antiretroviral agents.’ Such as our AZT lookalike, 3TC.

CHAPTER

John le Carré’s best-selling novel, The Constant Gardener (Hodder and Staughton, 2001) presented a shocking fictionalised exposé of the pharmaceutical industry – but in an interview in the second December 2000 issue of the Spectator, he mentioned that during his research for the book, ‘As my journey through the pharmaceutical jungle progressed, by comparison with the reality, my novel was as tame as a holiday postcard. … The pharmas,’ he said, ‘are engaged in the systematic corruption of the medical profession.’ In his piece, The criminals of capitalism, published in the New York Nation on 9 April 2001, le Carré continued: ‘Big Pharma is engaged in the deliberate seduction of the medical profession, country by country, worldwide. It is spending a fortune on influencing, hiring and purchasing academic judgment to a point where, in a few years’ time, if Big Pharma continues unchecked on its present happy path, unbought medical opinion will be hard to find.’

Unbought literary opinion too. The feature film of The Constant Gardener released in 2005 featured what is known in the industry as a ‘product placement’, with Boehringer Ingelheim paying the producers millions to punt nevirapine as an AIDS drug, not once but twice in the script, some of which would have been recycled to Le Carré for the film rights.

Cara Jeppe, a research assistant in the department of surgery at Chris Hani-Baragwanath Hospital, made just this point about the corporate corruption of South African medical research in an essay, Save us from sophistry, published in the Mail&Guardian on 13 August 2002: ‘Sponsorship of many medical schools and research programmes by drug companies ensures few embarrassing exposés are published and unwelcome research remains unfunded. Thus much evidence refuting studies is embargoed, and the public is persuaded to support unscientific orthodoxies propagated by the pharmaceutical industry.’

An article Towards a philosophy of Science and Technology, published anonymously on an Internet site discussing the insights of science historian Thomas Kuhn, noted consonantly – with particular pertinence in the AIDS era: ‘Kuhn’s analysis allows for the possibility of the immense corruption and influence of science, ideologically, methodologically, politically.’

In the last half-century the vulnerability of the scientific endeavour to corruption, particularly in commercial bio-medicine, has been aggravated by the vast amounts of money available for research – provided that the grant applications serve the donors’ commercial or private interests, as in the case of pharmaceutical corporations, or the dominant paradigm, where parastatals like the Medical Research Council have substantial funds to dispense for research sponsorship. The result is that scientists naturally flock to the cash. And these days the cash is in HIV-AIDS research – no one gets grants to research non-viral multifactorial models to account for the incidence of ‘AIDS’. Jeppe explained the problem in her essay – quoting from Kuhn’s seminal The Structure of Scientific Revolutions (University of Chicago Press, 1970):

Another philosopher of science, Thomas Kuhn, argued: ‘No part of the aim of normal science is to call forth new sorts of phenomena; indeed those that will not fit the box are often not seen at all. Nor do scientists normally aim to invent new theories and they are often intolerant of those invented by others. Instead, normal scientific research is directed to the articulation of those phenomena and theories that the paradigm already supplies. … Given a paradigm, interpretation of data is central to the enterprise that explores it. But that interpretive enterprise ... .can only articulate a paradigm, not correct it.’ Having established the paradigm through repeated circular referencing to its articulators and through suppression of opposition, the ‘enterprise’ can provide lucrative avenues for industry.

In How Giant Drug Firm Funds the Aids Lobby in the London Sunday Times on 30 May 1993, Neville Hodgkinson described how the Wellcome Trust – GlaxoSmithKline’s arm’s-length charitable face – was systematically entrenching the viral/antiretroviral model by showering cash on gay AIDS activist organisations plugging this line, the Terrence Higgins Trust most lavishly – in the latter case by setting up a fund-raising operation to cover salaries and the rent for its expensive, leafy, inner-London digs. Also pay for its glossy booklets. Especially gladly for the AZT one, Positive Benefits. Extolling the drug’s virtues for nine pages. And claiming that ‘there are no life threatening side effects associated with zidovudine’. Of course not.

The Wellcome Trust was likewise funding the All-Party Parliamentary Group on AIDS, the London School of Hygiene and Tropical Medicine and the University College and Middlesex School of Medicine, and notably, the British Medical Association Foundation for AIDS, set up by the British Medical Association on the back of a Wellcome Trust bequest of £36 000 annually – in the very year that AZT was licensed in Britain. And the Wellcome Trust had recently set up the Wellcome Centre for Medical Science, which was lecturing teachers to get the gospel into schools. George Galloway MP saw what was going on: ‘The British health service rolled over on its back for Wellcome, spending millions of taxpayers’ money on this drug. In my opinion the health service has been well and truly shafted. The hegemony Wellcome have built up ... may turn out to be one of the greatest medical scandals of the century.’ You could be onto something there, George.

Martin Walker explained the game in his essay published online, HIV, AZT, big science & clinical failure. And a jolly clever game it was too. With £200 million at its disposal to scatter annually, by the late eighties the Wellcome Trust already had a long-established honey relationship with the British Medical Association. Just as it has with our own Medical Research Council, evidenced by sponsoring a conference it convened, The Second Wellcome Trust Workshop on HIV/AIDS and TB – contact the MRC to register for a week in scenic Cape Town, starting on 27 November 2001. Importantly, ‘... there will be sessions on how to write a grant application’ to the charity for ‘HIV-AIDS-TB’ research, and it ‘will also be an excellent opportunity to meet other researchers in the field. A number of prominent international and local speakers have been invited.’ To keep the party line straight. And stave off any questioning of the link – boiled down – between sex and TB among the poor, or the sense of giving potent cell-killing chemicals to people fallen ill through hopeless, chronic hunger. Among humans, the equivalent of Wellcome’s relationship with the British Medical Association and our MRC would be criminally punished as secret incest. In business, it was an arrangement to dodge a criminal charge of graft. Which it was, by any name.

With similar corrupt intent the Wellcome Trust funded a three-day ‘Scientific meeting on the empirical evidence for the demographic and socio-economic impact of AIDS’ in Durban over 26-28th March 2003, hosted by the University of KwaZulu-Natal’s flagship AIDS research institute, the Health Economics and HIV/AIDS Research Division (HEARD). Three days of buzzing chat around forty-four expert presentations produced a meaningless and tedious report in June, distilled perfectly in its last breath: ‘The point that we wish to end on, nonetheless, is that the meeting clearly encouraged methodological innovation. In other words, there is scope for experimentation, be it with linking and reconciling epidemiological and demographic data, comparing large workforce and ANC survey data, or conveying the significance of “the cost of a cuddle”.’

Taking a special interest in AIDS scaremongering by demographers, GlaxoSmithKline likewise underwrote the cost of a meeting of the Demographic Association at Potchefstroom in mid-October that year. Robert Shell, now associate professor in the Department of Statistics in the Western Cape, having earlier been kicked out of Rhodes, obliged the company by intoning: ‘We have reached a medical emergency in this country. We are looking at the destruction of our population at unparalleled levels. We are at a very profound moment in our history.’ After which everyone broke to natter over tea and cake.

As it brought AZT to market in Britain, Wellcome (now GlaxoSmithKline) didn’t want any dithering general practitioners making unpredictable treatment decisions off the AZT track. So with ‘specialists’ in its pocket, it had no trouble getting the BMA’s General Medical Council to cut GPs out of the action and make the treatment of AIDS patients a specialised business, with disciplinary sanctions in store for any GP not passing the work on. On to a club of ‘AIDS experts’. Whose doctrines sprung from a single font: the British Medical Association Foundation for AIDS. Set up by the British Medical Association. And paid for by the Wellcome Trust. To pump a single unquestionable creed: You are going to die because you had sex without a condom. Semen kills. It carries a deadly virus. AZT takes care of it.

Fixing the doctors was Wellcome’s first trick. Its next was to manoeuvre around the road boom between it and the laity, for unlike the case in America, it was illegal in Britain to advertise prescription drugs directly to the public. Expanding on Hodgkinson’s report, Walker explained that it did so by targeting the ‘plethora of self-help organisations which were springing up throughout the country’ and buying them all up –

all the self-help groups which had contact with gay men who tested ‘HIV antibody’ positive … Where they were unable to fund them directly, they gave grants for journals, papers and magazines or for specific projects. There were no overt strings attached to such money but recipients had to adhere to the medical model of AIDS [which prescribes AZT] and act as conduits by which off-the-street gay men concerned about their health could be funnelled into the charnel houses of chemotherapy. … By bombarding newly tested gay men with partial information about AZT and other so-called anti-viral drugs, Wellcome had found a way round the Medicines Act and the perfect way to construct a drugs market. Wellcome adopted a strategy which has been known within politics for hundreds of years. Wellcome didn’t need General Practitioners to sell AZT; they mounted their beachheads in the bourgeois sectors of the gay community and developed a colonial class which administered the medical model for them. … The fact that people were ill with greater frequency and died more quickly when they took AZT, did not affect the public perception that users of AZT got better, or lived longer lives of better quality than people who unfortunately did not have access to the drug.

GlaxoSmithKline and Bristol-Myers Squibb play at the same board. In 1999 BMS announced a grant of $100 million (later upped to $150 million) for the fight against AIDS in Southern Africa. That’s right, don’t adjust your set. The Washington Post told us all about it on 29 December 2000 in The Limits of $100 Million: ‘a five-year, $100 million charitable initiative to fight AIDS in Africa’. Which sounds like a lot. It is, in terms of controlling the field. Because a scientist who proposes, for example, looking into chronic malnourishment as a significant contributory cause of collapsing health in early adulthood among ostensibly well blacks has a fat chance of winning a research grant from any of the organisations promoting the HIV-AIDS model appointed by the company to hand out the bread. Much less a scientist who wants to research and report the cross-reactivity of ‘HIV antibody’ tests. Or go looking for ‘HIV’ in the blood of a person diagnosed HIV-positive, to establish whether HIV-positive really means HIV-infected as nearly all ‘AIDS experts’ say . But a hundred million is small change to Bristol-Myers Squibb, with ‘sales of $20.2 billion in more than 100 countries last year’, derived inter alia from its AZT-class drugs Videx (ddI) and Zerit (d4T), which sold $810 million worth in 1999.

And which, the company admits, are killing pregnant women. On 2 February 2001 the New York Times reported an alert issued by the European Medicines Evaluation Agency after

seven cases of lactic acidosis – three of them fatal [one South African] – had been reported worldwide in pregnant women taking the two drugs in combination. … Echoing last month’s warning by the US Food and Drug Administration, the EMEA pointed out that lactic acidosis is a known side effect of the class of HIV drugs called nucleoside reverse transcriptase inhibitors (NRTIs) [such as AZT]. The use of this class of drugs is not recommended during pregnancy unless the potential benefit clearly outweighs the potential risks.

Although the drugs’ labels already included strong warnings that lactic acidosis could occur in any patient, the FDA warned in a special advisory that ‘new evidence showed pregnant women have a greater chance of developing the condition’ (per Reuters). Bristol-Myers Squibb added this warning to its labels, and chased the change with an explanatory warning letter sent to 50 000 AIDS doctors. Like the EMEA, both the FDA and Bristol-Myers Squibb thoughtfully advised ‘pregnant women and their doctors to consider Zerit and Videx only when the benefits outweighed the risks’. But terrified pregnant women told they’ve got a killer virus, which could kill their babies too unless they take their medicine, are hardly placed to decide whether or not to take the antiretrovirals touted. The question is: when can we expect doctors to finally conclude that it never does – given all the nucleoside analogue drug foetal toxicity reports reviewed in Debating AZT, with more in Poisoning our Children.

In August 2002 Bristol-Myers Squibb sent out a blizzard of worried Important Drug Warning advisories to South African ‘healthcare professionals’. No longer just pregnant women in the firing line, everyone:

Bristol-Myers Squibb would like to remind health care providers caring for people with HIV of the potential for mitochondrial toxicity and lactic acidosis as a complication of therapy with nucleoside analogues, including Zerit (stavudine, d4T) [including] the risk of serious adverse reactions such as neuromuscular weakness, hepatoxicity and pancreatitis. … Bristol-Myers Squibb has received reports of rare occurrences of rapidly ascending neuromuscular weakness, mimicking the clinical presentation of Guillain-Barré Syndrome [general paralysis], including respiratory failure. Some of the reported cases were fatal. … Female gender, obesity, prolonged exposure may be risk factors.

Etc. In their chemical composition and pharmacological action, AZT and d4T are identical twins. Why the reports should be ‘rare’ is because, as was vividly illustrated in the Xolani Nkosi case, doctors under the HIV spell who see their HIV-patients gravely sickening after commencing their life-extending drugs blame the virus. They see the HIV-disease progressing.

CHAPTER

On 5 March 2001 a confederation of thirty-eight pharmaceutical companies commenced their action in the Pretoria High Court for an order knocking over provisions of the Medicines and Related Substances Control Amendment Act that allow for the importation of generic drugs. AIDS activists adopted the case as their own, a new front for their cause, the next thing to froth about, and the media were sucked right in. The following day Jon Jeter of the Washington Post reported the case as a ‘challenge of [sic] South Africa’s efforts to buy cheap, generic substitutes for patented AIDS medicines … life-prolonging treatments’. Instead of reporting the case, the rest of his report banged the AIDS drum, taking a swipe at Mbeki in the process for having ‘questioned the effectiveness of anti-retroviral medicines that are commonly used in the West to combat AIDS, and [his refusal] to authorize administration of relatively inexpensive treatments that have been shown to reduce transmission of HIV from pregnant women to their unborn children’.

The TAC provided huge fanfare for the launch of the case, bussing in hundreds of protestors clad in the purple and white company tee-shirt (‘HIV POSITIVE’) to march and toyi toyi with placards near the court and outside drug company headquarters, as well as in Durban and Cape Town. An appeal for donations on its website goes: ‘T-shirts and posters must be printed. Busses to bring affected people in from local townships need to be booked and paid for.’ Also picnic lunches. Achmat and his crypto-fascists had learned well from their antecessors – the propaganda value of organised street demonstrations having been recognised by the Nazis in the twenties and thirties. Supervised by another street-fighting femme: SA leader Ernst Roehm. As the Nazi newspaper the Völkischer Beobachter put it: ‘The very best thoughts are those inculcated by marching; in them reverberates the secret German spirit, the spirit of centuries.’

But as the drug companies’ attorneys correctly pointed out, ‘the case has virtually nothing to do with access to AIDS treatments, but centres instead on whether South Africa is obliged to follow international law regarding intellectual property rights and the country’s own international trade pacts’. The case quickly got chaotic. Judge Bernard Ngoepe wasn’t sure whether he could hear it. Because the act had not yet been promulgated, he mused in court over whether he could overturn it: ‘Courts cannot enforce those acts until they are in operation. It may very well be they are still in the kingdom of the legislature or executive.’ But that wasn’t the point at all. The applicants wanted it undone before it was enforced. A couple of days later he allowed the kids yelling outside the door to join the party, this high-powered spat, and the TAC was appointed a friend of the court, so that Achmat could helpfully tell it what it didn’t already know: that AIDS drugs are very expensive and that the poor can’t afford them. Oxfam characterised the case as an attempt by the pharmaceutical corporations to ‘engineer a gross violation of human rights’ in denying AIDS drugs to the needy; the ‘Vietnam of the drug industry’; a public relations disaster in a country with the highest number of AIDS sufferers in the world. They could have added ‘with a government under the greatest concerted massed pharmaceutical corporation pressure anywhere in the world ever’.

Even as he joined the party, pressing himself on the government like a suitor who doesn’t understand No, he was attacking it, claiming a week earlier that it had the blood of the country’s children on its hands, and ‘We face a greater tragedy than the acts or omissions of the drug companies, and that is the failure of government officials to act with courage, humility and urgency.’ Obediently, that is, to my sulky dictates.

The activists even got Madiba lined up behind them. On 15 April 2001 Mandela was interviewed on SABC television: ‘I think the pharmaceuticals are exploiting the situation that exists in countries like South Africa – in the developing world – because they charge exorbitant prices which are beyond the capacity of the ordinary HIV-AIDS person. That is completely wrong and must be condemned. The government is perfectly entitled, in facing that situation, to resort to generic drugs and it is a gross error for the companies, for the pharmaceuticals, to take the government to court.’ This got them sweating. The moral authority in the Nobel peace laureate’s rebuke for the drug companies became too much to bear. The Opium-laden frigate began breaking up on the rocks it had hit in its hostile harbour.

Bearing out the adage that the biggest bullies are usually the biggest cowards, GlaxoSmithKline and the other majors (with their combined market capitalisation of $1.3 trillion – said the Star on 16 April 2001 – ten times South Africa’s annual gross domestic product) were the first to break ranks with the rest. Four days after Mandela’s scolding they cracked and fled the court. A report in the London Guardian on the morning that it happened told that the ‘five big firms – including the world’s largest pharmaceutical company, Britain’s GlaxoSmithKline ... have lost all heart for the fight’. Which made the smaller players bitter after their three years of preparation, and the stakes involved in a determination of their complaint. The Guardian elaborated: ‘A split has developed between some of the larger drug companies and the Pharmaceutical Manufacturers Association of South Africa (PMA), which headed the legal action. At yesterday’s hearing, several drug firms sent in their own legal teams.’ The relative minors were not persuaded that the big conglomerates’ surrender had anything to do with the legal merits, as opposed to a buckling under organised public pressure, but, ‘Although some smaller firms could technically pursue the case, lawyers said it was highly unlikely that they will.’

Not with the kind of heat fixed by the activists: ‘Dear friend, URGENT DEADLINE: Médecins Sans Frontières (MSF) asks you to support South Africa’s efforts to make essential medicines more accessible to its people by signing the global ‘Drop the Case’ petition at by April 15.’ And a great success it was too; in a joint press release by MSF, Oxfam, and the TAC, Achmat said: ‘…we are especially grateful to the 260,000 concerned citizens and 140 organisations from 130 countries who signed the global ‘Drop the Case’ petition.’ The local AIDS Consortium mentioned some local organisations that signed up:

Finally the AIDS Consortium would like to thank all its members for their support. The voice of civil society has been strengthened by the strong alliance of organizations including the AIDS Law Project, the National Association of People Living with AIDS, the Congress of South African Trade Unions, MSF, Oxfam, and the Consumer Project on Technology including all the other organizations and community based structures that have been involved.

In a public relations disaster zone, the drug companies approached Kofi Annan to guide them out of it. Who phoned Mbeki in turn, and soon a settlement agreement had been hammered out by the lawyers, based on a concession by government that it would negotiate with the industry before issuing any compulsory licenses for the import and/or local manufacture of generic drugs..

The TAC was ecstatic: ‘Urgent Press Release 19 April 2001: Victory for Activists, People With HIV/AIDS and Poor People Everywhere! Pharmaceutical Companies Beaten! … The government must now fulfil its constitutional duties to protect the rights to life and health of all South Africans.’ To be achieved perfectly by providing those lifesavers, AZT and nevirapine.

GlaxoSmithKline’s Chief Executive Officer in Britain, Jean-Pierre Garnier, made a risible attempt to save face after his company’s rout. The company ‘unreservedly welcomed’ the settlement, he said. It ‘meets the objectives of both the South African government and the pharmaceutical industry, but it is my fervent hope that the real winners here will be patients’. Sure it is, you pompous arse. Gliding down your oak avenue. On the backseat of your Rolls. Twinkling in Nazi gold. If this drug deal has gone sour, you can always go off and sell some arms. Like Black Hawk helicopters. As a director of United Technologies. Your other job.

Significantly, in her detailed press statement on the day the case was settled, Tshabalala-Msimang mentioned nothing about antiretrovirals, the drugs that the TAC and the media imagined the case was all about. Nor did a joint statement issued by the principal parties to the litigation the next day. But she did make the government’s intentions plain in what the Wall Street Journal described as ‘a crowded conference room’ moments after the case was abandoned. It reported: ‘“We never said we want to use antiretrovirals,” she told the audience, which just moments prior had been singing and clapping. “People who want antiretrovirals can go to the private sector.”’ Quite so. The TAC would do whatever it took, Achmat responded, including taking government on to bring ‘real drugs to real people’. Since people like Mbeki and Tshabalala-Msimang were unreal. Unlike the exhaust pipe franchise, Speedy Exhausts: ‘Real people, real value, real Speedy’. And the furniture retailer chain: ‘Beares really cares about you’. As the drug companies do, delivering ‘healthcare’.

The TAC’s jubilation now began to fade rapidly. As the people got real. The guys with ice-cream on their cheeks now came to, and realised that for them the whole thing had been a huge waste of time and energy. Hadn’t they heard Tshabalala-Msimang’s repeated public rejection of AZT on the grounds of its toxicity and carcinogenicity? Don’t they wash their ears?

The US administration had brought heavy political pressure to bear on the South African government in support of the drug companies suing it, insisting that the AIDS drugs patents be respected, on pain of sanctions. Even if that put the proprietary medicines out of reach of the Third World poor – as the TAC was complaining. And that without the drugs, bodies, they said, would pile up in South Africa and beyond, great mountains high. The Bush administration’s thinking on this score seems to have been ‘Shucks, they’re only niggers and gooks.’ Because as anthrax hysteria exploded on home turf after the World Trade Centre attack on 11 September 2001, they weren’t so hassled about the goddam patents: the New York Times told in an editorial on 31 October 2001 that ‘When the federal government wanted to stockpile the antibiotic Cipro as a treatment for anthrax, Health and Human Services Secretary Tommy Thompson persuaded Bayer, the patent holder, to cut the price of the drug [from $4.67 per pill down to 95 cents, per Newsday] by threatening to buy generic versions. Yet the Bush administration is derailing efforts by poor countries ravaged by AIDS to facilitate their efforts to do the same’ by blocking a motion to be proposed on 9 November 2001 at a meeting of the World Trade Organisation ‘to make it easier for countries to manufacture or import low-cost drugs, especially the anti-AIDS cocktail … While current world trade rules allow countries to break patents under certain circumstances, among them public health emergencies, no country has done it for AIDS medicines, in part because of pressure from Washington.’ That’s because the numbers are too sweet. In every war effort against enemies real or imagined, from the Indochinese to cancer, someone always does great, and for the medical industrial complex, the war on AIDS has been the fattest of cash cows.

Five days after GlaxoSmithKline chickened out in the High Court and threw in its cards, it tried rescuing its threatened AZT and 3TC market by offering further price cuts. The New York Times reported on 24 April 2001 that it had ‘offered to cut its price for Combivir in Africa to $730 a year – about a tenth of its price in the United States and a price that it says is equal to its manufacturing cost. But $730 is close to three times Cipla’s offer.’ Revealing what big liars work for GlaxoSmithKline. The standard defence of the drug industry’s high prices is that it has to recover research and development costs. But in the case of AZT there weren’t any to speak of. The drug was designed by Richard Beltz in 1961 on a grant from the National Cancer Institute. The government paid. (See Inventing AZT in the appendices.)

GlaxoSmithKline’s tremendous concern for ‘AIDS sufferers’ reflected in their one-tenth fire-sale price, represented a small-change cost to the company anyway. The Times mentioned a report by industry analyst IMS Health that more than ninety per cent of the $3.8 billion spent worldwide on AIDS drugs was in just five First World countries: the US, France, Italy, Germany and Britain. Because people in the Third World can’t afford them. And in any event, of its total drug market, AIDS drugs make up only a small part; GlaxoSmithKline, the world’s biggest selling AIDS drug producer earned only about six per cent of its revenue from selling them.

Following the collapse of the generic drug case, the TAC’s allies in Oxfam kept the pressure up on GlaxoSmithKline for cheaper AZT for Africa, by lobbying shareholders attending the company’s annual general meeting in London on 22 May 2001. Dressed in white coats they dished out pillboxes to shareholders to make their point, and those whose consciences had been moved by the stunt gave CEO Jean-Pierre Garnier a grilling. But his company led the way in offering AZT and 3TC to Africans at a tenth of their ordinary cost, he protested. And it was committed to researching diseases of the developing world. Which impressed Oxfam policy analyst Sophia Tickell – sort of: ‘Glaxo has taken small steps in the right direction but must do more. If it does not address the issue of patents in developing countries, it runs the risk that its good intentions will be seen as so much window dressing.’ Oxfam liked GlaxoSmithKline’s show of ‘good intentions’. And we found the childishness of Oxfam’s moral assessment unbelievable

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CHAPTER

On 3 May 2001 Mbeki was interviewed by Jon Snow on the British television channel ITN. Snow asked him: ‘Do you regret the original stance you took questioning the link between HIV and AIDS?’ To which Mbeki replied:

But I didn’t, that was misreporting as you so often have happening. The point I was making, which I would make still, is this. It seems to me, from reading all the things that have been written about this, that in the collapse of people’s immune systems, a virus is part of that but there are other factors which cause the collapse of the immune system, as a result of which people suffer from AIDS. And therefore we need a comprehensive approach to the matter. Ask any doctor and they will say the matter of nutrition and therefore the struggle against poverty, the matter of clean water, these are critical to the protection of the immune system. So I was saying, we can’t just focus on one thing. This is a country that is very poor, and indeed that level of poverty will impact on the capacity of the immune system to survive. Let’s have a more comprehensive approach to this matter that is what I was saying.

Asked why he thought he might have been misunderstood – because perhaps he’d taken the drug companies on, who had deliberately misrepresented his position – he proposed:

I think the problem arose because there was a slogan that says ‘HIV causes AIDS’ and therefore you respond like this. When you say, let us look at the matter more broadly, more comprehensively, the response is that you are questioning orthodoxy. I think think for a long time people didn’t want to listen, but I think the atmosphere has changed. Certainly in this country people are saying, medical people, yes, we need a more comprehensive response to this challenge rather than just one narrowly focussed on a virus. It includes the virus, but we must include all these other elements wich relate to the question of what acquired immune deficiency means. There is an immune deficiency – how does it come about? How is it acquired, and what is the syndrom that results? If you ask these questions they are simple. You acquire that immune deficiency via a virus, via bad health conditions, which will destroy the immune system. So let’s deal with everything that leads to immune deficiency, which leads to the syndrome and all the various diseases. But when you say that, in a situation where people are accustomed to a particular formulation thay might very well have thought that this was sacrilege.

Two weeks later, on the 18th, taking some questions over the Internet from participants in the BBC Online forum, Mbeki elaborated. Asked why he denied ‘pregnant women the use of AZT in pregnancy when there is solid evidence it reduces the transmission of HIV from mother to child,’ he explained:

This is part of the discussion that is taking place. The latest circular from the World Health Organisation was specifically on AZT. It says when you dispense AZT, it must be done under close medical supervision, bearing in mind the contra-indications and potential toxicities. The idea the you can just give out this antiretroviral without the proper health infrastructure [is] wrong – because in many instances you’ve got to check this patient every day. You cannot do this in a rural hospital. This infrastructure does not exist. One of the issues that scientists are looking at is that of where you have to dispense these antiretrovirals to large numbers of poor people in a poor country, with a weak health delivery system. What the WHO is warning about is that if you don’t do it properly, you might kill the pregnant mother because of the toxicity of the drugs.

Challenged on his decision to convene his AIDS Panel for lending ‘credence to theories that the medical community long ago rejected’ and about the danger that people might not ‘take precautions against HIV infection when they hear you question the relationship between HIV and AIDS’, he endeavoured to set things straight once and for all:

There’s been a lot of misreporting about this. Let me tell you what they have been saying and doing. It seems to me that there are a number of scientific questions that need to be answered with regard to this, not so much to ensure that we’re better educated about science, but to ensure that we make a more effective intervention against AIDS. So we then appointed the scientists representing all the different points of view with regard to the scientific discussion, which, as you know, has been going on for a long time. I agree with you the majority of scientists are saying one thing. We need answers because we need to be very focussed and very effective in the fight against AIDS. One of the consequences is that the scientists themselves, the scientists on both sides, agreed that, yes indeed there are many angles of scientific questions. They further agreed that indeed they had not been discussing these questions for fifteen years because there had been mud-slinging, throwing mud at one another. They further agreed that they would then meet under the auspices of the US government’s Centers for Disease Control. All factions would meet under the auspices of the CDC to look at these unsettled scientific questions that exist.

‘But the question is whether HIV leads to AIDS?’ worried the caller. ‘That’s one of the questions that the scientists are discussing,’ Mbeki replied. ‘I’ve never made any judgment on that. It’s an issue they are debating. They’re debating it also, not because they’re interested in abstruse scientific conclusions, but for all these years we still haven’t found a vaccine for AIDS, and this is something that must be troubling to the scientists and the rest of us.’

Mbeki’s tactical approach to the strident demands of the orthodoxy that he give up his doubts about their devil was clear. Resisting the virus’s champions head-on was simply unfeasible, so better to include HIV among a portfolio of contributory causes, with poverty prioritised.

But head-on he ran into a bunch of AIDS activists at Glasgow Caledonian University on 13 June, when he arrived to open a health faculty building named after his father during a four-day trip to the UK. ‘AIDS is the new apartheid,’ shouted one excited protester, as his companions waved banners declaring ‘AZT saves babies’ lives’. But Mbeki paid the foolish demonstrators no attention, and in his speech at the opening made no reference to the AIDS controversy. Except perhaps to drily offer some oblique advice to the indignant activists: ‘It is clear that if we are to change South Africa for the better we are going to have to be more educated.’

On 14 June 2001 Mbeki and Prime Minister Tony Blair met at 10 Downing Street for the Fourth UK-South Africa Bilateral Forum, and on the lawn afterwards they stood together taking questions from journalists. Asked about AIDS and Zimbabwe, Mbeki responded:

Well, we have discussed the more … matters. We have to engage the matter for instance of AIDS as we are engaging it. There’s got to be very strong awareness campaigns, strong interventions to treat, to deal with opportunistic diseases, there’s got to be strong social programmes about home-based care, about care of orphans and so on. We’ve got to do that whole variety of things and we are doing that whole variety of things. And so we’ll continue with these programmes. As they say, we say well that’s what happening and people of course can check for themselves. But then to say that we then have to ask the question are there other things that we need to do to make ourselves more effective with regard to those interventions. And therefore that question needs to be answered. It’s rational, of course it’s rational.

Blair then invited two final questions, and the next journalist continued on the same theme, thinking she had Mbeki cornered:

Mr Mbeki your government introduced yesterday a programme for drugs which will stop the transmission of HIV from mothers to babies. How does that square with your earlier comments that there’s no link between HIV and the spread of AIDS.

‘When did I make that comment?’ Mbeki asked.

You made the comment, it’s well recorded that you made the comment and your government introduced this programme yesterday. How do you square up the two things.

Mbeki turned the tables:

I’ve never actually made the comment. If you say it’s well recorded I’d like to see the recording. I’ve never said it. See the thing…. What’s happened…. What you’re referring to is a particular drug which has just got licensed in South Africa, which it is said helps with this matter of mother-to-child transmission. When the medical authorities licensed it, that’s the Medicines Control Council, they said there’s a number of matters that remain unanswered integral to this question. One of them that’s not been resolved in regard to this particular drug [nevirapine], which is whether the mother who gets one dose and the child who gets one dose when the child gets born, whether the mother should breastfeed, because part of the evidence is now that if the mother breastfeeds when this child is two years old then they will become HIV-positive again. Now the problem with that what then do you do if you are going to say there shall be no breastfeeding. What do you do with the mother who’s poor, who comes from a rural area which has no clean water, has no electricity to boil water so that you can prepare these foods so that the child must eat because it’s not breastfeeding. So what was decided was that we will do two trial runs per province, urban and rural, to say if you make this drug generally available how do you cope with it. Because if science as it stands now says don’t breastfeed it means this mother who comes from the circumstances where they can’t produce formula feed because they are not breastfeeding, the government will then have to find the means to address that particular matter. So how do you do it? So what we are talking about is a trial we are running in all nine provinces, urban and rural sites so that we can see down the road how does the public health system cope with this. To try to respond also, then, to the matters raised by the Medicines Control Council, which said, as it licensed, there are a number of matters which have not been answered with regard to this. So it’s that kind of experiment. It’ll do all those things so we need some answers before you say this drug is generally available in the public health system. So that’s what’s happening.

On 26 June, right after his trip to see Blair, Mbeki paid a formal visit to the new US President, George W Bush. At a media photo-shoot in the Oval Office immediately after their meeting, one question was addressed to each President, and both concerned AIDS. Bush’s reply indicated that AIDS had been a hot topic of their discussions: ‘Mr President, neither of you have mentioned the AIDS scourge directly in your opening statements here. How high on the list of priorities for discussing the scourge is this on your agenda?’ Bush:

Well, it’s an incredibly important part of our dialogue. The AIDS pandemic in Africa is terrible. And our nation intends to do something about it. As a matter of fact, our nation is doing something about it. We provide more money than any nation in the world to fund a strategy to defeat AIDS [$200 million to the UN Global Fund for HIV/AIDS, TB and Malaria.] And we will continue to work with nations that can afford to put money into the trust to do so. I was so pleased to see not only to announce that our government put money into an international trust, but the Gates Foundation, a private foundation here in America, contributed $100 million. And yesterday, Tommy Thompson and Colin Powell went to the U.N. to discuss this important issue. And we will discuss it, and we’ll discuss it in depth, just like we did in Austin, Texas. The President is concerned, as am I. I discussed it in Europe. I talked to the Europeans. I said, we’ve made a down payment into the international trust to battle AIDS; they should contribute, I said. And I hope they do. [They did. The UK contributed $100 million, France $127 million, and the UN’s Kofi Annan paid $100 000 in from his own pocket.] I hope the European Union will follow suit. Part of our discussion that night in Sweden was the United States taking the lead in the AIDS pandemic, not only in the continent of Africa, but around the world. And this is a big issue, as far as we’re concerned. We’ve got to do something about it.

Bush then turned to Mbeki for his comment: ‘Mr President?’ Mbeki subtly moved the spotlight to the structural causes of disease in black Africa:

Yes, indeed. As the President says, we actually did discuss this matter, even then, last year in May, when we met in Texas. It clearly is an important matter. That’s why I mentioned the matter of diseases on the African continent. AIDS, indeed, is one of those. We have to respond in a comprehensive way. One of the matters we’ll discuss with the President is this African recovery program that we’re working on. And one of the major priority areas in that African recovery program is precisely this area. So we certainly will discuss this. And we have to do something, because in many instances, these are diseases which are not only caused by poverty, some of them, but also cause poverty. So if you’re talking about an African recovery, you cannot but discuss AIDS, and really confront it. Malaria, tuberculosis, all sorts of communicable diseases are a particular matter of what has to happen – we have to address them.

But the American journalist swung the focus back to drugs:

Mr President, President Mbeki, last week the New York Times published an editorial accusing your government of, in its words, dooming half a generation of young people to an early, protracted and expensive death because of its failure to distribute antiretrovirals. How do you explain the amount of criticism that you’re coming in for in the United States for what is a perception that you’re not doing enough on HIV?

Mbeki replied: ‘Well, as we’ve said – all I would say to that, really, is that people must look at what we’re doing in South Africa, not their perception of what they think we’re doing, but what we’re doing actually in the country. And I don’t think on the basis of facts an accusation like that can be sustained.’

Two days later, at a National Press Club lunch in Washington, Mbeki was asked whether he thought HIV was the primary cause of AIDS. He ducked: ‘... that’s what the scientists say. I don’t think my personal belief is relevant to a scientific fact. But it is in ordinary medical textbooks that the immune system can get compromised by a whole variety of things, not only a virus.’ Again he emphasized: ‘We’ve got to respond to a human body in a comprehensive manner and that includes this issue of HIV.’ He said the pharmaceutical manufacturer Merck, whose vaccine research facility he’d visited the day before, had expressed interest in working with the South African government to examine ‘these broader questions’. Criticized for skipping the UN AIDS Conference focussing on AIDS in Africa then underway in New York, he answered simply: ‘One can’t be at two places at the same time.’ He’d sent a large delegation including his Health and Foreign Affairs Ministers, he said. ‘What the Ministers said at the UN AIDS conference is no different from what I would have said.’

Being otherwise occupied spared him having to sit through the speech of a dimwit like US Secretary of State, General Colin Powell. Carrying on in the Security Council like one of his Joes on bad acid: ‘I was a soldier. But I know of no enemy in war more insidious or vicious than AIDS. An enemy that poses a clear and present danger to the world.’ Selling hallucinations so obviously at variance with the facts: ‘AIDS respects no man, woman or child. It knows no race, religion, class or creed. No community, country, or continent is immune from its ravages.’ Alluding to Mbeki, who saw things differently, he said: ‘Opinion leaders from all walks of life must deliver the message that AIDS is real.’ To justify the US getting stuck in everywhere:

President Bush has put the full force of his government, the full force of his cabinet, behind the US response to this crisis. He has named Secretary of Health and Human Services Tommy Thompson, who is here today, and me to co-chair a special task force to ensure that my government’s efforts are comprehensive and coordinated. Comprehensive and coordinated these efforts must be, for AIDS is not just a humanitarian or health issue. It not only kills. It also destroys communities. It decimates countries. It destabilizes regions. It can consume continents. No war on the face of the earth is more destructive than the AIDS pandemic. … In this global war against AIDS, everyone can and must be a leader. Everyone can and must be an ally. We are all vulnerable – big nations and small, the wealthy and the poor. We cannot let AIDS divide us. My country is ready to work with all nations to build a global coalition of action against this common foe.

And on he went, full of big American talk. Which he no doubt picked up from sitting listening every Sunday to the bulging homilies of his small-town Baptist pastor. Including lessons in not telling lies. About weapons of mass destruction and killer germs. With the Stars and Stripes waving proudly outside.

CHAPTER

A pillar of Achmat’s AIDS drug advocacy campaign throughout Mbeki’s first term as President, a stratagem applied with enormous success for making propaganda, and winning a huge bevy of admirers, was his publicly traded declaration that he would not take the drugs himself. As he explained to Time on 22 April 2001, ‘he refuses to take the drugs until they’re available to all South African AIDS patients through the public health system’. He repeated this two years later in the same mag, honouring him for his bravery under the laurel ‘Heroes*Activists’ on 20 April 2003: ‘When the program of treatment is established and irreversible, then, and only then, I might go into some serious treatment of my own.’ This meant that he was Dying To Get AIDS Drugs To All, according to the headline, because, Achmat explained, ‘The cost of treatment, if you could find any, was way out of the reach of poor people. To have AIDS was a death sentence.’ That is to say he would abstain from taking his life-saving medicine and thereby put his life on the line in the political tradition of Bobby Sands. This marvellous courage was calculated to attract plaudits from journalists and all sorts of players in high places, and place the government under unbearable pressure – at a propaganda level at any rate. The first it certainly did, but not the second, because, not so brave after all, he called his game off on 4 August 2003 after despairing of any prospect that the government might surrender to his demands. (Within a few months of his experimenting with drugs it would all end up in tears for Zackie Achmat, but we’re getting ahead of ourselves.)

Achmat volubly explained the motivation for his strike to his fans: ‘I don’t want to live in a world where people die every day simply because they are poor.’ In other words I want to die too. My refusal to take my medicine doesn’t make me a hero though: ‘I don’t think it’s noble, I think it’s dumb. But it’s a conscience issue. … The political scenario in South Africa has lost its moral content.’ And I’ve got to show them the way. How to be moral. Even though I’m dumb. ‘The poorest of the poor are dying, only the rich have access to treatment. My fight is essentially about this. If we don’t have morals in our politics, then South Africa is doomed.’ Unlike Mbeki, I’m the one with the morals around here, but on the other hand, ‘I don’t want to kill myself for Thabo. I want to make sure that people get medicines.’ I loudly claim I’m willing to die for this by not taking them. I pump up the volume by making a big show of refusing my treatment, even when Mandela comes begging, with the TV cameras in tow.

Achmat’s announcement that he was avoiding the drugs explained exactly why he was always looked fighting fit in his regular television appearances bashing Mbeki and Tshabalala-Msimang for their reluctance to buy them. Larry Fox of the Division of AIDS in the US NIH obliquely predicted that if Achmat would briefly taste the medicine that he advocated, he would undoubtedly spit it out: on 16 October 2000 at a symposium in Gaithersburg, Maryland, convened by the FDA, Fox remarked: ‘We have got a number of problems with [AIDS drugs]. So in South Africa, we experience people screaming, I want therapy, I want therapy, I want therapy. In the United States, we hear people saying, get me off this stuff, get me off this stuff, get me off this stuff.’

Martin Delaney, director of the AIDS drug promoting lobby Project Inform in the US, explained why. On 6 June 2001 he took part in a programme Plague: AIDS at 20 hosted by Ted Koppel on his ABC television show Nightline. The Judas goat of the gay American AIDS holocaust (himself hetero and HIV-negative), whose corrupted outfit has foisted the drug company line murderously on his frightened, motly gay constituency under the guise of an independent treatment advice and advocacy group, he volunteered some remarkable concessions:

Well, I think the dilemma here is we’ve got to learn from what has happened here in the last 18 years and try not to repeat it, as we move into Africa … I can’t overstate, I think, how severe the problems are with the current therapies. … People are dying from the effects of the therapies themselves in some cases. … People are suffering from severe life-threatening complications of drugs. … So as we talk about bringing therapy to Africa, even if we can solve the problem and cost and infrastructure and delivery, I have this pang in my heart of are we doing the right thing, you know, with these drugs? Or are we unleashing another kind of epidemic over there of drug side effects as well?

Is that a conscience we see beginning to nag there, Marty? If only for a moment: soon after the licensing of AZT in the US by the FDA in 1987, Delaney wrote in a newsletter put out by the AIDS Health Project, an AIDS service organization affiliated to the University of California:

The multi-center clinical trials of AZT are perhaps the sloppiest and most poorly controlled trials ever to serve as the basis for an FDA drug licensing approval. ... Because mortality was not an intended endpoint, causes of death were never verified. Despite this, and a frightening record of toxicity, the FDA approved AZT in record time, granting a treatment IND [investigational new drug] in less than five days and full pharmaceutical licensing in less than 6 months.

But when on 14 February 2003 Rasnick reminded him of this on the online letters page of the British Medical Journal, Delaney responded five days later:

If anyone cares, it is true that I made a critical statement about an early AZT trial some 16 years ago. That comment came at a time when I was just beginning my learning path about clinical research. Looking back, I would say that I was merely ‘mouthing off’ on a subject I knew little about. … And while my view of AZT did change over time, it was because of the proliferation of later studies which better defined the drug’s activities and limitations. … I never cease to amaze at the denialists’ continued obsession with that single early study of AZT, or with the drug itself. … I don’t know when the denialists will get it, but their era is over. They have no point and nothing to offer. They have no real data about anything. What they have is a grudge of some kind against the scientific community (for having left them behind?). Unfortunately, there will always be some new or uniformed people who will listen to them and suffer the consequences of their misinformation.

Under the BMJ’s ‘Competing interests’ question, there were ‘None declared’. In fact Project Inform is openly subsidised by the pharmaceutical industry. Had Delaney listed his organisation’s donors, readers might have been better able to comprehend his remarkable turnaround. I asked him whether he considered any of his statements in his original criticism of the Phase II AZT trial to have actually been wrong. He implicitly confirmed not: ‘The biggest mistake of the AZT trial was simply that they extrapolated some pretty grand claims from a very small, brief and limited trial. The conclusions went far beyond anything warranted by the data.’

The lowest dose recommended by GlaxoSmithKline is 500 mg daily. That’s 1021 molecules of AZT down Achmat’s hatch: a generous 10 million molecules for every single one of his cells, report Duesberg and Rasnick in The AIDS Dilemma. Bringing about ‘AIDS-defining’ conditions and other deadly ones within weeks in animal studies at human-equivalent doses: mitochondrial necrosis, weight loss, myelodysplasia, thymic atrophy, T-cell depletion, neutropenia, leukopenia, lymphopenia, thrombocyopenia, bone marrow depletion, anaemia. Not forgetting death. We mentioned Lenderking’s et al. report earlier on that 500 mg of AZT daily caused such ‘severe side effects’ among ‘asymptomatic patients’ that it was ‘life threatening in some cases’. And they were talking about AZT straight, without its virtually identical poisonous twin, 3TC, thrown in to almost double the total nucleoside analogue drug dose. Not only almost double it, but also synergistically exacerbate the toxicities of both drugs, the sum being much worse than the parts – the well-documented trouble with taking ‘antivirals’ of the same type together. And to add insult to injury, when the drugs are taken concomitantly, they increase the concentration of raw unphosphorylated AZT swilling around in your veins by thirty-nine per cent, according to the encyclopaedic American Hospital Formulary Service Drug Information 1998. All of which effectively treats the swallower to the kind of massive AZT dose abandoned years ago, the metal baseball bat that finished Freddie Mercury off in no time. But revived in the age of ‘combination therapy’ – although ‘Highly Active Antiretroviral Therapy’ looks to be a fashion as brief as oversized jackets, on its rapid way out, as we read above, with ‘AIDS experts’ surveying the battlefield after letting loose the new weapons and scratching their heads over why the dead and wounded are mostly their own.

A paper published in Lancet on 20 October 2001 formally reported what DAID’s Larry Fox was talking about. A novel investigation of the frequency of adverse reactions to single, double, and triple regimens of AIDS drugs by Fellay et al. found ‘a high prevalence of toxic effects’ in a cohort of 1160 patients. More than two thirds of patients on these drugs suffered side effects severe enough to affect treatment adherence – in other words prevent them taking the drugs as prescribed. Forty-seven per cent reported clinical problems like vomiting, diarrhoea, nausea, fat growth, mood swings, insomnia and fatigue. Blood tests revealed ‘potentially serious’ abnormalities among twenty-seven per cent. The researchers classed a ‘significant proportion’ of these adverse events as ‘serious or severe’. Kidney dysfunction and severe fatigue that were ‘probably or definitely’ due to their HIV treatment led to some patients winding up in hospital. The Fellay paper was preceded by one by Descamps et al. in the Journal of the American Medical Association on 12 January 2000, noting that ‘During the maintenance phase early and late virologic failures appeared to be related more to problems of adherence and antiretroviral treatment potency, respectively, than to selection of resistant mutant viruses.’ The mutation excuse heads for the bin, and doctors accept that their patients just can’t stomach the pills. At the same time suggesting they’re not strong enough. Because they’re doctors.

The November/December 2001 issue of TreatmentUpdate reviewed a study by Moreno et al. (described as Abstract 93) investigating the Toxicity profile of antiretroviral drugs in naive patients starting highly active antiretroviral therapy in routine clinical practice. Noting the remarkable fact that ‘in the real world reports of side effects are usually greater than those that are received during clinical trials’, Spanish researchers

reviewed data on 499 subjects with HIV/AIDS who started taking HAART between the years 1996 and 2000. Their aim was to find out about drug-related side effects. These doctors collected data from PHAs [people having AIDS] attending an HIV/AIDS clinic. … Overall, about 34% of subjects (172 subjects) developed drug-related side effects. In most of these cases (145 of 172 subjects, or 84%), subjects had to stop using the drug that caused the side effect.

But the March 2002 issue of TreatmentUpdate bore even wilder news. A study by Reisler et al. of the US NIH, Incidence of grade IV events, AIDS and mortality in a large multicenter cohort receiving HAART (Abstract 36), looked at data collected from 3227 HIV positive subjects who had been on several clinical trials between 1996 and 2001. They compared the incidence of what they called ‘AIDS-related events’ (typical infections) and serious or life-threatening drug side effects, which doctors call ‘grade IV events’, and found three hundred and sixteen ‘AIDS-related events’ (fourteen per cent of subjects) but double that number of grade IV events: six hundred and sixty three (twenty eight per cent). By about thirty months, ten per cent of subjects had died. The reviewer of the paper remarked insightfully: ‘This attests to the severity of such complications.’ What were described as ‘psychiatric’ problems – drug neurotoxicity – joined bone marrow damage, liver disease, pancreatitis, kidney and cardiovascular problems as the most life-threatening drug side effects noted. In short on AIDS drugs you have twice the chance of succumbing to their toxicities as you do to ‘AIDS’. But if we remember what Collazos et al. told us in AIDS in June 2002, discussed above: the strangest things often seems to happen when you go on the drugs. Like developing B cell lymphomas, and experiencing ‘paradoxical flares of diverse opportunistic conditions shortly after the onset of HAART’ – so six cited studies reported.

Consistent with these findings, O’Brien et al. had just reported Patterns and correlates of discontinuation of the initial HAART regimen in an urban outpatient cohort in the Journal of Acquired Immune Deficiency Syndromes on 1 December 2003: ‘After a median follow-up of 8.1 months, 61% of patients changed or discontinued their initial HAART regimen. … The events most commonly cited as the cause for discontinuation were nausea, vomiting, and diarrhea. … Gastrointestinal adverse events of HAART are the most frequently cited reason for discontinuation of HAART.’

Back home, an article in City Press on 30 March 2003 reported that prominent playwright Gibson Kente, who announced the year before that he was HIV-positive, has ‘stopped using AIDS drugs and is now sticking to herbs. … He says he won’t take antiretroviral drugs as they have too many side-effects on him. Although he has been to the Chris Hani-Baragwanath Hospital for check-ups, he says he isn’t using any of the medications supplied by the hospital. “I am my own doctor. I’m going to stick to herbal medicines. I don’t want medical drugs any more.”’

As Mbeki was being disparaged and reviled for questioning the viral/chemotherapy AIDS paradigm, Achmat and his TAC were winning rich prizes one after another for promoting it. In 1999 the organisation was honoured for its fighting spirit by the South African National NGO Coalition. Its judicial patron cosied up in the happy moment: the TAC, Cameron said, had ‘given a life-enhancing focus to the PWA movement’ – before bestowing financial favour on the TAC himself: entitled under the rules of the Nelson Mandela Award for Health and Human Rights, which he won in December 2000, to designate a worthy organisation to receive an amount equivalent to his prize – $10 000 – Cameron picked the TAC. The pop music channel MTV Europe gave the lobby its annual Free your Mind Award on 8 November 2001. In December 2003 the TAC got the prize money again, this time directly chosen to receive the Nelson Mandela Award for Health and Human Rights.

As noted earlier, Achmat himself won a ‘Spirit of Hope Award’ from the SA NGO Coalition in September 2000. It was followed by a personal honour from Time magazine on 22 April 2001. He hadn’t hired a professional publicist to lobby behind the scenes, as Aaron Diamond AIDS Research Centre Director David Ho had to secure him Time’s Man of the Year award in 1996. So they gave him a Noddy badge instead, making him ‘Person of the Week’ for his role in organising the international pressure that caused the pharmaceutical corporations to cave in their case against the government. This was followed by a cash purse of $25 000 when winning the first ‘Desmond Tutu Footprints of Legends Leadership Award’ in 2001, for his ‘selfless services to humanity’. Achmat explained why he thought he deserved it: ‘The central value underpinning my leadership efforts is justice: to see that the right thing is done.’

Another AIDS prize-winner in 2001 was Deputy President Zuma, who won an honorary PhD on 26 May 2001 from Mhlongo’s university, MEDUNSA, for his ‘contribution to the liberation struggle as well as his outstanding effort in the fight against HIV/AIDS’. So praised Professor Ramaranka Mogotlane, Vice-Chancellor and Principal. As Zuma commenced his acceptance speech and began plugging the usual AIDS clichés, Mhlongo made punishingly plain what he thought. Unable to stomach it as he sat on stage among his academic colleagues in front of all the new graduates and well-wishers in the hall, he gathered his hat and robes and walked out.

Achmat got an honorary degree the following year too. With some reservations in the academic ranks it seems. On 21 June 2002 the University of Cape Town awarded him not the usual doctorate handed out at such self-serving dos, but a half-assed honorary masters degree in social science. But on 5 April 2003 he got that PhD – an honorary doctorate from the Law Faculty of the University of Natal. Time nominated him a ‘World Hero’ three weeks later: ‘I am proud because many of the people on the list are opposed to poverty, inequality and war. Also, Africa is often very underestimated in its contribution because of the bad reputation our continent has for poor governance, corruption, etcetera. I believe there is much more talent than anyone gives Africa credit for.’ Kind of off-topic, one might say. But sweet. The next month Doctors of the World, the Association Francois-Xavier Bagnoud and the Global Health Council awarded Achmat their jointly administered Jonathan Mann Award for Global Health and Human Rights for bravely not taking AZT. Nils Daulaire, president of the organisation, explained: ‘When Mahatma Gandhi went on his hunger strikes, a lot of people thought he was killing himself for no good reason. But he [Achmat] has made a moral judgment that by taking this position he can have greater impact. That is what I call moral courage.’ The New York Times agreed on 10 May, running a tribute to the great martyr under the tear-jerking title: In Grip of AIDS, South African Cries for Equity. Achmat was formally awarded the prize at a presentation on the 29th – worth R160 000, half of which he announced he’d be keeping, and the rest ploughing into his TAC. Which got even more cash on 6 October 2003 on winning the Nelson Mandela Award for Health and Human Rights.

On 20 November 2001 Health-e reported that Achmat had thrown a press conference in Cape Town at which he urged delegates at the two-day National Health Summit, which had commenced the day before, to ‘address the issue of access to anti-retroviral medicines for people with HIV/AIDS’ on the basis that the ‘benefits of anti-retroviral therapy far outweighed the risks’. Achmat identified getting AZT and such drugs into the bellies of the poor as our country’s number one health policy priority: ‘We feel the [National Health Summit] will fail, completely fail, if it does not address the most critical issue facing health in South Africa, the use of anti-retroviral drugs in the public sector itself.’ How about the use of food? The report said that the ‘TAC trumpeted the findings of a conference it had hosted in late October, which had brought together leading scientists working in the field of HIV/AIDS along with a range of participants including churches, trade unions and business organisations’ which had ‘acknowledged that HIV/AIDS was a major health problem in South Africa and that providing anti-retroviral drugs was a necessary way of dealing with the problem that must be facilitated by the government and the private sector’. According to the report, ‘Achmat said the conference had agreed that the benefits of taking the drugs outweighed the risks of side effects and toxicities. … “Extending access to these life-saving medications has become a moral, political, social and economic imperative.” He said more programmes to educate people about the drugs were needed so that “treatment literacy” among all South Africans could be improved.’ More programmes to give guys like him plush jobs flying around and selling AIDS drugs on behalf of the drug industry. And presumably by education for ‘treatment literacy’, he didn’t have in mind bringing to the attention of his arrogated ward any of the papers reviewed in Debating AZT.

A treatment literate bunch some Members of Parliament have become. On 14 November 2001, in MPs want antiretrovirals in public health system, SAPA reported that that the Joint Monitoring Committee on the Improvement of the Quality of Life and the Status of Women held public hearings in October and November on what to do about the impact of HIV and AIDS on women and girls. One can put money down that the TAC was there to make a pitch for AZT and/or nevirapine, because the committee’s report concluded that for ‘mother-to-child-transmission ... the benefits outweigh the risk and it is affordable’. The report advocated drugs for rape victims too. Would it be a reliable guess that the Honourable Members weren’t told about any of the foetal toxicity reports that had rained in at the turn of the decade?

On 10 February 2002 Achmat was interviewed in Rapport. A most revealing read it was. But it comes out in full colour offset against the foil of matters still to be discussed. So we’ll come back to the interview later.

The bathos of Achmat’s hypocrisy – fat and healthy, and making a fine living as an AIDS activist while studiously avoiding the deadly cell-poisoning chemicals he campaigns for – was paralleled in the story of another prominent AIDS activist and journalist, Lucky Mazibuko. Towards the end of August 2002 Mazibuko was interviewed by BBC HARDtalk host, Tim Sebastian. He’d ‘lived with HIV’ for ten years, he said; a girlfriend gave it to him – deliberately! But of course. She’s black – and your chances of picking up HIV from loving a black woman are just short of fifty-fifty. Particularly in KwaZulu-Natal. Since the HIV-infection rate reaches nearly 40 per cent in some parts, say ‘AIDS experts’ like Jerry Coovadia and his colleagues at the University of Natal’s Nelson Mandela Medical School. Except they were being perfectly serious when saying so in Lancet in September 2002, in a report of their study, led by Rollins: Prevalence, incidence, and mother-to-child transmission of HIV-1 in rural South Africa. Claiming also that rural black women are truckers’ whores. OK, not out loud, but unmistakeably implied: the infection rate ranged between 34 and 40 per cent in women aged between 21 and 25, they said – the lower prevalence among women living further from a major north-south highway. Lancet published this tripe without pause. Are you also beginning to despise the medical mind? Minds like Coovadia’s. Who never does his little blood tests on the abundant Natal Indian poor. Sharing his ancestry. Or on anyone else. Since it’s the blacks who shag around. For money. And who are all dirty and diseased.

Not only are these blacks promiscuous and dirty and spread horrible diseases, but when they pertinaciously deny it, it’s proof that they’re mentally disturbed into the bargain. Insolent it makes them too: they even demand better wages. RW Johnson wrote in the London Times on 29 August 2000: ‘Twice I’ve had to deal with employees who suddenly became petulant and incomprehensibly demanding. Both died of Aids soon after and I realised we’d been dealing with the special dementia that often afflicts Aids victims: there is no knowing the hidden psychological torments such unfortunates suffer.’

A correspondent of mine, who watched the Mazibuko interview, told me he appeared a picture of good health. After banging Mbeki about on AIDS policy for much of the first twenty minutes, Sebastian incidentally enquired: ‘You don’t take the anti-retroviral drugs yourself, do you?’ Mazibuko replied, ‘No, I don’t take them. This is to highlight the fact that others cannot easily get hold of them.’ Just like Achmat. But then he hastened to say that his health was ‘taking a battering’. Borne out by the fact, he said, that ‘I usually go to the doctor maybe once a year’. Evidently appreciating just how ridiculous that sounded, he added, ‘In the last year I’ve been eight to ten times.’ He didn’t say why, but he did let out that he wasn’t sure if it was on account of his ten-year-old HIV or ‘stress’. Following this pathetic Achmat-style performance, Sebastian didn’t close in for the kill. Not much HARDtalk from Tim Sebastian when interviewing AIDS wimps.

Achmat would abandon his moral stand and start taking his drugs in the second half of 2003, with disastrous consequences. How it all ended up in in tears is for later.

CHAPTER

Mbeki was challenged to what he rejected as an ‘irrelevant … publicity stunt’ on on 24 April 2001. The first question Debra Patta asked him was whether he’d ‘take an HIV-AIDS test?’ He declined for the reason just mentioned, even if ‘It might be dramatic, and make newspaper headlines’, and because it would be merely ‘setting an example within a particular paradigm’. What he meant was that it would be like submitting to an examination for the Devil’s hidden marks during the European and American witchery epoch. One recalls that rows of encyclopaedic tomes on that subject lined library shelves, penned by eminent demonologists, some being professional inquisitors, who imparted their knowledge of devilry at the University of Cambridge and such places, and whose learning was cited deferentially by judges condemning folks to hang and burn. In the same sport as those Spanish priests who had been allowed to develop the runaway power to anathematise, isolate, and immolate. Rather like medical practitioners today. Not with fire anymore, but with chemicals, causing massive oxidative damage to cells just the same, on the inside rather than out. And all with the same noble sense of higher purpose. Killing to cure. And killing to maintain their power, and public belief in it. The racket works like this. The doctor tell a person he has cancer and that he’ll certainly die of it without medical intervention. A harsh one, to be true, he says. The gulled and frightened patient accepts the proferred cure. It kills him, along with the high percentage of others who do likewise. Death all around from ‘cancer’ reinforces the demand for medical goods and services.

Mbeki illustrated his point about the shifting sands of HIV-AIDS science in the interview by referring to the new guidelines issued by the ‘US government ... about the use of antiretrovirals radically different from what had been the practice before, and they themselves – the US government and all the scientists who did this – say we are issuing these new guidelines based on our experience and because there are many unanswered questions. So they change the guidelines? Which is fine. But what they are raising fundamentally is that science does not have enough answers to deal with this question.’ He explained that this was why he’d convened his AIDS Panel: to bring scientists with different views together in a bid to resolve their differences. To advance knowledge. By way of open debate. The way scientists were supposed to do it. But not in the AIDS age – until Mbeki’s extraordinary initiative. He then reverted to the drug problem, and in forthright terms: ‘I would think it would be a criminal dereliction of duty if our government didn’t say: “How do we cope with issues of the toxicity of these drugs raised very sharply by these US government guidelines on the fifth of February?” They say the levels of toxicity of these drugs are such that we’ve got to introduce these drugs later in the incidence of the disease because you have these toxicities, and they even say that there are even other unknown toxicities … So, do I go down the street dispensing these pills knowing from the best science there is that there are these consequences about which science itself says we don’t know enough. No. So I think no stunts.’ Patta interrupted: ‘So antiretroviral….’ Mbeki pressed home: ‘Please, no stunts. Let’s stop politicising this question. Lets deal with the science of it. The panel said one of the things we have got to do is to determine when you do an HIV test what is the test testing. And those were the scientists: ‘What is it measuring?” So I go and do a test; I’m confirming a particular paradigm. It doesn’t help in addressing this health need. Our focus must be how do we improve the health of our people, and that is what we are focused on.’ Patta: ‘Well, what is the next step then?’ Mbeki: ‘I am very keen that this panel should do these scientific experiments itself, that on its own it decided it must do, to empower us to respond better to this crisis.’

One of those experiments, mooted and adopted as I sat and watched in awe in the hottest committee side-room of the whole event, involves trying to isolate HIV from the blood of HIV-positive people. We’ll talk about this later. It was the sweetest fruit of the entire meeting. Making it all worthwhile. The rest was a pointless cacophony. (Opposed to the experiment, Duesberg upped and left. Why, we’ll see shortly.) Mbeki referred to this crucial experiment in Parliament during question time on 26 March 2001: ‘I have said that the AIDS panel is doing its work and in the past few days scientists from both sides of the divide have met, further to work on the experiment that they decided should be carried out. They will continue with that work, and that work will also inform what the government does. We are not engaging in this matter as a academic exercise but in order that as government we respond in a targeted and effective way to these matters that cause ill health among our people, that cause death among our people. So yes indeed, honourable member, whatever comes out of those particular processes will inform government policy.’

On 2 December 2001, the Sunday Independent reproved Mbeki for declining the same proposal to be tested for ‘HIV antibodies’, made again at a briefing of foreign correspondents earlier in the week, commenting that his dismissal of what he called a ‘meaningless game’ ‘missed the point’. ‘An act of leadership’ it would be ‘to create an environment in which people feel more comfortable to come forward for testing’. And then veering off the point itself, the paper continued: ‘What message does the government send to the 4.7 million HIV-positive South Africans when it refuses to roll out anti-retrovirals, scientifically proven to be safe and effective?’ Just as the company says. Backed by a top judge. The former President. And all the clergy:

Archbishop Desmond Tutu has made common cause with his successor, current Anglican Church head Archbishop Njongonkulu Ndungane, in pleading for the provision of AZT and similar drugs by the government. On 7 October 2001, on the SABC television programme Newsmaker, the bishop, a kind friend to my late father Robin Brink during their time serving on the Truth and Reconciliation Commission together, criticised the government for ‘dithering’ while people died of AIDS – ‘the new apartheid, the new enemy’. He said he was glad that religious and union leaders had agreed: ‘... let’s stop fiddling while our robe [Rome?] is burning. … People are dying, people whose lives could be extended by getting the right drugs. Discussing whether this or that is the cause is a luxury we cannot afford. … Let’s stop playing marbles and roll up our sleeves and invoke the spirit that fought apartheid. We did it with apartheid, we can repeat it with AIDS.’

Invoking the horrors of apartheid to whip along the AIDS drug campaign is a trick that the National Youth Commission also used on its national public holiday in 2000, appropriating that heartbreaking snap of Hector Peterson being carried away lifeless, the first victim of the 1976 Soweto revolt, for a poster announcing its AIDS message in a dripping-blood designer font from a late show slasher movie.

Full of AIDS ire, Tutu was in a foul mood when he arrived at the University of Pretoria on 6 September 2002 for the award of an honorary theology doctorate. The Daily Dispatch reported the next day that in his acceptance speech he made ‘a scathing attack on government … [calling] on people to ask questions about the government’s controversial Aids policy … Tutu said toeing the government line was a threat to democracy.’ We should safeguard democracy by toeing the TAC line instead. AZT, nevirapine and everything. For women especially. Mostly black. Raped and/or pregnant.

CHAPTER

On 7 October 2001, in Glaxo gives up rights to AIDS drugs in South Africa, Reuters reported that the company had granted a voluntary patent licence and had waived rights to royalties on sales of AZT, 3TC and Combivir (the drugs combined) to South African generic drug maker, Aspen Pharmacare. In terms of the deal the locally made drugs are to be ‘distributed to the government, NGOs and charities, with GSK continuing to supply other markets.’ This keeps GlaxoSmithKline’s receipts securely pocketed from AZT sales in the private market, a market it has completely sewn up: Ask absolutely any media-exposed woman anywhere in South Africa what drug she’d take if raped, any white person here what precautionary medicine he’d swallow after coming into contact with the blood of a black. This is no ugly exaggeration. Jittery about reports from ‘AIDS experts’ headlined on the front page of the Natal Witness on 14 April 1999 as KZN HIV rate now one-third, it emerged that the Natal Blood Transfusion Service was ditching blood given by black donors into the street. Like sewerage in old London. Being dirty and diseased. Being black. To blacks responding to appeals to donate blood, thanks, but no thanks. After a ponderous liberal deliberation, an editorial on 13 September, with the title, Red lining, supported what it regretted appeared to be a ‘crude form of racial selection’ as a ‘difficult, pragmatic decision’, hastening to emphasize that the decision had nothing to with the ‘racial myths peddled by fanatics of the Nazi or Verwoerdian kinds’. But pedalling them just the same. Subscribed to by guys like French fascist Jean-Marie le Penn, leader of the National Front, who the Sunday Times reported on 28 April 2002 asking: ‘What do I have to do to prove I’m not a racist? Marry a black woman? With AIDS if possible?’

The same racist paranoia reigns at blood banks in the US: The sister of a white South African friend of mine, who lives in Massachusetts with her American husband, wanted to donate blood after the September 11 attack. Her offer was declined for the reason that she originated from Africa. One of the screening questions put to her husband was whether he’d had sexual relations with anyone from Africa in the past year. Which blew him out too.

The private market for antivirals may not be big, as Business Day pointed out on 8 October 2001, but it’s certainly ‘lucrative’ – including as it does, ‘medical aid schemes and larger buyers, like mining or manufacturing companies like Ford or DaimlerChrysler’. The newspaper reported the following day though that because of their cost only senior staff on medical insurance score. And even then the drugs are restricted to pregnant women and children; HIV-positive brass don’t get it for long-term treatment. But in August 2002, Anglo American, De Beers, Transnet and BP announced that they would be supplying the drugs to all comers on the payroll. Everyone was pleased. Old Mutual followed in September. With Deputy Managing Director Peter Moyo, duly advised by consultant ‘AIDS experts’, enthusing that ‘infected people can live for up to twenty years with the right management strategy and treatment’. Anglo changed its mind in October; the Financial Times quoted medical director Brian Brink explaining that ‘the company’s 14 000 senior staff would receive anti-retroviral treatment as part of their medical insurance, but that the provision of drug treatment for [its 146 000] lower income employees was too expensive’.

A further cleverly creative term of the deal is that Aspen has to pay 30 per cent of its take on sales to ‘non-governmental organisations fighting HIV-AIDS in South Africa’ – meaning lobbying for the purchase of AIDS drugs.

One really must stand up and clap hands for the marketing strategists who cooked up this smart scheme. GlaxoSmithKline come off smelling of roses – selfless Samaritans rather than rapacious merchants who have lost the bidding, having offered, to no avail, ‘the cheapest prices [for AZT and 3TC] anywhere in the world’ – so claimed GlaxoSmithKline’s South African boss, John Kearney. Having also dropped its demand that in return for a price discount, the government had to bind itself to guaranteeing the company a monopoly in the supply of AZT for three years after its patent expired – according to an online post on AF-AIDS on 3 March 1999: ‘That was not in the papers but it makes [then Health Minister Dlamini-] Zuma’s action [in rejecting the drug] more understandable.’

Getting more desperate by the minute, like a hooker with tired feet, Reuters reported on 30 November 2001 that GlaxoSmithKline had cut its price on 3TC and Combivir by a further twenty per cent ‘to mark World AIDS Day’. ‘We sincerely believe that our HIV-AIDS medicines will be more accessible to a greater number of people,’ Kearney said plaintively. We sincerely hope to boost sales by persuading those medical schemes not to be so tight-fisted: ‘GSK’s offer is ... limited to the country’s private sector and is aimed at those who could benefit from lower prices under existing medical schemes.’

The Aspen deal was cut just as the upper ranks in the medical clergy were slowly coming to their senses about what they have been doing to people with AIDS drugs, and they lose their lustre. Not to mention the collapse of GlaxoSmithKline’s case against the government to block generic imports, leaving Indian generic manufacturers Cipla, Zydus Cadila, Aurobindo Pharma, Ranbaxy, Hetero Drugs and Kopran circling hungrily above the new opportunities opened up.

At the point that Aspen won the deal, Cipla had been closest to the prize, having been the first to penetrate the African market. It had recently clinched a deal for the supply of AIDS drugs to Nigeria, and was manoeuvring to repeat its success in Zimbabwe, Cameroon, Ivory Coast and Algeria. It had even hooked the interest of South African multinational Anglo American. Much better to pay $350 to $500 for a year’s supply of an AIDS drug cocktail per patient on its medical aid scheme than the $10 000 to $15 000 coined by the proprietary drug manufacturers for exactly the same stuff. Cipla had taken everyone’s breath away earlier in the year by making good on its promise to supply a triple cocktail of AIDS drugs to Médecines sans Frontières for $350 per patient per year, the first lot of which had already been delivered to Cambodia. And in the first week of March 2001 it had applied to the South African Registrar of Patents for a compulsory licence to import AZT and other AIDS drugs on the basis that GlaxoSmithKline was abusing its copyright.

Pharmaceutical industry writer Ben Hirschler, who penned the Aspen story for Reuters, deduced that it was ‘an attempt to defuse a continuing row over access to treatment’. More to the point, to deflect the heat. Laying that tatty old guilt-trip on the government again, he wrote under the subheading, Government Holds Key: ‘But the success of the scheme will hinge on the response of the government – in particular, whether or not the health ministry decides to offer up a state tender for Aspen’s generic product.’ Noting reproachfully that ‘South Africa’s government – faced with the largest number of HIV-AIDS cases of any country in the world – has pursued a controversial policy on the disease’, he then made his ignorant opinions plain by writing, ‘President Thabo Mbeki touched off a storm of protest by questioning ... the efficacy of antiretrovirals such as AZT. His ministers have resisted the use of antiretroviral drugs in the state health sector on cost and safety grounds, despite the country having close to five million people living with the deadly virus.’

‘Close to five million living with the deadly virus’? We recall the Mail&Guardian’s unforgettable Just Say Yes, Mr President front-page headline plea on 15 September 2000 (that HIV causes AIDS, not let Jesus into your life). Renounce your heresy and accept the true faith. A headline as foolish as the exhortation, Aids Exists: Let’s Fight It Together, in the same paper on 11 February that year. Like we’re a jamboree of boy scouts. And that the obvious needs affirming. Just in case it’s not obvious. The sub-headline of Just Say Yes went: South Africa is gripped by a catastrophe that is killing millions of our people. Already in their boxes. But according to Hirschler, alive and kicking. By ‘our people’ the M&G meant the servants. In South Africa, when liberal whites say ‘our communities’ and ‘our people’, they always mean blacks. At risk of catching AIDS. From sex. Because black men are congenital philanderers. On 12 August 1999 the KwaZulu-Natal provincial health department ran a full-page ad in Echo, the Natal Witness supplement for blacks: ‘A Woman Has The Right To Say No To Aids – No to sex … No to unsafe practices. Women have the right to insist on the use of a condom.’ Apart from a token Natal Indian thrown in, the four other women with imploring eyes in the accompanying picture were all black. Apparently white women don’t have these problems.

Defeated in its plan to hawk AZT to the South African government and keep the dough to itself, GlaxoSmithKline delegated the battle to local mercenaries to open up a new front. Fresh in the trenches, Aspen immediately fired off a fresh salvo of marketing hooks to government. Chief executive officer Stephen Saad was reported saying, ‘Our price for Combivir will be about $1 to $1.50 per patient per day, compared to about $2 [for the original by GlaxoSmithKline]. This gives hope to South Africans. By far the majority needing the drugs, those not covered by medical aid and government, are in the public sector.’ He said he hoped to meet with officials from the Department of Health ‘to look at total health care savings. The government is already paying to treat secondary infections and for hospitalisation of people with HIV-AIDS, which is very expensive.’ As to cost, Hirschler pointed out that Aspen’s prices would still be about twice those that Indian generic manufacturer Cipla has long touted. But the government wasn’t impressed much by Saad’s pitch. On 30 November 2001 Reuters reported that ‘the move has so far failed to take off with no sign of a deal between generic producer Aspen and the health department’.

With the sound of jingling coins in the air, Heywood, speaking on the TAC’s behalf, said it welcomed the Aspen deal. In April 2000 Lancet had addressed a warning to scientists and politicians, but the hat fits these do-good lobbyists too: ‘All policymakers must be vigilant to the possibility of research data being manipulated by corporate bodies and of scientific colleagues being seduced by the material charms of industry. Trust is no defence against an aggressively deceptive corporate sector.’ Having consistently demonstrated the political sophistication of children, the odds look mighty low that South Africa’s AIDS treatment activists are about to exhibit much of the vigilance that Lancet was urging. It’s been like watching a performance of marionettes here, because, as Michael Ellner has pointed out in reference to the hullabaloo in March and April 2000 over the drug companies’ efforts to interdict the government from importing generics, ‘These staged battles over the prices of AIDS drugs are the best advertisement for these failed drugs possible.’ He’s right, because the most potent strategic propaganda always entails the fomenting of impassioned public controversy around a minor issue such that the major issue is neglected, with the result that the desired perception is taken for granted and consolidated.

CHAPTER

On 12 October 2001 Mbeki delivered the inaugural ZK Mathews Memorial Lecture at the University of Fort Hare, entitled He Wakened To His Responsibilities, an imperative Mbeki himself knew all about – demonstrated by his unpopular order, two years earlier, that the safety of AZT be investigated. In the course of his address, he made Frantz Fanon’s point (discussed below) about some medical models being essentially racist. Ashen-faced with shock, Drew Forrest reported in the Mail&Guardian on 26 October 2001, Mbeki in bizarre Aids outburst. What the white boy found ‘bizarre’ was Mbeki’s pained allusion to the basic racism of the African AIDS construct – an insight first flashed in his address at the Third African Renaissance Festival in Durban earlier in the year on 31 March, during which he mentioned the Eurocentric ‘image of our Continent’ that ‘history has created’, ‘one that is naturally prone to ... an AIDS pandemic caused, it is said, by rampant sexual promiscuity and endemic amorality’.

But now in his Fort Hare lecture he got stuck in. As Fanon had done, Mbeki referred in to medical schools where black people were ‘reminded of their role as germ carriers’, and said, ‘Thus does it happen that others who consider themselves to be our leaders take to the streets carrying their placards, to demand 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.’ Tony Leon’s sort of ideas – as revealed in a seamy swipe during his exchange with Mbeki over AZT in July the previous year: ‘I am not interested in whether my [mostly white] supporters or yours [overwhelmingly black] suffer more from STDs [sexually transmitted diseases].’

Rachel Swarns noted the talk in an article in the New York Times on 25 November 2001: ‘In October [at the Z K Mathews Memorial Lecture at the University of Fort Hare], Mr Mbeki suggested that whites, and unwitting black allies, were deliberately overplaying the AIDS epidemic to undermine a black continent on the rise and to perpetuate stereotypes of Africans as “promiscuous carriers of germs”.’

An old stereotype: in his Letter from the President in ANC Today on 13 February 2004, entitled District Six reminds us never to turn back, Mbeki recalled the mass eviction of black Africans from Cape Town in February 1901 during the bubonic plague scare: ‘This provided an excuse for the white authorities of the day forcibly to relocate the Africans living in central Cape Town to a state farm called Uitvlugt. This new settlement was called Ndabeni and was located near Maitland. The false and insulting reason given for this forced removal was that because they were generally diseased, the Africans in central Cape Town, many of whom worked at the docks, contributed to the propagation of the disease. … such was the strength of the racist stereotype of the Africans that the white authorities of the day, with the full support of the white community, punished the Africans for the outbreak of a disease that had nothing to do with them, by banishing them to Ndabeni. Within a month, 5,000 Africans had been moved to the new location. … Interestingly, and as part of the history of the formation of our urban areas, the next major health scare to hit Cape Town occurred in 1918. This time there was an outbreak of a flu epidemic. Again white Cape Town identified Africans as a health risk. Ndabeni was now viewed as being too close to “white” Cape Town. People were therefore moved to Langa, separated from the rest of the city by railway lines and a highway.’

Heywood was quick to get the broad if not the finer point of Mbeki’s Fort Hare talk: He ‘appears to describe those who believe AIDS is a virologically caused, mostly sexually transmitted disease that can be medically contained, as stigmatising and demeaning black people’. His address was ‘evidence [that] tragically but inexorably suggests that the President is an unreconstructed AIDS dissident’. Inexorably? Like the Italian guy who asked me after losing his car-crash case and I ordered him to pay the costs: ‘But what if they are exuberant?’ And ‘unreconstructed’? As in Nazi? A couple of months later, just such an indictment was served by the Mail&Guardian. On 7 December an article, Has Mbeki heard of Nuremberg? written by a couple of kids at Wits University’s law school, pleaded the TAC’s averments repeatedly, and foamed about the genocidal violated human rights of it all. OK, not quite as bad as the Nazi Holocaust, but same department, it argued lugubriously, and ever so earnestly: ‘... the South African government’s policy may well result in the deaths of millions of South Africans from Aids, and it thus seems plausible to call this policy a crime against humanity.’ An F for the childish essay, especially for breaching the rule against hearsay and confusing daydreams for facts, but an A for their grass, for sure.

Commenting further on Mbeki’s Fort Hare address Heywood said: ‘The dissident view rests on three pillars: that HIV is a harmless organism that causes no illness; that AIDS, if it exists at all, is caused by factors unrelated to HIV; and that drugs supposed to treat AIDS do more harm than good. Despite evasion and obfuscation, all these positions emerge from the President’s statements over the past two years. … Mbeki’s stand on AIDS is a tragedy of momentous proportions. The onus is on him to dispel the view that he is a dissident, which is widely held in South Africa and internationally.’ Mbeki met the criticism in Parliament a few days later. He’d asked Tshabalala-Msimang to evaluate the latest statistics on causes of death in South Africa, he said, and no reallocation of health budget funds would be made until she’d done so. ‘We want to have a proper profile of the incidence of the disease. The government is not an NGO ... focused on one particular disease. We are not a TB NGO or an AIDS NGO or a pneumonia NGO. We are concerned about the health of our people. I am concerned about the incidence of disease and the incidence of mortality comprehensively. We need to have a look at that so that we can see whether our programmes are correct. Health programmes do not consist only of drugs and medicine. They include improving the general health conditions of our people, and this includes nutrition, clean water. ... It includes the question of the violence in this society. We have to look at all of those questions ... to make sure our spending not only in health but generally throughout government responds to that particular health profile.’

Later in the same month Heywood, with his honours degree in English from Balliol College, Oxford, responded to Mbeki’s dismissal of the Medical Research Council’s fantastic AIDS numbers (to justify gilded funding demands) and his preference for those of Statistics South Africa, the professionals in number crunching: Mbeki was using Statistics SA as a ‘bulldog to savage’ the MRC findings, he said. ‘Damaging discussion has been set up and fuelled by a government which instead of giving inclusive political leadership is acting in a way that is alienating and damaging.’ Are these really the kinds of minds they turn out at Oxford? Apparently – some of the biggest jerks in this tale hale from there: Heywood, Makgoba, and RW Johnson. Howard Barrell – an expert in the history of the ANC, he considers himself – has a DPhil from the place too. No great shakes though, after you’ve read Rosa Ehrenreich’s revelatory embarrassment, A Garden of Paper Flowers: An American at Oxford.

The MRC’s next numbers racket was played on 3 September 2002. Its Debbie Bradshaw told the parliamentary Arts, Culture, Science and Technology Committee that ‘the number of people infected with HIV was projected to increase from the current six million to around seven million to eight million by 2006’. Six million? Just three months earlier, on 11 June 2002, the Department of Health announced 4.7 million infected in South Africa on the basis of figures supplied by the University of Cape Town’s Actuarial Science Centre. Where they keep computers to do the sums with special computer programmes, in order to come up with the numbers. Because there are no real data to be found anywhere. They don’t exist. It’s all thumb-suck presented as scientific fact. But anyway, building its house on this swamp, the MCC carried on: by 2010 five million South Africans would be dead from AIDS. Weren’t the apocalyptics in American medicine faffing just this way in the 80s? Ridiculously. Led by their Surgeon General, Everett Koop. Like Jehovah’s Witnesses predicting the end of the world, date and all, in their magazines.

Heywood won’t care for the University of California at Berkeley’s mission statement: ‘Under present scientific protocol, theories can only be recognized as true after withstanding extensive scientific review: publication in scientific journals, followed by experimental verification of the proposed theory. The process of scientific review, however, can only be effective as long as the competing theories are each given due consideration. Without diversity of thought provided by different viewpoints, science becomes locked into potentially inaccurate paradigms. ... In light of the recent controversy over racial diversity here at University of California at Berkeley, we, as students and scientists, carry the responsibility of maintaining diversity in science. Without minority views, majority views cannot be validated. The truth, in some cases, may even side with the few.’ But just hint to paid professional activists like Achmat and Heywood that they might be off-centre, and draw their attention to unsettling facts, and instead of pausing to consider them (and risk their jobs), they run off shrieking, covering their ears like charismatics fleeing from a church in which someone accidentally mentioned Beelzebub during the holy babbling.

Heywood was a guest at a meeting of the South African Association of Professionals in Health Care on 7 February 2002, at which Mhlongo presented a PowerPoint slide-show, A Critical Analysis Of The Evidence Considered Proof That Nevirapine Prevents Mother-To-Child Transmission Of HIV, in which the Perth Group detailed the radical flaws of the Ugandan nevirapine study founding the TAC’s case in the High Court for the mandatory supply of the drug by the state to pregnant women. The Oxford alumnus’s thoughtful response to Mhlongo when it was over? ‘The time for science is gone; people are dying.’ And during a debate with Mhlongo concerning AIDS and nutrition on on 24 January a year later, Heywood told him that the TAC would be applying for the revocation of his medical licence because he was a ‘danger to health’. And, as we’re still to read, he meant it.

Published alongside his ‘Mbeki’s bizarre outburst’ article, was another offering by Forrest, slating Mbeki’s speech at Fort Hare as ‘pompous’ and ‘tortured’. Behind the Smokescreen: The record reveals President Thabo Mbeki’s true stance on Aids went on to indict him for heresy, a la Galileo, assembling a long charge sheet, a ‘catalogue’ of recalled utterances upon which to convict him. Pronouncing him ‘obsessional’, Forrest cited as evidence Mbeki’s ‘focus on the toxicity of Aids drugs, absent, for example, in regard to equally toxic cancer medication’. (Hey, one thing at a time. If you don’t mind, sailor. But we appreciate the ‘equally toxic’ bit.) Unable to credit that there may be some substance to Mbeki’s concerns, Forrest stated: ‘In no other country would the Cabinet intervene so persistently on the technical issues of drug toxicity and effectiveness’, attributing this to ‘Mbeki’s own all-consuming interest in the disease, which drives his repeated interventions’. Well, he does have a handle not just on toxicity but also on the radical triphosphorylation problem. The isolation problem too, we’re about to discover. Stuff the hack at the M&G hadn’t bothered to check out himself.

Apart from how Mbeki had condemned himself in his own words, Forrest levelled further complaints: Mbeki had not declared his faith, as required by the crusaders in this 20-year-old cult of sex and death: ‘... just as revealing is what he has not said. He has never unequivocally conceded that viral infection is a necessary condition for the disease. He has never clearly stated that drugs can improve the life expectancy and quality of life of infected people.’ No he hasn’t. Should anyone, with even a passing acquaintance with the literature? Forrest mocked: ‘It is repeatedly suggested that pharmaceutical companies are promoting the virological view to swell their profits.’ Silly Mbeki for thinking that the Glaxo Wellcome AIDS Helpline, and the multimillion rand AIDS Research Centre in Matubatuba, KwaZulu-Natal that it is building for the University of Natal’s medical school, among other projects (like BristolMyers Squibb’s $100 million for the war on AIDS) were all about promoting and entrenching the HIV-AIDS model. You know, to keep its drugs moving. And for mistaking GlaxoSmithKline for a trading corporation rather than an international philanthropic organisation.

Why, the proof of it – that GlaxoSmithKline is actually a public charity – came in on 21 May 2001, when its local public relations firm, Meropa Communications, told us so in a press statement, GlaxoSmithKline’s 3rd annual winter charity drive to benefit HIV orphans gets under way: ‘From GSK. Supporting doctors in South Africa will once again be able to assist GlaxoSmithKline (GSK) with its Winter Charity Drive, which runs until September 30. The Drive aims to raise over R306 000 from the sale of ZINNAT(r), the proceeds of which will be donated to six organisations caring for abused children and terminally ill patients. ZINNAT(r) is a broad-spectrum oral antibiotic successfully used to treat a variety of respiratory tract infections, including bronchitis, sinusitis, otitis media and tonsillopharyngitis. “This is the third year that GSK has embarked on this project,” says Dominique Bielovich, GSK Product Manager. “We have been tremendously impressed by the results of the Drive to date and are confident that this year will be even better than the previous two years. The trend has shown that support is growing: in 2000, we raised R306 000 for the six charities, R104 000 more than in 1999!” The six charities chosen by GSK this year are the: Jakaranda Kinderhuis in Pretoria, Hospice East Rand, St. Nicholas’ Children’s Hospice in the Free State, PE Childline and Family Centre, Durban Children’s Home and St. Luke’s Hospice in Cape Town. Marion Snape, representing the Hospice East Rand, says: “The plight of orphaned, abused and HIV-positive children is great in this country and finances are not readily available to us. We welcome every endeavour of the private sector to assist us and I am confident that all the charities that benefit from ZINNAT(r) Winter Charity Drive 2001, join me in thanking not only GSK, but all the doctors supporting the Drive.” Steve Lancaster of the PE Childline and Family Centre agrees: “When doctors prescribe this product, they will not only help the selected charities financially, but they will also help to enhance the quality of life of all the recipients.”’

Real sweethearts, these drug executives. Concerned about those little kids. For as long as you don’t fuck with their profits: On 1 December 2000 the Wall Street Journal reported that the company had fired off a threatening letter to generic manufacturer Cipla and a distributor for ‘violating company patents’, as a result of which Cipla had ‘stopped selling its low cost version ... of expensive HIV drugs ... in Ghana’.

In his Mail&Guardian piece Forrest added a further charge against Mbeki: ‘Orthodox scientific opinion, here and abroad, is questioned from a non-specialist position.’ This of course is intolerable. Such affairs must be left to the new clergy, undisturbed. Professionals like Makgoba, Karim, Folb, Rees, Eagles and the rest of them. On whose diligence we can rely. But Forrest finds nothing remiss in non-experts conspicuously paying homage to the popular priests propounding the fashionable new doctrines, and publicly reviling accused heretics. Provided the laymen cheering are PC and important. Thus he approvingly quoted Cameron’s reckless insinuation that Mbeki and anyone sharing his doubts and concerns about AIDS medicine are dishonest in engendering ‘the crisis of truth-telling’ in relation to AIDS issues in South Africa.

CHAPTER

By the end of 2001, infected by the enthusiasm at last, Mandela was in a tizz over the AIDS drug controversy and could no longer keep himself from getting involved. He began trying to reach Mbeki by telephone to tell him what he thought he should do about getting drugs to the people, but the latter’s office blocked his calls. On 17 November Mandela made a speech at an HIV/AIDS clinic in Khayelitsha in which he criticised Mbeki, obliquely but unmistakeably: ‘We have wasted time but the more vigorous and focussed we are in what we do, the greater the chance we have of moving forward.’ Mbeki was annoyed by Mandela’s backseat driving, and had his one of his aides call him to tell him to back off.

To the reported joy of the TAC, Mandela added his stentorian voice to its call for AIDS drugs on World AIDS Day on 1 December 2001 at several stops around Cape Town. His first call was at Beautiful Gate Children’s Home at Crossroads informal settlement, where he announced how he thought Mbeki should be conducting himself in office – his wife too:

One of the most important things ... is that the head of state and the first lady must be in the forefront of the campaign to fight this disease. Like President Yoweri Museveni of Uganda and President Abdoulaye Wade of Senegal, and the president of Botswana. These presidents themselves are leading the campaign about AIDS. Every day they make certain that every minister who delivers a speech must spend five minutes talking about AIDS. They pick up children with AIDS, together with their first ladies.

Like the late Lady Diana too, he said, warming hearts by cuddling a few HIV-positive babies himself as he spoke. Showing how much he cared. Moving next to a community hall in Nyanga packed with schoolchildren, Mandela repeatedly stressed the need for AIDS drugs in his answers to their questions: ‘For those who are HIV-positive, we must ensure that they get the proper treatment and drugs which are going to help them resist the pandemic. ... We must combine various strategies, firstly giving people the necessary drugs to try and prevent the disease taking the upper hand.’ His final stop was the Victoria and Albert Waterfront to open the Nelson Mandela Gateway to Robben Island, a museum and ferry port for the tourists, where he sermonized some more: ‘Nothing threatens us more today than HIV/AIDS ... AIDS is a scourge threatening to undo all the gains we made in our generations of struggle.’ So the government should work with drug companies to get drug prices down, he said, and parents should discuss sex with their children, because their failure to talk sex and clear up the myths about AIDS were big problems. Then it got awkward. When a journalist questioned him about his open rift with Mbeki over AIDS, he responded by blaming ‘sections of the press’ for trying to divide them. He volunteered that he’d been ‘shocked’ when he’d been taxed over his criticism of Mbeki in a telephone call from the latter’s office, and repeated his justification – stubbornly and clumsily, and ticking Mbeki off even further:

I said the countries which have succeeded in bringing down the level of AIDS are those where the president of the country takes the lead. I said our President and Deputy President are doing the same thing, but the difficulty with the President is that he is busy with Africa and countries beyond. … As a result he cannot concentrate on the problems of the country because he has to attend to these duties as well, which are absolutely necessary.

He’s not giving AIDS his proper attention. He’s not doing his job properly. I was better.

Tutu accompanied Mandela to the children’s home to underscore his solidarity with the latter’s mission – putting the squeeze on government over AIDS drugs. During an interview on that night, Tutu said he agreed with Mandela: ‘Yes, our government ought to be providing the drugs that extend people’s lives.’ The TAC was mighty appreciative of Mandela’s drug drive: ‘There is a lot of internal pressure building up within the ANC, including from Mr Mandela, for Mr Mbeki to acknowledge the realities,’ said Mark Heywood. Mandela’s ‘comment would not have been made without realising it is in contrast with what Mr Mbeki has been saying’. Therefore it was ‘a subtle message to Mbeki’.

As Mandela was cuddling babies, selling drugs to schoolchildren, and justifying his political misconduct, Mbeki was busy discussing party business at a meeting on the same day of the ANC NEC. But on World AIDS Day, he had not a word about AIDS. As he waited patiently for the South Sea bubble to pop; the Tulip craze to wilt; and like Louis IV in France, wishing the witchcraft mania would pass (and frustrating the Church by determinedly commuting death sentences on condemned witches).

A couple of days later, Mandela phoned Cameron and asked him over to his house; it was urgent, he said. What lay heavy on Mandela’s mind was AIDS, he announced at their meeting the following evening – specifically, how Cameron thought Mandela might take a leading role in securing antiretroviral drug treatment to save the lives of those dying of AIDS in South Africa, in the face of Mbeki’s reluctance to do the right thing. As they concluded their little conspiracy, Mandela asked Cameron for a testimonial, a statement of the facts of AIDS according to Cameron, and a personal statement of how his life had been affected by the terrible disease. Mandela also requested that he phone Makgoba to ask him to pay a visit too. He did so immediately after the meeting. In Cape Town when he got the call, Makgoba flew up to Johannesburg to see Mandela the following day, first popping in to see Cameron for a discussion along the way.

Two months later, on 7 February, the day before Mbeki’s 2002 State of the Nation speech, Mandela made a big symbolic strike by crowning AIDS drug researchers James McIntyre and Glenda Gray of Chris Hani-Baragwanath Hospital’s Paediatric AIDS Unit winners of his Nelson Mandela Prize for Health and Human Rights, granted for their heroic work in giving pregnant African mothers AZT. In his speech at the event, at the Mount Nelson Hotel in Cape Town, Mandela delivered a personal parable about a dispute between several urologists, who had expressed different views about how his prostate cancer should be treated. Some dissenters urged that radio therapy was a bad idea for someone of his age. But he ignored them, and thanks to that decision his cancer was gone. Mandela’s moral for Mbeki being: Stick to the old thinking in medicine, it works.

Mandela then criticised him directly: debate over

some fundamental issues unfortunately continues to rage in manners that detract attention from what needs to be our core concern. However, I have reason to believe that insofar as this debate affects our country, it’s likely very soon we will solve the problem [that Mbeki is asking questions], and many people, especially in government, are thinking very seriously about the observations that have been made in regard to the policy of the government.

Writing in City Press on 10 March, under the title Leave Mbeki to Rule!, Thami Mazwai reflected the irritation amongst thoughtful Mbeki supporters over Mandela’s white-anting of the former’s thoroughly researched, thoroughly considered policy position:

Former President Nelson Mandela’s intervention in the HIV/AIDS issue and in fact in several other issues concerning the government is not diplomatic. Sir Ketumile Masire of Botswana left government and does not spend his time tutoring his successor, Festus Mogae, on how to run the country. If he does, it is within the confines of his office and that is not publicized. Likewise in the United States, Bill Clinton has left the White House and little is heard of him on issues of state.

As it’s prone to do the controversy highlighted the polar difference between the two men on the world stage – the one an adorable populist, easily symbolising the hopes and early achievements of the Rainbow Nation, and now finding a new role in glibly and ignorantly advocating the TAC agenda, the other, an intellectual and visionary grappling with hard problems after the honeymoon. (‘The time has now come that we go back to work,’ said Mbeki on the eve of his succession after the 1999 elections.) Hard problems like pointless toxic drugs being pressed on his government and people – not only by the drug companies, their agents in the TAC, the medical profession, academia, the courts, the unions, the clergy, the Communist Party, the liberal media, and foreign governments and foundations, but by his own immensely popular predecessor too.

Such is the power of the machine that even Tata and Tutu have bought the whole bill of goods, the useless poisonous drugs, everything, sold by the media. And by the ‘AIDS experts’ and activists who mythologize and obfuscate the desperate plight of the African destitute, by blaming their ill health on their sexual behaviour.

Even the Steve Biko Foundation has been recruited to the antiretroviral cause; its president Xolela Mangcu has added its moral weight to calls on the government to dish the drugs out in hospitals. I personally handed him a draft of The trouble with nevirapine in May 2002. He hasn’t responded. Mhlongo noted in a circularised email on 13 September that year: ‘Today is the 25th anniversary of Steve Biko’s death in chains in prison at the hands of the South African apartheid police, aided by white doctors. Only one white doctor (Wendy 0rr) protested – the rest of the South African medical establishment remained silent – but today with AIDS and the dreaded black penis, whites are out in the streets and trenches to save the black man from himself.’ With the support of the Steve Biko Foundation, sorry to say: its ‘Public health ... programme focuses’ not on the pragmatics of poverty alleviation but on ‘fighting the scourge of Aids’. Mhlongo added: ‘... shortly after the July 2000 Sheraton debate, I wrote in The Star that HIV/AIDS is dominated by white activists and white doctors in South Africa – marked similarities with the Christian Missionary epoch of some 100 years ago. Where were these hordes of whites when we were fighting apartheid?’

CHAPTER

On 4 November 2001, on its television show Carte Blanche, MNet screened an interesting collage of interviews with Cameron conducted by his varsity friend Ruda Landman in May 1996, in February and November 1997, and finally, shortly before the broadcast. When the interviews began Cameron had convinced himself that he was on his way to the arms of Jesus: ‘It feels almost like writing my will because I’m going to do things and say things with a view really to my death. We’re all going to die, but it’s my death that we’re talking about.’ Thanks to the virus that was going to take him: ‘Look at my hands, the virus is there. It’s a metre away from you. … if you pricked my finger, you’d have the virus. It’s got HIV in it and it’s everywhere.’ He was awfully scared: ‘I’m fearful this afternoon of going through that dreadfully debilitating, painful process that a death from AIDS means.’ By November 1997 he feared the tokens were upon him:

I’ve had my first symptoms, my first presentation of symptomatic AIDS. I looked in my mouth and I saw I had thrush all over, and that was the most scary night in ten or eleven years. … It’s terrifying. I was so horrified. It’s a terrible feeling to feel death in your lungs and you have to come to the momentous acceptance that you’ve now got AIDS and not just HIV, which is very traumatic. … I’ve got to look at you ... and say I’ve got AIDS.

Luckily he had this real bright spark for a doctor, Dave Johnson: ‘My approach is I believe in these drugs. I believe they work … My job is to get Edwin, or anybody else, information that says “I think these drugs are going to work. I think you should go on them.”’ Cameron believed in these drugs too, and made friends with them: ‘I talk to them. I say, “You’re my allies. I want you to enter my virological system [wot’s that?] and I want you to fight with me against this alien invader” and then I swallow them and it feels better. Isn’t it bizarre?’ Asked about this bizarre behaviour, he explained: ‘Because I’m so terrified, Ruda. If my body is intolerant to the triple therapy, I may be dead within thirty to thirty-six months.’ That’s why I talk to my medicines. I’m a sophisticated intellectual. I’m also a senior judge, deciding important cases. I have exceptionally fine judgment.

But in November 2001 he was still around, to be interviewed about the miracle of his salvation: ‘It seemed important to tell a story. So we, I think, were actually going to tell a story about my death – and what we’re telling now is the story about my life.’ Landman’s very first question went to drugs, and off he charged, telling of his ‘Lazarus experience’, and pumping his conviction that, but for the medicines, he would have been ‘lying in bed or hospital dying for the last three-and-a-half years’. Even as every epidemiological study of ‘long term survivors’ reports that the thing that all these guys have in common is that they avoided the drugs. But Cameron enthused that his staunch medicines fortified him. Rather like the former Indian Prime Minister who told Time several years ago that a glass of his own urine every morning did the same for him. Made him feel invigorated, he said. Put the fire back in his belly. Cameron didn’t see the connection between his Lazarus rebirth and ending eighteen months of protease inhibitor treatment, which had caused ‘terrible side effects’, making him ‘nauseous’ and giving him ‘terrible diarrhoea twice a day. … I felt an almost immediate surge in energy … I didn’t have to go to bed early, I could resume all my activities fully. So it was a wonderful sense – it was almost like a second birth.’ It was also a break from being poisoned. Is it any wonder he felt so much better? His instincts seemed to be telling him something his beholden mind could not: asked how easy it was taking the drugs, he answered all mixed up: ‘So it’s easy, but it’s also important to remember that it’s not so easy.’ Nor did he see any significance in the fact that ‘in 1994 I hadn’t started on the treatments yet, and I hadn’t fallen ill’. It’s important to note here that when Cameron noticed his thrush – medically unremarkable until it became one of the signs and wonders of the AIDS age – he wasn’t ill. It was after ‘I started anti-retroviral therapy in November 1997’ that his lung disease set in, along with fungal infestations of the mucous membranes of his throat and mouth in ‘December 1998’. Just as the toxicity literature predicted.

What was apparent from Cameron’s description of his new pill regimen was that his dose was low, confirming what he had said before, and accounting for why an upset gut seemed to be his only trouble. Not the grave broad-spectrum toxicity manifestations following conventional dosing that had given the US health authorities a serious case of cold feet about the drugs at the start of the year.

Having previously attacked the government vigorously at every public opportunity, to encouraging applause always, he now toned it down, regretting instead the government’s reluctance to give pregnant women the drugs he’s on, especially nevirapine, ‘which is a very good drug’, he said. ‘It’s been offered free to our government to give to mothers who are about to have babies and our government has not yet taken up that offer, which is a tragedy I think.’ He was referring to Boehringer Ingelheim’s offer to just give it away, having failed to close a sale deal with our government – so eager is the company to establish a beachhead in the developing world market. Cameron didn’t think as far as Michael Ellner in New York, who more wisely observed to me that ‘when the cheese is free it’s usually a trap’.

The precise appeals judge, ever scrupulous with the facts, informed us that three hundred thousand people had died of AIDS in South Africa in 2000 – a swollen puff, worthy of any prosperity gospel evangelist. ‘We have an epidemic of people who are dying,’ he said – right after Statistics South Africa’s rebuke of Makgoba for making the same idle claim last year, noting that there is ‘no new mortality profile’ here.

On 19 April 2002 Minister of Trade and Industry Alec Irwin confirmed on the morning radio show AM Live: ‘There is no definite concrete evidence’ that AIDS is having any impact on industry at all. Commenting on statistics just released predicting a massive reduction in the workforce, Irwin pointed out, quite correctly, that the numbers were just ‘projections based on models’. Asked after the weekend on the same show for his response, Congress of South African Trade Unions (Cosatu) General Secretary Zwelinzima Vavi, was full of talk about the ‘epidemic’ and the spectre of everyone dropping down dead as the ‘AIDS experts’ were predicting, but had to agree: ‘There is no indication that there is a large number of workers dying.’ Just reports of the odd worker ‘disappearing off the face of the earth’. Like sucked up into spaceships. The communists don’t go for Jesus – opium of the people and all that. They go for substitute tall tales. They call it the AIDS epidemic. So we have National Union of Mineworkers spokesman Moferefe Lekorotsoane disagreeing with Irwin and Vavi, and treating us to a lesson in logic: ‘In the mining sector we see workers leaving and not coming back and then we hear they are dead and that is proof enough for us that the disease has an impact on the industry.’ The professionals who make a living peddling the AIDS myth voiced similar thoughts. Steve Kraimer, head of Metropolitan Life’s AIDS research Unit, said 20 per cent of workers are infected, ‘significantly affecting production’. Contradicting Irwin. (Not that any of them have been tested for anything. The figure loosely derives from the extrapolation of single ELISA antibody test results among poor black women at antenatal clinics.) Wayne Myslik of industrial relations firm NMG-Levy rued that ‘most companies still have their heads in the sand’. In other words, aren’t hiring NMG-Levy. But Truworths human resources director Phil McInnes explained why he found claims about the terrible AIDS epidemic hard to buy: his company had not been affected. ‘But I can’t tell if there’s a bubble coming at me.’ There surely is, Phil. And it’s got more hot gas in it than Branson’s balloon.

Cameron urged in the interview: ‘The government should roll out a treatment plan immediately because the drugs have come down in price, the drug companies are offering to negotiate with African governments even cheaper prices.’ This is their famous compassion, demonstrated to impress again. A hit with progressive judges evidently. ‘We don’t need to suffer all these losses of our fellow countrymen and women. We don’t need to suffer because the treatments are available to stop many, if not most, of those deaths. … many, many tens and hundreds of thousands and even millions of people can be saved from a dreadful illness and death by a treatment plan on the part of the government now.’ What a galloping imagination! A multiplying enthusiasm! Whizzing up like Tulip prices in the 1600s. He went on: ‘... anti-retroviral treatment has broken the equation between Aids and death.’ Just like our Lord and saviour. ‘Because here I’m sitting – I should be dead by now, after three-and-a-half years after falling ill with Aids.’ Cameron seems to have his eschatology all wrong. Isn’t it meant to be about ten to blast-off, according to the ‘AIDS experts’? Although in the beginning they didn’t say so:

Ben Gardiner, an elderly gay man living in the Castro district of San Francisco, who witnessed the rise of CDC-fanned AIDS panic in the early eighties, told me during a visit in 1997 that the first deaths he saw, some among men he nursed, were relatively quick – drug intoxication diseases usually. With the introduction of HIV antibody tests, HIV diagnoses began. Even among people in good health. So the latency period/slow virus theory arose. Getting longer and longer to meet the need. Of doctors whose patients weren’t getting sick. And who needed an excuse. It started off as six months between infection and illness, then two years, then five, eight, ten twelve, fifteen. It’s now fashionable to talk only of ‘shortened life expectancy’. Whatever that’s supposed to mean.

With only the holy book missing from his raised hand, Cameron continued:

In my own life, it’s given me a second chance to live. And it’s a wonderful thing. It’s so mundane, it’s so corny in a way to be alive and yet it’s the most wondrous gift that one can have. And I feel deeply grateful for that, and I think it’s a gift that should be put in the position, in the hands of so many more people. … For most of the people very ill with AIDS, for most of the people dying from AIDS now, treatment offers a realistic, a pragmatic intervention to save them from death. That’s the fact – this isn’t a position that I take. The truth is, if those treatments can be made available to them, they need not die of Aids. It’s as simple and as dramatic as that.

Of course, Brother Ed. Pills are all we need. For happiness, and eternal life. Rich with daily meaning. Even with a chronically empty ballooning belly in a rural ghetto. Where kwashiorkor is king, but the girls are eager, and the guys really know how to party on down.

Mbeki’s persistent refrain that the disease burden of the poor comes of hunger, cold and despair – to the irritation of AIDS activists and journalists who say it’s all about endless rubberless sex – hasn’t been rejected everywhere. On 3 March 2000 Mbeki appeared at a press conference in Berlin with Bill Clinton and German Chancellor Gerhard Schroeder following an economic summit. Speaking to Mbeki’s insistence that poverty, tuberculosis and malaria lie at the heart of what presents as the ‘African AIDS epidemic’, Clinton noted: ‘We agreed that those of us who are members of the G8 will emphasize these issues, particularly the impact of TB and malaria in relation to AIDS.’ Tshabalala-Msimang agreed too in Parliament on 7 June 2000: ‘We believe that there are many confounding factors such as poverty and malnutrition ... which have an important impact on the pathogenesis of Aids in developing countries.’ She also mentioned tuberculosis and malaria: ‘A better understanding of these relationships is crucial for an appropriate and comprehensive response.’ Then she trod on the drug industry’s toes: ‘We strongly believe that a successful response to HIV has to be developmental in character and extend well beyond the narrow biomedical model.’ That’s what we like to hear, Mama. She made a similar point in her address to the United Nations General Assembly Special Session of HIV/AIDS (UNGASS) in New York on 26 June 2001:

Antiretroviral drugs were not the only form of treatment for HIV/AIDS. Those who propagate this thinking serve only to create unnecessary animosity between the people in the developing world and their governments. … Many developing countries, including South Africa, did not have the capacity and sufficient resources to procure and administer these drugs. These countries have opted for other effective treatment options. It is a known fact that vigorous treatment of opportunistic infections, coupled with good and healthy nutrition can make people with HIV/AIDS live long and healthy lives.

But in his address, UNAIDS chief, Peter Piot, had different ideas for the country, and said he wasn’t going to be obstructed by uncommitted local politicians like Mbeki and her: ‘This path ... must be one of commitment to stop this epidemic. To never give up. To never allow the obstacles along the way to defeat us. … To go on until antiretroviral therapy is essential care for anyone living with HIV.’ The rest of the delegates saw it his way, not hers, resolving in the UNGASS Declaration, ‘By 2003, [to] ensure that national strategies, supported by regional and international strategies, are developed ... to strengthen health-care systems and address factors affecting the provision of HIV-related drugs, including antiretroviral drugs, inter alia, affordability and pricing, including differential pricing, and technical and health-care system capacity.’

On 24 December 1998 the Chicago Tribune mentioned a survey just published in the New England Journal of Medicine by Bozzette et al. looking at nearly two hundred and fifty thousand adults in the US, who had been treated for HIV. Guess what they turned up: ‘The authors found that adult HIV patients are strikingly different from the general population. They are disproportionately male, black, unemployed, poor and without private health insurance.’ Just as McQuillan et al. reported in November 1994 in their paper, The seroepidemiology of human immunodeficiency virus in the United States household population: NHANES III, 1988-1991, in the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology: ‘Black participants were four times more likely to be HIV positive than white/other individuals.’ An article in the New York Times on 11 January 2001, The Quiet Scourge, claimed, ‘The AIDS virus is surging like a prairie fire through black communities in the United States ... concentrated in inner-city neighbourhoods.’ Odd how similar the epidemiological pattern to South Africa’s. Stressed health among the poor.

The class origins of the original white gay AIDS patients treated at the San Francisco General Hospital were meticulously researched and plotted by Michelle Cochrane for her PhD thesis, The social construction of knowledge on HIV and AIDS: With a case study of the history and practices of AIDS surveillance activities in San Francisco, awarded by the University of California at Berkeley in 1997 (the basis of a book, When AIDS Began: San Francisco and the Making of an Epidemic (Routledge, 2003)). Nearly all were unemployed or menially employed down-and-outs. The sort of blokes, one imagines, fleeing the bigotry of their small towns for the Castro district. The gay Mecca. Only to fall on difficult times. Cochrane’s findings debunked Randy Shilts’s myth-igniting proposal in his early history, And the band played on (Penguin Books, 1988) (reinforced in the Tom Hanks movie Philadelphia) that

AIDS first emerged among moderately wealthy ‘Guppies’ who ... lived the high and fast night-life in New York and San Francisco. … In Shilts’s estimation, it was only as the epidemic evolved out of this core group of moderately affluent gay men, that AIDS then began to appear in the ‘corridors of poverty’ associated with marginalized populations in urban centres on the East Coast. To the contrary, I am suggesting [following a painstaking analysis of the data] that the epidemic began, and to a large extent remains to this day, overwhelmingly (though not exclusively) concentrated among impoverished or disenfranchised inner-city populations; a population which does not ipso facto exclude homosexual/bisexual men.

Since empty pockets was what those gay AIDS cases had in common with their black hetero brothers and sisters in the US and in South Africa, the open-minded might want to ponder the possibility that the unpopular skin colour and the unpopular sexual preference have nothing to do with the burden of disease (or the health stresses possibly indicated by positive HIV antibody tests) among these folk. And that it might be their quality of life in a depressed environment instead.

But the Cameron interview wasn’t as entirely banal as he thought it was. Deconstructed, it offers a rich seam to mine for many of the social meanings of AIDS, and it lays bare the straw bricks and short-measured mortar that have made up this towering medical monolith in the popular consciousness over the last twenty years.

From the time of the ancients, folk at large have disliked lawyers. It’s in the literature all over, most recently in John le Carré’s tale about the murder of a troublesome barrister by a pharmaceutical corporation, The Constant Gardener: ‘Tessa was that rarest thing. A lawyer who cared about justice.’ Apart from their notorious greed, and their pretensions to serve the public interest rather than strictly their own, it’s mainly because lawyers are perceived to be too clever by half, the locus, as a class, of society’s coolest rationality, even chilly cunning.

Although Cameron’s language has become increasingly intemperate, as his bully’s confidence in his personal joust with Mbeki has grown in tandem with the latter’s intellectual and political isolation on AIDS, his demeanour is regal, pensive. ‘The tall, imposing Cameron had the gravitas of a judge some time before he was elevated to the Bench,’ licked fellow gay Shaun de Waal in a panegyric in the Mail&Guardian on 23 April 1999. His ‘academic trajectory was meteoric. A Rhodes scholar sent to Oxford, he got two degrees there with first-class honours (and a Vinerian scholarship) to add to his bachelor of arts from Stellenbosch and his LlB from Unisa – both cum laude.’ ‘One of the leading lawyers of his generation, possibly the leading lawyer. His record is one of great balance and judiciousness,’ praised David Unterhalter, a silk, now a professor and Director of the Mandela Institute at Wits Law School. His colleague Professor Martin Brassey seconded that: ‘A man of remarkable ability [distinguished by] the lucidity of his mind.’ A ‘man of the highest intellect’, opined the Mail&Guardian on 19 April 2002 in an op-ed piece knocking Mbeki: ‘The Triumph of Unreason’. So Carte Blanche is not to be faulted for introducing Cameron as an ‘intellectual’. Everyone reckons so.

Indeed, in an interview by Gavin Evans, HIV+ judge wants Aids justice, published by the Daily Dispatch on 13 November 2001, Cameron fancied he’s one himself: ‘I have no doubt that I have natural intellectual gifts.’ Unlike the rest of us. Unfortunately you have to look beyond his early legal articles on the human rights of AIDS sufferers for any evidence of them. You honestly do. Such as in Public Health and Human Rights in the South African Journal on Human Rights in 1992. Writing in the honeymoon of his diagnosis. Highfalutin shit like:

The premises on which the debate starts are unchallengeable. [He must have dozed off in philosophy. When his tutor was discussing Karl Popper’s observation that all knowledge is provisional. And that science is indissociable from myth.] The disease is incurable, it is fatal, and it will soon be rampant. Its spread, now at epidemic dimensions, is insidious. It occurs mostly in moments of intimacy between two people who do not know that one of their healthy bodies harbours eventual death for both.

Cameron had taken his confirmation instruction well. Especially its gist. That the flesh pulls us down into the flames of Hell. He could have been mistaken for one of those American businessmen who get their kicks spreading the word around hotels in the weekend. To save souls. (Especially those of the girls in the bar.) Because the introduction to the Gideon Bible sounds the same: ‘The Bible contains the mind of God, the state of man, the way of salvation, the doom of sinners, and the happiness of believers. Its doctrines are holy, its precepts are binding, its histories are true, and its decisions are immutable.’ May we be excused for not swallowing a guffaw over the judge’s lapsed faith in the incurable, fatal bit? After confessing it to Sister Ruda: ‘... for most of the people dying from AIDS now, treatment offers a realistic, a pragmatic intervention to save them from death.’ Challenging the unchallengeable. And sounding like Calvin changing his mind. But at least coming round to Nobel-winning physicist Richard Feynman’s point: ‘We absolutely must leave room for doubt or there is no progress and there is no learning.’

Strikingly similar too sounded the Reverend Samuel Parris’s menacing prattle in Salem in February 1692 at the start of the witchhunt there:

It is altogether undeniable that our great and blessed God, for wise and holy ends, hath suffered many persons in several families of this little village, to be grievously vexed, and tortured in body, to be deeply tempted, to the enduring destruction of their souls; and by all these came amazing feats (well known to many of us) to be done by witchcraft and diabolical operations.

The Evans interview plugged some gaps left in the Carte Blanche one, by providing more personal history and fleshing out the episteme within which Cameron’s silly mind ranges. Evans’s leading questions disclosed his own too. It’s Cameron’s claimed sophisticated rationality that makes him a particularly intriguing case study in hysterical suggestibility in what we like to think to be our cool, intelligent, modern, enlightened, secular, industrial society. On which Orwell threw some light in 1984: ‘Doublethink means the power of holding two contradictory beliefs in one’s mind simultaneously, and accepting both of them. … In general, the greater the understanding, the greater the delusion: the more intelligent, the less sane. One clear illustration of this is the fact that war hysteria increases in intensity as one rises in the social scale.’ Hence the top judge’s enthusiasm for the war on AIDS. Made possible by a thinking trick:

Crimestop [a Newspeak term for ‘acquired internal discipline’ to avoid crimethink] means the faculty of stopping short, as though by instinct, at the threshold of any dangerous thought. It includes the power of not grasping analogies, of failing to perceive logical errors, of misunderstanding the simplest arguments if they are inimical to Ingsoc [‘English Socialism’], and of being bored or repelled by any train of thought which is capable of leading in a heretical direction. Crimestop, in short, means protective stupidity.

Cameron’s Carte Blanche spiel would have been right at home in a fellowship circle of Jesus freaks witnessing fervently about their salvation from perdition. Caused by possession by demons. Miniature ones. That’s how it sounded. And was meant to:

Ruda, you know, we’ve been friends for 29 years now since we’ve been revealing secrets. We were first years together at Stellenbosch in 1972, and you were one of my first friends that I told about this. It was a very emotional time for both of us, and I expected to die. I believed that I would die before I was 45 or 50. I’m now 48 and I’m in better health than I’ve been almost at any time since I’ve been an adult. But at the time, it seemed important to tell a story. You and I discussed it and I think from your producer’s and filmmaker’s and anchor’s perspective, you thought that this might be a story worth telling and worth showing to your viewers. I think we were actually going to tell the story of my death, and what we’re telling now is the story of my life, and I’m more involved with more things [I’m into drugs now], with more public-interest projects, with more organisations, more involved with my work and with my life than I’ve ever been.

I’m more and more in touch with my inner being.

In her study, Hystories: Hysterical Epidemics and Modern Culture (Picador, 1997), Showalter sums up the type, these hysterical ‘career patients ... addicted to their symptoms’ for whom ‘the patient career may be a permanent way of life, with a self-supporting network of friends, activities, doctors, and treatments’. She describes how they typically ‘learn about diseases from the media, unconsciously develop the symptoms, and then attract media attention in an endless cycle. Culture forces people to deny the psychological and emotional sources of their symptoms, and to insist that they must be biological and beyond their control, for them to view themselves as legitimately ill.’

Showalter quotes Norman Cohn in The Pursuit of the Millennium (Secker and Warburg, 1957), writing about the currents churning around the turn of the first millennium – but human psychology has a dreary consistency, as Cameron and Achmat’s hysterical agitation over AIDS bears out:

Those who are first attracted will mostly be people who seek a sanction for the emotional needs generated by their own unconscious conflicts. It is as though units of paranoia hitherto diffused through the population suddenly coalesce to form a new entity: a collective paranoiac fanaticism. But these first followers, precisely because they are true believers, can endow their new movement with such confidence, energy and ruthlessness that it will attract into its wake vast multitudes of people who are not at all paranoid but simply harassed, hungry or frightened.

And, Cohn noted, when ‘a paranoiac mass movement captures political power’, disaster follows.

As gay men, Cameron and Achmat’s sick roles are very much a throwback to Victorian ideals of femininity. Constitutional delicacy was considered refined and attractive. Crippling corsets tied tightly for hourglass figures caused extreme discomfort (there were even reports of wombs forced down unmentionable passages) with the result that ladies were reduced to mincing around helplessly like their Chinese sisters with bound feet. Fainting spells were all the rage. A sick pallor was prized, and women took drops of arsenic and silver nitrate to keep up the look. I suspect that rouge applied to cheeks, favoured by prostitutes and common women, was a bid to imitate the upper class complexion – flushed red by mercurial intoxication, thanks to the diligent attendances of Victorian doctors. Keeping them permanently sick. And attractive to their men. Cameron and Achmat seem to think we find their daintiness in health sexy too. Journalists certainly do.

I mention en passant that in their essay, Overview of Mass Psychogenic Illness: Hysteria Revisited? introducing their collection, Mass Psychogenic Illness: A Social Psychological Analysis (Lawrence Erlbaum Associates, Publishers, 1982), Michael Colligan et al. remind us of Hippocrates’s fascinating suspicion, all those years ago, that hysteria (which he diagnosed for the first time in an unmarried woman) was the result of ‘an unnatural state’ of ‘sexual abstinence’. (The word ‘fascinating’, my Latin professor explained, has a fascinating root in male tumescence. Whoops!) Sigmund Freud, I might add, contended that hysterical men tend to be sexually passive; Wilhelm Reich that they typically display a ‘feminine facial expression and feminine behaviour’. About Cameron and Achmat in this regard, not another word.

Cameron’s AIDS Law Committee (he’s proud chairman) of the South African Law Commission was quite happy to note in its Fifth Interim Report on Aspects of the Law Relating to AIDS that the Criminal Law Amendment Act 105 of 1997 prescribes a mandatory sentence of life imprisonment for rape by a man knowing he’s ‘HIV-positive’ or ‘has AIDS’. Not because the sexual assault is thereby transformed into assault with a deadly weapon of sorts, mind you, but because, the report explains to us, this aggravating fact could make the victim feel extra distressed – suffer ‘psychological harm’ as the original language in the preceding bill had it. And so our criminal law is fouled with AIDS hysteria just as the Nazis, with their own mystical notions of defiled blood, once corrupted theirs. Our labour law too. (The several ponderous reports produced by Cameron and his fabulously paid committee of ‘AIDS consultants’, are enough to make a man hold his head in hands and cry. With pity. Especially where they get ‘scientific’.)

Could the new rape law be all about keeping them in their place? The modern way? Caged forever. Where they belong. Those guys whose faces blend into the night. Jumping over white picket fences. Or grey concrete walls with voortrekker wheels. Spreading disease. (One in three in HIV-positive in KwaZulu-Natal say the ‘AIDS experts’. Where Zulus live – those militant threatening people with warrior traditions.) Sick from all that sneaking around with the maids. Even if they feel perfectly vigorous, and appear so in court. But on the other hand if leprous, tubercular, syphilitic, pocked, or plagued by boiling buboes, the law has no business. Reckons the South African Law Commission. With Cameron’s concurrence. The guy with the ‘natural intellectual gifts’. The new rape law is redolent of Charlemagne’s edicts prescribing death for tormenting one’s fellows with sores and diseases. Also afflicting them with barrenness, troubling the atmosphere, exciting tempests, summoning down lightening, drying up the milk of cows and blasting fruits and crops. Stand by for the Law Commission to propose life in C-Max for Muslims attempting murder by spreading anthrax. In jokers’ envelopes containing talcum powder. Or sprinkled on your long end before you go.

The judge’s hysterical lunacy has even infected such otherwise sober dudes as international war crimes prosecutor Richard Goldstone, Chancellor of the University of the Witwatersrand and, until his resignation on 1 October 2003, justice of the Constitutional Court. On 7 March 2001 Goldstone presided over a special rally held there, a rare General Assembly of the University, to whip up highbrow fervour against the threatened new menace – since the black democratic government didn’t seem to be as alarmed by it as the white liberals were. Chief Justice Arthur Chaskalson, Cameron JA, various High Court judges, and Gauteng’s health and education MECs, duly taking their parts in Cameron’s grand folly, all listened in rapt attention, gathered along with staff and thousands of students to hear Goldstone make a special statement about AIDS, and to learn about the launch of the University’s new HIV-AIDS policy. A remarkable affair when one considers that all eight other general assemblies had been called to protest the distinctly palpable evils of apartheid. Individuals, families, communities, societies banished to remote wastes to starve. By the million. Just to begin with. Something worth protesting about.

‘While apartheid was an attack by a white minority on a black majority, AIDS poses a threat to the whole society,’ Goldstone remarked by way of an introduction, not having noticed apparently that the employed had by and large been left untouched by the diseases suffered by the black poor, which the ‘experts’ had taken to calling AIDS. But you can always count on judges to be careful with the facts. Especially as they step out of their sequestered, socially aloof little worlds into the big wide one. And get all fired up at Jimmy Swaggart style conventions.

Even if we uncritically accept the ‘everyone’s dying’ alarmism of AIDS activists and the newspapers, only the blind can miss just who. Not Mbeki – in the course of whose exchange with DA leader Tony Leon over the appropriateness of AZT for rape victims (discussed below) he noted: ‘Contrary to what you say [(‘death and disease know no race’)], even a child, from among the black communities, knows that our own burden of disease coincides with the racial divisions in our country.’ But the Cape Times got hot and bothered in a typical white liberal end-is-nigh article on 16 April 2001: Death rate trebles as AIDS crisis hits Cape. Like Mbeki, one couldn’t help noticing that there were no white, Indian or ‘coloured’ deaths mentioned, and that they were reportedly occurring in the wretched black townships of Khayelitsha, Langa and Guguletu. Not Constantia, Houghton, or Durban’s Berea.

Undertakers say business ... is ‘like a factory’ at weekends, with up to 20 burials at once. … In Johannesburg and rural KwaZulu-Natal, death rates have rocketed because of AIDS. Jack Bloom of the Democratic Alliance said that, in Johannesburg alone, the number of funerals had doubled in the past five years from 15 000 to 30 000 a year and figures were expected to double again by 2005. ‘At the Avalon cemetery in Soweto, between 100 and 150 people are buried every Saturday,’ he said.

The puzzling thing about these sorts of neurotic reports is that a couple of months later renowned journalist and author Rian Malan did a thorough survey of his own, looking into how brisk business is for funeral parlours – supposedly experiencing boom times thanks to the ‘AIDS epidemic’ – and found quite the opposite. Commissioned to research the subject by Rolling Stone, with a view to exposing Mbeki’s irresponsible ‘AIDS denialism’, he expected to find ample evidence, but found himself soon disabused of all his preconceptions, his confidence in the medical and scientific establishment forever wrecked. As he put it to me in my kitchen in October 2000: ‘I began looking into AIDS with a view to bashing Mbeki, but I found the facts reluctant to cooperate.’ His demystification of the African AIDS holocaust fancy, subscribed to and promoted by Cameron and his brother judges, appeared in the October 2001 issue of Rolling Stone as AIDS in Africa: In Search of the Truth. We recall that ‘AIDS experts’ in the Department of Health were reported in the Natal Witness on 24 October 1997 predicting that ‘Between 3,5 and 4,8 million South African children younger than 15 years will have lost their mothers to Aids by 2000.’ So where’s this gaggle of orphans – the ‘feral’ black orphans everywhere in the streets, as RW Johnson envisioned. Like where?

Unnoticed was the bleak irony of the 9th General Assembly of the University of the Witwatersrand celebrating and formally embracing a new medical ideology that black African intellectuals like Mbeki had recognised to be profoundly racist, inhumane, alienating, hopeless, callous, mechanically reductionistic, simplistic, aggressive, fearful, mercantile, and politically antagonistic to the poor – by casting them as personally responsible for their lot when their health fails. In short, intrinsically American. But then after apartheid, something had to fill the vacuum – some new schema within which white liberals could relate to blacks. Providing new furniture for racist ideology, AIDS came tailor-made with its inarticulate burden that blacks are the harbingers of disease, spread by their uncontainable sexual proclivities, an evergreen fascination and horror among the European-descended. For white folk rushing to help their swarthier countrymen (always code for control), AIDS as an ideology arrived as perfect a vehicle as the Beatles were as a vent for the social pressures of the sixties.

And there’s an intriguing precedent for racist sentiment swelling along with plague hysteria. In his study, The Black Death (The History Bookclub, 1969), Philip Ziegler devotes a gory chapter to Germany: the Flagellants and the Jews in which he details the especially severe and widespread persecution of Jews in German villages in mid-1300, accused of spreading plague by poisoning wells – themselves or via hired lepers. Jewish leaders and rabbis were arrested and naturally confessed on the rack. Zurich began by voting to exclude Jews from its precincts; the Jews of Basle were penned up in wooden buildings and burned alive, and those of Hansa walled up in their homes to suffocate and starve. Instigated by Christian zealots, the genocide fanned over the country and enveloped dozens of villages, spreading even to Spain: in Barcelona, the Jewish ghetto was sacked; there were anti-Jewish riots in other Spanish cities, and in Tarrogona three hundred Jews were killed. ‘Anno domini 1349 sloeg men de Joden dood’, went a chronicle of the time, summing up the fact but not the scale. Ziegler tells that the attacks ‘virtually wiped out the Jewish communities in large areas of Europe. In all, sixty large and one hundred and fifty smaller communities are believed to have been exterminated and three hundred and fifty massacres of various dimensions took place. It led to permanent shifts in population, such as the concentration of Jews in Poland and Lithuania, which have survived almost to the present day.’

Guess who the Wits General Assembly’s keynote speaker was? Gee, none other than Chair of Council, Judge of Appeal Edwin Cameron. He reiterated that same hysterical point: ‘... every one of us is vulnerable.’ In the teeth of all the epidemiological data. And then shared with us again his odd idea that just as long as you have the cash, expensive poisons keep you well: ‘... wealth can buy you life and health. … This drug battle shows that HIV-AIDS is not about hopelessness.’ Urging students to join the fray in the campaign for cheaper AIDS drugs, he said: ‘We can change the conditions in which South Africans live with and die of the disease. By our own efforts and actions we can give hope. Wits will continue to make positive choices to act upon, build for and defeat this pandemic.’ With pills. Not rural development, food and water. Very expensive pills. To take forever, keeping the till tinkling: as Carr pointed out in Lancet in July 2002: ‘Near perfect and life-long adherence to treatment is not required for any other chronic infectious disease.’ Even antibiotics are generally capped at a week’s course. Being cell poisons too. Bacteria being unicellular organisms. And when chemotherapeutic drugs are given to cancer patients, there’s always a similar tight limit to the duration of the treatment. Because it’s killing you along with your unwanted cells. But with chemotherapeutic AZT, the most poisonous chemical ever licensed for indefinite use, you take it until you die. Which you will. Sooner rather than later. Just how long it takes depends. On your luck.

Wits Vice-Chancellor Professor Colin Bundy then launched the university’s HIV-AIDS policy, adopted by Council in December. We half braced for an announcement that the university would be expelling its Jews and revising all its syllabi, but we were spared the former. He announced that the new policy would have five components: The rights and responsibilities of staff and students affected by and living with HIV-AIDS were to be codified (red stars for their coats?); HIV-AIDS was to be integrated into teaching – reminiscent of Nazi physics, Nazi mathematics, Nazi history, Nazi music and Nazi art; all faculties would be pressed into doing performing AIDS research and ‘service activities’ – just as those German faculties were required to serve volkische aims; stations would be set up on campus manned by commissars to provide political education in the new ideology that intimacy can kill you (the closer you get, the more dangerous it is) and to dish out rubbers to stunt sexual connection, by reducing the flash and staunching the spirit (also jamming some amazing female biochemical receptors to about two dozen prostaglandins and other merrymaking ingredients of seminal plasma); implementation of the new policy would be constantly monitored to expose recalcitrant holdouts; and it would be regularly reviewed to further its goals. Yep, you got it baby, right out of Ripley’s Believe it or Not.

The President of Convocation, John Shochot, announced that the assembly was ‘sadly not much different to the previous ones against apartheid’ that he’d attended. Then after he’d mopped his eyes he really got going: ‘This crisis will divide South Africa in ways that apartheid never did,’ he said, both right on and right off the mark, in ways the earnest fellow would never understand. Like a child throwing his gorged cookies, the self-flagellating penitent, sick with all the propaganda he’d downed, said he was ashamed that South Africa has more HIV-positive people than any other country in the world and what our country was doing about it. He meant not buying GlaxoSmithKline’s medicines, since we spend no end of public money on ‘AIDS prevention’ – confirmed in a Lancet editorial on 5 April 2003: ‘The Government of South Africa has been severely criticised for moving too slowly, yet there are more AIDS programmes and initiatives on the ground in that country than anywhere else on the continent.’

But all this was just a curtain-raiser for SRC president Muhammad Cajee’s delirious show: ‘Twelve per cent of students and staff are living with HIV-AIDS,’ he said, ‘meaning that every tenth student you see here will not live long enough to complete their studies.’ A Roman decimation! For rebellion against the Moral Majority! Punishing our defiantly irreligious, permissive modern society! On the ten years countdown to AIDS theory, they sure must be taking their time to get through their degrees, these dim Wits students. To make sure he and his fellow SRC members weren’t left out of this Passion Play, he said they would all be off for HIV tests within a day or two and invited other students to join them. Checking up to make sure there’s no bad blood in those veins. Like Germans checking their family trees. But half-hoping that there is, so that they can become cult-heroes like Edwin Cameron and Zackie Achmat.

Presumably, Judges Chaskalson, Goldstone, and their other judicial brethren present at the Wits General Assembly concurred in the proceedings by nodding in accord. Because none of their Lordships were observed to clutch their sides and fall about laughing, or at least cough or clear their throats in awkward embarrassment, much less get up and walk out of the final act of this unimaginable farce.

We interpose here that at neighbouring Rand Afrikaans University the results of a blood-testing survey performed, released in mid-January 2002, were just 1.1 per cent HIV-positive. Whatever conclusions you want to draw from the comparison. Probably not too many after you’re done reading what’s coming up.

Cajee’s and Cameron’s subscription to the odd idea in the AIDS age that you can be sick without knowing it is actually as old as the hills in Western culture – rooted, I suspect, in the Christian concept of original sin. Daniel Defoe reported such notions exactly in his romance invention, Journal of the Plague Year, published in 1722, romanticizing the ‘last great visitation’ of the plague in London in 1665 so titillatingly that the rich and lurid legends he propounded for his novel have entered the popular consciousness as real history – no small thanks to his ‘peculiar talent’, like Cameron’s, ‘for telling fiction in the guise of truth’, according to Defoe’s modern editor, Kenneth Hopkins.

Compare Cameron: ‘The disease is ... spread ... mostly in moments of intimacy between two people who do not know that one of their healthy bodies harbours eventual death for both.’ And Mandela, speaking at the Barcelona AIDS Conference in July 2002: ‘The great tragedy of HIV infection is that most people, surely more than ninety per cent, do not know that they are infected with the virus. They continue, unwittingly, to spread the infection.’ With Defoe:

This infecting and being infected without so much being known to either person is evident from two sorts of cases which frequently happened at that time … 1. Fathers and mothers have gone about as if they had been well, and have believed themselves to be so, till they have insensibly infected and been the destruction of their whole families … 2. The other particular is that many people having been well to the best of their own judgment, or by the best observation which they could make of themselves for several days, and only finding a decay of appetite, or a light sickness upon their stomachs; nay, some whose appetite has been strong, and even craving, and only a light pain in their heads, have sent for physicians to know what ailed them, and have been found, to their great surprise, at the brink of death, the tokens upon them, or the plague grown up to an incurable height. It was very sad to reflect how such a person as this last mentioned above had been a walking destroyer perhaps for a week or fortnight before that; how he had ruined those that he would have hazarded his life to save, and had been breathing death upon them, even perhaps in his tender kissing and embracings of his own children. … This frequently puzzled our physicians, and especially the apothecaries and surgeons, who knew not how to discover the sick from the sound; they all allowed that it was really so, that many people had the plague in their very blood, and preying upon their spirits, and were in themselves walking putrefied carcases, whose breath was infectious and their sweat poison, yet were as well to look on as other people, and even knew it not themselves. … Sometimes a man or woman dropped down dead in the very markets, for many people that had the plague upon them knew nothing of it till the inward gangrene had affected their vitals, and they died in a few moments.

Sure they did. Like Jesus ascended into the heavens. Passing through the clouds like a rocket in slow motion.

‘AIDS experts’ such as Makgoba and lay preachers such as Cameron like to excite themselves (we’ll later read) with allusions to ‘the Black Death’, packing plague imagery onto their attacks on Mbeki and the government for not doing enough in the war on AIDS. Yet there’s surprisingly little in the many myths that abound about it – the first being in the name itself. Rather like the fallacies inherent in the acronym ‘AIDS’ that we’ll be getting onto soon: that it’s acquired; that people diagnosed with AIDS necessarily have ‘compromised immune systems’; and that the diseases renamed AIDS if the patient is HIV-positive are part of a coherent syndrome in any meaningful sense – from invasive cervical cancer to dementia to TB, among an American list of about thirty completely disparate illnesses. Balding to foot fungus, just about.

In The Black Death, Ziegler reveals that the name derives from the ‘traditional belief that it was so called because the putrefying flesh of the victims blackened in the final hours before death supervened. The trouble about this ... plausible theory is that no such phenomenon occurred.’ There is every reason, I think, to suspect that the rest of our conventional wisdom about the Black Death is as solid as the Virgin Birth. Although most of us have a pretty fixed idea of what it was from our history lessons, opinions and orthodoxies about the causes of widespread collapsing health in the mid-14th century, both contemporaneous and later on, have varied as widely and radically as constructions of the putative disease itself. And when one considers the fantastic claims of the ‘AIDS experts’ in the modern era concerning the devastation allegedly wreaked by the ‘AIDS epidemic’, the generally accepted belief that the Black Death took a third to half the population of Europe starts looking less like history and more like the story of the Easter bunny.

It’s currently widely believed by modern doctors that fleas leaping off rats spread the bubonic plague, their bites inoculating folk with a bacterium residing in their stomachs, Pasteurella Pestis. (Which is a joke for another book.) In fact there is nothing in the chronicles to support the rat and flea theory at all. On the other hand, Ziegler notes, ‘almost every fourteenth century savant or doctor took it for granted that the corruption of the atmosphere was a prime cause of the Black Death’. This was the ancient and long-lived miasma theory, which held that noxious vapours carried disease. Nor was the Black Death exclusively what doctors call bubonic plague manifesting in the glands of your groin or armpits swelling up into hideous, suppurating buboes, according to some accounts. But not others – some doctors claimed that it was precisely because the swellings were hard and didn’t leak that they were deadly. (Curious that the boils and lumps should allegedly occur in the groin – next the genitals. But then this was Christian Europe: the first book of Samuel (5:6-12) speaks of a plague of ‘tumours in the groin’ as a special divine punishment for the thieves of the Ark of the Covenant.) Or instead of boils or lumps, such sufferers might develop blotchy skin, even go mad. According to medieval accounts ‘In Provence a man climbed onto the roof of his house and threw down tiles into the street. Another executed a mad, grotesque dance on the roof.’ Doesn’t this sound all too familiar – archetypal plague horrors resurfacing in the AIDS age? Swollen glands, skin blotches, lunacy?

To this diagnostic hodgepodge, second and third elements were thrown in – the sinister appearances growing dizzily like the US CDC’s ever-expanding list of AIDS-defining diseases. Pneumonic plague was joined – meaning about any ailment of the lungs. Along with septacaemic plague, doctors’ handy catch-all explanation for folk in fine health who didn’t get up in the morning or who suddenly fell unwell and were shortly dead, but who didn’t exhibit any symptoms. Today called a heart attack. Or a stroke. As with their talk about AIDS today, doctors and their believers during the plague years liked to emphasize morbid inevitability following the appearance of the signs upon the victim. ‘For example,’ wrote Defoe,

many persons in the time of this visitation never perceived that they were infected till they found, to their unspeakable surprise, the tokens come out upon them; after which they seldom lived six hours. … when the disease was come up to that length nothing but certain death could follow, and yet as I said, they knew nothing of their being infected, nor found themselves so much as out of order, till those mortal marks were upon them.

And similarly, Ziegler cites Boccacio, telling us that the bubo was an ‘infallible token of approaching death’. But, as Ziegler also points out, ‘Other contemporary records as well as observation of subsequent epidemics’ noted plenty of full recoveries.

It was widely believed that not only did the plague pass by breath, but also by looks, and quickly too: Ziegler quotes a contemporary doctor: ‘Instantaneous death occurs when the aerial spirit escaping from the eyes of the sick man strikes the eyes of a healthy person standing near and looking at the sick, especially when the latter are in agony; for often the poisonous nature of that member passes from one to the other, killing the other.’ Also by touch or breath: Ziegler quotes Simon of Corvino telling of priests who ‘were seized by the plague whilst administering spiritual aid; and, often by a single touch, or a single breath of the plague stricken, perished even before the sick person they had come to assist’. The fabulous credulousness of doctors remains unchanged through the ages: today they’re telling us equally wonderfully that making love with a new mate (unmarried or of the same sex) can kill you – ten years afterwards.

But unlike contemporary AIDS enthusiasts, even a dreamer like Defoe recognised that the widely disparate diseases lumped together as ‘the plague’ largely took the struggling broke, not the well to do: ‘It must be confessed ... that the plague was chiefly among the poor.’ Ziegler mentioned a consonant epigram of the day: ‘No lady ever got the plague.’ Just as white ladies rarely develop AIDS – those treated with AZT aside. Ziegler cites the 19th century French historian Michon making the same point, implicitly debunking, on the way, the myth that during the great plague of the mid-thirteen-hundreds something qualitatively exceptional was about: ‘The plague of the fourteenth century was no different to those which preceded or which followed it. It killed more people, not because of its nature, but because of the conditions of suffering and servitude in which it surprised its victims.’ A discussion of the ruptured social, political and economic conditions prevailing in Europe at the time is, as they say, beyond the scope. But Ziegler captured it: ‘... general malnutrition was a contributory reason for the high death rate of the plague years.’ In relation to the London plague three centuries later, Defoe alludes to overcrowding in London in mentioning ‘the exceeding populousness of the city at the time of the infection’. Christopher Hill wrote similarly in Liberty against the Law (Penguin Books, 1997): ‘In the 1660s the victims of plague, Clarendon tells us [in Life published in 1759], were mostly the poor (and sectaries [i.e. dissenters from the Church of England], almost all from the lower classes). … Plague, when it came, hit the poorest classes hardest, especially in the overcrowded and insanitary towns. … Some said the plague was a blessing since it killed off “the baser and poorer sort, such whose lives were burdensome, whose deaths were beneficial” to their society [as Robert Harris commented (with a full belly) in 1626].’ This is just how many whites see the blessing of AIDS in South Africa and Africa generally. I hear it all the time.

The Nazi revisionist historian David Irving recorded such thinking in his diary in 1987 during a trip to South Africa to hang out with Clive and Gay Derby-Lewis and other such charming hosts: concerning ‘the AIDS epidemic in Black Africa’ a white doctor practising in Swaziland told him that

he thinks that the Black population in all Africa will die out within a very short space of time. He attributes the incredibly high AIDS incidence among Blacks to their sexual activity, few Blacks apparently engaging in less than five sexual acts per night. He says the astonishing sexual activity among Black men accounts for why a large number of white female intellectuals and students like having Black boyfriends, which now, of course, they will regret. God works in mysterious ways, but here, He appears to be working remorselessly towards a Final Solution, which may cruelly wipe out not only the Blacks and homosexuals but a large part of the drug addicts and sexually promiscuous and indiscriminate heterosexual population as well. He says the virus is clearly the same as one known for a long time to have affected the monkey population. ‘The only weapon against AIDS,’ I suggest, ‘is an aspirin: clenched firmly between the knees at all times.’

Medieval doctors, like their modern counterparts, were apparently too hung up on their poisonous mists and scientific theories to notice their patients’ dire living conditions. But to those of us less fired up than Ziegler by thrilling thoughts of deadly aggressive germs (‘this sudden and horrifying holocaust’), widespread hunger was more than a contributory reason; it was a sufficient reason – if one factors in the profound psychological deterioration that springs from hopeless destitution, and the ready contagiousness of ideas and fears. And one keeps in mind the medical care: the stock treatment of the sick was bleeding, as always. Ziegler quotes one top doc: should the patient faint, splash cold water on him and carry on as before. To ensure his speedy passage to the next world. All manner of aggressive chemicals too were administered too; Defoe notes:

Nay, there was another thing which made the mere catching of the distemper frightful, and that was the terrible burning of the caustics which the surgeons laid on the swellings to bring them to break and run. … On the other hand it is scarce to be imagined how the posts of houses and corners of streets were plastered over with doctors’ bills and papers of ignorant fellows, quacking and tampering in physic [medicine].

After cataloguing a whole page full of crooked examples, Defoe records: ‘Tis sufficient from these to apprise any one of the humour of those times, and how a set of thieves and pickpockets not only robbed and cheated the poor of their money, but poisoned their bodies with odious and fatal preparations: some with mercury, and some with other things as bad, perfectly remote from the thing pretended to, and rather hurtful than serviceable to the body in case an infection followed.’ In their ‘foolish humour’ folk went ‘running after quacks and mountebanks ... blindly, and without consideration, [taking] poison for physic and death instead of life.’ Sort of like Edwin Cameron.

Making the poor to blame when they got sick – just as ‘AIDS experts’ currently do, especially when facing defiant rejection of their new doctrines by plebeian folk – Defoe complained:

But it was impossible to beat anything into the heads of the poor. They went on with the usual impetuosity of their tempers, full of outcries and lamentations when taken, but madly careless of themselves, foolhardy and obstinate, while they were well. … This adventurous conduct of the poor was that which brought the plague among them in a most furious manner, and this, joined to the distress of their circumstances when taken, was the reason they died so by heaps.

But he acknowledged frankly that ‘when they came to be taken sick they were immediately in the utmost distress, as well for want as for sickness, as well for lack of food as lack of health’.

Finerman and Bennet described the modern tendency in industrialised societies to shift responsibility from the environment to the individual, consummated in the AIDS era, in a brief but powerful analysis published in the journal, Social Science and Medicine, in 1995: Guilt Blame and Shame: Responsibility in Sickness and Health. They reported ‘a sudden and dramatic proliferation in what Foucault termed medical policing [in his The Birth of the Clinic: An Archaeology of Medical Perception (Vintage Books, 1994)], as social institutions and their agents increasingly monitor, regulate and subdue individuals in the name of health’. Among a host of instances cited,

Visa applicants face probes on their sexual behaviour and those with HIV-positive status can be barred from entering the United States. … Such policies reflect a shift in medical worldview. They signal the emergence of new explanatory models, particularly prevalent in Western and industrialized populations, which are responsibility and blame focussed; that is, disease, onset and outcome are directly ascribed to the afflicted themselves. These responsible parties are then subject to censure for personal failures which ‘caused’ their condition. … In essence, such blame-oriented models are more accusation than they are explanation. In many respects, accusation in explanatory models speaks louder about our own culture and values than it does about the health seeking behaviour and medical systems of other populations. … Kirmayer indicates that blaming patients for illness results in status loss, social moralising and medical paternalism, noting that, ‘Sickness makes the patient’s stewardship of the body suspect. The physician then appropriates the body and performs caretaking functions for the patient who has failed to protect the body and lacks the expert knowledge necessary to understand what is wrong.’

Nowadays ‘AIDS experts’ force feed AZT to babies with the backing of the courts, as the horrific experiences of David and Kathleen Tyson, Pamela Anderson and Valerie Emerson in the US, Sophie Brassard in Canada, and Toni Watson and the late Molly Radcliffe in England, among countless others, have told. The tendency described by Finerman and Bennet to blame the victim may be more prevalent nowadays than before, but it’s not recent. In her meditation, AIDS and its Metaphors (Allen Lane, 1988), Susan Sontag – bright to its meanings, but dull to its core vacancy as a socially supported scientific construct – noted that ‘Plagues are invariably regarded as judgments on society … This is a traditional use of sexually transmitted diseases: to be described as punishments not just of individuals but of a group.’ Other widespread diseases too have been interpreted

as a sign of moral laxity. … Responses to illnesses associated with sinners and the poor invariably [recommend] the adoption of middle-class values: the regular habits, productivity, and emotional self-control to which drunkenness was thought to be the chief impediment. Health itself was eventually identified with these values, which were religious as well as mercantile, health being evidence of virtue as disease was of depravity.

Senator Walter Bennett has the idea. At a rally at Manzini, Swaziland in December 2002 the senior advisor to Swazi King Mswati III proposed that the government should not provide medical care to ‘HIV/AIDS’ patients because they ‘contract the disease out of their evil habits and out of choice’. So has Sunday Times columnist, David Bullard, playing with his penile cigar in a snapshot next to his by-line, and writing Life’s more fun when you know you’re going to die on 9 March 2003:

In most cases [HIV infection] is a ‘voluntary’ condition, transmitted sexually. … AIDS is not a particularly strong deterrent to people who know their lives will never amount to much. … some people actually embrace their own mortality. … Almost a year ago I wrote a column suggesting that the government was unwilling to pump public money into providing AIDS drugs because it would involve keeping an economically unviable portion of the population alive. The chances of many of these people becoming active contributors to the South African economy after a course of free drugs is, sadly, remote. I was expecting howls of protest but I heard nothing, so I must assume that I was spot-on.

Yes, David, you were, in articulating how your average white South African reader thinks, sitting alone in his car in the morning traffic jam.

A month after the Wits General Assembly on AIDS, the university set to work, hosting a four-day conference under the moniker, ‘AIDS in Context’. Cameron, needless to say, was there to open it on 4 April, sermonising interminably, as ever, in that feebly emotive, over-ripe fruity pitch of his – funny grammar, peculiar adjectives – that makes him the darling of AIDS career types all over. With his oratory billowing grandly without conceptual content to match. Saying so much yet so little other than, basically, how terrific the drugs are and why everyone should get them. But two tidbits caught the ear: ‘... this epidemic has from the outset involved as much a battle of ideas as a battle about bodies and organisms and cells.’ Indeed – because the AIDS controversy has been a stage on which a profound clash of thinking systems, value systems and political styles has been played out: pragmatic, open-ended African versus dogmatic, intolerant European. In a way, AIDS has afforded liberal ideology its last gasp in Africa, with Mbeki’s scornful lapse posing a dire and infuriating challenge to it. And whereas Cameron’s brother Goldstone J had just declared, ‘AIDS poses a threat to the whole society,’ Cameron now corrected him: ‘... the disease overwhelmingly, now, affects poor heterosexuals in the developing world. What these groups have in common in their vulnerability to AIDS is that HIV remains overwhelmingly a disease of the dispossessed, the marginalised and the stigmatized.’ Or to put it more simply, it’s the poor, as Mbeki points out: ‘... even a child, from among the black communities, knows that our own burden of disease coincides with the racial divisions in our country.’

A front-page headline report in the Sunday Times on 28 July 2002, Dread diseases hit SA’s starving kids: Three quarters of all South Africans do not have enough food, sketched a desperate scene ordinarily beneath the view of the newspaper-reading, television-watching, AIDS-fascinated public in South Africa – an entirely novel subject in the liberal media, and remarkable for a main story, particularly since it’s been politically incorrect to talk about chronic hunger as a cause of disease and early death after the fuss Mbeki caused by linking them in his opening address at the Durban AIDS conference in July 2000.

Mhlongo endorsed the Sunday Times article in a letter published the following week: Poverty and destitution explains the poor health status of black South Africans, picking up where it left off:

When President Mbeki and I repeatedly focus on issues of grinding poverty and destitution as the main reasons for the extremely poor health status of Africans, we are pilloried by all the media in South Africa. The media’s unbalanced preoccupation with HIV=AIDS=DEATH prevents any meaningful attempts to examine crucial health indices such as the deprivation index for South Africa. … Infant mortality, chronic malnutrition, marasmus, kwashiorkor and hypoproteinaemia as listed in the report can all be explained in terms of grinding poverty, squalor and deprivation. It is futile to focus on political correctness around issues of assumed heterosexual AIDS at the expense of the real issue of poverty. … Antiretroviral drugs are no substitute for food in Africa. Infant mortality, stunted growth and the link with poverty have been well documented in South Africa by Professors Reid and Moosa at the Durban Medical School in the sixties, i.e. long before the advent of HIV. These two professors noted then that 50% of black children in Natal were dead before reaching the age of five. (Archives of Race Relations in South Africa, Braamfontein). What we are seeing today as The Sunday Times article shows is nothing new. What is new is that those of our citizens from the former apartheid homelands are free to travel, seek hospital care, seek work and live in any part of South Africa.

Mhlongo’s final observation usefully explains why post-apartheid, formerly white urban hospitals have filled up with unwell blacks, a phenomenon chalked up by most whites to rampant AIDS.

Talking about poverty is frowned upon but not sex anymore, provided it’s coupled to the groovy American medical wisdom that it can kill you. When it’s ‘unsafe’. So we have Mandela, Tutu, and other celebs urging us endlessly in the newspapers and on radio and television to ‘Love them enough to talk about sex.’ Reinforcing the medical and social construction of diseases of poverty as a behavioural problem. Not a raw political one.

Public health programmes in the fight against AIDS, whether government or private sector originated, all have one thing in common: a didactic tone that casts their market constituency in the role of children in need of grown-up advice. Imparting wise information as a launch pad for behavioural directives. And some of the kids tutored play junior in turn. As we’ve seen from the pathetic tone of the TAC’s public statements. In his essay, The AIDS Cult and its Seroconverts, included in The AIDS Cult, Young notes incidentally that even the name, ACT UP, the AIDS activist organisation lobbying for AIDS drugs with branches all over the US and elsewhere, comes from what children do to win attention. Like Achmat and his refusal to take his medicine, playing up, mouth clamped shut.

CHAPTER

Much of USAID’s annual $54m grant to South Africa goes ‘into Aids programmes, including initiatives that deal with aspects of mother-to-child transmission’ – so US Senator Jim Kolbe told journalists in early April 2002, and slated to go up to $62m in 2003. Add a zero to work out the South African rand equivalent, and you begin to understand why there’s a chokehold on the free flow of ideas about AIDS in this country. Because thinking about AIDS is bad for business. And business in AIDS in South Africa is very good. Kolbe could have learned his lines from Cameron:

It is tragic that we have such a lack of leadership on the part of central government to deal with this problem, but we are getting services to where it is needed … So we are in South Africa simply working around the lack of leadership at the central government level to make sure that we’re dealing with the Aids problem. The money is getting there [‘to private health foundations, NGOs, clinics, hospitals and provincial governments’], the programs are there. … It is very sad and I’m very discouraged to see that the government has decided to appeal the decision of the [High Court] here to allow the distribution of nevirapine. They have not been able to demonstrate one bit of evidence that shows it is not a safe drug. [But see The trouble with nevirapine.] And when you’re looking at the alternative, which is certain death, it strikes me as common sense to make this drug available: it’s being used widely everywhere else. It is a tragedy of unspeakable magnitude.

He said he didn’t understand Mbeki’s position on HIV/AIDS; Mbeki was seen as a ‘conflicted’ back home. Whatever that’s supposed to mean. But basically unwell on top, since to a guy with Kolbe’s imagination Mbeki’s independent standpoint on AIDS can only signal mental disturbance. Imagine a senior South African politician visiting the US and publicly commending Michael Moore’s book about the Bush administration, Stupid White Men – ‘providing fascinating details on just how stupid Bush is’, as the back-cover blurb puts it. Or quoting gaffes from Mark Crispin Miller’s hilarious but chilling collection, The Bush Dyslexicon (Bantam Books, 2001), such as, ‘More and more of our imports come from overseas.’ Or pointing out that even one of Canadian Prime Minister (at the time) Jean Chretien’s aides openly called Bush a ‘moron’ in late November 2002. Followed by Mandela in late January, describing him as ‘a president who cannot think properly’. Kolbe went on: ‘There is no doubt he is a brilliant individual, probably one of the most intellectually brilliant people that has ever been a leader in Africa. He is a person that should know better that to say the kind of things he has said about HIV/Aids. That’s why it is puzzling to us.’ Not to Arthur Schopenhauer though, who once explained: ‘Intelligence is always invisible to the man who has none.’

It’s not only the Americans pitching in to save South Africa from AIDS, but the Europeans too. On 8 February 2002 the EU’s European Commission announced that it had allocated 50 million euros (about R400m) in aid, to be spent over 6 years to fight HIV/AIDS in South Africa and to strengthen primary health care.

To top up the coffers, as if we we’re running short, Health-e reported on 26 April that the Global Fund to Fight HIV/AIDS, TB and Malaria had just added R1.8 billion. Explaining why the United Nations was funnelling much of the cash – about R800 million – directly into AIDS organisations in KwaZulu-Natal province, rather than to national structures, a spokesman for the fund, Dr Christopher Benn, said that it would make these direct injections in countries that ‘suppress or have not established partnerships with NGOs’.

Both Mbeki and Tshabalala-Msimang were justifiably irked by the UN’s move to bypass national government and defy national policy. The Financial Mail reported on 14 June that when the minister demanded that the grant to the province be forwarded on to national government, Professor Umesh Laloo, dean of the University of Natal’s medical school and leader of team that had made the direct bid for funding, blew her off with the retort that his bid had been accepted already and it was too late for her to interfere. The next thing was that Laloo, along with the provincial premier and health MEC, found himself up on a red carpet before Mbeki and Tshabalala-Msimang ‘to explain the province’s breach of bid protocol’. But that was just a red herring, claimed Heywood in the Mail&Guardian on 26 July; the real reason for their opposition was because ‘When the grant goes ahead it will be the beginning of the provision of antiretroviral drugs to poor people in the worst-affected areas.’ The TAC’s national manager Nathan Geffen added: ‘What lies at the root of what is going on is the agenda of the AIDS denialists.’

Archbishop Ndungane’s reaction to Tshabalala-Msimang’s persistence in her objection was to demand that she resign, adding, ‘We must eliminate the fear fuelled by misinformation and stop dithering about response and responsibility [which is to buy AIDS drugs with the UN money]. We must unite in a stand for hope.’ The TAC’s response was to threaten to sue her. On 11 July, flushed with victory against the government in the High and Constitutional Courts over nevirapine, Heywood announced that another interdict application was on the cards: ‘The Ministry of Health, and the Minister of Health in particular, in trying to block that grant. It is extremely urgent that this situation be resolved quickly. It is not beyond the rules [sic] of possibility that we take this to court. This situation is about saving lives.’ UNAIDS director Peter Piot chipped in that ‘governments blocking funding of care and treatment’ might be bypassed in future, with the money being sent to ‘civil society’ instead, ‘as happened under apartheid’.

On 19 June, claiming that two thousand babies get AIDS [sic] from their mothers every day, Bush announced that he had proposed the allocation of a further $500 million to ‘prevent mother to child transmission’ in eight African countries and the Caribbean – in other words to buy to buy AZT and nevirapine for pregnant black women, to ‘save children from disease and death’ – on account of being born to ‘AIDS-infected’ mothers. As the New York Times put it: ‘Included on the target list in Bush’s proposal is South Africa, which has the highest rate of HIV infection in the world. The government there had until recently been widely criticized for government policies that did not do enough to provide access to lifesaving treatment.’ AZT and nevirapine. ‘Lifesaving’ like Nestlé formula milk.

On 23 July the German government announced that it had committed R550 million to South Africa for various vaguely defined, feel-good projects, with HIV-AIDS prevention on the top of the list. And that it had made a grant of a further R9 million for constructing and manning centres for HIV testing and advice. A statement from the German embassy went: ‘The devastating HIV/Aids pandemic remains a central cross-cutting issue in the development cooperation with South Africa.’ Cutting across the most basic common sense and empirical facts.

The US NIH’s NIAID bought itself some political shares with the Bush administration on 26 July by announcing through the US embassy here a grant of R110 million for AIDS research made to ‘a new, collaborative Center for the AIDS Program of Research in South Africa (CAPRISA), led by the University of Natal in Durban’. The idea seems to have been to deliver an implicit insult for Mbeki. The embassy commented that ‘the grant is one of the largest NIH grants made directly to international investigators. It demonstrated that South Africans can be among the world leaders in HIV/AIDS research and that the U.S. is prepared to be a committed partner in South Africa’s fight to prevent and treat HIV/AIDS to save human lives.’ Stuff Mbeki wasn’t doing and was frustrating. With all this pointless talk of his about poverty and things. If you won’t do your job looking after your people, we will.

Joining the fashion for pouring cash into the country to wage war on AIDS, the Danish government pledged R110 million of its own for the fight on 19 August.

There can be no gainsaying that, like apartheid and Nazism, AIDS, with the massive infusion of cash it has drawn from abroad, has been a fantastic boon for job creation, and a huge boost for the economy – tapped here largely by the lighter castes. For consultants, advisers, researchers, counsellors, non-governmental organisations, journalists, university academics, project managers, auditors, advertisers, printers and hoteliers, AIDS has been a bonanza bigger than Christmas. And for the fight against AIDS there’s a king’s ransom swilling around the country right now, and particularly in KwaZulu-Natal. The terror and hopelessness inflicted upon the mostly poor by its beneficiaries is a matter of no account. The trouble with this kind of massive infusion of money is that, as Indian AIDS dissident activist Anju Singh in Delhi has noted, it ‘sidelines our democratic institutions to the dictates of alien agendas’. And it practically buys opinion, chokes off critical voices, and effectively bars scientific inquiry and policy formulation off the beaten path. It’s why the Wellcome Trust have so generously endowed a chair at the University of Cape Town’s medical school, for instance. Followed by two research fellowships worth ten million rand over five years announced in June 2003. To keep things on track. Theirs.

And it’s not just an incidental effect of pouring tons of foreign cash into our country that our democratic institutions are sidelined – it’s become a deliberate policy of the UN. Using big business as a conduit. On 30 August Business Day reported:

The United Nations (UN) has abandoned its policy of relying on governments to tackle the HIV/AIDS crisis in developing countries, saying it will now help fund corporate initiatives to provide antiretroviral drugs to sufferers. It may also presage a situation in which the SA government, which is reluctant to concede to most prevailing orthodoxies about the pandemic, is simply bypassed by international agencies wishing to assist affected populations. … Peter Piot, [head of UNAIDS said] that the $2bn UN Global Fund ... would consider supporting corporate programmes that offered antiretroviral treatment to employees and their dependants

– in line with his plans to bypass ‘governments blocking funding of care and treatment’, as he said in July, the money being sent to directly to ‘civil society’ instead, ‘as happened under apartheid’.

Excited by talk of such lolly, the South African Medical Association made a pitch, announcing in the Cape Times on 3 September that it intended establishing two stations in each province, one urban, the other rural, through which people ‘with HIV/AIDS’ would be funnelled ‘to doctors in the private sector ... paid a lower rate than usual, but ... assured of a large number of patients’. SAMA had trained eighteen hundred of them, it said, many of them members of its HIV/AIDS Clinicians Society. Its president Des Martin said the drug-dispensing programme would be the biggest in the world, dwarfing those in other countries. All it needed was R80 million. To pay for the drugs, it said. And, of course, the all-important doctors’ consulting fees.

After three visits to persuade him to act as patron of this clever business scheme, SAMA president Kgosi Letlape reported that he’d got Mandela ‘very keen to get involved’. So announced the Mail&Guardian on 20 September with expected fanfare in a front-page headline: Mandela leads charge on Aids. The caption to a photo inside seemed to have confused him with Jesus: ‘Nelson Mandela has toured the country calling for a treatment programme and for the sick to come forward.’ And for just one light moment we thought the editorial, Roll out the drugs, meant reefer – until we read:

This week the admirable South African Medical Association boss Kgosi Letlape announced a plan, backed by former president Nelson Mandela, to give free anti-retroviral treatment to those who cannot afford the drugs. … Manto Tshabalala-Msimang has complained she is being forced to “poison my people” by providing anti-retrovirals. … One can assume she would not act and speak in this way if her principal, President Thabo Mbeki, disapproved. … And to show that they are no longer prey to dissident fantasies, the health minister and her Cabinet colleagues should consider submitting to Aids tests and publicising the results.

Classic Howard Barrell, getting in his last word on the South African AIDS epidemic before quitting to emigrate to mother England.

Any Cabinet member lighting up the ‘antibody’ test can get ‘monitoring tests’ done cheap: on 20 August the South African HIV-AIDS Clinicians Society announced that anyone consulting one of its members could get a half-price discount for an HIV test, viral load and CD4 cell count combo from Toga Laboratories. Penny Penhall, a ‘spokeswoman for the society’ said: ‘The society views this as an important development which could ultimately lead to an increasing number of people living with HIV/Aids being able to access antiretroviral therapies. …Toga has also notified the Treatment Action Campaign about the offer and we urge other laboratory service providers to join in this initiative.’ It would have been a bit awkward also telling us that Toga Laboratories’s Des Martin moonlights as president of the HIV-AIDS Clinicians Society.

On 26 September the Anglican Church announced that it had adopted a R22.5 million programme to fight AIDS by way of ‘a youth ministry curriculum on sexuality and HIV’, ‘pilot projects for ministry with orphaned children’ and the development of ‘a policy for AIDS in the workplace’. Drawing it up had taken a year, it said, with over a thousand parishioners participating in the process. Every single Anglican diocese in the country would be involved in implementing it. And who would be funding these aforementioned services? Foreign governments and institutions, starting with R1.8 million from USAID, the church announced, to be administered through the Church’s Mothers’ Union and the Anglican Women’s Fellowship. Archbishop Ndungane took off overseas the following week to shake down international donors who had expressed interest in the programme – accusing Mbeki, Tshabalala-Msimang and the government of being sinners and criminals before he left: it was ‘sinful’ to withhold AIDS drugs, he said, and ‘It is criminal that thousands remain at risk of HIV infection and still many more are dying from lack of treatment. This is all because of government’s failure to obey the law and act.’ Maybe we should throw the criminals in jail. Or make them do some penances. For their sins.

On 31 October, at the 6th World Congress of the International Association of Bioethics in Brasilia, Brazil, the Wellcome Trust launched a £34m scheme to finance research into ‘the ethics of biomedical research in developing countries’. The principle target for the imminent funding deluge was suggested by the posts of the guys announcing it: Michael Bennish, Head of the Wellcome Trust’s Africa Centre for Health and Population Studies in South Africa, and Sassy Molyneux from the Trust’s Kenya Unit. Any chance of getting a grant to explore and report the ‘social, ethical, legal and public policy issues’ involved in giving AZT to pregnant women? Rape victims? And South Africans generally?

One of the biggest AIDS projects in South Africa, funded mostly from abroad, is an ‘AIDS awareness’ campaign called ‘loveLife’. All around the country its enormous billboards elevate the most humdrum, timeless politics of sexual negotiation to some sort of urgent contemporary issue. Always suggesting deadly danger below the belt: ‘I only do it skin on skin. James 18.’ As if there’s something reprehensible about that. The deadly hint is driven home by such messages as: ‘Eish, I’m doing too many funerals these days.’ The largely white ad agencies and ‘AIDS workers’ who turn out this slickly presented propaganda assert that everyone’s at risk, but the black township slang and mostly vernacular names appearing in the messages leave no doubt at whom it is targeted. As does the name of loveLife’s toll-free AIDS counselling helpline: ‘thethajunction’ – thetha being Xhosa for talk, but how many whites outside the Eastern Cape know that? And then there’s the location of the billboards – everywhere, but especially on arteries in and out of small towns with colonial names in drab rural backwaters, beaming their brightly coloured messages at their predominantly black inhabitants.

A daily affront to the local poor, the garish loveLife signs sharply exemplify the irrelevance of AIDS ideology and prevention programmes in such regions, where the social and infrastructural investment need is so obvious, the waste of money so gross, and the ignorant arrogance of the city-slickers who ‘workshopped’ their inane messages so offensive. And of course the parallels with Christian mission penetration a century and more earlier are striking. Until recently, the most common loveLife billboard urged parents: ‘Love them enough to talk about sex’ – absolutely foreign to African culture. It was followed by: ‘Tell them sex is worth waiting for.’ The effect of the loveLife messages is to drill blacks with a negative racist sexual stereotype, as ugly and insidious as the lessons in Bantu education textbooks, and they reinforce the same in the minds of whites, and South Africa’s other non-black populations. So that a white caller can phone in on the national Talkback radio show on 27 November 2002, and complain irritably about Mbeki’s questioning of what causes AIDS, because ‘everybody knows it’s promiscuity that’s killing our people, not poverty’. By ‘our people’, of course, he meant black. Since whites are doing swell, as always. And a report of a nationwide survey conducted by the Department of Health, released five days earlier, found that whereas two years ago a similar survey conducted by Soul City found that forty-seven per cent of black and ‘coloured’ people thought they were at risk from AIDS, the figure was now sixty-seven per cent. But only half as many whites did: thirty-five per cent. Since the ‘messaging’ is so obviously not directed at them. Indeed, the report recognised this: ‘White respondents were less likely to perceive themselves, their peers or partners as being “at risk” of contracting HIV/AIDS, and therefore may take less interest in the issue. This highlights the dangers of HIV/AIDS being labelled as a problem affecting particular groups of people and the imperative need to develop a range of messages which appeal to different audiences.’

Too late for the next crop of loveLife billboards, pasted up in November 2002: all but two that I’ve seen feature blacks. ‘Too smart for just any body’ says a pretty black girl. Implying that black girls are congenital sluts. But the billboard will put a stop to it. ‘Sex – worth waiting for.’ Till when? The eager looking black couple on the billboard offer no clue

In his study, The Libidinal Economy, post-modernist philosopher Jean Francois Lyotard set out further objections, both political and practical, against campaigns like loveLife’s: denying libidinal drives is an implicitly authoritarian act, but more than that, in repressing natural processes beyond logic and reason they are always doomed to fail. Because American propaganda on roadside billboards is hardly going to cool anyone’s hots. Sex owns itself. As rivers tend to the sea.

An article in the November 2002 issue of the South African Airways magazine Sawubona revealed the premises from which the loveLife programme proceeds, and the quality of the social science research behind it: ‘The idea was conceived by a group of South Africans along with the [American] Kaiser Foundation because they believed [!] that conventional public health messaging wasn’t working. A loveLife survey found that over half of the girls questioned said they didn’t want to have sex with their boyfriends, but did it anyway because they thought they had to. Sex in exchange for money or food was found to be common, and a high proportion of girls admitted that they had had sex with teachers in exchange for good marks. The survey also found that many young men didn’t understand what constituted rape. These attitudes were all threatening to worsen the spread of Aids.’

The girls in question would have been black. Since no one is suggesting that white boys and girls are spreading AIDS. Given the starting assumptions of the ‘concerned group’ of South Africans and Americans who drew the questions (‘who believed that conventional public health messaging wasn’t working’) the manner in which the questions in the survey were framed are bound to have shaped the answers. Is it really likely, if we could just come down to earth for a while, that more than half of girls who have sex with their boyfriends don’t think it’s the best thing going? And really think ‘they have to’. That screwing for money or food was common? As opposed to occasional. Other than among the destitute for survival – in which case, ‘messaging’ will be totally irrelevant. That ‘a high proportion’ trade sex for marks? And that many young men couldn’t tell the difference between willing and forced, and didn’t know that might in place of a smile to score a home run was against the law?

On 25 September 2002, accompanied by gay actor Kevin Spacey, Bill Clinton flew into Rwanda on a mission to help save Africa from AIDS: ‘I believe reversing the AIDS [epidemic] is the most important issue that is facing the whole world,’ he said. ‘It should unite all people.’ People with nothing better to do. Three days later he hooked up with another retired President – ours – having shared the podium with him in July at the opening of the Barcelona AIDS Conference. The meeting with Mandela was arranged to consecrate the new loveLife Y-centre at Orange Farm, a poor black township near Johannesburg, where they joined Kaiser Foundation boss Drew Altman in making speeches and pledging their support for the loveLife programme. We should be ‘rolling up our sleeves and climbing into the trenches’, said Mandela. Make no mistake, Tata, on the medicine you want everyone drinking – (it’s ‘a matter of time before we will see a huge infusion of anti-retrovirals into the health system’) – it’s into the trenches we’re headed, the ones dug side-by-side. The skull and crossbones on the orange Sigma label leaves no doubt. Mandela spiced his exhortations with a dash of struggle talk: ‘Orange Farm is a product of apartheid. Orange Farm is testimony to our people’s fighting spirit.’ What oubaas failed to notice is that ‘our people’ weren’t there. Other than the BMW set cruising in. It was apartheid again: for ‘security reasons’ local community leaders and residents were excluded from the festivities.

The gap between Mandela’s political naivety, as compared with his incumbent successor’s radical ideological sensibilities – way beyond European left and right – was highlighted by the Anglophile’s wholehearted participation in what was essentially a frenzy of big business dealing, as the Sunday Independent made plain the next day:

A number of new partnerships between business and loveLife were announced and these include reiteration of existing partnerships with the South African Broadcasting Corporation, the Sunday Times and Independent Newspapers, Custom Group Holdings and Spoornet, as well as innovative new partnerships with Mondi Paper, South African Airways, Ster-Kinekor, Sentech, the Vodacom Foundation, the Digital Partnership and ... MedScheme. The value [to loveLife] of these partnerships [discounts and concessions] exceeds R50 million a year. The existing public-private partnership between the government and the Henry J Kaiser Foundation in support of loveLife was also consolidated.

SABC radio reported on the evening news that the Nelson Mandela Children’s Fund and William J Clinton Foundation were pitching their cash in too. Not that loveLife was running short; it’s funded to the tune of $20 million annually, half from the Kaiser Foundation, and the rest from the Bill and Melinda Gates Foundation, topped up to the rim by the Department of Health.

Don’t think for a moment that the business types involved were in it for the love of it. As Fair Lady made clear in June 2002:

Ster-KineKor and loveLife have a new partnership that gives loveLife exposure on screen and in Ster-Kinekor foyers, and branding in Ster-Kinekor’s public toilets. In return, Ster-Kinekor will gain exposure in the loveLife print publications, youth centres and clinics. … Ster-Kinekor marketing executive Odette van Wyk argued that the agreement with loveLife was a win-win one that had a commercial element for Ster-Kinekor, which was ‘very interested’ in the youth market loveLife was reaching.

Pick up either of ‘loveLife print publications’ Scamto and ThethaNathi, included inside the Sunday Times and Sunday Independent, for which favour loveLife pays millions beyond counting, and it seems to be less about Fucking than Shopping. Apart from the latest must-see movie on circuit at Ster-Kinekor cinemas, the glossy supplements punt must-have high-ticket fashion gear like Soviet and Skechers shoes.

Mandela could see no further than a public spirited indaba at which to plan getting the safe sex message across: ‘I applaud the government for ensuring funding and for its far-sightedness in recognising how necessary it is to get the attention of young people.’ Before they all screw themselves to death, as American doctors like Drew Altman fly over to warn. His jaw jutting presidentially in the photo, like Kennedy’s. Or some other Ivy League toff. Mandela admiringly quoted Clinton’s soaring oratory on a previous occasion: ‘... the question is not what can be done for Africa, but what can be done with Africa.’ The kind of paternalism at which Mbeki bridles, but not our grandpa. Mandela’s lines were recited on stage with pitiful cluelessness as to the bigger picture. It wasn’t about sex and nefarious germs and runaway African promiscuity; it was about markets and money and control. By Americans. Relishing the revived power and popularity that his AIDS drug advocacy was giving him, Mandela made plain that he had no intention of quitting the back-seat driving that was proving so irksome to Mbeki and the leadership of the ANC. After calling two of his grandchildren up on stage, he waged his finger at them and then said: ‘I have 29 grandchildren and six great-grandchildren. They are very naughty. They tell me I have lost power and influence, that I am a has-been. They tell me to sit down. That I must stop pretending I am still the president. Now, you have heard all these important people here today, you have heard what they say about me. So, now you must stop telling me to sit down!’ It was really rather pathetic. But at the same time it highlighted a most remarkable switch in positions. We noted earlier that as President, Mandela had showed no interest in the AIDS craze whatsoever. Deputy President Mbeki, on the other hand, had been swept up in it. But within weeks of his succession he began to find out that it was all a lot of nonsense, like the mediaeval witchcraft mania. And as Mbeki’s faith lapsed, Mandela’s took off.

LoveLife CEO David Harrison was quoted in the Sawubona article saying, ‘It’s too early, after only three years, to tell how successful loveLife has been. But so far the evidence is positive.’ Liar, liar, pants on fire: the month before, the popular magazine Bona reported the results of a sex survey that loveLife had just conducted. Harrison was mum about it. Not surprisingly: Despite being bombarded by the loveLife message on billboards, over the air, and in glossy newspaper supplements year after year, seventy-eight per cent of teenagers had had sex by the age of fifteen, thirty-two per cent of young guys never used condoms, and a further thirty-nine per cent generally avoided them. So much for: ‘I told James to wrap it or zip it. Zola 17.’

The results of loveLife’s own survey were hard to match with rather different claims made by loveLife on the little flip-down overhead TV screens of its ‘partner’ in the war on AIDS, South African Airways: ‘Sixty-seven per cent of young people exposed to loveLove say they are now more likely to delay or abstain from sex.’ Giving the kind of answers that will please the researchers. Boyfriends and girlfriends exchanging winks after they’ve left. Probably left with a free loveLife tee-shirt for participating in the study. And some condoms.

Responding to a critical article about his organisation’s programme in the just-mentioned issue of Fair Lady, Harrison began with the old ruse of the AIDS trickster, deflecting criticism with incoherent alarmist propaganda: ‘LoveLife is different, and deliberately so. Up to 50 percent of our children under the age of 15 will, sometime in their lives, contract HIV – unless we change the course of the epidemic.’ The rest of his defence was more of the same flimflam. Thought up in his new Jag on the way in.

The government, we recall, was lambasted endlessly over the Sarafina II episode, in which several million was spent on taking an energetic musical play around the country to sell safe sex to black youngsters. It was conceived, written, produced, staged and acted by black artists. There is no reason to believe it had any more or any less influence on the sexual behaviour of its target audience than the loveLife programme that succeeded it. Especially since official ‘messaging’ has never had the slightest effect on private behaviour anywhere in the world. Be it concerning sex, drugs or rock and roll. Relative to the cost of keeping the loveLife scam going, Sarafina II was small change. Why then, notwithstanding its failure to show anything for all hundreds of millions spent on it, the loveLife programme hasn’t been condemned in similar terms, its executive board locked up as Harksen type swindlers, appears to me to be because loveLife was thought up by and is supported by whites. Local and American. Aiming to control the sexuality of blacks. (As they sought to do while propounding the population explosion myth.) On the basis that it’s black sexual intimacy that’s spreading disease. With the guys at it like excited dogs, and the girls yielding like complaining cats. Or for pay.

In April 2003 loveLife hired actor John Kani and musician Johnny Clegg, both international South African brand names, to recite on radio and television: ‘Most teenage girls who have had sex say their boyfriends gave them no choice.’ The inherent improbability of the implication that for most girls under twenty sex is rape, like so many other outlandish claims in the AIDS age, doesn’t faze them, or anyone else, and it richly reveals the essentially unrealistic, religious character of HIV-AIDS dogma – driven by an ‘all men are brutes’ subtext supplied by American feminism’s lesbian left misandry. As AIDS itself does, I think this American feminist concept of female victimhood springs originally from Christian constructions of sexuality and morality, and succeeds them essentially unchanged – the idea that sexually and morally men are basically bad, and that women need protecting from them. Don’t yearn equally strongly for sexual union either. The pervasiveness of such thinking in the US, this contemporary feminist ideological offensive against men, against masculinity, even against male children in schools, is charted in grotesque detail by Christina Hoff Somers in her book The War against Boys (Simon and Schuster, 2000). And now it arrives on our shores, exported from the US, in the form of loveLife’s current behavioural modification programme. Aimed exclusively at males. Fathers urged: ‘Talk to our sons about the difference between love and sex.’ As if they need telling. As if feeling, suffering in love, is the female preserve. ‘We need to help our sons become real men.’ As if they need helping – and, when it comes to getting down, girls don’t get equally hot and heavy. Instead, stand around frigidly backs to the wall, pigeon-toed, knees clamped, their eyes gazing heavenward like the Mother of God. Keeping the dog off. Aren’t finally in charge of the whole game. Transmitting all the signals to play. And holding the ace always, pouting petals glistening.

Bisexual, post-feminist radical Camille Paglia commented on the modern foundation of the thinking behind the new loveLife project:

A major failing of most feminism is its dumb stereotyping of men as tyrants and abusers, when in fact men are tormented by women’s hemming and hawing, their manipulations and humiliating rejections. … It is woman’s destiny to rule men. Not to serve them, flatter them, or hang on them for guidance. Nor to insult them, demean them, or stereotype them as oppressors. It is not male hatred of women, but male fear of women that is the great universal.

In an article he wrote on 2 April 2003 for , in which he described how he nearly got arrested for asking awkward questions at a university AIDS panel meeting, David Crowe in Calgary, Canada provided a crisp deconstruction of this ‘feminist model of AIDS’ – with its especially horrible implications when applied to Africa: it conceptualises women as

the victim of sexual aggression by men, with HIV being transmitted as a side effect. This feminist argument relies on heterosexual intercourse being the main means of transmission of HIV. Without this, the connection between sexual power politics and AIDS falls apart. The argument has two other weaknesses as well. It portrays men as incapable of love and fidelity, stereotyping them as interested only in satisfying their own lust, with no concern for women. Women on the other hand, are portrayed as sexually passive, as incapable of being sexually irresponsible or adventurous as men are of being responsible. Ultimately, it is a very Victorian view of both genders. But a larger problem is the unspoken, racist, dark side to this view. If all men were like this, then AIDS should be evenly distributed around the world, not just in Africa. Consequently, a corollary of this argument is that it is largely black men who are insatiable sexual predators. People who attend these meetings do care about the world, probably much more than average. Consequently, beliefs about AIDS have to be wrapped in a rhetoric that will appeal to them. The story that people are dying in Africa because men are irresponsible, and women need to be more empowered, is an attractive idea. None of these people would have likely attended if the panel spoke directly of how black men are sexually irresponsible. Yet, this is the racism underlying the feminist sugar-coating.

CHAPTER

There’s a palpable backdrop to all the special AIDS excitement in South Africa. The privileged castes are tense and unhappy. The reassuring certainties of the old order are recently gone, even if they were inherently untenable and unstable, and, by a tiny few of the elites, abhorred. They fret about what the future holds for the country and their children. With Mbeki prioritising poverty relief and development over Mandela’s reconciliation agenda. And always going on uncomfortably about racism everywhere. An editorial by some prominent ANC intellectuals – Netshitenzhe, Jordan and Cronin, inter alios – drew the scene well in the tenth issue of Umrabulo, the ANC’s steam-chamber for analyses of the state of the revolution, published on May 2001:

A variety of classes and strata see in the project of social transformation an immediate challenge to their material conditions and way of life. … Running across the mindsets of most of these classes and strata is a common fear of ‘black majority rule’. This conjures up images of vengeance, collapse of the rule of law, dispossession, and all the frightening things that the Natives can do! To these, the apocalypse has just been postponed. Reconciliation and nation-building meant a reprieve from this outcome; and the ‘miracle’ of transition had to be followed by pestilence and the rumblings of hell and damnation. In other words, the political constructs of the white-based Opposition are not artificially generated. They are a genuine representation of the fears, prejudices and defence-mechanisms of sections of communities that have psyched themselves into a siege mentality.

An AIDS-ridden black populace at the gate is just such a construct, and it perfectly embodies them all. A construct with immense cohesive ideological potency, around which all manner of inchoate apprehensions and dark ideas cohere. AIDS plugs the ideological void left by the sudden collapse of apartheid. Whether you were pro or con. I pick this up over and over at social gatherings. A gay journalist high on E, with whom I was enjoying a friendly conversation at a party in Cape Town in mid-July 2004, became aggressively agitated at the first whiff that I was a ‘dissident’, as he noisily declaimed repeatedly, caused a big scene, and had to be calmed down by others around us. To question AIDS is to experience, as Rian Malan noted in noseweek and the Spectator in December 2003, something ‘very ugly: ruined dinner parties, broken friendships, ridicule’. The psychic power of AIDS as an ideology, over those whose inner world is ordered by it, strikes me afresh every time. It is not to be trifled with.

For ‘the most privileged society this side of the Shah’s family’, as someone once quipped about white South Africa, things are changing rather fast. Such a climate is conducive to ‘hysteriform manifestations’, notes Sirois in his analysis, Perspectives in Epidemic Hysteria (included by Colligan et al.): ‘The climate of the Catholic Inquisition, ... which dealt with the legal examination and sentencing of witches, arose at a time of strains and tearing of the social tissue with the exploration of new worlds, the uprising of free thinking and the rupture of the religious order’ with the Catholic Church losing its complete power over body and soul in Europe and Protestant sects getting going.

The Inquisition into heresies is akin to our post-revolution AIDS mania, a type of ‘maladaptive group response’, assuring a ‘diffused responsibility between members, a displacement of wrongdoings and the taking over of the situation by external agencies (administrators, police, doctors etc)’. And then, with a raspberry for both Cajee and Cameron at the Wits Special Assembly, Sirois moots: ‘Moreover, it might be hypothetically put that the leader who operates as the Ego of the group aligns himself along the wish of the index case, thus fostering the identificatory process of all members to the wish of the affected individuals, increasing the fantasmatic resonance in the group.’

‘It was surprising ... how ... university faculties knuckled under the Nazification of higher learning after 1933,’ noted William Shirer in The Rise and Fall of the Third Reich. He quoted Professor Roepke (fired for resisting): ‘It was a scene of prostitution.’ Well, Prof, you wouldn’t have wanted to be anywhere near Wits on 7 March 2001 – with its speakers exhibiting ‘the zeal of a Goebbels and the fuzziness of a Rosenberg’, as Shirer described the ‘preaching of the Nazi gospel’ by Rust, Reich Minister of Science, Education and Popular Culture. Cooking up a spectacle deplored by Susan Sontag: ‘That even an apocalypse can be made to seem part of the ordinary horizon of expectation constitutes an unparalleled violence that is being done to our sense of reality, to our humanity.’ But violence is the lifeblood of fascism, Susan. You should know that. It’s what makes AIDS and all it implies so attractive to Cameron and what he calls his ‘AIDS movement’.

Culturally, apocalyptic paradigms serve the function of jackboots, as Efron explains in The Apocalyptics:

A frightful catastrophe [is declared] to be imminent, so imminent that there is no time for facts, logic, or the slow, serious development of an authentic predictive science – if such a predictive science is possible. Once adopted, the ‘apocalyptic paradigm’ acquires a pathological life of its own. It leaves time only for hysteria, for ‘suspicion’, for scientific ‘fiction’ and mythology, for demagogy – and for the use of political force to impose moral and political substitutes for science on industry, on the nation – and most crucial of all, on the academic opposition. … It is a profoundly anti-intellectual phenomenon, which, in the realm of science, is to say that it is profoundly antiscientific. … The ultimate effect of the ‘apocalyptic paradigm’ has been to inaugurate a mitigated Lysenkoism … – mitigated because those scientists who dissent are free to publish in arcane journals rarely or never seen by the press or the public. [This, for the most part, is precisely the experience of AIDS dissident scientists.] They are simply not free to argue with the state where the citizens and the press will hear them. [Efron was referring to the state in the context of state-supported paradigms, such as those propounded by its cancer agencies.] … Thus the public has not only been kept from encountering scientific dissent, but has been educated to believe that scientific ‘truths’ imposed by the state are morally and intellectually proper, while dissent from the state in this realm is evidence of intellectual and moral corruption. Whatever other roles it may play, this particular result of the ‘apocalyptic paradigm’ is culturally deadly.

It’s worth noting here that in South Africa the unique situation exists where the democratically constituted state stands on the side of scientific dissent. The resultant fallout is revealing about the extent to which the country remains governed by extrinsic and hostile ideological and economic forces, and how weak it is to resist them. So that in the teeth of their vehement opposition, Mbeki and Tshabalala-Msimang would later find themselves railroaded into shelling out billions to provide AIDS drugs in the public sector.

In his essay The Homofascist Identity, published in the radical American gay journal Magnus in April 2000, Alex Russell (son of film director Ken), queer himself, pounded the particular gay psychology of Cameron’s ‘AIDS movement’ with exploding shells like:

Fascism’s obsession with rebirth, the new man, youth and the cult of the masculine is found in the Leni Riefenstahl-inspired body images promoted in HIV pharmaceutical advertisements. Such HIV Volkisch Kulture imagery is the Nazification of the Queer Body Politic. … AIDS doctors (like Nazi doctors) operate through genocidal bureaucracy using pseudo-science to justify sexual ethnic cleansing. Many gay men branded HIV-positive passively accept that they are marked for slaughter, slavishly sign their own death warrants and run giggling into the gas chambers. … Robert Jay Lifton [a scholar of Nazi medical philosophy] wrote: ‘The genocidal bureaucracy contributes also to collective feelings of inevitability. The elaborateness of the bureaucracy’s organization conveys a sense of the inexorable – that one might as well, as a perpetrator or victim, go along because nothing else can be done. Under certain circumstances, victims’ bureaucracies can be coerced into participating in their own people’s victimization.’ … Today, the many AIDS bureaucracies run by gay careerists are participating in their own queer brothers’ iatrogenic and psychogenic annihilation. … Fascism is said to be an example of the administrative mechanism of power coupled with old symbolisms of blood … HIVism is genocidal bureaucracy initiated by blood testing rites sanctioned by totalitarian science. Plus ça change?

But Russell’s superb piece cast light onto the dynamics of the Wits 9th General Assembly too: ‘Many attributes of the HIV Homofascist Movement (or HIVism) resemble those of Fascism and the psychology of the Freimen: an authoritarian personality; extreme emphasis on the masculine principal, male dominance and blood brotherhood bonding; exclusive membership of an elite in-group; and the fetishization and aestheticization of suffering, self-sacrifice and death.’

Another Russell commenting on the same tricks – the philosopher Bertrand – noted before him: ‘The next step [in a fascist movement] is to fascinate fools and muzzle the intelligent, by emotional excitement on the one hand and terrorism on the other.’ Both in abundance at Cameron’s Wits rally, and in his ‘AIDS movement’ generally – inspiring the deepest terror in the lumpen, and more fervour in its lay preachers than any other contemporary cause. Wilhelm Reich amplified: ‘Reactionary concepts plus revolutionary emotion result in fascist mentality.’ (But you really mustn’t go about saying so because, as Miguel de Unamuno noted: ‘That which the fascists hate above all is intelligence.’)

Russell the younger continued:

One can see actual group hypnotic trance phenomena working within both Fascism and HIVism where devotion, ceremony, and obedience are called upon and used by the cloned membership of the elite in-group. Fascism and HIVism, as products of group hysteria, are psychologically contagious cultural/social beliefs spread through mass hysteria, mass-hypnosis and mass-media. … Theodor Adorno gave an account of the regressive psychology of organized groups which fits the ethos of the HIV Homofascist Movement: ‘What happens when masses are caught up by fascist propaganda is not spontaneous primary expression of instinct but a quasi-scientific revitalization of their psychology – the artificial regression described by Freud in his discussion of organized groups. The psychology of the masses has been taken over by their leaders and transformed into a means of their domination. The collectivization and institutionalization of the spell have made the transference more and more indirect so that the phoniness of enthusiastic identification and the dynamics of group psychology have tremendously increased.’

David Mertz, a philosopher at the University of Massachusetts at Amherst, delineated another dominant current pumping through the safe sex campaigns of the AIDS activist lobby, and immanent in the new AIDS policy announced at the Wits General Assembly, in an essay published in Rethinking Marxism in Spring 1996/7, Sex Wars: The New Left’s AIDS-Related Scientism. He qualified his observation that the ‘so-called Sexual Revolution of the 1960s and 1970s’ died in the 1980s, by pointing out that very little actually changed in sexual habits after it, or indeed during it:

What has changed dramatically in a decade is the ideological tools and strategies used in conceptualizing sexuality, and the relation of sexuality to broader notions of social power, political struggle, freedom and responsibility. Most of the renegotiation of sexuality has been a determined effort on the part of the right-wing to reinstitute its fantasy conception of ‘family values’, normative heterosexuality, and condemnation of non-monogamy. An additional contribution to such a conservative renegotiation of meaning has come from certain self-identified feminists who have repeated the puritanical strains of 1920s ‘first wave’ feminism in its ‘anti-prostitution/anti-vice’ crusades.

He then hit the nail on the head:

AIDS [as an ideology of sexuality] has succeeded in shifting the left-wing discourse of sexuality away from one of liberation, freedom and resistance, to one of responsibility, danger and obligation – concepts much more at home with a right-wing scheme of social control, xenophobia and authoritarianism than with anything on the Left. “Safe sex” has succeeded in performing this conceptual shift – a shift which would be seen through if it came from traditional conservative forces, and which would be largely resisted if it came from anti-porn ‘feminism’ – precisely because the language of ‘safe sex’ is one inextricably signed with the imprimatur of medico-scientific authority. … The altars of science – in particular scientific sounding pronouncements about AIDS – have been the one significant form of social authority generally unquestioned – or at least not very deeply questioned – by academic leftists. Somehow science has served in dismantling the language of liberation in the Left more than any other institutions possibly could have, because the Left has not gone beyond an automatic doxastic presumption in favor of moralism bearing the imprimatur of science.

Wyndham Lewis, the English writer and painter, explained precisely the kind of science that Mertz refers to: ‘When we say science we can either mean any manipulation of the inventive and organizing power of the human intellect; or we can mean such an extremely different thing as the religion of science, the vulgarized derivative from this pure activity manipulated by a sort of priestcraft into a great religious and political weapon.’

Interviewed for Playboy’s fiftieth anniversary edition in January 2004, actor Jack Nicholson commented on this ‘phenomenon’ described by Mertz that he’d

noticed … These have been troubled times in the area of sexual expression. I rank the publicizing of AIDS right up there with the atomic bomb as events that impacted our culture for the worse. We were moving toward a more feeling, freer society until AIDS, which came along and gave the right wing the chance to reinstitute its idea that sex is negative. Anybody who owned a bar in the 1970’s can tell you it was the end of the bar business, period. It was a sign of society reversing itself in term of the enjoyment of freer sex, because sex was associated with death.

When the interviewer countered, ‘There was always safe sex’, as if, contrary to what Nicholson was saying, having sex without donning a condom had always been considered life-threateningly dangerous, Nicholson rebutted:

But safe sex became the equivalent of ‘I won’t kiss you’ for a girl. It became just another obstruction. Most people who investigated this knew that if you were not shooting up or getting fucked in the heinie, you were as likely to get AIDS as have a safe fall on your head while walking down Wiltshire Boulevard. But you could not proselytize this view. The facts were almost useless. You couldn’t give a woman the facts and have her respond, ‘Oh, all right.’

Quoting Frank Furedi in Culture of Fear, Geshekter explained in A Critical Reappraisal of African AIDS Research and Western Sexual Stereotypes (published online) that ‘For conservatives who want to see “the notion of sexual responsibility [shake] off its puritanical image ... public anxiety about AIDS is seen as an important sentiment for popularizing a more restrictive and puritanical sexual ethos”’ – imposed on African sexuality, Geshekter explains, by ‘conservative appeals to restraint, empowerment, negotiating safe sex and a near evangelical insistence on condom use’. With Cameron, the TAC, the churches, and even the unions standing primly in the frontlines.

But there’s another aspect to it. Chomsky often makes the point that fear atomises us, isolates us, and engenders deference to power, promising security and deliverance. The fear of HIV serves the right handily. And yet paradoxically it has been the left not the right that has promoted AIDS most passionately. Perhaps explained by Spectator associate editor Roy Liddle, taking a very different view from Mertz, in Back to basics in the 28 June 2003 issue of that magazine: ‘... the Left has its heart in a dismal, totalitarian and very Victorian ideology which emphasizes the need to restrain, confine and overcome human nature; if you doubt that, read the Communist Manifesto, and tremble’.

On 11 June 2002 the TAC’s Mark Heywood was interviewed on radio by John Perlman about the Department of Health’s announcement of HIV-prevalence statistics in South Africa the day before, furnished by the University of Cape Town’s Actuarial Science Centre: 4.7 million infected – more than one in ten. They didn’t say, but of course they meant blacks. Having her say after the announcement, the DA’s Sandy Kalyan MP predicted that ‘AIDS could claim more than 10.5 million lives by 2015’. And the Medical Research Council followed a couple of days later with the claim that South Africa would be looking after 1.8 million AIDS orphans by the same year – but antiretroviral medication could halve that number, it said. Like the more ridiculous the numbers, the better they go down. As Hitler understood: ‘In the size of the lie is always contained a certain factor of credulity since the great masses of the people ... will more easily fall victim to a great lie than a small one.’ But the epidemic is now stable said the health ministry; the numbers in 2000 were more the less the same as earlier.

Heywood’s diarrhoeal radio commentary bore out Mertz’s point; it was like listening to a pot of pop-corn going off, with the words, ‘control’, ‘vigilant’, ‘vigilance’, ‘responsibility’ and ‘delaying sexual activity’ snapping out, some repeatedly – from Mr ‘No sex please, we’re British’. The Tony Blair sound-alike drumming out pieties like a moral regeneration preacher. Sexually prescriptive like the director of the Junior Anti-Sex League in Orwell’s 1984. Always equivocating painfully, interpolating his favourite word, ‘but’, followed by the briefest theatrical pause. Along the lines of, ‘Yes this holds out hope, but, we mustn’t allow ourselves to be lulled into losing our vigilance. And becoming irresponsible.’ No fan of Oscar Wilde apparently, who advised in The Importance of Being Ernest: ‘Our responsibility to women is to make love to them if they’re pretty and to someone else if they’re plain.’

A big thing Heywood has with telling people what to do with their privates. On 20 August 2003 he was special speaker at a meeting of Wits Positive, a group formed to promote ‘behaviour change’ at Wits University. ‘Does anyone in this room have sex?’, he asked the largely black student crowd. (Laughter at the silly question.) ‘If you have sex you are at risk for HIV infection.’ So, ‘Get tested.’ Do what I tell you. With your favourite organ. Which means nothing at all. Unless under wraps. Then it’s safe. Through a sheet. Of rubber. For a much reduced emotional and spiritual peak, and correspondingly enfeebled sense of primal unity. And there’s to be absolutely no touching down there. That evil muffin. For which we guys are such suckers. Well some of us. But if in the heat of the moment you are transported away, completely forget, and get your fingers wet, dash for the Jeyes Fluid. Rinse similarly if in the heartiness of your protected gusto there’s an inadvertent spill. I mean one can die from these juices. There’s death in them. In any event, ‘Get tested. Know your HIV status.’ Since if the thing lights up, you’re sure to come back to ask me if you can join my TAC. To fight for drugs. As auxiliaries of the pharmaceutical industry. Eroding the autonomy of the most important new democracy in our time. And betraying your government. An immigrant fink like me. Bargaining for the best price.

Pity Heywood’s girlfriend. Sure, you get me all hot and hard whenever you come near, but we must delay our sexual activities. For some other time. Not quite sure when though. Perhaps we can ask our friend Archbishop Ndungane. Meanwhile I’ll keep my hope up. Hold it out also. We have to be responsible. Vigilant and in control. Of ourselves. Also of each other. Since I like being in control. We must call on others to restrain themselves too, and welcome it when they do. And it would be incorrect to imagine you’re getting a squirt out of me without a condom. I mean I have to set an example. It’s called practising what you preach. Do you take me for a hypocrite? Just because, unlike our counterparts everywhere else in the world, we South African drug industry lobbyists are always saying we don’t accept drug money, but when we go on overseas holidays (‘working’, we call them), we’re happy to let GlaxoSmithKline pick up our expensive registration fees at AIDS conferences. We don’t mind accepting their little thank-you for helping to bust the government’s balls over AZT.

As Elsworth Baker captured it in an online tribute, Wilhelm Reich described Heywood’s type:

Reich’s discovery of armor and orgasm anxiety explained many enigmas of human functioning, such as mysticism and mechanistic thinking. One of the most important of these enigmas he termed ‘emotional plague’. This is the character structure that consistently blocks all progress towards natural functioning. No one is completely free of this malady, but there are certain persons who function essentially as emotional pests. These individuals are generally capable, intelligent, and energetic, but they are anti-sexual and prone to attain positions of authority where they can dictate rules of living; they are the bulwarks of society. They cannot tolerate natural functioning because it creates an intolerable longing in them, so their prime purpose in life is to place restrictions on any natural living. At the same time, they rationalize their behavior so very well that it is accepted as being for the common good.

Another famous champion of natural intimacy, DH Lawrence, similarly warned against the Heywood sort in his essay Introduction to Pansies (flowers!), describing ‘certain persons with a sort of rabies, who live only to infect the mass. If the young do not watch out, they will find themselves ... engulfed in a howling manifestation of mob-insanity, truly terrifying to think of. … Sanity, wholeness is everything. In the name of piety and purity, what a mass of disgusting insanity is spoken and written.’

Reich’s ideas, outlined in The Function of the Orgasm, were developed in The Mass Psychology of Fascism – both books banned, curiously enough, along with all his other work (like it or leave it), by a court injunction obtained by the FDA in 1954 at the instance of the American Psychiatric Association. Which order also directed that the police burn all Reich’s journals, as they duly did. Yes, in the US, not Nazi Germany. (Reich died in prison on a contempt rap for defying the interdict.) Baker gives Reich’s explanation of why AIDS activist Heywood always comes over so tight-assed, looks so uptight: overcome the neurotic’s ‘libido stasis’ and his

face becomes relaxed and expressive. His body loses its stiffness and appears more alive. He becomes able to give freely and react spontaneously to situations. What has made this change? His body becomes relaxed where, formerly, it remained rigid through muscular contraction as a defense against feeling and giving. The neurosis had been anchored in this rigidity, this armor which produced and maintained the character, whose dissolution produces the orgasm reflex, the ability of the organism to yield to its functioning. With this finding came the understanding of character.

But Heywood’s personal drive against natural sexual connection has powerful political uses – identified by Orwell in 1984, in which Winston Smith muses:

It was not merely that the sex instinct created a world of its own which was outside the Party’s control and which therefore had to be destroyed if possible. What was more important was that sexual privation induced hysteria, which was desirable because it could be transformed into war-fever and leader-worship. The way [Julia] put it was: ‘When you make love you’re using up energy; and afterwards you feel happy and don’t give a damn for anything. They can’t bear you to feel like that. They want you to be bursting with energy all the time. All this marching up and down and cheering and waving flags is simply sex gone sour. If you’re happy inside yourself, why should you get excited about Big Brother and the Three-Year Plans and the Two Minutes Hate and all the rest of their bloody rot?’ That was very true, he thought. There was a direct intimate connexion between chastity and political orthodoxy. For how could the fear, the hatred, and the lunatic credulity which the Party needed in its members be kept at the right pitch, except by bottling down some powerful instinct and using it as a driving force. The sex impulse was dangerous to the Party, and the Party had turned it to account.

Hence the fact that during the Stalinist terror in Eastern Europe, noted by Milan Kundera in The Incredible Lightness of Being, ‘Soviet films, which flooded all the cinemas of all Communist countries ... were saturated with incredible innocence and chastity.’

Like Heywood, the leader of another famous political movement had issues with intimacy. Two elements of his neurosis were identified by Joachim Fest in Hitler (Classic Penguin, 2002). He suffered an ‘oft-expressed fear of venereal disease and fear of contagion in general. He knew that “microbes are rushing at me.” He was ridden by … fear of the “niggerizing of the Germans.”’

On 2 December 2001, above the caption, ‘Aids Activist Mark Heywood prays at a news conference this week’, the Sunday Independent published a photograph of him, his joyless visage looking up to Heaven, his hands clasped devoutly together like Billy Graham’s – replicated in pressed copper plate and framed in the lounge of every white lower-middle class home. In AIDS Inc, published in Continuum in August 1994, Farber described the Heywood look: ‘[AIDS used to be] believed to be a medical condition. Today it is a multinational corporation complete with its own belief system, figureheads, logos and even facial expressions ... like a Walt Disney that markets pious morbidity instead of cheer.’ On its website, the TAC has a picture of Achmat seated behind the pulpit from which Anglican Archbishop Ndungane offers a prayer on 1 November 2001 for the toxic eucharist mentioned on a placard at his feet: ‘Nevirapine for pregnant women with HIV/AIDS now!’ His face shining beatifically with the satisfied rectitude of a Crusader’s sword, the clergy on his side. Spooky stuff. Having slipped a ring through the nose of the trade unions, Achmat further swells the numbers of his bussed crowds with an invisible host. A battalion of cherubs. About all of which Oscar Wilde commented a century earlier: ‘Self-denial is the shining sore on the leprous body of Christianity.’

The TAC’s public response to the Department of Health’s HIV seroprevalence announcement was full of the same sex-negative alarmism, and more: the figures suggested ‘that prevention programmes that target youth, but are not complemented by equally strident messages targeting older people (and particularly married people), lose their benefits as people enter relationships where they have less sexual autonomy and control’. Can you follow any logical thread? But anyway, we must keep that sex-is-dangerous message ‘strident’! And banging your brains out in the white-hot burst of a new romance means losing ‘autonomy and control’. Hell, who cares? In the restaurant powder-room. Other than Achmat and Heywood, the sex prefects. Isn’t good sex the very antithesis of ‘autonomy and control’? The more surrendered the better it gets? Can these sad prigs really not know this, not have experienced it? That geyser pounding. Riotously. Milk river bursting forth joyously. Into a wide-open, welcoming, enveloping midnight sea. Apparently not among such responsible guys. Instead for God and country. Just close your eyes, dear, and think of England. And hastily resume your nocturnal apparel afterwards.

Like Achmat, Hitler was also hugely drawn to the idea of sexually transmitted disease; and he recognized the political value of deploying Christian culture’s ancient fear of the bogey as an ideological lever for the accumulation of political power and undermining the legitimacy of the extant democratic state. Hitler goes on and on about syphilis in Mein Kampf (translated by Ralph Manheim; Pimlico, 1992), identifying it with the alleged promiscuity of the Jews. ‘Particularly with regard to syphilis, the attitude of the leadership of the state can only be described as total capitulation. To fight it seriously we will have to take somewhat broader measures than was actually the case.’ He stated one of the ‘broader measures’ he had in mind:

Thus, by the use of all propagandist means, the question of combating syphilis should have been made to appear as the task of the nation. Not just one more task. To this end, [it] should have been thoroughly hammered into people as the most terrible misfortune, and this by the use of all available means, until the entire nation arrived at the conviction that everything, their future or ruin, depended on the solution of this question.

Nazi propaganda later coupled the corruption of the Aryan race by germs with its corruption by bad blood. Jewish people were presented as sexually corrupt. ‘… nightlife and syphilis … became aspects of that age-old struggle whereby the lower races attempted to destroy the noble Aryan’, wrote Joachim Fest in Hitler, explaining the manipulation of these ideas by the Nazis in their rise to power. Today in South Africa, everybody knows it’s those blacks who spread AIDS. But the AIDS experts and activists tend to imply it, rather than shout it. Mostly being white liberal people.

Cameron’s gay activist friend Timothy Trengrove-Jones, an ‘Aids researcher and academic’ as he likes to bill himself, but in fact an English lecturer at Wits (believe it or not after reading his prose), wrote in the Mail&Guardian on 30 June 2000: ‘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”.’ He didn’t like the sound of that: ‘The document’s very language itself fails to understand the crucial truth that there is no such thing as “safe” sex.’ In fact his stray shot hit the mark, although in a sense to which he was oblivious. Because safe sex, among the young anyway, is indeed an empty idea. But not because of deadly germs. As Celia Farber pointed out at the conclusion of her article, Unprotected (about the eroticisation of ‘HIV-infection’ by some gay men) in the online magazine Impressions: ‘... sex is not a kitchen that can be cleaned up and child-proofed – … sex is not safe.’ Meaning that entry into and especially exit from intimate relationships can be a very turbulent and injurious business. Heaven and hell right here on earth. Taking an overview she added: ‘The only thing that can be guaranteed once a pendulum swings so fast and so far as the Safe Sex pendulum did is that it will eventually swing back, not to the middle, but first all the way to the other end.’ Like all oddball social tendencies. The conclusion to Trengrove-Jones’s piece, Democracy and the pandemic, concluded in his signature garbled English: ‘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 democracy.’ Thanks Tim. We get it now. Did you get your degree in hamburgers?

Slipping in another three hundred thousand – hoping we wouldn’t notice – the TAC concluded its statement on the Health Department’s HIV seroprevalence figures with some jolly hockey sticks: ‘We must all work together to develop better prevention strategies and to ensure that the lives of the 5 million people with HIV/AIDS are valued and saved through treatment.’ To show we care by giving them drugs. But the trouble with Achmat’s friendly calls to ‘all work together’ is that when you decline his invitation walk down the street with him holding hands on one of his marches, he rounds on you, and hotly too, ugly names flying. With guys like Achmat and Cameron, there’s no room at all for a different view.

The TAC should stick to selling drugs for the industry. What it’s good at. Not so much when it gets into a different game off field. Like playing finger-wagging public chaperon. A paper in the British Medical Journal on 15 June 2002 reported the finding that programmes advocating ‘safe sex’ with condoms that rely on ‘alarmism [are] almost completely useless’. The pregnancy rate among teenagers in the US, Canada and Western Europe who participated in pro-abstinence programmes was 50 per cent higher than those who didn’t. So the TAC’s sort of strident ‘scare tactics’ should be abandoned, the researchers urged. And programmes preaching teen celibacy work worst of all. Predictably, since a paper by Susan Moore presented two days earlier at the International Child and Adolescent Mental Health Conference in Brisbane, Australia, came up with the resounding news that young people who have sex are happier than those who don’t, and that virgins had the lowest sense of sexual well-being. It gets even better: Moore said that she had expected to find that young people who engage in ‘unsafe sex’ would have a low sense of sexual well-being. But no, she reported: ‘That didn’t happen at all. In fact, the more unsafe sex they were having, the happier they were.’ How odd! (The biochemical magic in glue we heard about a moment ago.) And she was also surprised, she said, to find that going to church did not encourage safe sex: ‘The young people who went to church were more likely to be virgins, but those who were not virgins were no more likely to practise safe sex than unsafe sex.’

Mertz’s take on what drives AIDS is shared by Sontag; it speaks to a ‘desire for stricter limits in the conduct of personal life. There is a broad tendency in our culture, an end-of-an-era feeling, that AIDS is reinforcing; an exhaustion of purely secular ideals – ideals that seemed to encourage libertinism or at least not provide any coherent inhibition against it – in which AIDS finds its place [resulting in] neo-celibacy and a waning of sexual spontaneity among the educated in this decade [(the eighties), and] a growth of the ideal of monogamy, of a prudent sexual life.’

Playwright Arthur Miller was in the same conceptual boat. In his notes to The Crucible, a play which Showalter notes ‘explored the psychology and politics that created the Salem witch-hunts and, by extension, McCarthyism’, Miller wrote that ‘The witch-hunt was a perverse manifestation of the panic which set in among all classes when the balance began to turn towards greater individual freedom’. As in South Africa, post-1994. The sexual moralising of the AIDS age feeds back into it: Colligan et al. highlight that historically ‘outbreaks of mass psychogenic episodes became more frequent [with a] pervasive concern with religiosity and righteousness’. And in a striking parallel between the ignition of the witch hysteria in 1692 and AIDS hysteria in South Africa after the surrender of the apartheid regime in 1994, Miller noted of the people of Salem that ‘in their own time a revolution had unseated the royal government and substituted a junta which was at this moment in power’ giving rise to a dread of ‘deep and darkling forces’, since ‘social disorder in any age breeds ... mystical suspicions’.

In writing about her subject in Hystories, and discussing a collection of contemporary cases, Showalter missed its most patent instance in AIDS, despite remarkably apt insights such as: ‘Hysterical epidemics require at least three ingredients: physician-enthusiasts and theorists; unhappy, vulnerable patients; and supportive cultural environments. A doctor or other authority figure must first define, name, and publicize the disorder and then attract patients into its community. … The most influential doctors of hysteria are also theorists who offer a unified field theory of a vague syndrome, providing a clear and coherent explanation for its many confusing symptoms.’

Relevantly to post-1994 South Africa, Showalter observes that ‘Epidemics of hysteria seem to peak ... when people are ... alarmed about social change [producing] apocalyptic fantasies [interacting with] social forces such as religious beliefs, political agendas, and rumor panics. Traditional enemies or social scapegoats become part of the scenario fuelling fears. The longer the epidemic continues, the greater the participant’s need to believe it is genuine. … The chain is hard to break, because each new wave of publicity recruits new patients, who feel more and more invested in the search for external causes and a “magic bullet” cure.’ Being precisely the business of the TAC. With HIV, AZT and nevirapine.

Apartheid was built on swart gevaar, the manipulation of whites’ fears, conscious or otherwise, that the conquered black majority would rise up, breach the ramparts and overwhelm and exterminate them. This politically packaged peril was sold with increasing success to the English middle classes, not just the traditionally conservative white Afrikaans constituency. More than a political arrangement, the system was a totalitarian ideological one, tightly setting everyone and everything in a certain order – most crazily during the end-game when it was in crisis in the ‘total onslaught’ era. And then suddenly it collapsed. Quite unexpectedly. The psychic shock for the white man in the street was immense. Apartheid’s ideological framework and controls were gone. The repressive order evaporated. We were all free. Discomfortingly so. And there was no vengeful bloodbath. As had occurred in parts of post-colonial Algiers and the Congo. A new reason to fear the black man replaced the old, or at least to continue seeing him as something less than fully human, as apartheid had implied: just about ever second one of them carries a deadly disease – in their vital fluids: blood and semen. Thus did the black man once again become the scapegoat repository for the anxious apprehensions of the white man in Africa.

Conversely, those South African blacks who, like Makgoba, embrace AIDS, bring to mind the story of the slave set free, who woke his former master saying, ‘Put my chains back on. I can’t sleep.’

Makgoba’s defence of scientific medicine’s martial paradigm – at its apogee or nadir in the HIV-AIDS model, depending on your point of view – against Mbeki’s challenge is interesting for another reason. In their classic analysis, The Political Economy of Health (Pluto Press 1979), Doyal and Pennell highlight the ‘process of medical socialisation’ that occurs in colonised countries in which even the most outrageous, racist medical models get taken on board by indigenous elites. They quote Martinique-born Algerian revolutionary Frantz Fanon telling in his essay, Medicine and Colonialism, how the notion that ‘the native Algerian is a born criminal’ had entered the syllabus at the medical school in Algiers. Fanon quoted a student there: ‘It’s a hard pill to swallow, but it’s been scientifically established.’ Such co-opted elites in colonized countries, like Makgoba, become ‘bearers of Western science and rationality, ... the bourgeois doctors of the neo-colonial state. … This rigid adherence of third world students to the Western medical model is usually accompanied by a largely negative view of indigenous health systems – an attitude which is strongly reinforced by medical education which either gives no account at all of traditional medicine or actively seeks to discredit it.’

The American AIDS model is simple-mindedly monocausal and deterministic, with unseen aggressors to be rooted out and destroyed with maximum violence – by burning with deadly chemicals. Ancient folk health systems across the globe on the other hand broadly have one thing in common: a goal of restoring homeostasis – internally, with family, with community, and with the cosmos. Among Mbeki’s objections to the exported AIDS model, along with all the inhumane values with which it comes packaged, is the fact that it masks the obvious causes of infectious disease – poverty in all its manifestations, thanks to colonial violations and capitalist formations – and it devalues any political programme to address it. But as a high priest of scientific medicine, Makgoba sees only lethal germs spread by African promiscuity. At it like pigeons. All the time. Just as liberal whites like Appeals Judge Edwin Cameron reckon, we’re soon to see. Along with ‘AIDS expert’ Alan Whiteside, an economic history professor at the University of Natal. Who informed Geshekter in a private chat in his office a few days before the first meeting of the AIDS Panel in May 2000 that rural Zulu men working in small factories and on sugar plantations in the Manguzi region of KwaZulu-Natal often had several women on their way home. Explaining all the AIDS up there. Not that he’d ever been up there to establish this physical feat first hand. Much nicer flying around the world, business class always, staying in swanky hotels, and generally having a grand time researching AIDS on USAID millions. In his fancy Chinese-collar suits. Looking radical and all. A Third World Man. His family stashed safely away in England, far from AIDS-ridden Africa. Geshekter shared the amazing tale with fellow panellist and AIDS dissident Professor Sam Mhlongo, whose mother came from there. ‘What’s this I hear?’ Mhlongo challenged Whiteside at the first Panel meeting. Whiteside glared at him without answering before walking away.

Makgoba is a fellow black African who has professed his allegiance to Mbeki’s Africanist agenda, with its humanist foundations, in African Renaissance. But put to test over AIDS, Makgoba finds himself too heavily mortgaged, and sooner turns his back on it than risk the riches and honours bestowed by his secular priesthood. He’s an immunologist, a fitting speciality for him, since of all scientific medicine’s special arts, immunology must be the closest to Scientology – the high mumbo jumbo of its textbook canards about as glaringly incompatible with (and contradicted by) the empirical data as one can imagine. And an aeon away from holistic indigenous healing systems. But there’s a tale for another day.

Sensitive to the profoundly inhumane way AIDS ideology plays out among Africans infected by its poisonous ideas, isolating and terrifying them, Mbeki commented in a newspaper advertisement presenting his Presidential Task Team on AIDS on 28 April 2002: ‘Our common task as a nation is to bring hope to fellow human beings. It is wrong and inhuman to treat anyone said to be HIV positive as a person who should be isolated and turned into a social outcast. To communicate a message of hopelessness is to sentence other human beings to death. And to protect ourselves as a nation, remember, each one of us has a duty to protect his or her health.’ In this regard I have an intriguing story. In February 2003 I asked Iaan Bekker about how open his brief had been to design our country’s new Coat of Arms, the initiative for which had come from Mbeki himself. He told me he’d been given a free hand, but on the inclusion of one element Mbeki had been insistent: our country’s Secretary Bird. Unlike Mbeki, never having once been a herd-boy dodging vipers in the grass, I had to ask why. To signify spiritual protection, Bekker explained; the Secretary Bird is adept at spotting, killing and devouring hidden snakes – one was always safer when the bird was around. A curious coincidence it is that the ancient symbol of Western medicine should be a snake entwined around a sword. How interesting too that the Greek god Mercury carried a staff with two snakes winding around it – the god of travellers he was, but also of thieves. The African weapons of war are spear and knob-stick, taking the place in the Coat of Arms of the Secretary Bird’s long, gangly hunting legs. Lain down, at rest. But at the ready. At the presentation of the design to the Cabinet, Foreign Minister Nkosazana Zuma demurred. As Bekker patiently explained its elements and composition, she persisted. Mbeki rapped the table sharply; ‘Listen to what he is saying,’ he said. And the objection was stilled in a moment.

Mertz makes the point that what is happening in the moral politics of AIDS is nothing new:

What I find most interesting in the history of syphilis is that virtually every argument made today about AIDS was made almost verbatim prior to the 1930s about syphilis: the arguments of the public-health authorities, of today’s feminists, of today’s gay-press, of leftists and liberals, and the arguments of today’s rightwing Christian fundamentalists … myriad confluent groups who united around venereal diseases. Disappointingly, the Left suffered all the same failures in its ideological construction of syphilis as it has with AIDS. It was largely self-identified progressives, and especially self-identified feminists of the nineteen-teens who led the anti-prostitution and anti-vice campaigns which were some of the most widely orchestrated state-repressions of 20th century U.S. history. The victims of these repressive campaigns were, of course, poor women. … the chief argument for these police-state measures was syphilis. [Thousands of frank prostitutes or lower-class single women living near military bases were arrested and interred during the First World War as a syphilis threat to the armed forces.] The very same derivation of moral laws – and thereby state actions – from epidemiological facts was the centerpiece of much progressivism and feminism of the early century, just as it is today. Then, as now, it was only a specifically sexually-related disease which convinced leftists of the need for police action. Other diseases, then as now, never seemed to carry such an imminent demand for the forfeit of freedoms.

No one in their right mind would propose a law to punish a man diagnosed with TB for kissing his wife and children. Not even Cameron and his South African Law Commission.

That liberal Wits University so readily served as cradle to the extreme irrational and reactionary geist of AIDS was foreshadowed on German campuses, as we have noted. But not just under Nazi government, even before it: Grunberger mentions in A Social History of the Third Reich (Weidenfeld and Nicolson, 1971) that during the Weimar democracy at its strongest, in 1927

77% of all Prussian students had demanded the insertion of an “Aryan paragraph” (the exclusion of Jews) into the instrument of university self-administration. … Early in 1931 about 60% of undergraduate university students supported the Nazi Student Organisation, while Nazi support among the electorate stood at approximately half that level. In that year anti-Semitic riots erupted at the universities of Berlin, Cologne, Griefswald, Halle, Hamburg, Breslau, Kiel, Königsberg, Munich and Vienna. (Austrian universities were, incidentally, the pacemakers of Jew-baiting throughout the German-speaking student world.)

The race by German university professors to join the Nazi Party and conspicuously identify with its ideals and programmes we have dealt with already; Grunberger provides an example: ‘A prestigious bloc of 300 occupants of professorial chairs addressed a manifesto to the electorate, asking them to vote for Hitler in March 1933.’ Academics in South Africa lobby for Achmat and his drug agenda in just the same way.

Following upon the roaring success of the Wits General Assembly, ‘Thousands of students and staff from 20 tertiary institutions in various cities and towns nationally staged an anti-HIV-Aids march’ on 29 July 2002 – so the Daily Dispatch reported the neo-Nuremburg rallies the next day. Guest speaker at Wits was the guy they call ‘the safe-sex pastor’, with the unfortunate name of Grippa Khatide. Treating the varsity intellectuals to advice like: ‘If young people have the right attitude to sex [have as little as possible] we can beat HIV-AIDS. We are not victims of HIV-AIDS. But HIV-AIDS is the challenge of our time and we can beat HIV-AIDS by adopting an attitude of sexual responsibility. … We can never begin to address the matter of HIV-AIDS unless we acknowledge that we are sexual beings. If we can change our attitude to one of sexual responsibility we can protect ourselves and future generations.’ Interesting how he chants the hypnotic mantra. Like the Jews, the Jews, the Jews, the Jews, the Jews. But for Heaven’s sake, Grippa, you priests have been threatening us with eternal fiery death as the price of our lustful moral degradation for as long as you’ve been around. Find yourself a new story, man.

Students were part of that ‘especially vulnerable group’ of twenty- to thirty-year-olds, warned the TAC’s Gauteng coordinator, Pholokgolo Ramothwala. Because they’re enviably doing it more than anyone? Wits equity and transformation officer Riedwaan Kader picked up on the theme: ‘For the first time in many years, students are uniting around a common issue that is threatening our futures.’ As the Jewish problem threatened the volk. So pull in to check for bad blood, he urged; a thousand free test kits were available for students who wanted to find out their HIV status.

Frankly, how many ‘thousands’ actually joined the marching is moot, in view of a disclosure in an accompanying article, Rhodians support Aids awareness. Jabulile van Niekerk, manager of the St Raphael (AIDS) Support and Counselling Centre in Grahamstown described ‘about 150’ marchers as ‘a wonderful turnout’. Led up High Street by another academic bigwig turned sanctimonious AIDS fool: Rhodes University Vice Chancellor David Woods.

In his study published in 1999 of the quasi-religious devices by which medical power is maintained, Médecine, Religion et Peur; l’influence cachée des croyances (overviewed online in his English essay, Modern Medicine: The New World Religion: The Hidden Influence of Beliefs and Fears), Oliver Clerc, without mentioning AIDS in particular, provides an explanation of the ready, uncritical acceptance of AIDS by ostensibly irreligious rational people, as a subconscious sink for turbulent irrational feelings, fears, and urges:

even a superficial study of contemporary culture will reveal that the supposed secularization of present day society is just an illusion. Even though most people do not conform to the outward show of religious custom and practice – mostly Judeo-Christian in Western culture – the beliefs and superstitions remain deeply embedded in their subconscious, influencing many aspects of their daily lives without them realizing it.

Whenever he gets carried away, one remembers that Achmat comes from an Islamic fundamentalist family. Clerc invokes a fine illustrative analogy:

Just as the magnetic field of a magnet placed under a sheet of paper controls the way iron filings fall on its surface, revealing the invisible lines of force between the two poles of the magnet, a ‘religious field’ likewise imperceptibly structures and organises the development of modern medicine. Invisible, impalpable, this ‘religious field’ is made up of all the beliefs, myths and values of the Christian – and more specifically the Catholic – religion. In other words, the secularisation of society happened only on the surface. We took away the ‘iron filings’, the specific religious forms, but we did not change the ‘current of thoughts’, the underlying ‘religious field’, which continued to exert the same influence, but through medicine. That is the reason why behind the different structures of medicine and the Church of Rome we find the same fundamental concepts, the same relationships, the same characteristics, the same fears, the same hopes and expectations [– ‘autocracy, centralization, the control and manipulation of people, censorship, propaganda, total obedience, infallibility, the destruction of heretics, the stamping out of individuality. All this, of course, has been done in the name of public health and the general good, just as the Church acted for mankind’s salvation.’] This substitution of medicine for religion has had many unfortunate consequences. In medical research, it influences what should be looked for and what can be discovered. Any discovery or theory that is at odds with the over-arching orthodoxy is rejected, and its authors called heretics. Entire areas of research, as well as promising new lines of approach, are thus disqualified. … The medical credo takes precedence over reality, something that scientists refuse to acknowledge when it does not correspond with their preconceived ideas. And lastly, the hidden religious dimension of modern medicine inhibits the free debating of already fixed beliefs, and preventing them from being properly re-examined and criticised. Indeed, dogmatism, irrationality and passions – all characteristic of the religious experience – take precedence over any calm and carefully thought out argument, even over the most tenuous facts. The same vehemence that led Galileo to be condemned by the Church for his theories, in spite of the scientifically demonstrable facts, is now being used by medicine to reject any thesis that is contrary to its own dogmas. Science has learnt its lessons from the Church.

And there’s the fact that in AIDS medicine, there’s only one way to salvation, and that’s by swallowing the eucharist sold by the drug companies.

My own reflections have been related, and I hasten to record that I’m an atheist with no conventional religious affiliations whatsoever. I’ve long had a sense that, like a ship drifting from its moorings at night towards an open sea, the more secularised, materialised and ostensibly rational Western culture becomes, the more urgently it excites deep atavistic, irredentist yearnings, given expression in extremely irrational concepts and beliefs. Flying in the face of all sense. We fundamentally need an analogical, mythological belief system (Mbeki mocks AIDS subscribers as ‘the believers’) that allows us a mystical experience and participation in the world. We can’t actually do without an irrational, Dionysian component to our lives, and as modern Western industrial culture suppresses it, denies it, it bobs up in a different form. An alternative cosmology. Clung to with inflamed quasi-religious fervour by the sort of educated folks who write for and read the Mail&Guardian. Carrying on like holy rollers. And there’s another element: having mastered the elements and the uncertain environment, and slain or contained all our old predator enemies, we need a substitute to quail before in their place. Like scary sex-germs.

Gugu Dlamini was a young Zulu woman told by doctors that she was HIV-positive; and when the news got out in May 1998 she was stoned to death by her neighbours. Thinking she was inhabited by contagious demons. Well, that’s more or less what the white doctors had told her. How primitive these people are. How appalling. But the whole of AIDS is a vast superstition, and in the mind of whites, no less crude, terrifying, hysterically infectious – and, in the way doctors approach it, murderous. We can’t seem to do without bogeys to fret about. And destroy violently. Whether we live in skyscrapers or straw igloos.

Or sit on the bench of our highest court. Giving judgment in the nevirapine case (discussed in The trouble with nevirapine) the Constitutional Court held:

The HIV/AIDS pandemic in South Africa has been described as ‘an incomprehensible calamity’ [impenetrably mysterious, like the Holy Trinity; a woe like sin] and ‘the most important challenge facing South Africa since the birth of our new democracy’ and government’s fight against ‘this scourge’ as ‘a top priority.’ It ‘has claimed millions of lives, inflicting pain and grief, causing fear and uncertainty, and threatening the economy.’ These are not the words of alarmists but are taken from a Department of Health publication in 2000 and a ministerial foreword to an earlier departmental publication.

We wise Constitutional Court judges just swallow everything written for politicians and bureaucrats by richly paid private consultants. Building professional empires and small fortunes on scare stories – the population explosion, the ozone hole, global warming, the millennium bug, you name it, we believe it. Like loving can kill us, humans only, in the last twenty years, all of a sudden, after millions of years. Due to a brand new sex germ. Mutated from monkeys. Harmless to them but lethal to humans, although on the strangest ever-extending slow fuse. Brought into the US and Europe by gay airline stewards. Also by African-looking Haitian immigrants. (We prefer immigrants fair.) A sex germ that white gays and black Africans are spreading like wildfire, but hardly anybody else. Oddly enough. We believe this because we’re the clever guys. Much cleverer than this race-obsessed new President who can’t see the overwhelming evidence. And who thinks it’s all a lot of baloney. Unlike him we think and see clearly. We see the evidence all about. We fill in the gaps with our sophisticated powers of reasoning. Honed over many years in the courts. Pursuing human rights, some of us. Of blacks. Deprived by the Afrikaners. And the English before them. We like looking after blacks. It’s a calling that’s hard to give up, even though they’ve got their own government in place now to look out for them. But like all African governments they’ve turned out callous and useless and incompetent. Letting their babies die when they could be so easily saved. With what the manufacturer itself admits is an extremely poisonous chemical. A sort of baptism of fire. We’ll save the black babies of South Africa from their parents’ goosing around. What a blessing it is that white people don’t carry on this way. Which is thankfully why HIV-positive babies and AIDS orphans are all black, and black only.

The most learned judges expounded further: ‘In our country the issue of HIV/AIDS has for some time been fraught with an unusual degree of political, ideological and emotional contention. [Could the persistent agitation of Cameron and the TAC have something to do with this?] This is perhaps unavoidable, having regard to the magnitude of the catastrophe we confront.’ Sort of like Sodom and Gomorrah. Perhaps the heat is ‘unavoidable’ rather because it’s all hot air, an essentially religious affair, with the ‘HIV/AIDS issue’ functioning somewhat like the core concept of ‘sin’ – potently dreadful, and around which an edifice of enormous temporal power has been erected, claiming the power to protect us from it. From ‘the catastrophe we confront’.

Mostert reports in Frontiers that English explorers visiting the court of the Zulu tyrant Dingane in the mid-19th century alleged that a quota of about half a dozen sniffed-out miscreants were clubbed to death every week at an execution site permanently circled by vultures. In a lull the inkosi was reportedly wont to say, ‘Call out the doctors, the birds are hungry.’ Western culture has the same simmering need for bloodletting it seems to me. Perhaps it’s why the US, with the most dynamic modern form of it, is permanently at war, periodically turning on and sacrificing its own, when not venting its extreme mechanised violence on other cultures that it has first demonised. To be perfectly honest, from this side of the ocean, American culture sometimes looks completely psychotic to me. Certainly it regularly displays an uncommon susceptibility to extreme hysterical contagions. Concerning internal and external enemies. Concerning drugs too – with the hardest, most addictive and most destructive lawfully traded, and the softest classified ‘hard’ and fiercely outlawed. (There’s none softer than heroin.)

Dingane’s ‘doctors’ in modern guise continue to enjoy unrivalled pre-eminence in modern industrial societies: ‘The hospital has succeeded the cathedral as the archetypal institution of Western culture,’ noted Irving Zola. (Appreciated by the Church long ago, which is why it got into the hospital business early: St Marys, St Augustines, etc.) The medical-industrial economy is second only to the military. We even pay it tithes, called ‘medical aid’, with an express or implied ticking off (‘irresponsible’) in store for anyone refusing to pay. Unlike the help in the hardware store, we look up to pharmacists working on raised podia in their shops when purchasing our drugs. We address medicine’s rote-tutored functionaries with their bachelor’s degrees as ‘Doctor’. Like ‘Father’. We simply do what they say. After their little tapping, listening, peering and touching game is done. (Especially women’s breasts – my girlfriends have consistently complained. It’s an old problem: Hippocrates found it necessary to include in his Oath an enjoinder from ‘all seduction, and especially from the pleasures of love with women or with men be they free or slaves’.) We tolerate their administration of useless and deadly poisons to those sniffed out as harbouring HIV and cancer. Et cetera. And when such victims die in their hands, we take it that this is right, this is fitting. After which, even their struggle to survive their doctors’ violence is commemorated in the newspapers in martial terms: ‘He died after a brave battle with cancer’, or ‘AIDS’, and so on. All is well as long as the quota is killed. Nowadays by the chemical in the bottle with the skull and crossbones.

The Cameron interview on Carte Blanche was like watching a cup of sugar spun into candyfloss, all touchy-feely pink goo, the disdained gay man being loved by everyone at last. All thanks to his virus. A soul saved, having discarded his erstwhile death-hex dread (‘I’ve regained my life’), his testimony implied the ‘sex kills’ credo that founds it all. But with a scientific spin: he referred to his declining ‘viral load’, as if the expression means ‘infection level’, as the words might suggest. He said he’d ‘fallen ill in December 1998’, well after his diagnosis. Even without the toxic drugs to confound the picture, who wouldn’t eventually get very ill, having accepted his doctor’s suggestion that he was certain to die soon, and worried sick about it all the time? Indeed, Cameron said he felt like a man condemned: ‘And one of the reasons why I didn’t tell the Judicial Services Commission in December 1994, when I was appointed [a judge], that I had HIV, was that I hoped to stay well, although I feared that I was going to die.’ But back before the JSC again in 1999, trying to get promoted to the Constitutional Court, he figured it was no use having a banjo and not playing it, and sprung the news. This crass manipulation didn’t work, though. It tugged everyone’s heartstrings alright, just the way he intended: ‘They listened partly horrified, partly also engrossed with sympathy and I think also with respect. … I was scared of reaction and I didn’t expect the extent of public support and love that I got. It was an outpouring.’ Unfortunately they didn’t feel sorry enough to give him the job.

Cameron said that thanks to the umuthi he was taking: ‘You cannot find the HIV virus live in my blood anywhere now. It’s still somewhere in my body – it’s lurking there, but the medicine is keeping it down.’ Hawu! Sceptical Zulu folks watching the interview, who think this new ingculuzi business of white amadokotela is more in the latter’s minds than the blood would recognise a protracted bout of umfufunyane, with this umlungu’s head full of creepy bogeys, ‘lurking’, as he put it, in dark corners. They’ve been purged from his blood by the strong medicine. Nice clean blood he’s got now. But, he says, they’re still there in dank redoubts where they’re holed up invisibly, kept at bay by drugs. Like by red-hot pincers sorting out those medieval hairy sprites with horns, tails, cloven feet and dragons’ wings.

If you’re one of those credulous medically docile guys, unhesitatingly believing the doctor when he tells you that you’re as good as dead, on borrowed time, even though feeling fine – perhaps because you’re uneasily gay in an aggressive hostile authoritarian patriarchal culture, with a history of stoning, psychiatric violence and until recently imprisonment for such deviance, and so therefore half expect it – you’re going to happily swallow whatever potions he dishes up to you, certain they will be as beneficent as the isangoma’s seawater, bark and wild herb preparations to purge that inyongo. And feel much better afterwards. After throwing up. And/or blowing it out the other end. Then go around giving testimony for the good cause, the wonderful drugs: ‘And we know that that isn’t the case, we know it’s no longer true that AIDS is necessarily a fatal illness. So it’s changed the social nature of the disease, and if we offer people hope, if we offer people the good news about treatment, the hope and possibility of treatment, we’re going to reduce the stigma.’

A coincidentally big thing among gay AIDS activists – this stigma business. But how can pills conceivably reduce it? Please don’t despise me anymore. I may be a dirty sick fag or nigger, but I am taking my medicine, I really am. I’m being obedient. My doctor says I’m being ‘treatment compliant’ as I continue to swallow what my body is telling me to reject.

Of course there’s a better way to ‘offer hope’ than by handing out poisonous chemicals. One simply has to wind down the propaganda, so that everyone can just forget about AIDS, like we’ve forgotten the syphilis and herpes scares. Which came to absolutely nothing. Apart from those poisoned on the way.

Black friends of mine have commented on how homosexuals, nearly all white, dominate the South African AIDS activist scene, presuming to represent their straight black countrymen and keeping their alleged affliction on the front page. Stirring up crowds with rousing Sturmabteilung devices. Like that short fat guy in the brown shirt whom Hitler had popped off during the Night of the Long Knives, Ernst Roehm. Along with the rest of the queer clique that ran his SA with him. Such as Karl Ernst, leader of the SA in Berlin. And Edmund Heines, SA Obergruppenfuehrer of Silesia. Found in flagrante delicto, announced Hitler’s press chief Otto Dietrich – ‘a scene that defied description’ to those paragons of Lutheran morality, the SS goons who arrested and shot him. Along with his rented pal.

It’s Cameron’s high standing, the gifted demagogue Achmat’s too, that keeps AIDS’s shares so high in the media and in the public mind. Interviewed in Continuum in 1993, Camille Paglia revealingly explained the waning of AIDS as a news item in the US terms of gay activism, gay activist energy:

There was a period of absolute hysteria, cover stories just constantly in the public eye. And that would have been in the late 1980s and early 1990s. I think there’s been a slow decline in the attention paid to the issue at all here. Part of it was that ACT UP was very, very active at that time. … AIDS, the way AIDS has gone to the back burner here in America, is simply a part of the general loss of prestige of the gay leaders. We don’t have a Martin Luther King. There’s been no figure who’s been particularly talented.

Cameron’s evangelical ‘good news’ talk is clever because it makes us go all warm and fuzzy. As it did at Sunday school. Indeed, the word gospel means good news – god spel in old English. Also because ‘good news’ is what everyone craves every single day, making the expression a hit in drug propaganda. Spotted by John le Carré in The Constant Gardener: ‘GOOD NEWS FROM KVH: DYPRAXA is a highly effective, safe, economic substitute for the hitherto accepted treatments of tuberculosis. It has proved itself to be of outstanding advantage to emerging nations.’

Every sentence in the Cameron interview was a mess. It reminded me of the kind of unexamined cliché-strewn bromides that I used to draw when raising problems within the HIV-AIDS paradigm with South Africa’s ‘AIDS expert’ scientists. In my many conversations on the telephone and in correspondence by post and email, I was always left with the appalling sense that our ‘AIDS experts’ at universities around the country were myth-bound simpletons lacking the wherewithal to follow my inquiries, let alone answer them. I felt like a mathematician trying to discuss a problem in calculus with primary school children. If this sounds exaggerated and arrogant, you should read our exchanges. As dismal as Makgoba’s cretinous conversation with the Perth Group’s Turner (posted at for all to see) concerning the HIV isolation question. No wonder they didn’t want him at Wits. And opposed him at Durban.

So let’s not waste any more time wallowing in the syrupy mire of the interview, and instead put our gears into reverse as we trace the likely trajectory of Cameron’s recent life, following his calling to participate in the drama of AIDS. But before we do, an illustrative short story.

Several years ago I did a murder case for a Zulu bloke, Makhaye, with kind eyes and a wide smile. He’d been feeling ill at ease. So he duly consulted a local traditional healer, who asked among other things: ‘Is there anyone who bears you any ill-will?’ ‘Well, yes, come to think of it, one of my work colleagues does.’ A discussion ensued in which the history of some smouldering strife was related, the evidence it disclosed debated, and the proofs identified. At the conclusion of these ratiocinations the isangoma made his diagnosis. ‘Your colleague must have sprinkled umuthi on the backseat of your car.’ Our man took this news badly. Having heard that his colleague was importuning evil forces to do him in, he became frightened half to death. His health now took a serious dive. But being a cautious, measured fellow, he sought a second opinion, travelling to a distant village in which another isangoma worked, with such reputed success that his fame had reached the city. And there the cycle of suggestion was repeated and the hypothesis consolidated. But the implications of this second identical divination, and the absolute imperatives it prescribed were awesome, so he left the country for a third opinion. Eminently sensibly, who’d disagree? He queued for ages to consult another isangoma in Swaziland, no doubt admiring his nice fleet of Mercedes Benz cars parked outside his hilltop mansion while he waited. Bearing out his expertise. Needless to say he was told the same thing. The long and the short of it is that soon after Makhaye’s return home, and via the agency of a contracted hit-man, the maledictor divined took a bullet in the back of the neck, not suspecting or feeling a thing. With that the spiritual and moral equilibrium was restored. Makhaye’s health recovered completely. Gone were his terrible nosebleeds that had seeped like stigmata. The buckling lameness of his legs was over. But best of all, alleviated was that terrible sensation of monstrous poisonous insects crawling all over his face all day and night. No matter that he couldn’t actually see them.

‘Killing witches went out centuries ago among civilised people,’ thundered the culturally sensitive liberal white Natal-English judge. (In fact such lynchings persisted until the late nineteenth century in rural England.) He might have added: ‘Slaughtered in their thousands, by guys like us sitting in English courts like this. Ardently, right up until 1736, when the government repealed the witchcraft statute. In cases presided over by such prominent jurists as Lord Chief Anderson. Who warned in 1602: ‘The land is full of witches. They abound in all places. [Without prompt, firm measures against them, they will] in short time overrun the whole land.’ And if in a bright mood in our country assize from a good breakfast in the morning and a pleasing local tart the night before, we permitted a benevolent hanging before the burning. Otherwise it was ‘alive and quick’. Quick meaning feeling every minute at a leisurely pace, not hastily. And you can say thanks for not having to watch your entrails drawn out of your slit belly too, after your neck had been stretched for a bit by hanging, and your limbs thereafter simultaneously plucked from your torso by ropes fastened to four horses, whipped to gallop north, south, east and west. At the same time. The deserts of rebels and traitors. Not to mention blinding and castration. To cure poaching. Of the gentleman’s deer. Getting the message across. We English being a civilised bunch. Not like you people.’

‘To think that people like you have the vote,’ he said instead – he really did – before throwing away the key. Moved by this counsel’s pleas in mitigation as the face of a granite quarry. His head in a terrible spin from observing the inexorable collision of two freight trains yet again, laden with millennia of incompatible cultural formations, as grievous a spectacle as the World Trade Centre movie.

There was no room in that angry court to make the argument that its members, wives, children and friends in their Sunday best probably attended temples every week, fronted by the statue, not of a philosopher-prince in deep meditative repose, but of a man pinned to a gibbet, being tortured slowly to death, a human sacrifice for their benefit two thousand years earlier, in order to appease a vengeful spirit. And that the accused’s ideas were scarcely more barbarous. The expungements in question putting things right all the same. Nor more preposterous than the European court’s rule that before telling what he knew, every witness was required to swear an oath to the same unseen Aztec ghost and call down its help to speak honestly. Right there inside the white courtroom at the close of the 20th century. But just as long as the witnesses didn’t then go on, as English witnesses from all walks of life used to do, to depose in the High Courts to the mischiefs of imps such as Peck-in-the-crown, Pye-wackett, Grizel-Gredigut, Ilemazar or witches’s familiars such as Sack and Sugar, Jarmara, Holt, Newes, Dandie, Tibb, Fancie, Ball, and Vinegar Tom, or their Zulu equivalents. Or to needles somehow swallowed or pricking in the dead of night – an old hysterical penetration delusion resurfacing in the AIDS age in the paranoia about ‘needlestick injuries’ and pinpricks at schools and young folks’ nightspots. Also in kooky reports of probes put up jacks by alien abductors.

Incidentally, if you find still having to swear oaths by the book bizarre, you can thank your lucky stars that we’re currently relieved of the antecedent rule for such occasions prescribed by the early Yids. Or your day in court might have gone something like this: ‘Before I sing a note, pal, you’re going to have to climb off that high bench of yours and come down over here. Dropping your drawers and parting your robe in short order. Because I need to stretch my hand in there, and fix myself a firm grip around your puckered old nuts. As you stand patiently by in your uplifting pose until I’ve said all my say. If it takes all day. Offering a salutary squeeze from time to time, as needs be. To make sure your Lordship is paying full attention. And not drifting off during the technicalities. Especially after lunch. Since it’s well known that, as is the wont of one top beak among you, amadoda alele emini. Actually snores. Beats shouting for his attention.’ And if it’s a junior Milady that you draw to hear your case, Hallelujah.

The words testimony and testicle share the same root in the Latin word testis. In euphemistic King James English, Genesis 24:2-3 reads: ‘And Abraham said unto his eldest servant of his house … Put, I pray thee, thy hand under my thigh: and I will make thee swear by the Lord ... that thou shalt [‘keep certain promises’].’ And later in that book at 47:29-31: ‘And the time drew nigh that Israel must die: and he called his son Joseph, and said unto him ... put, I pray thee, thy hand under my thigh, and deal kindly and truly with me; bury me not, I pray thee, in Egypt: but I will lie with my fathers, and though shalt carry me out of Egypt, and bury me in their burying place. And he said, I will do as thou hast said. And he said, Swear unto me. And he sware unto him.’ A Commentary on the Holy Bible edited by Dummelow explains awfully proper: ‘It is from the thighs that one’s descendents come, so that to take an oath with one hand under the thigh would be equivalent to calling upon these descendents to maintain an oath which has been fulfilled, and to avenge one which has been broken.’ Guthrie et al., editors of the New Bible Commentary, explain a touch more directly: ‘Under my thigh is probably an allusion to the genital organ.’ And add the remarkable note that the practice reportedly survived in modern times among Egyptian Bedouins. Something to think about long and hard if ever called upon to testify up there.

In December 1986 Cameron’s doctor, a family friend about to retire, drew his blood. Why we don’t know. What we do is that without consulting him he sent a sample of it for testing for HIV antibodies. Probably because before AIDS was reconstructed as everyone’s disease (but especially blacks’), it was conceived to be the malady of gay men and other social undesirables like poor black Haitian immigrants and heroin addicts, so aware that he was gay, the doctor thought this guy’s at risk for AIDS so best do a check for HIV. Point is he lit up the test. As perfectly healthy people who have telephoned me have done, some remarkably prominent, scared to death at first but sceptical in the end. Properly so, because as we read in my article, Why the ‘AIDS test’ is useless and pathologists agree in Debating AZT it is. Completely. The administration of HIV antibody tests by doctors ranks alongside the use of callipers by Nazi doctors to measure suspected Jewish noses. Or swimming a woman suspected of witchcraft, by tying her left thumb to her right toe and vice versa and pitching her into a pond – with floaters judged witches and hanged, and sinkers, who drowned, posthumously declared innocent.

HIV antibody tests were never designed to be diagnostic instruments, merely screening tools to exclude possibly risky blood from blood banks, and no more than that – but they have become arbiters of life and death. It’s unbelievable. Maddening to ponder too long. As it was to hear former acting Cape Town mayor Belinda Walker, other politicians, journalists and AIDS activists urging everyone to go out and ‘get tested’ on the radio. Cape Town’s ‘City AIDS Testing, Counselling and Support Centre’ still does: ‘Get tested!’, it encourages folk reading its posters stuck in shop windows. An enormous billboard in Butterworth urges the same in Xhosa. Billboards in East London proclaim in English, Afrikaans and Xhosa: ‘I’ve tested and saved lives. Test now and stay healthy.’ Likewise in Cape Town: ‘“I’ve tested. I know.” By knowing you can make the right choices.’ When to start AZT. A lot of the people reading the proposition will be able to afford it: the billboards stand strategically situated next to the highway to Johannesburg, the airport turnoff on the way.

The billboard suggestion that getting tested is a positive step in taking control, like Big Tobacco’s message that that smoking makes you sexy, employs a proven psychological trick. Lauritsen reported in HIV Voodoo from Burroughs Wellcome in the New York Native on 7 January 1991 that the AZT manufacturer had flighted full-page ‘Living with HIV’ advertisements in the New York Times and other newspapers around the world, and in subways and on bus shelters: ‘In a typical ad, a man is shown in silhouette by a grand piano, his head bowed in dejection, and above his head the statement, “I learned I was HIV positive five years ago. I felt angry, deserted, and victimised. Today I’m back in control.” The theme of ‘control’ is echoed in the ad slogan, “The sooner you take control the better.” In all of the ‘Living with HIV’ ads, the body copy is the same:

Every day, more and more people are learning to live with HIV. People are finding ways to stay healthier, strengthen their immune systems, develop positive attitudes. They’ve found that proper diet, moderate exercise, even stress management can help. And now, early medical intervention can put time on your side. Today HIV positive doesn’t mean you have to give up. So, the sooner you take control, the better. For more information on living with HIV, we urge you to call the number below ... anonymously if you wish.

You’re doomed to die soon. Take up a yuppie health-fad and then phone us. We’ll tell you all about our lifesaving drug. We call it AZT.

Into psychology they are. In the same article, Lauritsen tells that early in 1991 the company mailed a promotional video to AIDS specialist physicians entitled The Psychology of Treating Patients with HIV Disease: ‘This video will share with you the psychological reactions we’ve seen from patients who are diagnosed positive for HIV antibodies, and then alert you to the emotions that follow as they encounter the progression of the disease and then are motivated towards treatment with Retrovir.’ And when they get sick on it, and start raising issues about deadly side effects, doctors should help them ‘realize that their fears were unfounded’. It’s just their bad nerves:

Some patients, who have begun AZT, have complained about side effects which, once they’ve talked about it with their counsellors, were determined to be more related to their anxiety about being on the drug, than to the drug itself. Sometimes a person could benefit medically from the treatment, but rejects the drug for psychological reasons, after being on it for just a brief period. Therefore it’s important to recognize that some of your patient’s early reactions may be psychological.

If you haven’t puked already, this will do it: A doctor says with a smile: ‘That pill should be an absolute symbol of life, and not a symbol of, “Oh, I’ve got this…” The whole issue of empowerment here, of people taking charge of their own lives, is involved with this decision making, to take this drug.’

Told by his doctor that he was HIV-positive, Cameron would have inferred the unspoken implication that the test had detected the virus. Or at least antibodies in his blood that would be there if, and only if, he was infected. Like a swat team that only shows up for urban guerrillas. And that he wouldn’t have had any such antibodies if he wasn’t ‘living with HIV’.

What Cameron wouldn’t have been told, because his doctor probably didn’t even know himself, is that the test is not like a burglar alarm, either on or off. It always goes off; it’s just that with some people the siren is louder than with others. Because after the prepared, diluted blood sample is stirred up with the reagents in the test tube, the mix will always go cloudy. It’s a matter of shades of grey, as it were.

See, we’ve all got those antibodies. Are you surprised? Does the question leap to mind: ‘If these antibodies are specific to HIV, how come I have any at all if I’m not infected with HIV?’ Try asking an ‘AIDS expert’ to explain. Or better not.

If slightly to moderately cloudy, not to worry. If darker than that, you’ve got the virus that lurks. Says the ‘AIDS expert’. But not the test kit manufacturer, which produces these tests for a limited purpose only: to identify blood with more immunoglobulins in it than the next guy’s, suggesting that it might possibly have met the lurker and this possibly kick-started its B-cells into producing them. Like cops rushing out for a burglar alarm. Set off by a burglar. Although usually the cat. So you shouldn’t have your blood pooled with the rest at the local blood bank. This is not an entirely senseless precaution. It’s a bit like looking into how many police stations there are in similar sized cities when choosing a safe one for your family, and reasoning that the more police there are, the rougher the streets are likely to be. And so avoiding the risky ones. But your survey does not and cannot tell you specifically whether there are any rapists or paedophiles in town.

Unlike ‘AIDS experts’, the test kit manufacturer knows a few plain facts. First, there are no specific antibodies on God’s earth. Meaning that they react with all sorts of things. In the case of HIV antibody tests, about 70 documented different conditions, having nothing to do with ‘HIV infection’. This is why the instruction manuals are so cagey about what you should deduce from a ‘reactive’ result. The ELISA test kit manufacturer Abbott Laboratories, for instance, is perfectly frank: ‘EIA testing alone cannot be used to diagnose AIDS, even if the recommended investigation of reactive specimens suggests a high probability that the antibody to HIV-1 is present.’ The Genetics Systems ELISA package insert, revised in 2000, states: ‘The risk of an asymptomatic person with a repeatedly reactive serum sample developing AIDS or an AIDS related condition is not known.’ Similarly, the Cambridge Biotech Western Blot package insert published in 1998 points out: ‘The clinical implications of antibodies to HIV-1 in an asymptomatic person are not known.’ Which is not what the ‘AIDS experts’ and doctors tell you. Who consider reactivity to repeat ‘HIV antibody’ tests synonymous with ‘HIV infection’. Unlike the manufacturers of the test kits themselves, and their lawyers, who don’t share that expert medical opinion. Most intriguing is the last part of OraSure Technologies Inc.’s Premarket Approval Information for its brand new OraQuick Rapid HIV-1 Antibody Test. Something to throw at the ‘AIDS experts’. Who always tell you that HIV causes AIDS as a matter of unchallengeable, scientifically proven fact. As opposed to current medical belief – like so many others that have come and gone: ‘Acquired Immune Deficiency Syndrome (AIDS), AIDS related complex (ARC) and pre-AIDS are thought to be caused by the Human Immundeficiency Virus (HIV).’ Thought.

Each and every ‘HIV antibody’ test kit approved by the FDA and currently on the market is licensed for screening blood only, not diagnosing infection. That is, their use is intended for excluding possibly tainted blood, not telling people they’re going to die. Even the CDC, in its CDC 2000 Revised AIDS Surveillance Definition, which sets out ‘reporting criteria for HIV infection’ emphasizes that repeated, confirmed reactive HIV antibody test results mean ‘HIV infection’ for ‘public health surveillance only ... not [for] clinical diagnosis or for any other use’. But doctors use them to diagnose HIV infection among their patients anyway. And researchers use them on their subjects for the same purpose. Because they’re the experts.

How anyone can suggest that a repeat of this bum ELISA test can confirm the result of the first is a mystery. But the ‘AIDS experts’ do. Because they’re clever. In most First World countries, before you’re saddled with a scary HIV-positive diagnosis, doctors use another kind of antibody test to confirm the first two: a Western blot. They say this is because ELISA antibody tests are over-sensitive, over-react and are insufficiently specific. But not in England and Wales where Western blots are not used to confirm reactive ELISAs for exactly the same reason. Isn’t that great? Maybe someone in the UK read the manual – Organon Teknika Corporation’s, for instance, the manufacturer of one such ‘HIV-1 Western Blot Kit’: ‘Do not use this kit as the sole basis of diagnosing HIV-1 infection.’

Where Western blots are used to confirm ELISA results, what are we to make of the fact that their results are interpreted by quite different criteria from place to place? So that you’re infected by or free of the deadly sex-germ according to which lab you walked into. And where should we slot Standstrom’s study in? The paper published in Cancer Research in 1990, reporting that the blood of exactly half of one hundred and forty-four dogs tested with Western blots for ‘HIV antibodies’ was reactive to one or more ‘HIV proteins’?

AIDS doctors might try telling you, ‘No, we don’t rely only on lab testing. We interpret the results in the light of clinical symptoms.’ They’d be telling lies. Because most people diagnosed HIV-positive, and told so to their crushing distress, have no symptoms of any illness. Many are in peak health, such as those dozens of black South African boxers disqualified year after year. By doctors. Ruining their careers. Destroying their lives. For the fee. And in rare cases where the person tested is ill, and is judged ‘reactive’ to the test, the signs are no guide to whether he’s HIV-infected in any event. They can’t be, in any rational system of medicine, because none other than Professor Luc Montagnier – the discoverer of ‘HIV’, he claims – has correctly noted that ‘AIDS has no particular symptoms’. Unlike chickenpox or measles, for example. Distinct illnesses. Real ones.

When Tim Modise pointed this out to Cameron during a radio interview on SAfm on 18 July 2000 – ‘What do you mean, Judge, when you say the symptoms of AIDS itself? Because we’ve heard others say there are no specific symptoms for AIDS. AIDS is merely a syndrome and therefore not a disease’ – the judge knew better: ‘Tim, the people who believe that I think really operate from a position of dogma not from a position of reasoned inference. … Tim, it’s almost like the creationists. … It’s like the white supremacists or the Holocaust deniers. … The Holocaust deniers are very similar.’ (This guy’s a judge, who bills himself as an ‘intellectual’.)

AIDS as an acronym was originally coined by the US CDC as a mere ‘surveillance tool’, a category in a ledger under which some sleepy clerk would enter a count of cases of disparate familiar diseases thought linked by weakened immunity. For the books, not the patient. But like Cinderella’s pumpkin in the magic of our time, AIDS has become transformed into a disease: ‘I’m sorry, but you’ve got AIDS. Take this. It comes with a skull and cross bones on the bottle when we give it to rats and monkeys. But not on the box of capsules I’m giving to you.’ Some doctors even talk of ‘HIV-disease’ now. Among the perfectly well. No, you’re not dreaming. They are. As they were about black bile, from the time of the ancient Greeks until well into the modern era. Causing melancholy if you had too much of it, out of balance with your three other humours: blood, phlegm, and yellow bile – the latter substances all real enough, in a physical if not theoretical sense, since they can all be seen. By us as well as the experts. But never the black stuff, which they said was secreted from our ‘suprarenal glands’ situated above our kidneys. Which don’t even exist. The theory however was elegant. So doctors weren’t going to be disconcerted by the facts. Are they ever? As they wrote volumes about a causal agent that existed only in their learned imaginations. And tapped blood, drilled scalps, branded flesh and purged guts to get it back in balance.

When the manufacturer talks of the ‘specificity’ of its HIV antibody test and puts up an impressive figure of around 99.6 per cent, as it typically does, it doesn’t mean what you think (because it’s what the word ordinarily conveys), namely, how seldom (4 cases per thousand) it lights up falsely in the absence of the virus. How reliable it is. It doesn’t mean that at all. That’s because the performance of the test has never been calibrated by comparing its responses with confirmed viral infections. And without confirmed viral infections to assess the performance of the test by, you can’t establish its positive predictive value: its reliability, its accuracy. The correlation between ‘positive’ and ‘infected’ is completely unknown.

Are your eyes beginning to smart as you read this? If they are, best quit peeling this onion right now my friend, and find a rugger match to watch instead, because it gets much worse. You’ve no idea. You see, we are approaching the nub of this whole catastrophe, and it’s not something for the feint-hearted. But it’s not hard to grasp either. If you’re not intimidated by the mumbo-jumbo of lawyers and priests – the abracadabra they’ve developed to keep ordinary folks off their turf like iron pales – you are not going to be put off by ‘AIDS experts’ and their shibboleths. Take cheer from Einstein: ‘The whole of science is nothing more than the refinement of everyday thinking.’ Consider that reading and writing were once the elusive, daunting weapons of the elite against the laity in the Middle Ages, but as we’ve found out, it’s not so impenetrably hard after all.

The gold standard for measuring the performance of an indirect test for a viral infection – such as an antibody test – is the virus itself. Just as a foetus is an absolute reference for the performance of a pregnancy test. ‘Yes, obviously,’ you retort impatiently. Well eat this: ‘HIV’ has never, repeat, never been isolated and electron photomicrographed like other viruses – on its own, separate from bits of cellular debris and objects that look like infectious viral particles (‘mock-virus’) but aren’t. This is why you read incredulously in the test-kit manual, your mouth agape: ‘There is no recognised standard for establishing the presence or absence of HIV antibodies.’

As I mentioned in my antibody test article in Debating AZT, the specificity of the HIV test has been determined in a manner rather like treating thin women as controls for non-pregnancy and plump women as controls for imminent mothers in an exercise to ascertain how reliably a new pregnancy test is working. And then reporting the results as sensitivity and specificity values. Fair enough for a very rough anonymous screening survey in a nation of generally slender people perhaps, but criminal for a test used to make life and death diagnoses. Yet now in use as such everyday. Unchallenged, because what crimes have in common with debts is that the bigger they are, the better your chances of evading them. The crimes of the Church for instance.

The New Shorter Oxford English Dictionary defines a virus as a ‘submicroscopic organism that can multiply only inside host cells, has a non-cellular structure lacking any intrinsic metabolism and usually [comprises] a single DNA or RNA molecule in a protein coat’. (Let’s stay with this.) The definition implies that it can be seen. So what distinguishes the HIV theory of AIDS from the witchcraft theory of crop failure and family misfortune is that unlike the putative causative agents of the former, the cause of the latter can notionally be captured and visualised, like a criminal suspect standing in a dock. And that when ‘AIDS experts’ talk of HIV, they are implying to you not only that HIV can be seen, but also that it has been. You understand that they are referring to more than a trail of ambiguous chemical clues suggesting that HIV is in town. (Let’s further accept the conventional view for present purposes that viruses are the cause of disease, and not the result: particles expressed from stressed cells.)

By ‘submicroscopic’, the dictionary means too small to be seen with a light microscope. Very small indeed: about 120 nanometres (thousand-millionths of a metre) in diameter for that class of viruses they call ‘retroviruses’. But visible at that size to electron microscopes with a magnifying power of about twenty thousand. Now being so very small, you can’t easily isolate one of them for inspection and characterisation, like a dogfish scooped out of a rock-pool in your son’s fishing net. So you do the next best thing. You concentrate them. Separate from everything else. Thereby purified. Like a trawler’s net containing nothing but mackerel. So that when you gaze into this teeming mass you’re looking at and working with nothing but a very specific creature and nothing or very little else. If you mince the contents of the net, you can be sure to get mackerel meat, mackerel bones, mackerel scales and mackerel tails. Pure mackerel.

There’s a tried and tested procedure in virology for isolating viruses – variously named but involving the same essential steps. Call it isopycnic zonal density gradient ultracentrifugation if you like, but that’s only half the thing. Which is where the guys who claimed to have isolated HIV in 1983 and 1984 screwed up, raining a disaster on the world bigger than New York’s. By the end of 2003 the American government had spent $132.4 billion on AIDS according press releases issued by the Department of Health and Human Services, with another $14.2 lined up for 2004. All wasted. Let alone inestimable fortunes privately raised and spent. And more heartache and terror than all of it put together.

The viral isolation procedure is a trick a bit like royal English or Zulu huntsmen getting their vassals to beat the fens, forests or veld to drive antelope into a killing zone, to concentrate them for easier shooting and spearing. Separate from hares, snakes and birds. A procedure discussed and written about at a dedicated symposium of some of the world’s top virologists convened at the Pasteur Institute in 1972. I’ve got their papers, and this is what they tell us to do. You get hold of some cells you think are virus infected. (And some cells that aren’t, so that you can run a parallel control exercise.) You dismember them with solvents and enzymes, and then plop a drop of this mess atop some sugar syrup in a test tube prepared such that its density gets lighter bottom to top. You spin it at high speed for several hours, and what happens is that the stuff separates out in fractions, or layers. It’s like shaking up muddy water in a bottle and leaving it to stand over-night: in the morning you’ll have clear water on top, followed by dusty silt, and then grittier sand, with tiny stones at the bottom.

All retrovirologists accept that because of their characteristic buoyant density, retroviruses will band in a particular spot in the syrup, at a density gradient of 1.16 grams per millilitre – say like where the silt is. Here’s the next absolutely crucial step: You take a snap of what has collected there through an electronmicroscope, and you examine it carefully. You do this because although all retroviruses present will collect as aforesaid, so can other things – bits of cellular debris and intact parts of cells: enclosed minifactories called microvesicles. It’s like landing other kinds of fish, seaweed and sharks in your mackerel trawling net. You look out for the retroviruses you’re after, orbitally shaped with suckers all round – as ‘AIDS experts’ conceive and describe them in the textbooks. If that’s all that you see in your micrograph, or at least the preponderance of stuff there has the structural appearance of retroviruses as described, you’re in business. You incubate some virgin cells with these particles and repeat the whole procedure, to make sure they’re infectious. And thereafter, when you take a dip into this stuff, you can be sure you’ve got retroviruses. In abundance, with which to work, and make a heap of money from. Like a net full of mackerel – verified by peering into the net. You can use the proteins derived from this purified viral concentrate in antibody tests, confidently claiming that they are retroviral proteins that will react with corresponding antibodies. You can use the RNA you find in there in a test that seeks out matching RNA in a person’s blood, and likewise confidently claim that whenever you get a match you’ve shown a retroviral infection.

This procedure is commonsensical you’ll agree. It’s viral isolation. Nothing less will do. No short cuts. Not finding some proteins thought to be HIV-originated. Like a pair of sunglasses found near a crime scene, assumed to be the criminal’s. But equally possibly the victim’s. Especially since Papadopulos-Eleopulos and her colleagues demonstrated in their June 1993 paper, Is a positive Western blot proof of HIV infection? in Bio/Technology (now renamed Nature Biotechnology), that each and every protein that has been considered uniquely retroviral by ‘AIDS experts’ is actually cellular. Meaning part of us. For heaven’s sake. We are talking about the proteins used as antigens in HIV antibody tests. Alleged to be ‘HIV’. Actually human.

Nor will it suffice to find a peak level of this enzyme that ‘AIDS experts’ call reverse transcriptase. Because it’s not specific to retroviruses. Everyone in biology knows this. Even dopey South African ‘AIDS expert’ Professor Ruben Sher (on the documentary The Truth on AZT): ‘Now reverse transcriptase is also present in many other functions of the body. So although we were assured originally that [AZT] acted only on the HIV reverse transcriptase because it was specific to HIV, it would seem that it is not quite the truth.’ The plot thickens: the presence of ‘reverse transcriptase’ is never established directly. It is deduced from a biochemical phenomenon called retrotranscription. Which can be achieved by ordinary cellular enzymes. Which puts ‘reverse transcriptase’ in the same scientific category as the ether, electrical fluid and phlogiston. All of which substances, we know now, don’t exist – never did, except in the minds and books of scientists and their students, to explain things. For ages too.

And likewise in the words of ‘AIDS expert’ virologists in the employ of the mighty US CDC (in Emerging Infectious Diseases 2001, Vol 7 p756): ‘Detection of viral nucleic acid is not equivalent to isolating a virus.’ Right, although you might reasonably wonder on what basis they call the molecule ‘viral’, when they have not yet collared the suspect from which to take a sample for comparison purposes. But anyway, it’s why Roche Diagnostic Systems, Inc., manufacturer of the ‘HIV RNA’ detecting ‘viral load’ test, cautions: ‘The Amplicor HIV-1 Monitor test is not intended to be used as a screening test for HIV or as a diagnostic test to confirm the presence of HIV infection.’

Because babies inherit their mothers’ antibodies, ‘AIDS experts’ in the CDC appreciate that they can’t usefully be tested for ‘HIV infection’ with an antibody test kit, because it will detect the mother’s antibodies in the child’s bloodstream. Which puts them in a quandary. What to do? It’s easy. They just close their eyes to Roche’s warning that its test ‘is not intended to be used as a ... diagnostic test to confirm the presence of HIV infection’, and proceed to use the test to diagnose ‘HIV infection’ in babies, irrespective. Being ‘AIDS experts’. Who know what they’re doing. Sometimes they ‘confirm’ the result with a similar test, known as a qualitative (as opposed to quantitative) test – Roche’s other one, its Amplicor HIV-1 test (without ‘Monitor’ in the name). They likewise do so in defiance of the manufacturer’s express contraindication: ‘For research use only. Not for use in diagnostic procedures.’

It’s this abuse of the word ‘isolation’ by ‘AIDS experts’ that has caused all the trouble. (And ‘HIV isolates’.) They can’t even agree among themselves what they mean by it, as we saw in a spectacular performance by our National Institute of Virology at the second meeting of Mbeki’s AIDS Panel on in July 2000 – with virologist Lynne Morris telling us glibly in the morning that ‘HIV is easy to isolate. We do it every day’, followed by her boss Professor Barry Schoub contradicting her in the afternoon: ‘HIV is very difficult to isolate.’ Morris probably meant achieving a nice peak of reverse transcriptase in a cell culture stressed with various mitogenic chemicals. (Like nails hammered into an avocado tree to induce it to fruit.) Or finding some proteins as discussed. Or some protein interactions. And then jumping to the characteristically sloppy conclusion. Like a dull cop with a bad hunch. What Schoub had in mind when talking about isolating HIV is anyone’s guess, for reasons we’ll discover in a moment.

You’d assume then that all steps in this purification procedure were observed when HIV was allegedly isolated in the early eighties. Now that the American Robert Gallo’s plagiarism has been exposed, Luc Montagnier of the Pasteur Institute in Paris is generally acknowledged to have first isolated HIV (then called LAV) in 1983. Even though his idea about what HIV’s constituent proteins are is way out of joint with Gallo’s. Like giving a description of a grape for a banana. But in 1997, in a videotaped interview by a sharp French-Algerian investigative journalist, Djamel Tahi (I have a copy), Montagnier made some extraordinary concessions. As the camera purred Montagnier was asked, ‘Why do the electron micrographs published by you [in Science in May 1983] come from the culture and not from the purification?’ His bumbling reply should have marked the end of the HIV theory of AIDS:

There was so little production of virus it was impossible to see what might be in a concentrate of virus from a gradient. There was not enough virus to do that. Of course one looked for it, one looked for it in the tissues at the start, likewise in the biopsy. We saw some particles but they did not have the morphology typical of retroviruses. They were very different. Relatively different. So with the culture it took many hours to find the first pictures. It was a Roman effort! It’s easy to criticise after the event. What we did not have, and I have always recognised it, was that it was truly the cause of AIDS.

Montagnier had thought so as early 1990, at the San Francisco AIDS Conference: ‘HIV’ needs ‘cofactors’ to do any harm, and he had a mycoplasma in mind. But the conference organizers wanted none of it and refused him a podium, with the result that he had to present his paper on this in a nearby hotel, after which, the atmosphere being so chilly for him, he flew back to Paris immediately. Yet he didn’t see any contradiction in later stating in his book, Virus (W W Norton & Company, 1999): ‘I did not think, when I first began writing this book, that I would have to explain once again why AIDS is an infectious, communicable disease caused by a retrovirus, HIV.’

How in the light of those micrographs he could have gone on to claim that he’d isolated anything, let alone a new retrovirus, is incomprehensible, except that I’m afraid that Montagnier is a dreadfully stupid person, aided into print by a very powerful crook. (Asked in the interview whether Gallo had isolated HIV after him, he answered: ‘I do not believe so.’) Far from isolating a new retrovirus, all Montagnier had achieved was to obtain what appeared (from indirect clues) to be peak levels of reverse transcriptase in his 1.16 density gradient. And he found some objects swimming around the stressed biopsied cells in his test tube culture that didn’t even look like a textbook retrovirus – as sketched by the experts. Indeed, ‘a French specialist of electron micrographs of retroviruses publicly attacked me saying: “This is not a retrovirus, it is an arenavirus.” Because there are other families of virus which bud and have spikes on the surface, etc.’ Can you believe what you’re reading?

Probably not: it’s surely incredible to suggest that a leading virologist could publish a peer-reviewed claim in America’s top scientific journal that he’d isolated a new retrovirus when he hadn’t. Except that it had happened once before. In January 1975 Gallo, then head of the Laboratory of Tumour Cell Biology at the National Institutes of Health, alleged in the headlines of the Washington Post that he’d isolated the first observed human retrovirus – which he called HL23V. Type C RNA Tumor Virus Isolated from Cultured Human Acute Myelogenous Leukemia Cells, published soon thereafter in Science, formally staked his claim – backed up by a convincing electron photomicrograph of virus-like particles. But when he made a presentation the following year at the annual meeting of the Virus Cancer Programme, his colleagues in the game were waiting for him. They openly mocked his alleged discovery, joking that a better description of his alleged new ‘tumour virus’ might be ‘the rumour virus’. In 1980 two papers formally poked holes through Gallo’s find, and the following year, in a paper of his own, he conceded himself that the antibodies which he’d claimed were reacting with his alleged new virus had actually reacted with cellular proteins, not viral ones. With that, ‘HL23V’ finally evaporated. Right off the face of the scientific earth.

Significantly, however, Gallo’s evidence for his isolation of HL23V was even stronger than that which he put up in April 1984 in support of his rival claim, against Montagnier’s, to have first discovered HIV. Because unlike his ‘HIV’ pictures, his ‘HL23V’ micrograph depicted duly concentrated identical particles banding in sucrose where one expects retroviruses to mass after being spun by a centrifuge. And secondly, no mitogenic chemicals had been sprinkled onto his cell culture – to confound the show by stimulating the production of particles that look like infectious viruses but which aren’t.

Robert Gallagher, Gallo’s collaborator, who was cited as lead author of their co-authored Science paper, lamented to Linda Marsa, author of Prescription for Profits (Scribner, 1997): ‘There has never been for me an adequate explanation to this day as to how you could have all this positive data, and then all of a sudden there’s no evidence and it is totally discredited. The most likely explanation is that someone just got sloppy.’ Another is that you guys in Gallo’s ‘Bob Club’ mob didn’t know what the fuck you were doing. Borne out by your even crummier claims about HIV in 1984. Before the police came knocking for patent fraud. But making up for scientific incompetence with a good head for politics. For pulling funds from Congress, hand over fist. And most importantly, knowing how to play the media – and taking it on its biggest ride ever.

I met and spoke with Montagnier in Pretoria at the first meeting of the AIDS Panel in May 2000, and later sat at dinner with him, across the table a few chairs down. I eavesdropped aghast as New York journalists Celia Farber and Mark Drescher chatted to him, taking it up on hand-held video camera, adroitly teasing out the scientific ideas that fill his head. Like HIV is spread by insect bites. And then I had to turn away, unable to stomach any more. It was incredible, like a rerun of the Peter Sellers movie, Being There, in which the comedian played the retarded gardener Chance, mistaken by Washington movers and shakers for a Thoreau-like philosopher, and fêted as such. The tentative proposer (and later the recanter) of the retroviral theory of AIDS has the brains of a flea.

After a string of cracks from German-born Duesberg sitting at my left – a famously funny man in good spirits – I added one at the expense of dissident French Canadian pathologist, Emeritus Professor Etienne de Harven, sitting opposite us, telling how when Debussy went to visit Brahms, he was met at the door by his valet, who went up to announce his arrival. ‘Who’s Debussy?’ asked Brahms. ‘French composer,’ answered the butler. ‘No such thing!’ retorted Brahms. To which Duesberg added, pointing diagonally across the table at Montagnier, ‘Just like French virologist’, thereby bringing the house down again.

To those who’ve really looked into this mess though, Duesberg and Montagnier sit at the same table scientifically-speaking too. Their disagreement is trivial. Duesberg accepts Montagnier’s claim to have isolated HIV. Actually argues it against Papadopulos-Eleopulos. Ineptly, even a layman can see. And at the second meeting of the AIDS Panel in July 2000 he theatrically supported Makgoba’s assertion, ‘Even Peter agrees that HIV has been isolated.’

But the world’s most notorious AIDS dissident, Duesberg, and the world’s most famous HIV expert, Montagnier, agree: HIV cannot possibly cause the onset of AIDS diseases. Duesberg says not at all; Montagnier, since 1990, has asserted the need for causative co-factors. HIV needs help, he says, because it can’t do it on its own. Are you amazed to learn this?

In championing Montagnier’s HIV isolation claims, Duesberg’s dismissal of Papadopulos-Eleopulos’s more radical critique has frequently been rude and scornful – reminiscent of Galileo’s attitude to Kepler in dismissing his discovery of the lunar influence over the tides as a ‘puerile superstition’. Hubris gets in the way with these guys sometimes. Even the bravest and the best. So we have Duesberg demeaning as ‘impassioned’ Papadopulos-Eleopulos’s dry-as-bones, meticulous repudiation of his claim to the Continuum prize – offering the jackpot to anyone showing ‘HIV’ to have been isolated (see the Missing Virus debate at ); ‘unfortunately or fortunately’ she hadn’t attended an AIDS dissident conference in Colombia in October 1997, he said; ‘The Perth Group are dead,’ he said dismissively of her case to his audience on the veranda of the Sheriton Hotel in Pretoria at the first meeting of the AIDS Panel meeting; when she approached him at the second AIDS Panel meeting in Johannesburg to mend the bridges he’d burnt, he coldly turned his back on her; and a day later walked out as her HIV isolation experiment was proposed there. Yet she continues graciously recognising his tremendous contribution and exemplary courage nonetheless, crediting him in her subsequent opus, Mother to child transmission of HIV and its prevention with AZT and nevirapine, ‘for showing us that tenacity and perseverance are needed by scientists in their search for truth’.

But one can sympathise. It must be harsh for Duesberg to contemplate that much of his career as a retrovirology specialist has been a lost diversion. Like those ‘phlogiston’ experts grappling with Lavoisier’s discovery of oxygen, which explained the oxidative process much better: oxygen coming in, not ‘phlogiston’ going out. Or those guys who were experts in ‘the ether’ filling the universe. Or ‘electrical fluid’. Non-existent entities upon which they had erected their careers, misled along with everyone else by deceptive appearances and clues. And tough it must have been hearing his erstwhile supporter Nobel laureate Kary Mullis scorning him at dinner during the Colombian meeting as a ‘proctovirologist’. Mullis had been won by Papadopulos-Eleopulos’s case, presented by Colombian research biologist Dr Helman Alfonso and supported by German virologist Dr Stefan Lanka, demonstrating that the study of ‘HIV’ – and indeed the whole of infectious retrovirology – is a load of, shall we say, scatology, coprology. Irritated by Duesberg’s unexamined reiteration of the claim of the ‘AIDS experts’ that the ‘HIV genome’ has been sequenced, Mullis let loose a shower of sarcastic remarks. (He’s another amusing bloke: ask him what the acronym PCR for his invention means (polymerase chain reaction) and he’ll tell you ‘post-coital reverie’.) Duesberg sat stung and silent. At last. Having earlier attempted to shout Alfonso and Lanka down. Misbehaving dogmatically with stopped ears, just as he did at the first and second meetings of the AIDS Panel, repeatedly getting up and walking out.

Duesberg is wrong about a number of things, including critically important ones: the specificity of the HIV antibody tests, the HIV isolation question, and the real reason why AZT is so poisonous. And as mentioned, he has behaved very badly towards his detractors on his left flank. His scientific manners in his engagements with them have been as lacking as those who have pilloried him from the right for his efforts in exposing the more obvious anomalies, paradoxes, insufficiencies, and predictive failures of the HIV-AIDS model. Because to the guys who make their living fanning the hysteria of AIDS ideology, Duesberg is like the Moslems’ Shaatan. Good only for stoning. That’s why you seldom hear his name uttered without execration. Like their favourite: ‘discredited’. By whom? His published critiques of the HIV-AIDS causation model, identifying its gross failings, at an epidemiological level mostly, have never been properly addressed, much less refuted. They stand timelessly like the heads on Easter Island. The author of the HIV-AIDS theory, Robert Gallo, broke his promise to write a rebuttal of Duesberg’s magnum opus debunk in the journal Proceedings of the National Academy of Sciences in 1992, a promise made in a notice published alongside it. It bears mentioning that Duesberg remains a member in good standing of that exclusive outfit, and has recently published his novel theory of cancer aetiology – aneuploidy – in its said house journal.

Until he started causing trouble for the AIDS industry, by refusing to buy the mob line, and telling why with irksome logical force, Duesberg had been regarded by his peers as one of America’s most distinguished biologists. He had identified oncogenes (an irrelevance, he later admitted), had been the first to map retroviruses genetically (we await a similar concession), and for these and other achievements had notched up a California’s Scientist of the Year award in 1971, had won a seven-year Outstanding Investigator grant from the National institutes of Health in 1986, the largest research grant available in biology, and had been admitted to the prestigious National Academy of Sciences. There was talk of a Nobel Prize. Students flocked to his courses to sit at his feet, leaving other teachers’ lecture halls embarrassingly empty. (At Berkeley where Duesberg is tenured, there are over a hundred professors of biology in his faculty.) Also to laugh at his cracks, because when he gets going, he’s a very funny guy. I can confirm that first hand because he asked me to sit opposite him to catch up at dinner on Friday night at the Sheraton Hotel in Pretoria before the first weekend meeting of Mbeki’s International AIDS Advisory Panel in May 2000. Let me report that the humour at the table was unsurpassed. Aching ribs. Round after round. And it was the same at meals at the second AIDS Panel meeting in Johannesburg in July. None other than Gallo once described him as ‘a man of extraordinary energy, unusual honesty, an enormous sense of humour, and a rare critical sense’. In short, it would be safe to say that before his fall from favour, and he found himself on a McCarthyesque blacklist for critiquing the HIV theory of AIDS, Duesberg was biology’s brilliant blue-eyed boy.

He may be its turbulent priest, but Duesberg is no radical Beyers Naude of biology dogma. Even less a sort of Robert Altizer thanatheist. Actually he’s about as faithful an old dog conservative biologist as you can get. Too stubbornly so, some of us think. He just sticks to the old rules; he won’t let them go, and he says that the rules he keeps have no room for the HIV theory of AIDS. But even if Duesberg’s rocket fuel runs out half way down the road, the truth is we love him from the bottom of our hearts. Like your children no matter what. It has to do with scientific integrity and its price, expressed in the working title of Bialy’s authorised biography: Unbuttering his own bread: The scientific life and times of Peter H. Duesberg (published by the National University of Mexico in 2004 as Oncogenes, Aneuploidy, and AIDS: A scientific life and times of Peter H. Duesberg). For his courage, his determination, his sacrifice and his humanity, Duesberg, I propose, is the Mandela of AIDS.

Apart from an eccentric sect of Unitarians who call themselves Christadelphians, nearly all Christians believe in the Devil. (As they all believe in HIV.) One of the top gods of their religion. The big bad one. On whom lots can be blamed. His mischief alone being ample proof of his existence. That he’s not ever directly seen doesn’t count. To the faithful. His works are, and they evidence his hand. Satan has much in common with HIV. A scary ugly name for a start. Implying great wicked power. Invisible too. In the sense of never physically seen.

Imagine a sudden itch. Your eyes zoom in on a speck at the site. An unfamiliar tiny freckle. With a scratch it comes away. You peer at it a foot from your nose and recognise it as a pepper tick. Under a strong lens you’ll see the mandible that pierced your skin, along with the rest of its particulars. No doubt, to any right thinking guy, the tick bite caused the itch. But what of odd, disobedient, gangly behaviour among children. Today they’ll be drugged with Ritalin. But during the European witchcraft epoch, such kids were prone to being tried for witchcraft and thereafter hanged and/or burned. Yes, not only grownups. Because the devil was in them. It was obvious.

So it is nowadays: when someone’s syringed blood happens to react more colourfully than the next guy’s in a test-tube of what ‘AIDS experts’ call HIV proteins, they’re said to have the virus in them. Kind of the opposite of being filled with the Holy Spirit. And if and when they take ill for whatever reason, obvious or occult, well there you go, they’ve got AIDS. Caused by the virus.

Something else in common between the two bogeys is the fact that if you believe in the Devil, even a little bit, no amount of persuasion can change your mind. Certainly not such unreal talk as the virus never having been isolated and seen.

Another respect in which AIDS medicine keeps company with devilry is that, as we noted earlier in regard to the latter, a vast body of learning, hierarchies of experts, and even state sanctions can all flow from notions that are purely mythical, especially when dressed in the garments of scientific authority. And with power comes money and vice versa, and the next thing a vast St Paul’s Cathedral has been raised. For the veneration of morbid superstitions. Peculiarly Western ones.

That Mbeki himself entertains something of this perspective – that HIV-AIDS is essentially a superstitious fancy – emerged in the first week of April 2003. Asked whether he’d consider his just established Presidential Press Corps successful if it changed journalists’ opinions concerning government policy on AIDS, he replied in the negative; right on the button, he explained why he didn’t expect they would: ‘You have prejudices, superstitions, all sorts of things.’

Montagnier’s astounding concession to Tahi did not come entirely out of the blue. Turner told me that when he mentioned to Papadopulos-Eleopulos back in 1983 that Montagnier had reportedly isolated a new retrovirus, her answer, having just read his paper as well was, ‘Oh no he hasn’t,’ waving her finger in the air between them. And thus began an extraordinary odyssey together as they published one paper after another taking apart every piece of the HIV-AIDS paradigm, brick by brick. Nearly all their papers have since been archived on the Internet. Duesberg’s key papers too.

After Montagnier’s concessions to Tahi on video in 1997, a second pivotal development occurred that year: two papers by independent research teams led by Julian Bess in the US and Pablo Glushankoff in Germany were coincidentally published in the March issue of Virology, putting up the very first micrographs of what were supposed to be concentrated HIV isolates in banded density gradients – only to report in their titles and reports that the overwhelming majority of matter in the pictures was cellular, not viral. A few blobs were arbitrarily identified by the researchers as HIV, ‘co-purifying’ with all the junk. But all were wrongly sized and wrongly shaped. Rather like a ringmaster assembling an assortment of circus animals, pointing at the ponies among them, and saying, ‘Look, my performing cats.’ The Bess team also published data (in the form of electrophorectic patterns) on the proteins that they found in their ‘infected and ‘non-infected’ cell cultures. One would have expected that the ‘purified’ material from the ‘infected’ cells would have contained unique, distinct viral proteins, and that such proteins would not have been present in the centrifuged material from the ‘non-infected’ cells. But no: the ‘non-infected’ cells contained the same proteins; the only difference between the ‘infected’ and ‘non-infected’ electrophorectic patterns being quantitative. Bess himself conceded this when it was raised with him by the Perth Group. A somewhat awkward state of affairs for the ‘AIDS experts’, if you get the point.

Sadly it was all too much for the president of the Medical Research Council. At the second meeting of Mbeki’s AIDS Panel in July 2000, and in correspondence thereafter, Makgoba dismissed the Perth Group’s identification of these problems in the following terms (in full grammatical and spelling glory):

The Perth Group themselves in our correspondence recognised that own deficiencies and were critised by several members for living and present outdated data eg Dr. Carolynn Williamson and Dr Lynn Morris. [In fact neither commented on the Bess data]. If the recordings are correct that is what you will find. I do not use rhetoric but I equally cannot be deceived by presented electrophoretic patterns that are completely wrong as they attempted to do. My whole PhD thesis was based on doing and reading minute differences in electrophoretic patterns on cell lysates, so I know what I am talking about here.

Bess himself didn’t think so. Invited by the Perth Group to comment he said:

I would like to answer any questions you have about my work. However, I do not understand the quote … Was it spoken in another language and translated directly into English? Please read it carefully. It has significant syntax problems. Also, I suggest that you re-read my manuscript. You will discover that I presented no data on cell lysates. As to how the electrophoretic patterns can be ‘completely wrong’ – you will have to get that one answered by the questioner. I have no clue how they could be wrong. It is possible that the questioner is not aware of what material was electrophoresed (e.g. a cell lysate vs. microvesicles). If the questioner thinks these are cell lysates, he will likely come to an erroneous conclusion.

Over the last two decades of the HIV-AIDS nightmare, the original source of the proteins and RNA’s used in HIV tests has been the bands of what has been assumed to be concentrated HIV particles. Mass production resorts to genetic engineering techniques to produce the same in bulk and to higher uniform standards – such as recombinant proteins in antibody tests. But the crucial assumption that the proteins and RNA are viral was disconfirmed in 1997 when the stuff assumed to be nothing but mackerel, turned out to be kelp, clams, seals, sardines, stingrays and eels. English lacks words sufficient to carry the scale of this disaster. But the Juggernaut rolls on, with lives daily crushed under its wheels.

If you find yourself heaving under the weight of this, join the club. But here’s a hot tip. Leave it here and call it a day. Don’t talk about it, and don’t scratch any further. At stuff like Rabies, Polio, SARS, Mad Cow, Foot and Mouth, virology generally, immunology generally, syphilis, germ theory generally. Modern oncology’s constructions of cancer and its treatment. Or the possibility that the central dogma of molecular biology – the notion that genetic information is stored exclusively in DNA – might better be described as its central fallacy. And that it’s high time to yank the chain on it, flushing all of ‘retrovirology’ down the pan too. Turn from ruminating about what ‘HIV-AIDS’ as a new medical ideology says about the metaphysical foundations of modern medicine. From what kind of ground would sprout such a poisonous weed. And what kind of culture would support an allopathic ‘healing’ system currently dominated by such grotesque, perverse, death-fomenting superstitions and practices. Rather than kicking out the bums who propound them as wicked charlatans. Because this is where the fire under your feet starts getting uncomfortably warm. You’ll quickly appreciate that your inquiry is not innocently scientific as you naively supposed it was when you began. It is taboo and it is absolutely forbidden. Einstein’s advice, ‘The important thing is to never stop questioning’, doesn’t apply here. Fortunes derived from the settled notions you weigh dwarf the Vatican’s holdings to farthings. You threaten jobs and you expose reputations to ridicule. It would be like going around saying, ‘The Trinity is ridiculous. It’s a pagan idea not even in the Bible and it was only established as the Christian religion’s central creed by the whims and forceful exertions of the Roman emperor Constantine. Stamping out a bothersome doctrinal squabble – potentially dangerously divisive, because the two sides were pretty evenly matched in terms of the eminence and numbers of their supporters. Three hundred and fifty years after his government sanctioned the lynching of the guy he now decided should be turned into a god.’ Imagine the atomic crescendo of stuck pigs squealing, the vast pack of snapping Dobermans charging.

The world’s most famous Jew was murdered to satisfy a popular call. Because he was going around saying the wrong things. Uncomfortable things. Hanging out with working girls. And washing the sores of those absolutely ostracised and stigmatised ‘AIDS sufferers’ of his day, lepers. Laughing off the universal belief that their condition was infectious. If to the touch, most certainly via lovers’ secretions: in The Group-Fantasy Origins of AIDS, the late Casper Schmidt, a Namibian-born psychiatrist and Afrikaans poet who practised in New York after a stint in Soweto, quoted the famous Gui de Chauliac, medieval physician to the Papal Court at Avignon, advising doctors interrogating male patients ‘to enquyre yf he hath had the company of any lepresse woman. And yf lazar [a leper] had medled with her afore hym, and lately, because of the infect mater and the contagious filth that she hadde received of hym.’ The idea that leprosy was sexually transmitted was current on the other side of the Channel too: Ziegler notes incidentally in The Black Death that Edward III banned lepers from London in 1346, since ‘by carnal intercourse with women in stews [brothels] and other secret places, detestably frequenting the same, [they] do so taint persons who are sound’.

Schmidt observed that

The fantasy complex of AIDS (i.e. the triad of promiscuity, poison blood, poison sperm) is not new. It is identical to the one in vogue in the Middle Ages to explain the origins of leprosy. It was generally accepted that leprosy was associated with violent sexual excitement and moral impurity … ‘the filth of lechery’, ‘the impurity of lust’ … It can be seen today that this fantasy complex has not changed and is encountered intact today, except that in the AIDS epidemic the fantasies have been translated into modern idiom (so that ‘contagious filth’ becomes ‘semen containing cytomegalovirus or HTLV-III’ [the old name for HIV] or more sophisticated still, ‘immunosuppressive sperm’). These unconscious fantasies are found not only in the lay press, but they determine the direction of our scientific thinking, so that in scientific magazines usually sceptical clinicians subscribe to them without sufficient proof.

Like Mbeki during the AIDS craze today, the carpenter among lepers then was remarkably sharp to the obvious fact – in the face of conventional wisdom – that those suffering the disease were generally the desperately poor and hopeless, conveyed by the Xhosa and Zulu adjective, hlupekile. And that he wasn’t going to get ill by embracing them – the germ Mycobacterium Leprae being ubiquitous like its cousin, Mycobacterium Tuberculosis. Colonizing the weak. Not the strong. As Alfred North Whitehead once noted, and it applies to both men: ‘It requires a very unusual mind to make an analysis of the obvious.’ Christ’s compassion for lepers provocatively flouted the popular taboo. The taboo on people branded HIV-positive is enforced hardly less viciously – as Mbeki has discovered in disregarding it, spat on in all the media, and flatly accused of mental illness and of incompetence to hold his office. And curiously, like those circumcised matrons in certain Northern African countries, who defend their mutilation of young girls in turn more strenuously than anyone else, it is those under the hex of HIV-positive diagnoses themselves who have been Mbeki’s most virulent detractors.

The antagonistic vehemence of the mob, high-brow and low, offended by Mbeki’s and Christ’s scorn of the contemporary popular opinions is explained by Arthur Schopenhauer from a simpler tack: ‘There are three steps in the revelation of any truth: in the first, it is ridiculed; in the second, it is resisted; in the third, it is considered self-evident.’ A fact of life noted by Denis Beckett in his delightful Madibaland (Penguin, 1998): ‘A delusion after it has died is a wonderful thing to attack; everybody rolls up to kick its corpse, especially the people who once believed it and are thus doubly angry. But a delusion in full swing is hard to see as a delusion. A delusion in its own time is a holy cause, and its adherents become irritated if doubt is expressed.’ So when entering into these matters you have to be careful. At the least of it people will begin to look at you askance. They might even call out the constabulary. As they did for the freethinking sceptic Bruno Geordio. Before burning him in Rome in 1600 for the offence of being just that.

Anyway, knowing none of the trouble with the HIV tests and with AIDS medicine that we’ve been talking about, Cameron is freaked, broken hearted, and in tears. This is the standard reaction to a medical sentence of death. As absolute as a judicial one.

Cameron told his interviewer Evans that his quack had nonchalantly told him over the phone in December 1986, ‘By the way, you’re HIV-positive.’ His mind glowing in overdrive, he understood that he was infected with the virus that lurks. He traced his infection ‘to a specific, single unrepeated act of unsafe sex’ – receptive, he’d explained on Carte Blanche. A one-night stand apparently. ‘Barebacking’ as these guys call it, Cameron taking the ‘bottom’ role, his temporary mate the ‘top’, as they say. For him ‘it was a tremendous shock, a nightmare. I went into deep clinical depression. I didn’t tell my family’. Not for four years. ‘I only told my lover after a delay, and it had a profound effect on my sexual confidence, capacity for sexual interaction even. … It was the most appalling thing.’ Understandably. In the olden days in South Africa, men, invariably black, standing in criminal docks and being told they were to swing from ropes didn’t feel so cheerful either. Served a chicken and a bag of sweets to lighten their mood the night before their big day. Likewise women finding lumps, or being confronted with terrifying mammograms, given what modern medicine-men make of them. And do about them. Using scary language like ‘malignant’. But don’t worry, it can be treated. I keep my knife shiny and sharp. Dark bottles in my bag. And a kind of nuclear microwave oven for you over at the oncology centre.

So like Makhaye bewitched, Cameron gears up to die. The news they’ve got is as flummoxing as a right to the jaw. It’s been called the ‘nocebo’ effect. He’s seized with the kind of horror conjured up by the Nazi newspaper the Völkische Boebachter in Germany in the twenties and thirties, describing syphilis, which, ‘born of brief, forbidden lust, beginning with a small hard sore, gradually attacks all the limbs and joints, even all the flesh, down to the heart and brain’. (Sure, if treated with arsenic injections, alone or mixed with mercury and or bismuth.) After a few years Cameron starts drinking venomous brews recommended by the ‘AIDS experts’. Replaying a script from the era of the syphilis terror. (The protease inhibitor story is as vile as AZT’s.) Fungi start to thrive on his poisoned tissues. But even as the drugs sicken him, he believes the opposite. It’s known as hypnosis. Eventually his body rallies, and the fungal infestations pass. He quits the protease inhibitors and right away his health is restored. Not only can he feel it, like a Christian reborn, but the tests confirm it. He believes, because his doctor has told him, and unlike George Bernard Shaw – ‘To be frank, I don’t believe in doctors’ – he believes everything his doctor says, that there’s this test that measures levels of HIV infection in his blood. That’s the next big cock-up, because in fact it doesn’t.

Mullis who won the Nobel Prize for the technology employed in these ‘HIV viral load’ tests has repudiated them as an abuse of his invention. Quite right. And quite a thought. Since the test is said to be counting molecules of genetic material thought to comprise part of the ‘HIV genome’ and thereby revealing the number of viruses ‘lurking’ about in your blood, you’d imagine that it would run with fingerprint matching precision. Yet this test is not allowed even for screening, let alone diagnostic or confirmatory use. It’s like a test for the number of marbles in a schoolboy’s pocket, except that it can’t tell whether he’s got marbles, chips of windscreen glass picked up off the road or even sweets in there. Does this make any sense? Is such a test really counting marbles? Is it even counting? A study published in 1997 in the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, entitled Effect of HIV-1 genetic diversity on HIV-1 quantification in plasma: comparative evaluation of three commercial assays by Coste et al., reported counts ranging from zero to hundreds of thousands of ‘HIV-1 RNA copies’, depending on the ‘HIV-1 clade’ and test used. Demonstrating, at bottom line, that ‘viral load’ testing is utterly worthless. (For elaboration, see the particulars of claim in An AIDS Case in the appendices to Debating AZT.) The name ‘viral load’ popularly given to this type of PCR test is entirely misleading. It most certainly does not tell you how many viruses you’ve got per millilitre of your blood, as your doctor tells you, and ‘AIDS sufferers’ like Achmat and Cameron believe it does. Nothing of the sort.

‘AIDS experts’ might try putting you off your slide into bewildered HIV agnosticism by assuring you with scoffing condescension that the ‘HIV genome’ has been sequenced – meaning its genetic architecture has been mapped. It hasn’t: ‘AIDS experts’ cobble together bits of what they think is HIV’s genetic heart, so to speak, and call it HIV. Like a stranger flying over New York, surveying the debris, and, not having seen the twin towers before, describing the building plans. Or someone picking up some grit in a field and asserting: ‘These are fragments of a great temple that stood here once.’ When the grit looks exactly the same as the dirt for miles around. To convince you that they are talking about a distinct creature, a distinct species of virus, ‘AIDS experts’ talk of clades (mutants from a common ancestor), wild-type virus, and HIV-1 and HIV-2. Tests for the former not the latter, and so on. All variations of the same nursery rhyme. The genetic makeup of humans and chimpanzees is more than 99 per cent homologous (identical) – that is, between different species of great ape, it differs by a fraction of a per cent – in a comparison of an enormous amount of genetic material. Just think then how much smaller the genetic variation is between humans: Koreans, Swedes, Masai. But ‘AIDS experts’ find nothing remiss in calling infinitesimally minute stretches of genetic material that differ by up to 40 per cent ‘HIV’. The clever guys.

Cameron didn’t mention it, but the judge with the great government sponsored medical aid scheme that he spoke about in the interview probably also had his CD4 cells counted from time to time, on the house, thinking – because his doctor had told him – that their number was an index of the strength of his ‘immune system’. They aren’t. It’s another total waste of time. The absence of a correlation between their ever varying numbers and the clinical health of their trial subjects led the Concorde AZT trial overseers to report ‘serious doubts on the value of using changes in CD4 count as a predictive measure for the effects of antiviral therapy’. But this was hardly news, because the irrelevance of CD4 cell counting had been discussed and reported in legion papers in the medical literature well before 1994. And after it too. It’s just that ‘AIDS experts’ like to keep busy, earn money, and feel relevant performing their little tests. Like those criminologists who used to measure the space between prisoners’ eyebrows to determine criminal propensity. So they pay no attention.

Duped by all this junk medical science, Cameron goes on a crusade. Boiling down to promoting GlaxoSmithKline’s drugs. With the best will in the world. Isn’t it usually the case? And the rest we know well. As journalists swoon at his every utterance. Like John Perlman interviewing him on SAfm morning radio, gushing with AIDS-think solidarity, chuckling along sycophantically, his laugh like a hen clucking, his humour as flat as his vowels, delivered in an unbearable sing-song nasal whine with random cadences, a little boy giving a classroom speech, or talking to his mummy – ‘What do you do when you get scared and lonely?’ he actually asked HIV-positive AIDS journalist Lucky Mazibuko – drenching the airwaves with adulation. We’re in this together. I’m on your side. I also wear a red ticket on my tit. To show that I care. I’m a new age guy. And like Cliff Saunders interviewing National Party politicians before me, you never have to worry about any difficult challenging questions when I’m around.

On 19 November 2001 Perlman interviewed Tshabalala-Msimang following her public statement that her department had made mistakes. In service delivery, she meant. And in the interview made unambiguously clear. But you could hear that the doctor’s son, sold on GlaxoSmithKline’s propaganda mouthed faithfully by Cameron and Achmat, wasn’t interested in any of this. He took off like a bluebottle fly straight for its favourite landing place, and pressed her on why she wasn’t dishing out antiretrovirals. She parried the question on cost alone. Like Kellogg’s All Bran, Perlman keeps it nice and regular, with at least one slot booked every Thursday morning for an interview with an ‘AIDS expert’ or activist, telling us how the fight against AIDS is going.

In his Evans interview Cameron reproached Mandela for not selling for Durex, as the judge was doing for GlaxoSmithKline:

Of all the leaders of the 20th century who might have had an impact on people’s behaviour [he means black men having sex – we’ll see in a moment], he was the one who could have done the most, but without a doubt this was one of the grievous omissions of his presidency. Mandela did 199 things that contributed to our nation’s salvation, but the one thing he didn’t do as president was to take the lead on Aids. We tried to get to him in every way, but he didn’t take it up. It was a tragedy.

Everything seems to be ‘a tragedy’ for this sad sack arriviste from a broken home, dragged through ‘seven schools’, suffering ‘quite severe material and emotional deprivation’. From boarding houses to children’s homes. Yearning for love and belonging. Eventually finding it in the ‘AIDS movement’, like those stray souls taken in by cult churches: ‘The response was overwhelming’ to his statement that he had AIDS at a public hearing of the Judicial Services Commission weighing his application for a Constitutional Court job: ‘The most moving thing was that I’m a white, gay man in an epidemic that overwhelmingly affects black heterosexuals but I was claimed as an African who spoke out on the fact that I had AIDS.’ Well, by whom exactly? The peasantry? Or the narrow coterie in the room, white journalists mostly? Hanging on his every word. Like Elvis among them. Cameron was too moved, apparently, to wonder why among whites in South Africa, doctors should largely locate AIDS among homosexuals, but among blacks, among the lot of them. Or consider whether it really made sense to blame HIV for AIDS, if HIV infection in the US, as determined by antibody tests, is spread equally across the sexes. As it is here. But about 90 per cent of AIDS case diagnoses in the US have always been among gay men.

In his address to the Durban AIDS Conference, Cameron described in more detail the glowing happiness that flooded into his life after he came out with the news of his diagnosis:

I had many, many, many hundreds of individual responses … almost without exception generous, affirming and loving responses. For me personally it was a turning point in my life, it enable me to integrate in many ways the personal, the political and to lead a single life, it has had enormously positive benefits in terms of people’s support for me, in terms of the strength and energy with which I feel that I have been able to speak on these issues since then. It has been very positive. At the time that I disclosed I thought that my public statement would be a precursor to other people in politically and publicly prominent positions coming out, that has not happened. I thought there would be cabinet ministers, entertainers, sports stars, people in business life coming out, speaking out but that has not happened. It shows how intensely fear-laden and personal the issue of AIDS remains.

Maybe it shows instead what a narcissistic exhibitionist he is. Inspired by the delusion that he’s the queer Messiah. With the sexy disease. And that other gay men just weren’t buying it.

Most anyway. Photographer Michael Meyersfeld published a collection of photographic portraits of gay South Africans entitled Gaze (Bell-Roberts Publishing, 2003), for which he got Cameron, South Africa’s leading gay man, to write the foreword: ‘Open this astonishing collection of portraits anywhere. You will find gay men and lesbians. Their poses are open, challenging, exultant, revealing, and affirmatory.’ What Cameron’s own pose sought to affirm, it’s difficult to say. Seated in a black suit, sans shirt or shoes, he stares grimly at the lens. It’s a most unpleasant photograph, and leaves one ruminating darkly over just what it is that Cameron imagines he conveys by such peculiar showing off. Because, but for his hands crossed in front of him in a pair of translucent lacy gloves, an SS cap with a silver skull badge covering his sparse pate wouldn’t have been out of place.

Apparently paraphrasing Cameron, Evans wrote, ‘Mandela’s successor’s activism, on the other hand, was absurd. Thabo Mbeki famously sanctioned a second look into the scientifically discredited “Duesberg hypothesis” that Aids is not caused by HIV and suddenly no one in his government was prepared to acknowledge the link with sex.’ It may sound ‘absurd’, bro, but then so has every critique of bad medical and scientific ideas during their heyday. Goldberger in the US was vilified for decades in the early 20th century for having had the temerity to contradict the universal expert consensus that pellagra was caused by germs, and for proposing that it had something to do with diet instead (Vitamin B was identified after his death), a proposal denounced with that very word, ‘absurd’. And if anybody can show me the research paper demonstrating that having sex spreads HIV and AIDS, he or she can have my entire jazz CD collection.

As Goldberger in the US did, Robert Koch in Germany before him was ridiculed for proposing in 1882 that a strange, spongy-walled germ, Mycobacterium Tuberculosis that he’d just observed with the help of a new stain, Erlich blue, to illuminate it, might cause TB. Not heredity, foul air or anything else asserted by ‘the experts’ in their textbooks, at their conferences and to their patients. (Actually the cause of TB is rather more complicated than infection, or maybe simpler, but a discussion of the rise of germ theory, as the foundational marketing paradigm of the pharmaceutical industry, would fill another book). I can still remember being mortified by the big herpes scare in my schooldays – completely bogus it turns out. It was syphilis in my father’s. Toilet seats and everything. To contend back then that there was simply no proof for any of this, and that medical knowledge based on overwhelming evidence was mere superstition, would have been to risk confinement in the nuthouse. Because it was ‘absurd’.

Yet it is difficult to imagine a more absurd, superstitious account of syphilis than the standard exposition appearing in the 13th edition of Black’s Medical Dictionary in 1936. Before reciting it, it is noteworthy that English doctors (from a culture with moral qualms about sexual gratification) see syphilis, like AIDS, only among humans – and the darker their skins, the more prevalent the disease. But curiously enough, among the people Western doctors claim syphilis is rife, it doesn’t exist as an indigenous disease construct. There are two possibilities accounting for this: Africans across the continent, in all their vast variety of cultures – Indians, Chines and South Americans too – have been blind to the obvious since the beginning of time. Alternatively, European doctors have been superimposing a culturally generated and conditioned received wisdom upon vague signs and symptoms – their diagnosis confirmed by their hopelessly non-specific Wasserman antibody test and its successors. (As the Oxford Companion to Medicine (3rd edition, 1986) puts it: ‘It was not until the early 1940s that it was fully realized that many diseases could be responsible for a positive Wassermann reaction.’) And English doctors have classically believed syphilis to have spread to England from Europeans speaking the romance languages – thought less straightlaced in pursuing amorous adventures.

Black’s Medical Dictionary tells us that: ‘Syphilis may be acquired from persons already suffering from the disease, or it may be inherited from one or both parents. … Not only may the disease be spread as a venereal infection, but cups, spoons, towels, sponges, sheets, which have been used by the diseased, have been known to convey the contagion to others. … Accordingly any one acting as a wet-nurse to, or even frequently handling [‘infants suffering the inherited form’] runs great risk of infection, although the mother may handle it with impunity (Colle’s Law). … [Black’s Medical Dictionary then sets out various non-specific symptoms.] Still later effects are apt to follow at a subsequent period of life, such as ... early mental failure; also certain nervous diseases, of which locomotor ataxia and general paralysis are the chief. … The drugs possessing a special influence upon the progress of the disease are salts of mercury and arsenic, and arsenobenzol compounds, which seem to be most beneficial in the earlier stages.’ And are most effective in achieving early dementia and paralysis. Attributed to germs burrowing up your spine into your brain. In fact numerous different germs are found in ‘syphilis’ sores, but the one they like to blame has an exotic corkscrew tail. They call it Trepona pallidum. Some imaginative doctors suggest that the germ takes numerous different forms when they find the wrong-looking one. They say it’s pleomorphic. Black on syphilis talked like ‘AIDS experts’ do today. First you experience a ‘flu-like illness’. And then you feel perfectly fine. But thereafter: ‘Still later effects are apt to follow at a subsequent period of life, such as ... early mental failure’ and paralysis. If, in the olden days, you were put on mercury and/or arsenic. And when, as a woman treated with these neurotoxic substances, your baby was predictably born blind, deaf and/or otherwise brain damaged, doctors called it ‘congenital syphilis’. But as ridiculously as Black’s Medical Dictionary reads on syphilis, the extensive entry on the same subject in the current edition of the Oxford Textbook of Medicine comes over in much the same way. As with AIDS, the idea with syphilis seems to have been: construct a new disease paradigm, link it with sex and blast it with the most deadly chemicals available in medicine’s arsenal. The patient too, but that’s incidental to the higher purpose. Sort of like collateral damage. Only, blamed on the disease: in 1952 the 23rd edition of Martindale’s The Extra Pharmacopœia, doctors’ standard reference for what to give people when sick, advised that injected arsenic

may cause severe, and even fatal, reactions … a few days to several weeks after administration; these include jaundice, acute yellow atrophy of the liver, acute purpura, aplastic anaemia, and agranulocytosis. Severe nervous manifestations may occur after an interval of weeks or even months of treatment; these include cranial nerve palsy and neuritis of the auditory, optic and facial nerves; these are generally regarded as being syphilitic rather than of arsenical origin and their occurrence calls for more vigorous arsphenamine medication.

This is the medical mind at work. At the highest level. Martindale again:

The standards of treatment laid down by the League of Nations Committee in 1934 are now almost universally accepted. They include … treatment as early as possible [with] comparatively heavy individual dosage of the arsenobenzene and of the bismuth and mercurial compounds, the doses being administered in comparatively rapid succession … persistent attack on the disease, avoiding intervals of such length as to afford the parasite an opportunity of recovering.

(That’s Martindale in 1952 – not today, of course, when these ‘almost universally accepted … standards of treatment’ are not just unthinkable, but criminally insane.)

Bovine stubbornness in persisting with barbarous, violent and useless drug treatments that cause the very disease symptoms they claim to be treating is not the preserve of modern AIDS doctors and their AIDS drugs. It’s apparently a trimeless trait of the sort of people drawn to the profession.

And the harm these people do going about caring for the sick (or those they declare to be sick) – not intuitively as in folk cultures, but rather as they’ve been taught – has had a massive negative impact on the evolution and shape of Ango-Saxon culture. If we allow, just for now, the awesome idea that historically syphilis has largely been an iatrogenic disease – and indubitably so in its severe, late manifestations – then DH Lawrence’s insight in his essay in 1929, Introduction to his Paintings, acquires an an additionally dreadful significance: ‘I am convinced that the secret awareness of syphilis, and the utter secret terror and horror of it, has had an enormous and incalculable effect on the English consciousness and on the American. Even where the fear has never been formulated, there it has lain, potent and overmastering. … The appearance of syphilis in our midst gave a fearful blow to our sexual life.’

Of course, these days no one in South Africa even thinks about syphilis when eyeing a prospective partner in the hope of a possible yentz – other than doctors in clinics self-importantly administering their useless tests, on blacks mostly). Syphilis is completely absent from our consciousness today. But not at a time when it’s ghastly manifestations couldn’t be missed: ‘Wherever syphilis, or “pox” came from, it was fairly new in England at the end of the fifteenth century. But by the end of the sixteenth its ravages were obvious,’ wrote Lawrence of the gross physical and mental harm, missing the fact that these ‘ravages’ coincided with the introduction of calomel (mercurous chloride) as a treatment. Curiously – and here’s a mighty clue – the ‘pox’, he said, ‘entered the blood of the nation, particularly of the upper classes’ (who could afford the ministrations of quacks plying their mineral medicine, having just elbowed their way past herbal medical practitioners in the medical hierarchy by dint of some clever political manoeuvring).

In his popular book recounting Historical Blunders (Andre Deutsch, 2002), Geoffrey Regan revealed that ‘The true dangers of mercury as a medicine had been hidden from physicians since the sixteenth century, because its characteristic indications – skin eruptions, ulceration and neurological effects – were usually attributed to syphilis itself … from the sixteenth century mercury was well established in every medical textbook for its therapeutic value … the majority [of physicians] insisted that mercury was the only substance to get syphilis to relinquish its hold on the body. … By the mid-nineteenth century doctors were beginning to realize the severe limitations of mercury … Unfortunately, those who strove to replace mercury as a medicine frequently suggested arsenic as an alternative. … The use of mercury as a treatment for syphilis inflicted suffering on a scale almost beyond comprehension.’ As did the alternative, arsenic, which followed it – peaking in popularity in the first half of the twentieth century, despite, like mercury, the terrible harm it obviously caused, again invariably ascribed to syphilis.

Lawrence made the terrible point that

no man can contract syphilis, or any deadly sexual disease, without the most shattering and profound terror go through him, through the very roots of his being. And no man can look without a sort of horror on the effects of a sexual disease in another person. … we are all at once horrified and terrified. … Our consciousness is a strange thing, and the knowledge of a certain fact may wound it mortally, even if the fact does not touch us directly. … The terror-horror element which had entered the imagination with regard to to the sexual and procreative act was at least partly responsible for the rise of Puritanism, the beheading of the king-father Charles, and the establishment of the New England colonies. If America really sent us syphilis, she got back the full recoil horror of it, in her puritanism. But deeper than even this, the terror-horror element led to the crippling of the consciousness of man. Very elementary in man is his sexual and procreative being, and on his sexual and procreative being depend many of his his deepest instincts and the flow of his intuition. … Intuitively we are dead to one another, we have all gone cold. … Modern people, but particularly English and Americans, cannot feel anything with the whole imagination.

Just to think then how doctors have poisoned our lives, our culture, with their poisonous allopathic medicines, and how they continue to do so today. The root evils for which they are responsible. Calling for a robust remedy of the Stalinist sort, one might argue, approved by Pope Innocent VIII in his Papal Bull of 1488: ‘Cut out the gangrenous members from your Christian community. It is well worth sacrificing some lives in order to save the souls of many. With this scripture as your father it shall empower you to extract the evil and destroy all those who contribute to its spread.’ After all, doctors themselves heartily apply this philosophy in the treatment of their HIV-positive patients – justifying, for example, in one paper after another, the appalling harm they find AZT does to unborn and newly born children on the basis of their governing myth, the one that has them by the throats and from whose mental lock they are unable to break: that HIV-positive means HIV infected, and is an augury of fatal disease and a certain early death. So the benefit, they say, outweighs not just the risk, but the repeatedly demonstrated damage.

The power of the idea of AIDS on these people I’ve experienced firsthand. A recent girlfriend of mine was a plastic surgeon. To her, the possibility that there might be anything wrong with the HIV theory of AIDS and with the traditional medicine for it, AZT, was simply out of the question. The entire subject was simply off limits. Needless to say our thing was doomed.

Evans’s conversation over tea in the judge’s chambers (or perhaps in his funky modern house with the ducks in the garden) drifted overseas: ‘Thailand and South Africa had identical rates of HIV infection in 1990. Today Thailand is down to 2 per cent. In South Africa it is 12 per cent and rising.’ Cameron commented: ‘You have to put this down to sexual practice, but there is a lack of will about confronting this fact and its implications.’ By the black government, he meant. Because white liberals like Cameron carry on endlessly about the ‘facts and implications’ of black African sexuality. Different from white sexuality, claims Cameron – we’ll see soon. Did the intellectual ever wonder what happened in Thailand to the ten per cent between these two figures? Fallen down dead but unnoticed? Or divinely rewarded for their new Catholic chastity by conversion from HIV-positive to negative? Or is there some other Ptolemaic adjustment on offer to add to and prop up the HIV-AIDS creed? This teetering tower. Something perhaps like the hilarious explanation for the anomaly of busy HIV-negative Nairobi prostitutes proposed by ‘AIDS expert’ Francis Plummer in Science on 18 June 1993: ‘... the uninfected women have rare alleles to genes coding for the class I major histocompatibility complex (MHCI), an integral part of the immune system that allows the body to distinguish self from nonself.’ A rare and mysterious immunity in other words, to account for the failure of the HIV-AIDS model to pan out, as planned by ‘AIDS experts’, in Kenya. But no, said Luc Montagnier, the world’s top ‘AIDS expert’; on 7 September 2000 Africa News quoted him announcing that

his research has shown that the prostitutes would eventually succumb to Aids once they left the streets. The sex workers acquired the immunity because of repeated exposure to the virus a temporary immunity that wears off once the body is no longer in contact with the virus, the scientist said in Kampala last week. The ‘immunity’ to the virus also explains why discordance occurs in marriages, where only one partner develops Aids while the other remains HIV negative. ‘When the immune system in the body is exposed to small doses of the virus, it develops immunity,’ Prof Montagnier said.

Unprotected sex is good for you, in other words; it’s when you stop having unprotected sex that you get AIDS. Indeed, confirmed Ugandan virologist and AIDS researcher Ben Biryahwaho in the same article: ‘The immunity thus acquired has a short life and without repeated contact, the immunity fails.’ So the more you bang your HIV-positive partner the better.

Was Cameron seriously proposing that the ancient cultures of the Thai people had suddenly adopted the behavioural norms preached by Western AIDS missionaries? Abandoning their own? And that they had been more libertine than the Americans’ and Europeans’ in the first place? The Durex Global Survey 2001 into ‘sexual attitudes and behaviour’ didn’t find so. By far the most promiscuous society in the world, Americans have more than twice the number of sexual partners, get down much more often and start doing so at a much earlier age. It’s their favourite activity. Thais voted sleeping as theirs. Was there even a smidgen of evidence to sustain the ‘fact’ that anybody in Thailand gave two hoots about what any of these ‘AIDS counsellors’ were selling? In fact Durex found that only 26 per cent of Thais were concerned about getting AIDS, against 40 per cent of Americans. Or is it just that because the judge says so, and the TAC and the white liberal press applaud in agreement, therefore it is so – as in his judgments settling questions of fact forever? The guy with the final say. As a judge of our highest court of appeal.

The Evans interview suddenly hotted up. And drew up to the racist root of the African AIDS construct. Rolled right off the tongue of the intellectual liberal white judge. His sickening insinuations now express. Asked how he managed ‘as a white gay person [to] confront the issue of risk behaviour among heterosexuals without being accused of bias’, he replied evasively: ‘It’s the one issue I can’t tackle directly.’ But then he blurted it out: ‘Instead I talk about how promiscuity in the gay community contributed to its spread [a baseless canard] and that gives me the opening to ask, “Do you think sexual practice among African men has contributed?”’

Here we go. Cameron recoils from sun-fired, black African virility, disgusted by those repulsive conceptions of it subscribed to by the English from the time their missionaries set foot here. And by Americans with the same sick Hellenic dichotomous body/spirit religious heritage too. Their religion fed originally by Judaism’s harsh sexual strictures – mandating the sexual mutilation of male babies, the murder of homosexuals and outlawing sex outside marriage, and even in it for two weeks in the month. Although notwithstanding this, Jewish people were presented by Nazi propaganda as sexually corrupt. ‘…nightlife and syphilis … became aspects of that age-old struggle whereby the lower races attempted to destroy the noble Aryan’, wrote Joachim Fest in Hitler, explaining the manipulation of these ideas by the Nazis in their rise to power.

At the hearing of his application to the Judicial Services Commission for a Constitutional Court judgeship in mid-1999, where his AIDS ace failed to trump it, Cameron’s characteristic hide and seek with race came up again. When Chief Justice Ismail Mahomed complimented his performance, ‘It seems that you were so devastating in your replies that it was a technical knockout’, Cameron replied peevishly that ‘certain considerations’ might defeat him. What he scaldingly implied by this was that because he was running against a black competitor for the gig, Judge Sandile Ngcobo, he was handicapped in the running. Also that he, Cameron, considered himself to be the better man. A man of Africa. Better able to interpret the new constitution of Africa’s most important new democracy. In touch with the feelings, outlook and aspirations of the African man. And articulating them on his behalf. Even though white to his marrow. But I’m an intellectual liberal, it doesn’t matter.

Everyone there on the JSC panel understood Cameron’s ‘certain considerations’ barb. But a judge on the panel wasn’t going to let him get away with this hypocrisy and pressed: ‘What are those other considerations?’ ‘Race,’ Cameron answered with tremendous courage. Fortunately the panel didn’t then get into discussing his opponent’s penis when deciding whether to promote him. As they did at the Senatorial hearing before raising Judge Clarence Thomas to the US Supreme Court. (We’ll be onto that affair shortly.)

Before we move on, a shocking fact emerged in Cameron’s indescribably dreadful little book, Witness to AIDS (Tafelberg, 2005): It turns out that his failed AIDS gambit had been prompted by Arthur Chaskalson, then Deputy Chief Justice, and a judge on the panel hearing the applications. Shortly before the hearing, Chaskalson invited the hopeful contender over to his home for lunch, during which, already aware that he was HIV-positive, he suggested that this was a real neat time to break the news publicly. Because ‘Many people have HIV. And the time has surely come for someone in public life to begin by speaking out. Why not simply do it at your interview in two weeks time. The commission offers you an appropriate and dignified environment to do so.’ But the main thing is it will cause a huge sympathetic stir – and give you a foot-up in the bargain. Unbelievable. Here were the progressive white liberals conspiring for advantage, with a top judge scripting his favoured protégé to finesse his application for a judgeship next to him on the same bench. To the disadvantage of the black guy after the same position. (Luckily Mbeki vetoed Cameron’s application in Cabinet, and Ncgobo was appointed instead.)

To the public, though, Cameron naturally spun his motivation for playing his ace very differently: ‘The choice to speak is available to me for very particular reasons: because I have a job position that is secure; because I am surrounded by loved ones, friends and colleagues who support me, and because I have access to medical care and treatment that ensures that I remain strong, healthy and productive. For millions of South Africans living with HIV or AIDS, these conditions do not exist.’ Mbeki, still in thrall at the time by the AIDS scare, voiced his admiration for Cameron’s courage.

Geshekter thoroughly traced and exposed Cameron’s dainty suppositions – his repelling yet delicious fancies about what black men are like in the sack – in his Critical Reappraisal paper mentioned earlier, building on Rosalind and the late Richard Chirimuuta’s searing preceding treatment of similar themes in their book, AIDS, Africa and Racism (Free Association Books, 1989). A passage from their introduction put it succinctly:

The depth to which racist ideology has penetrated the Western psyche remains profound. The association of black people with dirt, disease, ignorance and animal-like promiscuity has in no sense been eradicated. When a new and deadly sexually transmitted disease, the Acquired Immune Deficiency Syndrome, emerged [in the medical, and then the popular mind] in the United States [in the eighties], it was almost inevitable that black people would be associated with its origin and transmission.

And that with missionary zeal and no shortage of pity, white ‘AIDS experts’ would rush in to save Africans from themselves, subliminally driven by what Mark Crispin Miller describes wryly in The Bush Dyslexicon as ‘ancient racist fears of Negro sexuality’. Geshekter cites a study, Sexual Behaviors Relevant to HIV Transmission in a Rural African Population, by Schopper et al., published in Social Science and Medicine in August 1993:

In 1991 researchers from Médicins Sans Frontières and the Harvard School of Public Health did a survey of sexual behavior in Moyo district of northwest Uganda. Their findings revealed behavior that was not very different from that of the West. On average, women had their first sex at age 17, men at 19. Eighteen per cent of women and 50% of men reported premarital sex; 1.6% of the women and 4.1% of the men had had casual sex in the month preceding the study, while 2% of women and 15% of men had done so in the preceding year.

Cameron’s slurs on Africans are too gross to voice openly. So he talks obliquely, dropping Victorian hints, some weak, some in your face. But when weighed against the findings of shoe-leather researchers who have taken the trouble to slog around and gather the facts directly in African villages and cities, Cameron’s white liberal ideas about African sexuality turn out to have dropped from the south end of a horse.

The judge’s fallacies about a characteristically and distinctly promiscuous African sexuality are shared by top ‘AIDS experts’ too. In fact such thinking long antedates the AIDS era, and is as old as European colonialism itself – along with the idea that profligate sex among Africans spread deadly disease that will surely wipe them out. In Epidemiologists, Social Scientists, and the Structure of Medical Research on AIDS in Africa, published in the journal Social Science and Medicine in 1991, Packard and Epstein tell that

Early medical researchers in East Africa concluded that between 50 and 90% of the African population in parts of Kenya and Uganda were infected with venereal syphilis. Col. F.J. Lambkin, a leading British expert on syphilis, who was seconded to Uganda to study the problem, concluded in 1906 that ‘As things are at present, the entire population is in danger of being exterminated by syphilis in a very few years, or at least of being left a degenerate race fit for nothing.’ In explaining this extraordinary situation Lambkin ... argued that Christianity had broken down customs that restricted the social movement of women. At the same time sanctions against adultery had been eliminated at the behest of the British colonial authorities. These changes, he argued, had permitted Ganda women to engage in ‘promiscuous sexual intercourse and immorality’, resulting from ‘their natural immoral proclivities’. … Similar claims were made by observers in Western Kenya [by Gilks for instance:] ‘The whole attitude of the native towards sexual matters renders it certain that venereal disease, once introduced, is bound to spread among old and young.’ … In a similar vein, Daniel Hardy, who is trained in both medicine and anthropology, wrote in an article on cultural practices relating to HIV transmission in Africa [for a ‘USAID/NIAID sponsored conference on “Anthropological Perspectives on AIDS”’], ‘Although generalisations are difficult, most traditional African societies are promiscuous by Western standards. Promiscuity occurs both premaritally and postmaritally.’ … [Such claims] reinforce, perhaps unintentionally, the impression that sexual promiscuity is culturally determined. For example Edward Green ... noted [in AIDS in Africa, edited by Rockwell and Miller (The Edwin Mellen Press, 1988)], ‘Changes in behaviour which promote the spread of AIDS will go against social and cultural norms and values in Africa and against deeply ingrained behavioural patterns.’ … Similarly, Francis Conant writing in the same volume concluded, ‘In dealing with AIDS we are not just dealing with sex; we are dealing with lifeways and complex cultural patterns.’ … As Sander Gilman notes [in Difference and Pathology: Stereo Types of Sexuality, Race and Madness and Disease and Representation: Images of Illness from Madness to AIDS (Cornell University Press, 1985 and 1988)], the association of Africans with sexuality and the tendency to link African sexuality to disease has a long history in western thought. By the end of the nineteenth century ... the association could be found in many works of literature and art in continental Europe and held a central position in the constellation of ideas which made up European perceptions about Africans. As a result, early medical authorities, missionaries, and colonial administrators came to Africa with strong assumptions about African sexuality.

The pre-eminent idea among whites, their doctors especially, that blacks have too much sex, and consequently suffer epidemic venereal disease, is, as we see, a perennial one. It’s popular among South African Indian doctors too – Professors Jerry Coovadia, Salim Karim, Umesh Laloo, Barry Kistnasamy and their colleagues at the Nelson Mandela Medical School in Durban, for instance, and the ANC’s health committee chairman Saadiq Kariem. Dr Michael Gelfland’s The Sick African, published in Cape Town in 1944 (Stewart Printing Co), contains several gems of European medical wisdom about alleged widespread African syphilis, which excited the imaginations of Rhodesian doctors. Following a brief tutorial in typical African sexual immorality (converted Christians aren’t in it for real, and will remain natural polygamists), Gefland wrote:

Syphilis is a subject of paramount importance. The incidence is difficult to gauge, but it seems to be present in 20 per cent. or more of all Natives. Its recognition is important, not because the treatment given to the Native is in any way inadequate, but largely in order to prevent his spreading the infection by contact with the Europeans or his own people. This is accomplished by giving the syphilitic a short course of arsenical injections, to render him non-infectious. … Of course, if ... the Native can be persuaded to attend for a longer course, better results will be obtained. … Perhaps the solution to the problem may be found in the administration of arsenic in massive doses by intravenous injection continued over a few days. Reports from the Union of South Africa … appear to be promising. This is certainly a form of therapy that should draw the attention of the public authorities. … I am confident that the solution to syphilis in the Native lies in this form of treatment, but its potential danger must not be overlooked.

After this neurotoxic treat, the next bit follows naturally:

Certain doctors appear to believe that neuro-syphilis in the Native is rare. This is incorrect, for the disease is by no means uncommon. … No difficulty should be experienced in recognising a case of general paralysis, providing the condition is remembered. It is characterised by gross mental disorders, such as depressive and maniacal states of dementia. The patient may be euphoric or may exhibit grandiose delusions and hallucinations. … Voluntary power is impaired and inco-ordination marked. The gait may be unsteady. Epileptiform seizures occur in some of the cases, or an apoplectiform attack may set in, with resultant hemiplegia or aphasia. In the Native, G.P.I. [‘general paralysis of the insane’] must be distinguished from other causes of psychosis. … The G.P.I [case] should be certified and sent to an asylum for treatment.

With more mercury and arsenic.

In Public Health in South Africa (Central News Agency, 2nd ed., undated, but c. 1940) EH Cluver advises that venereal diseases ‘tend to spread particularly among uneducated non-Europeans crowded together in the less salubrious portions of our towns. … The detribalizing of large masses of natives was also followed by promiscuous habits so that infection rapidly spread over wide areas of the country.’ They’re full of it.

The sort of predictions for Kenya and Uganda, made in 1906 by Colonel Lambkin, the English ‘expert’ on African syphilis (‘the entire population is in danger of being exterminated by syphilis in a very few years’) were resurrected for South Africa a century later by American ‘AIDS experts’, reflected in a report in the Washington Post on 6 July 2000: ‘More people are infected with HIV in South Africa than in any other country – one in five adults in a population of about 41 million. AIDS threatens to slow social change and undo economic development with the staggering costs of caring for the sick, the dying and those they leave behind.’ An editorial in the New York Times on 4 November 2001 painted a similar phantasmagoria:

Thabo Mbeki’s views on AIDS have drawn so much criticism that he has lately kept them to himself. Last month, however, the South African president gave two speeches that showed he remains badly misinformed about a virus that now infects one in four adult South Africans and will kill between five and seven million over the next decade, the vast majority of them poor black people. … Mr. Mbeki came to politics after a lifetime of fighting white rule in South Africa. Though it is hard to imagine a more malignant evil than apartheid, AIDS has already taken more South African lives. If Mr. Mbeki does not begin to address the crisis, millions more deaths will follow.

And, as Packard and Epstein recall, whereas English experts ‘advocated public health policies which centred largely on the development of measures, often draconian in nature, to control the behaviour of prostitutes’, while ignoring ‘problems associated with living conditions and sanitation’, American expert opinion reflected in the New York Times presses for the most drastic imaginable medicinal approach – blanket, indefinite chemotherapy administration in the form of AZT, in the same league as ‘arsenic in massive doses by intravenous injection’:

Mr. Mbeki downplayed the problem, exaggerated the toxicity of antiretroviral drugs and suggested that advocates for treating the disease are racist. South Africa, with a medical infrastructure capable of providing antiretrovirals [the Health Systems Trust disagrees], should be a global leader in AIDS treatment. Yet even though thousands of affluent South Africans buy these drugs, the government has done nothing to make them available to the poor. It has not accepted international offers of free or low-cost medication and runs only a few programs to cut mother-to-child transmission.

(Not a word from the Americans about social and living conditions.) An editorial in Science on 16 May 2003 went the same way: ‘In that country, skepticism from the Mbeki government has hampered progress for the five million citizens who are already infected … 20% of adult South Africans.’ The millions should be grateful. The reason why the nobility, in times gone by, tended to have a shorter life expectancy was that unlike their less fortunate subjects they had access to professional medical care: bleeding, mercury, arsenic, antimony, the works.

Geshekter exposed a few more ‘AIDS expert’ racists in his Critical Reappraisal paper:

At the 10th International AIDS Conference in Yokohama (August 1994), Dr. Yuichi Shiokawa claimed that AIDS would be brought under control only if Africans restrained their sexual cravings. Professor Nathan Clumeck of the Université Libre in Brussels was skeptical that Africans will ever do so. In an interview with Le Monde [on 14 December 1993], Clumeck claimed that ‘sex, love, and disease do not mean the same thing to Africans as they do to West Europeans [because] the notion of guilt doesn’t exist in the same way as it does in the Judeo-Christian culture of the West.’

UNAIDS’s AIDS epidemic update published in December 1999 concluded from its own numbers concerning the alleged African sex plague that ‘since not every encounter between an HIV-positive and HIV-negative partner will result in a new infection, a sustained heterosexual epidemic suggests that a substantial proportion of the population, both male and female, have a number of partners over their lifetimes’. Implying a lot more than the American norm. In fact half as many in South Africa – 8.2 here versus 14.3 in the US, the former figure sitting around the international average, and the same as in Germany, according to the Durex Global Survey 2001. A paltry 4.2 in Nigeria, 4 in Mexico, 3 in India, and 2.1 in China at the bottom of the pile. People in the First World (mostly) – in Italy, Holland, Britain, New Zealand, Russia, Japan, Greece, Turkey, Canada, Australia, France and the US, in ascending order – typically had between 8.5 and 14.3 sexual partners.

But the idea that rampant black male promiscuity is the cause of AIDS in Africa is nonetheless very much at the core of UN Special Envoy on HIV/AIDS in Africa Stephen Lewis’s thoughts: interviewed by Health-e on 6 August 2003 the white Canadian ‘said that while changing male sexual behaviour had to be addressed, this would take generations as there was “nothing more obdurate”. However, the empowerment of women “can be done more rapidly” and there was “no time to lose to stop losing all the women that we are at present.”’ Being killed by their amorous men.

To escape the destructive implications of Durex’s findings for their racist theories, one might hear from ‘AIDS experts’ that, unlike sexually irresponsible black South Africans, Germans, who typically have the same number of sexual partners, wear condoms. Not so. In his review discussed at the first meeting of the AIDS Panel in May 2000, It’s 20 years we live with HIV/AIDS: A call for an open discussion of contradictory facts, panel member Christian Fiala, an Austrian gynaecologist, pointed out that following the outbreak of the AIDS scare in Germany, official prevention campaigns had virtually no effect on condom use at all. According to Deutsche Latex Forschung, Kondom-Abatz in Deutchland, Düsseldorf and Statisches Jarbuch 1996, whereas the ‘annual usage in 1980 was 2 condoms per inhabitant, in 1995 it was 2.3’. In fact Germans are about the world’s worst when it comes to ‘unsafe sex’. Noting that internationally ‘Almost four in ten people (38%) admit they do not take measures to prevent HIV/AIDS or another STI’, the Durex survey found that the ‘Taiwanese (59%), Germans (57%) and Chinese and Poles (both 54%) are the least likely to take prevention measures’. Conversely, ‘South Africans and Nigerians (both 81%) and Thais (77%) are most proactive when it comes to protecting themselves’. A local study released in mid-November 2002 conducted by the Community Agency for Social Enquiry found that sixty-seven per cent of South Africans worry about contracting HIV, up from forty-seven per cent in 2000. Forty-nine per cent of those interviewed said they always used condoms during sex. Hard to believe. Seems we’re a nation of believers: fifty-eight per cent also said they thought antiretroviral drugs could beat HIV.

In an interview by the Zambian Daily Mail on 14 November 2000, visiting American ‘AIDS expert’ Robert Shell felt uneasy about saying out loud what he thought accounted for his assertion that

the pandemic marches forward. Every day we get 1,700 new cases. … Promiscuity is a loaded word. I would say that AIDS is a result of unsafe sexual practices, and unguarded sexual behaviour is the most important factor. Ignorance about reproductive health is the biggest factor and it is related to poverty and illiteracy. Ten per cent of the Africans in my province [the Eastern Cape] have other sexually transmitted diseases.

In his Analysis: Mbeki and the Aids sceptics on 20 April 2000, BBC News Online’s Martin Asser wasn’t so coy: ‘If [the AIDS dissidents] were to consider Africa, they might conclude that HIV and Aids have spread so dramatically because of heterosexual sex in increasingly mobile and sexually promiscuous communities.’ Similarly, in Aids: A Battle Of Sex, Race And Politics, the London Independent on Sunday asked on 9 July 2000: ‘After all, why is Aids particularly rampant in Africa [‘and in South Africa – the country worst affected by Aids’]? Are local parasites, which reduce human immune levels, responsible? Or is it due to the promiscuity of black Africans, and Africa’s higher levels of untreated sexually transmitted diseases?’ The newspaper made the same point again on the 15th, quoting the Economist: ‘In the year since he took office, Mr Mbeki has impressed many with his grasp of arcane policy detail but, sometimes, he seems to lose sight of the big picture. Take Aids, which threatens to kill a third of his people. A less wonkish president might have urged South Africans to sleep around less and use condoms more.’

University of KwaZulu-Natal academic, now professor, Suzanne Leclerc-Madlala, an American ‘medical anthropologist’ disenchanted with her understandably bored and wandering Zulu husband (so a colleague told me), published a liberal libel in the Mail&Guardian on 11 August 2000:

For a variety of reasons, all strongly rooted in the continent’s unique political, economic, social and racial history, there are layers of denial and silence that preclude a serious grappling with sexual cultures. There are widespread beliefs that males are biologically programmed to need sexual relations regularly with more than one woman. … Social science studies point to high levels of premarital sexual activity, extramarital relations and sexual violence, making African societies more at risk for HIV/Aids than those in other parts of the world.

Not according to the latest international sexual behaviour survey by Durex, we recall; for promiscuity, Americans like her take the honours. And as for the allegation that African men are the most sexually violent in the world, Suzanne and Charlene appear to twitter at the same book club: ‘In many communities, women can expect a beating, not only if they suggest condom usage, but also if they refuse sex, if they curtail a relationship, if they are found or suspected to have another partner, or even if they are believed to be thinking about someone else.’ More tea?

A week later in the London Observer David Beresford described Leclerc-Madlala’s ‘analysis’ as ‘most compelling … a lengthy and sensitive article on the subject’; it called for ‘strong national leadership’. That South Africa under Mbeki lacks. Leading African men into a reformed kind of manhood.

Tragically, in Mbeki the country seems to have precisely the opposite – a man who is not only in denial himself, but whose sensitivity on the race issue points to a previously undiscovered psychological trauma. Nursing dreams of an Mbeki-led African ‘renaissance’, in the cradle of which he sees the rebirth of black pride, he seems driven to deny the reality of Aids. He has tried to force an alternative explanation of the pathology of the disease on a scornful and appalled medical world. He is allowing his people to die painful, lonely, and at times unnecessary deaths. Nero fiddled while Rome burned. And while Mbeki spreads his fanciful opinions about Aids, South Africa sickens and dies.

And while the typewriter cools down, Beresford finishes the bottle.

Leading award-winning AIDS journalist Kerry Cullinan, then recently divorced from her black husband Nat Kekana (a former MP and now a parastatal boss), sounded similar bum notes to Leclerc-Madlala’s in AIDS: the year in review, written for Health-e on 2 December 2002:

Government also has yet to speak out or campaign against the widespread practice of men having multiple sex partners. [In principle even, should this ever be any of the government’s business?] Uganda attributes its success in halving its HIV prevalence rate over 10 years to people changing their sexual behaviour. Ugandan men reduced their sexual partners while teenagers started having sex at a later age.

If only South African black men would take after their Ugandan brothers. But concerning the Ugandan success story, it’s actually white ‘AIDS experts’ in UNAIDS who make such claims. Which we dismantled in Appendix I of Debating AZT.

Since there’s no AIDS among whites in South Africa to speak of, and HIV, the alleged cause of it, is said to be spread sexually, Cullinan was obviously referring to the sexual behaviour of black men exclusively. When I spelt this necessary implication out to her, she denied it: ‘I don’t see any mention of race anywhere in my paragraph.’ However, the characteristic disingenuity of such AIDS activists on this score was laid bare in her piece, A new sexual identity: As men struggle to define their identity, researchers grapple with issues that affect notions of masculinity, published in the Mail&Guardian on 8 August 2003. Cullinan appeared to be struggling with why her ex had cuckolded her (no mystery to me) because the entire piece grappled with why black men, in her view, should be so promiscuous. Quoting three terribly serious white academics as experts on the subject to enlighten us about this, and her too, she teed off by citing an American expounding authoritatively on the allegedly shifting meaning of the Zulu word, isoka (lover). You honestly don’t want to hear the rest. Delegates at the just ended Sex and Secrecy Conference at Wits University, where the papers she cited were presented, had to.

HIV-AIDS consultant Clive Evian, who markets himself as a public health specialist and epidemiologist, contended that South African blacks are having fantastic amounts of sex in ‘Sugar daddy’ syndrome shortens the route of HIV infection, in World Aids Day, a special supplement to the Mail&Guardian on 29 November 2002. Like Cullinan, he didn’t use the rude word black:

the risk of HIV transmission on a single sexual contact is less than 1%. … Yet between 15% and 20% of South African adults are HIV infected. … clearly there is too much sex (multi-partner sex) between too many people, too often. The amount of indiscriminate (or reckless) sex occurring in the society needs to be of such an order and such a magnitude that even in today’s permissive society, this must be considered grossly ‘abnormal’ and needs further analysis. [By white ‘AIDS experts’ like me.] What is it that creates a social environment where sexual promiscuity has reached abnormal levels?

But Evian’s racist insinuation was unmistakeable in claiming that what he called the ‘sugar daddy syndrome’ was especially prevalent ‘in poorer areas, where men are often dislocated from home [as black migrant workers] and seek out sex and girls and young women are most available’.

In his acceptance speech at the University of the Witwatersrand on 24 June 2003, on being awarded an honorary doctorate (these academics seem to spend their lives kissing each others’ butts), Professor Jerry Coovadia revealed himself to be as big a racist as all of them: ‘As we stagger under the massive weight of AIDS’, it is the ‘unbridled sexuality ... of newly independent people ... especially the promiscuity of men’ that has led to ‘AIDS ... ripping through millions of our people’. (In the parlance of South African ‘AIDS experts’ ‘our people’ is a sympathetic reference to blacks (hung like a horse unbridled).) And whence these ‘emerging new infectious diseases’? Why, ‘from a seemingly deep pool of animal reservoirs’. By which he meant monkeys and baboons living deep in the woods – close to blacks. But ‘newly independent people’ like Mbeki reject this medical wisdom, he said, and shift the cause of AIDS ‘from sexuality to other causes of transmission’, because the truth of the matter ‘was too uncomfortably a part of the remembrances of racism to be accepted’. ‘Remembrances of racism ... accepted’ by racist white and Indian doctors teaching them in the country’s university medical schools. Just like in Fanon’s Algeria under the French.

It’s interesting that medical experts should constantly finger African jungles as the evil spring for ‘emerging new infectious diseases’ (always allegedly lethal viruses) since as Miller noted in his commentary for The Crucible, ‘the Salem folk believed that the virgin forest was the Devil’s last preserve, his home base and the citadel of his final stand … the last place on earth not paying homage to God’.

Curiously, it’s not whites and Natal Indians alone who openly subscribe to negative sexual stereotypes about black Africans. Some black Americans too. Of the saved sort. The Canadian Globe and Mail ran an article, Blunt talk on AIDS, on 12 January 2000:

as the AIDS crisis grows, more and more people have begun speaking out about its social roots and calling for a transformation in sexual attitudes and behaviour. Among them is Rev. Eugene Rivers, a black preacher renowned for his work with inner-city youth in Boston. … ‘Promiscuity and rape now function as weapons of suicidal mass destruction,’ he said last month. He blames African leaders for ignoring sexual exploitation of women and the sexual misbehaviour of men, and calls for a new ethic of restraint, abstinence and sexual fidelity. ‘We should fight the behaviour, not make up fancy excuses for it.’ … his ideas have inspired the Vice-President. … Al Gore took a break from campaigning for the presidency of the United States this week to talk about AIDS, sex and Africa. It was an unusual foray for a presidential candidate. Mr. Gore, Vice-President since 1993, appeared before an extraordinary session of the United Nations Security Council in New York to discuss the AIDS crisis in Africa. It was the first time the 15-member council has departed from its usual menu of diplomacy and security to discuss a health issue – a token of just how serious the crisis has become. … In an interview with The Boston Globe, Mr. Gore said African nations must accept sex education, sexual abstinence and the use of condoms by sexually active people. Migrant workers must learn to refrain from visiting prostitutes, and people should start speaking up against the rape and sexual exploitation of teenaged girls by their male teachers. Africans in general should fight the disease by ‘stigmatizing promiscuity’. ‘AIDS is relatively difficult to transmit from one person to another,’ said Mr. Gore. ‘There has to be an exchange of bodily fluids. Once that simple fact has been understood, then the only other thing that is needed is widespread awareness and the constant reinforcement of the public knowledge of what steps interrupt the transmission.’ And that, said Mr. Gore, means changing behaviour. ‘It means providing condoms. ... It means promoting responsible sexual activities and habits, it means abstinence for those who can practise that approach.’

It means buying into and promoting racist sexual stereotypes. It means Americans emasculating Africans. As Americans sleep around more promiscuously than in any other country on earth. Sneaking side nookie too: in reply to Shere Hite’s renowned probes concerning sexual experience in the US, collated as Women as Agents of Revolutionary Change: The Hite Reports 1972-1993 (Bloomsbury, 1993), seventy-two per cent of American men married for over two years reported having had sex outside their marriages, as had seventy per cent of women married five years or more. Research in the UK and Europe, employing equally widely disseminated questionnaires similar to those drawn by Hite, turned in comparable findings. But to white ‘AIDS experts’, politicians, journalists and activists, it’s those Afs who egregiously sleep around.

In his harrowing history of English aggression towards the Xhosa people in the Eastern Cape, Frontiers (Pimlico, 1992), Noël Mostert recalls British missionary attitudes to Xhosa sexual style in the mid-nineteenth century – epitomised by Robert Niven’s deprecation of their ‘hereditary vanities and polluting amusements’. Their ‘carnal minds’, he said, were ‘an enmity against God’. Henry Calderwood, commissioner to the Ngqika clan, likewise criticised the Xhosa chief Sandile as a ‘promoter of the grossest sensuality among the people’. Mostert explains that

it was the unselfconsciousness of the Xhosa about their bodies and their sexual life that most affected the missionaries, being surrounded as they were by a largely naked people and constant demonstration of their wholly uninhibited attitude to sexual matters. They wanted to cover the bodies and to veil the minds, and to create a sense of sinfulness where there was no concept of it in the Xhosa. Much of their outrage was spent on the fact that Xhosa boys and girls began their sexual experience at an early age. Love-making [short of coitus] between young people was freely accepted, notably at joyfully explicit dances that accompanied the rights of passage for young men and women alike.

Xhosa culture ‘had no libidinous guilt’, its ‘cosmology ... devoid [according to Xhosa historian JH Soga] of “any reward or punishment in a world to come for acts committed in this life.” The missionaries found it difficult to suppose a moral code without this. Vengeance, social or eternal, was at the core of their own moral outlook.’

In the AIDS era, sexuality construed as illicit by the same Christian rules will be punished, say ‘AIDS experts’, activists and journalists, with much the same sort of penalty threatened by the missionaries: a horrible, fearful, painful, lonely, drawn-out terminal disease – with an emphasis, they love to lay, on ‘painful’. Our Constitutional Court talks the same way: ‘the nature of the suffering so grave’. You know, like expiation in purgatory.

Such notions as Cameron’s, of race-determined sexual difference, have persistently informed the white liberal discourse about AIDS, rooted, I propose, in European materialism and its Christian industrial ethic – forever postponing present enjoyment against a hope of future material benefit. Not a principle that 19th century Xhosa people had much truck with; High Commissioner Harry Smith wrote how he ‘embarked on the task of rescuing from barbarism thousands of our fellow creatures endowed by nature with an excellent understanding and powers of reasoning as regards the present’ but no idea of ‘futurity’. Perhaps because their ‘excellent understanding and ... reasoning’ had led them to the appreciation that his culture’s extreme preoccupation with ‘futurity’ had spiritually impoverished it profoundly, draining out much of its soul, and culminating in the modern consumer culture. With its funny ideas about sex. Corrupted it too: in the shadow of 19th century social and sexual rigidity, prostitution back home in London flourished like a gold rush. And by 1976, according to Forbes magazine, pornography in the West was making more money than the regular film and music business combined.

Cameron’s charge about a distinct, blameworthy kind of ‘sexual practice among African men’, to be civilized and changed, derives from a common white sense, of centuries-old vintage, that there’s something sexually nasty about black men, that unlike whites, they don’t crave perfect unions cemented with visceral emotions, don’t love and cherish their wives (for as long as they’re not turning into bitches), and that affectionate intimacy isn’t their thing – instead goatish lust, spreading disease wherever they plunge, randomly, faithlessly, brutally, abusively. Oh, and indefatigably and insatiably. (But the 14th century English poor, poking at their betters, had a delightfully ribald answer: ‘When Adam delved and Eve span, who was then the gentleman?’) The concomitant idea is that in negotiating and transacting genetic fusion – or trial runs for the same – black African women don’t make their own choices, are politically powerless, and lack instinctive and socially acquired wiles to deploy in these elemental arts. Variously purring or voracious. In short, they’re not people but things. Not strong. Not vibrant pillars of the nation. With chocolate eyes. They’re not like us. They don’t have the same feelings. So it never occurs to white South African industry and mining bosses that there might be an unutterable violence done to black labouring men by posting them in vast single-sex dormitory compounds. With white suburbia doing the same to black women, confined to tiny backrooms as live-in servants, hopeless miles away from their husbands. And children. While the braais come along nicely, and the beers go down, next to the pool.

This background construction of women as male prey and not equal hunters, running through AIDS awareness programmes, surfaced in a radio ad in late 2002 in African accents: ‘Did you know that one in four South Africans is HIV-positive? Brothers, protect your women, use a condom. Sisters, if you’re not ready to have a sexual relationship, you have the right to say no. When you know you can’t say no, use a condom. Brought to you by YouthAIDS.’ The implicit message that men generally, black especially, are violent sexual predators is sometimes express: Tandeka Teyise wrote for Health-e on 15 October 2002: ‘Khaya Nkontso, coordinator of PPASA’s Men As Partners programme, is trying to help raise men’s awareness around issues of reproductive health, sexuality and HIV. Khaya says not all men are violent and want to dominate women.’ One is tempted to retort, Khaya, that not all women are duplicitous, grasping, superficial, materialistic, intolerantly judgmental, controlling, wasteful, ungrateful, emotionally capricious, conniving, cowardly, extravagant, quarrelsome, cold, humourless, fickle, cruel, unreliable, nurse ancient grudges, are incapable of apologising, likewise forgiving, take reprisals by way of collective punishment for early hurts, gossip faithlessly, prize social reputation over social justice, lack any artistic sensibilities or political and moral passions, are given to cretinous religious enthusiasms and life-negating pieties, throw and break precious objects to make points in arguments, express and enforce fierce antipathies towards their husbands’ vintage close friends, kick up raucous ructions in public places, commit perjury vindictively, and are fair-weather friends whose affections inversely track the overdraft. And who can’t drive motorcars. ‘He says many men are showing a greater willingness to become involved in health issues that affect themselves as well as women and children. One of Khaya’s aims is to educate men about HIV/Aids, sexual violence and how to work in partnership with their wives or lovers.’ Men need re-educating – in the new sexual ideologies of the AIDS age. Heartless raptors that they are.

As illustrated by a story put out by Health-e on 1 January 2003, HIV/AIDS won’t disappear unless men become decent humans:

‘A 10-year old boy is arrested after a five-month old baby is raped’, read one newspaper headline as we were still celebrating the New Year. ‘Police arrest four men out of six in the act of gang-raping a woman at gun-point’, read another. These are only two of countless sad and horrific tales of the brutal rape of women and children that still form part of South Africa’s daily life. In the face of HIV/AIDS, these reports further confirm the assertion, and rightly so, that it is the behaviour and actions of men that feed the growth of this epidemic. And unless men are challenged to change their attitude, the fight against HIV and AIDS will but remain a losing battle.

Part of South Africa’s daily life?

Health-e continued the theme on 9 September in What’s wrong with South African men? The white author, some twit called Laura Twiggs, was talking about blacks:

Ask most men what’s wrong with South African men or why they’re so abusive, and the response is equally unsatisfying. South African men, it appears, are in deep states of denial, usually blaming women for ‘emasculating’ them or ‘giving them a bad name’ before speaking out against other violent males. … The price we’re paying for male dominance is mounting, and fast. It’s driving our rising HIV infection rates [among blacks] and threatening country’s development as a whole. And it is a price that men, as well as women, will pay unless men start to address questions about masculinity, about what it means to be a man.

A black man.

In 1959 John Howard Griffin darkened his skin and disguised himself as a black man to find out what being black in America was like, and wrote up his experience in Black like me (Signet, 1962). In his conversations with white men, especially offering a lift after dark, their enquiries invariably turned to sex, their salacious imaginings revealed in their questions – how big, how often: ‘All showed morbid curiosity about the sexual life of the Negro as an inexhaustible sex-machine with oversized genitals and a vast storehouse of experiences [and all] presupposed that in the ghetto the Negro’s life is one of marathon sex with many different partners.’ Perennial fancies showing up in that perfectly tasteless but screamingly funny Jim Carrey flick, Me, Myself and Irene: A crop of dusky kids are born to the cracker cop after his wife’s affair with a black guy. He loves them just the same. A buzz-cut hick at a barbecue tries nudging him to the realisation that something’s out of the ordinary. His comment about their curly hair doesn’t register, nor his reference to their ‘year-round tan’ – not even an exasperated, ‘Goddamit, Charlie, their dicks are bigger than them sausages.’ The Carrie skit has an echo in a local joke: Two guys are taking a leak. Making out the letters W and Y tattooed on the black guy’s cock, the white guy says, ‘Hey brû, I see you’ve also got “Wendy” tattooed down there. Me too.’ ‘Not on mine, shomae; mine reads, “Welcome to Boputhatswana. We hope you enjoy your stay.”’ Andre d’ Allegmagne noted: ‘Colonialism reduces the culture of the colonised person to the level of folklore and propaganda.’ Colonialism here, enslavement in the US.

In her shattering analysis of the racist dynamics at play at the Senatorial hearing at which Clarence Thomas was voted onto the Supreme Court, Native Son: Why A Black Supreme Court Justice Has No Rights A White Man Need Respect, published in Reason in February 1992, Edith Efron painfully detailed how, after Anita Hill suddenly raised a charge of sexual harassment two decades after the alleged event, the ‘hearings, which had woven a web of progressively destructive racist stereotypes around Thomas, had culminated in the worst conceivable stereotype of all – the black male as mythic sexual beast. And most of the nation – 80 percent of it – found itself watching a black nominee to the Supreme Court discussing, before a Senate committee of white men, the subject of black men’s genitals.’ Thomas refused to listen to Hill testify. He explained why to Senator Orrin Hatch:

Senator, language throughout the history of this country, and certainly throughout my life, language about the sexual prowess of black men, language about the sex organs of black men, and the sizes, etc., that kind of language has been used about black men as long as I’ve been on the face of the earth, and these are the kind of charges it is impossible to wash off. ... If you want to track through this country in the 19th and 20th century, the lynching of black men, you will see that there is invariably – or in many instances – a relationship with sex, and an accusation that that person cannot shake off. That’s the point I am trying to make, and that is the point that I was making last night, that this is a high-tech lynching. I cannot shake off these accusations because they play to the worst stereotypes we have about black men in this country.

In Debating AZT we read the odious racial prejudices of the New York Times’s Donald McNeil, dressed up as liberal compassion, in his prescription for how African men need to change in order to beat AIDS. (The Mail&Guardian was naturally outraged by my charge against its friend.) On 29 November 2001 McNeil gave us another spurt of the same poison. His article, AIDS and Death Hold No Sting for Fatalistic Men at African Bar, curiously reported the general rejection of Western HIV-AIDS fretting by local people in the very country town claimed to be worst affected. Which just goes to show that it’s all about the colour of the sunglasses through which you peer. As you survey the scene. For some mixed up guys it’s ‘believing is seeing’ – since as Alexander Pope noticed, ‘All looks yellow to the jaundiced eye.’

The American was immediately mortified by his friendly black hosts’ hearty camaraderie in sharing a half-jack of brandy straight from the bottle because there weren’t enough glasses: ‘That in itself explains why safe sex is not the No. 1 topic in Hlabisa watering holes. [Maybe it’s because, unlike McNeil, the guys there prefer actually doing it to talking and reading about it.] Poverty and ignorance about health run so deep that even safe drinking is rare.’ So now, according to the New York Times, shuddering with American hygiene neurosis, even a trace of a black man’s spit carries disease and death – news even to the ‘AIDS experts’. But South African ‘Europeans’ have always known this, hence separate cutlery and enamel crockery for the Bantus in the kitchen and the garden.

Why ... won’t the men wear condoms? By now, everyone has heard the message: have safe sex or die. So why does it not sink in? [Through their thick skulls.] … ‘We are not scared of death,’ said one [police] officer who declined to give his name. ‘I don’t see the importance of AIDS.’ His partner on the job, M. B. Ndlela, 34, said: ‘I use a condom 20 to 50 percent of the time. Because we are Zulus, we don’t believe AIDS can affect us. We see our sisters dying, but we don’t believe it’s AIDS. We think it’s TB or pneumonia.’ [So does Mbeki, Don.] Cynicism about condoms is virtually universal. … The same questions were put to nine young women training to become health educators. They confirmed the essential, hopeless conundrum: everyone in Hlabisa has been advised to use condoms, but few do.

The visiting foreigner gauchely interrogated his hosts about their sexual habits, but was left more confused than when he started. On one hand he drew a story of female powerlessness, but on the other, found ‘the men were fairly sympathetic to the plight of women’. Not such thuggish black oafs after all. Then he spiced the story up with the kind of thing that his readers crave, a tale of exotic sexual adventure from darkest Africa, soft porn for the middle classes: ‘In the 19th century, Zulu teen-agers were allowed a practice called ukusoma or “thigh sex” avoiding penetration. Only battle veterans were allowed to buy [buy?] brides and father children, and it was shameful for a woman to become pregnant before the bride price had been paid.’ Setting the record straight after this bull in a china shop rendition of the historical and cultural facts I’ll leave to someone else with the time and the inclination. So we won’t get into the rest of his piece fishing for and holding up ridiculous scraps to support his white liberal preconceptions, shared by Cameron, of general African male turpitude and female victimhood. With a nice big dollop of whoredom slopped in too. Herman Melville long ago put his finger on it: ‘Of all the preposterous assumptions of humanity over humanity, nothing exceeds the criticisms made on the habits of the poor by the well-housed, the well-warmed and the well-fed.’

Banging away at his typewriter the next day, his profound racial and cultural antipathies on exhibit, the American on safari knocked out another lurid piece for the New York Times entitled South African Victims Face Rapists and H.I.V. It described a miserable rape case, like one anywhere in the world, except that it was written up with voyeuristic detail to titillate, with piquant local spices of the white liberal variety: the unavailability of ‘antiviral’ prophylaxis for HIV; ‘one of the world’s highest rape rates’; ‘a society where girls are nearly powerless’; ‘In rural KwaZulu/Natal Province, where this rape occurred, there is about a 40 percent chance that a young male rapist is H.I.V. positive’; a white doctor confirming, ‘Yes, rape by an H.I.V.-positive man is a death sentence’ and ‘Forced intercourse is not regarded as a hell of a crime by the average rural Zulu. It’s very accepted.’ One would think the New York Times had editors to throw out such obvious trash. Printing all and any issue from the pen of its resident Africa expert unchecked. ‘We know our kaffirs’ – some whites used to say, as they ignorantly attributed all manner of degenerate traits and startling racial characteristics to blacks. And still do, only in the age of AIDS, liberals say it more politely. But levelling the same sickening racist calumnies.

A couple of years ago I worked as a Regional Court magistrate trying serious crime on the western side of the Eastern Cape from where both Mandela and Mbeki hail. Murder, armed robbery, rape and manslaughter being my bread and butter. McNeil needs to sit in on a couple of rape cases among these country people to appreciate how diabolical his approvingly quoted doctor’s imputations are. Or to take a stroll from the court outside Butterworth along the path to the nearby houses and fields where the poor scratch a living from the soil. As they do in Hlabisa. I did so in October 2001, and chatted in Creole (I speak Zulu fluently but not Xhosa) with some men in charge of a large community-tilled vegetable plot. ‘We are starving here,’ I heard twice. So I returned a couple of days later with my court interpreter to propose sponsoring some seed and seedling purchases before the summer rains were done. We encountered a woman hoeing alone, and asked when the men to whom I’d spoken would be back. Her manner was hesitant. Choking back infectious tears at the whole affair, the young interpreter explained that it wasn’t proper for her to speak with us strangers without a local man present. Such was the moral conservativism in the country. My impression was of immense dignity and humanity in perpetual adversity of the hardest kind. McNeil, on the other hand, sees thugs, and womanhood abused and sold. Because those were the secret thoughts he arrived with. His patronising attitudes – painted so well by Jim Sleeper in Liberal Racism (Penguin, 1998) – makes plain yet again the reason why black men in South Africa generally prefer openly chauvinistic Afrikaners to the liberal English. So they’ve often told me. It’s that cool distance that they perceive behind affected appearances of acceptance. With the result that they never know quite where they stand. A smile in the morning, a knife in the afternoon, a black colleague, now a judge, told me after joining an old Natal-English law firm. Guys like McNeil in the bar talking to his hosts through snake eyes. Gleaning for evidence to support his grand charges against the African black man. In the manner of an apartheid security policeman interrogating with a malevolent, adamant agenda. But smiling. Talking nicely. (Alternating with the Biko stuff.)

After his initial delicate demurral, Cameron’s rhetorical question containing his nearly unspeakable phrase ‘sexual practice among African men’ – and he wasn’t asking, he was telling – was probably meant to imply more than just the standard white notion of unrestrained black promiscuity, but the rest of their basket of myths too. So we have truck drivers spreading AIDS by consorting with professional women at their stops. But only if the itinerant and his evening companion are black. White travelling salesmen up to the same amusements do not. Whatever the colour of their passing friends. This tabloid truck driver theory filling university theses isn’t damaged in the least by the reality that in the main, for as long as both are earning, neither the driver nor the ‘sex worker’ seem to get ill.

The ‘dry sex’ fixation was all the rage for a while, but white ‘AIDS experts’ seem to have lost interest in that one. This is the idea that, unlike guys everywhere else in the world, who like their girls runny in the middle, black men enjoy them sandpaper dry. Being different from the rest of us. Look around and you’re bound to find an ‘AIDS expert’ somewhere also telling us that black girls favour their guys as rampant as marshmallows.

But still popular is the idea that for men to have to have all their tackle in one piece is dirty and spreads disease. Lurking in the end bit. In the black ones. So UNAIDS urges they should all be nipped: In mid-September 1999, the San Francisco Chronicle reported a study by Careal et al. under the title, Teen Sex Linked to AIDS in Africa: Study says lack of circumcision also risk factor. A paper in Lancet claimed the same. Unbelievable but true. They’ve got to go. To save them from AIDS. But not the white ones: according to the American Academy of Paediatrics, the scientific ‘data are not sufficient to recommend routine neonatal circumcision’. Well obviously. In short we speak of all that fervently written, essentially racist garbage you read in the newspapers and in AIDS Internet discussion fora, posted by academics, AIDS activists and NGO people. With Christian sex-negative puritanism, American feminist victimology or gay angst invariably leaching in somewhere.

In July 1998 I thought I’d do some investigating of my own. I took a drive to the Medical Research Council station at Hlabisa, KwaZulu-Natal, to have a chat with David Wilkinson, an English ‘AIDS expert’ with a nice contract post there. Next to three of the finest game reserves in Africa. But he was out, so I spoke to his personal assistant instead, a Zulu guy in a balaclava with a toothache on the day, who had lived in the region all his life. ‘Much AIDS here?’ I asked, right in the epicentre of the world’s AIDS epidemic according to the ‘AIDS experts’, or at least the region with the highest ‘HIV seroprevalence’. ‘Not here,’ he said dismissively, ‘You have to go to Durban, Richards Bay, Empangeni and Matubatuba. Where the prostitutes are.’ It was that old story: whenever you go looking for AIDS, it’s always over the next hill. As well as the prostitute myth. That they spread AIDS. Which would stand to reason as the most likely vectors of any sexually transmitted disease. Yet countless studies of prostitutes all over the world, ones you never hear about in the newspapers, find otherwise. A point made in a single line in a report in 1990 by the National Academy of Sciences in the US, AIDS: the second decade: ‘Non-drug abusing prostitutes have no higher risk of AIDS than other women.’

On the other hand white doctors surveying the black poor with hopeless hollow eyes in their miserable wards see AIDS everywhere. I once did a case for one working at Edendale Hospital in Pietermaritzburg, catering for Zulu people. ‘Do you get many AIDS cases at Edendale?’ I asked. ‘At least seventy percent of patients,’ he answered. ‘Really?’ I responded, ‘What sort of presenting diseases?’ ‘Oh everything,’ he said, ‘From brain tumours to organ failures.’ I didn’t have the heart to tell the old geezer that neither were ‘AIDS indicator diseases’. Not even if the patient lights up the test. In the doctor’s book: you sick, you black, you got AIDS.

Most whites think like this. It pleases many to do so. Before he went in for life for his organising role in the conspiracy to murder Chris Hani, Conservative Party MP Clive Derby-Lewis stated: ‘If AIDS stops black population growth it would be like Father Christmas.’ I recall overhearing a white country magistrate some years ago talking similarly about the local black hospital being ‘vrot met VIGS [putrid with AIDS]. Miskien gaan dit ons redding wees [Perhaps it will be our salvation].’ I’ve heard it repeatedly. Even from liberals. David Beresford on the Mail&Guardian, his simple daughter Belinda, and their pale journalist colleagues also see AIDS everywhere – among blacks. As we noticed from the conclusion that Beresford jumped to when his washerwoman died. Cameron too: In the Carte Blanche interview he resuscitated their rumour that Presidential Spokesman Parks Mankahlana had died of AIDS, turning it over like a roast on a spit. And savouring the dripping. ‘Poignant,’ he described it. (It subsequently emerged from the Castro Hlongwane discussion paper that he had been killed ‘by the anti-retroviral drugs he was wrongly persuaded to consume’.) Whites universally believe former ANC Youth League chairman and subsequentely ANC NEC member and party election strategist the late Peter Mokaba to have died of AIDS. Liberal whites like Allister Sparks, whose book, Beyond the Miracle, features photographs of Mokaba and Mankahlana captioned by the claim that both were ‘AIDS victims’ who ‘died in denial’. Because they were black. When on the other hand the white headmistress of a posh school in Pietermaritzburg took ill and died suddenly a few years ago – of what no one ventured – it never entered anyone’s head to suggest AIDS. Being white and all.

I asked Wilkinson’s sidekick about the cultural mores of the Hlabisa community. Most people were followers of the conservative traditional Christian Shembe Church, he told me. Most girls were virgins at marriage (confirmed by inspecting matrons in accordance with rural Zulu custom). And it was not hard to believe. I saw what appeared to be a poor but socially intact traditional rural people, whose ordered clustered dwellings spoke to a social surveillance system typical of such communities – in which nothing is missed, nothing goes unnoticed. Burgeoning romance in particular. A society in which Cameron and McNeil’s understanding of the way these humble people live their lives sits very ill. In fact it’s disgustingly inapposite. To say nothing of profoundly insulting.

But right up their street was an article by Rachel Swarns in the New York Times on 25 November 2001, South Africa’s AIDS Vortex Engulfs a Rural Community, sketching a Black Death scenario of Hlabisa completely at variance with the account that I got from the local guy with the sore tooth right there on the spot. Loaded with Afro-pessimism so fashionable in white journalism, it brought to mind an observation made by journalism professor Andrew Tracey in his inaugural lecture to the University of Salford, England in 1995, Mere Smoke Of Opinion; AIDS and the making of the public mind: ‘But to the media, ... it satisfied a certain kind of news value that is ignorant but loves to wallow in gore, and that readily has the ear of a public which is fascinated by the bizarre, the gruesome, the violent, the inhuman, the fearful.’ Germans call it Schadenfreude; Afrikaners, leedvermaak. The dull facts take a back seat when there’s copy to sell. About black people copulating out of control. And being visited with a deadly plague for it as a mark of divine reprobation. Right out of the Middle Ages. Great story.

All right thinking people shirk from the idea of the state looking into their bedrooms. But when it comes to black sexuality, white liberals drop the tolerant permissiveness claimed by their name, and revert to controlling in the tradition of their colonial forebears. Consequently they find nothing repugnant in having the government dictate the conduct of the intimate lives of blacks with endless ‘safe sex’ propaganda. Such as on the side of a taxi: ‘I had sex. Will I die? – Sipho, 14.’ Is sexual negotiation ever ‘safe’? Isn’t this potently charged experience, especially among the young, fraught with emotional risks having nothing to do with germs? The ‘safe sex’ sermons of armies of ‘life skills’ educators in this country blind youngsters to the emotional hazards in their path and only add to the heartbreak of the AIDS era. Over and above perniciously equating sexuality with death. Unless ‘protected’. Then it’s ‘safe’ they say. Best abstain, they urge. Like Catholic priests. To save yourself from conflagration. If not in eternal hellfire, then in an incurable plague. No sex, and we’ll all be fine. Even the impoverished poor.

‘... say no to sex for a brighter future’, urged a pretty young black woman in a full-page AIDS advertisement flighted by the Department of Health in the Natal Witness in 1997 – in the Echo supplement for Zulu readers, naturally. Blacks being most at risk due to their excessive sexual drives. The Pope likewise urged abstinence on 1 December 2001 on World AIDS Day, addressing an AIDS symposium held at the Vatican. As did Anglo American’s AIDS-populist Clem Sunter on three days later: ‘We’ve got to get people to have less sex, to abstain.’ Exhorting, swinging his arms around, his voice brimming with the joy of spreading the word. We take it that it wasn’t his own flies he had in mind to keep buttoned up, or those of his gin and tonic friends. But if you can’t help yourself, wear a condom. Repeating the gospel in mid-January 2002 in an interview in Ubomi, a supplement for Xhosa readers in the Daily Dispatch, Sunter qualified: ‘I advise abstinence, but if that doesn’t work, the rule is: in a sexual emergency, use a condom.’ A spontaneous spark being a dangerous emergency to such guys. To be insulated by that ultimate rubber token of political correctness. Unlike Catholics, we’re very liberal about them. We want everyone to wear them, to demonstrate how responsible they are. But especially blacks. Who really get around. Not pizza-reared white kids in the suburbs, with wheels and cell phones and open afternoons. Not them so much. (Am I the only one who always sniffs infinitely more pumping testosterone, more bitches on heat, and more sexual tension on mainly white beaches than mainly black? Or is it my straying middle-aged imagination?)

Cameron and his white liberal allies urge black men to change their behaviour. Claiming there is generally something wrong with it. Such guys nominally allow black men political freedom. But can’t cope with their sexual freedom. Just to run their ship as their cultures allow. That’s expecting too much. I think it’s to do with why the Egyptians cut off their slaves’ erogenous nerve-laden prepuces – containing all the primary nerves of sexual arousal, and about half the organ’s total erogenous tissue – stretched out like a goat hide pegged to dry in the sun it would cover a postcard. Causing the moist parcel beneath to dry out, like an eye without a lid, the surface nerves withering in turn. A massive loss of sensation all round. The fallacious intention was to suppress the lower chakras, as Hindus would put it, in order to make those sensually diminished more compliant. Closer to mules. The working class. How very sad that even after walking to freedom through the Red Sea parted they should have become so used to half pay that they adopted their manly reduction as a mandatory mark of belonging. (It’s the Xhosa and Sotho tragedy too.) Not just a tribal scar, but good for the soul also: the sensory diminution of being half-cocked ‘cured a moral defect’ said the medieval Jewish philosopher Moses Maimonides; you removed the foreskin ‘to quieten the organ’. That’s because neurologists who’ve looked into this recently have found that the bit cut off is the best part, with a richer blood supply and a higher concentration of nerve endings – a complex of uniquely coiled Meissner’s corpuscles – than in our lips and fingertips. Without which the entire physiology of male sex is stultified: instead of enjoying a slowly building rippling train of subtle impulses transmitted from the shifting fold of the foreskin as the sword is sheathed and unsheathed, clipped guys get their short dulled kick from friction.

So there we have it from the mouth of a judge on the bench of our highest court, the whole hateful white liberal secret, that insidious reborn, reshaped racism that inspired Gallo and his fellow ‘AIDS experts’ to hypothesise an African origin for HIV, nested in their fantastic preconceptions about a distinct, orgiastic African sexuality. A supposition taken as a given by both ‘AIDS experts’ and regular white folks. It lies at the heart of white liberal African AIDS hysteria: African men, lower in the orders, can’t control themselves. But don’t feel singled out, Sun-brothers; the English had similar notions about the Irish they conquered. And, just as mortified by Irish directness, spontaneity and warmth, depicted their subjects as bestial. All the less troubling then to oppress them cruelly. In The Faerie Queen, which he wrote in the seventeenth-century, Spencer had Lord Grey deploring the ‘licentiousness’ and the ‘liberty’ of the Irish, ‘wallowing in their own sensual government. … As it is in the nature of all men to love liberty so they becomes libertines and fall to all the licentiousness of the Irish’, something that could only lead to ‘degeneration’. The English had similar ideas about the Scots too. Discussing the endless bawdy lampooning by London wits of George III’s unpopular Scottish tutor, John Stuart, Earl of Bute, in Kings, Lords and Wicked Libellers (History Book Club, 1973), Wardroper mentions the reputation that ‘strangers from simpler lands’ had for ‘great carnal vigour’; many mocking tunes adverted to Bute’s ‘staff, which he always bare upright ... equal in bigness unto a weaver’s beam’ and so on. A sort of sexual jealousy driven by banal anxieties: elites endeavour to restrict the sexuality of those they control because it threatens them. In their property particularly. Female chattels most prized. For obvious reasons: it’s a matter of time and numbers.

Efron described how Thomas recognised at the Senate hearings

that he had been hit by the oldest and most murderous racist stereotype directed at the black male: the black male as sexual beast; the subhuman, predatory ape without sensibilities and without morals … He also knew its origins, its vicious hypocrisy, and its social uses. For all the constitutional talk forbidding blacks human status, our Founding Fathers – like the French, Spanish, and Portuguese aristocrats who imported black slaves into the New World – were fully aware that blacks were human beings. Such men happily slept with black women, fell in love with them, protected the children they fathered by them, freed those children, adopted them. They safeguarded their own black sons, often by sending them abroad for higher education. But they reserved a different and frightful fate for the unprotected black boy – not for the girl, only for the boy. As soon as he reached puberty, as soon as he was sexually mature, he turned, magically and abruptly, into the Mythic Black Beast who became sexually taboo for white women. Thus did the white men control their paternity and property lines. Any alleged breach of the sexual taboo could, and often did, mean death – for the black male. That is what the dangerous legal junk meant to Thomas. He knew that, regardless of the lack of legal evidence, the humanity of his female accuser would be assumed, as indeed it was. He knew he would have to establish his own humanity, and to do so at a mock trial.

Note that Cameron picks on ‘sexual practice among African men’. Not women. Because to his mind it’s black men going around spreading AIDS. Even if it takes two to tango. But it’s black men who lust. Abusing helpless African women. Those black bastards. David Crowe proposed a reason for this in a private note that ‘feminism is a stronger card than racism. In other words if you were to say it was the uncontrolled sexuality of African women that was the problem you’d be crucified right away. So you can get away with blaming blacks, as long as you emphasize it’s only the men, because everyone knows that men are rotten sexual predators, especially black men.’

I suggest that essentially the same well-buried racist suppositions drive Western evolutionary palaeontologists, digging endlessly in their Darwinian quest for traces to show an African origin for the human species, a link to African jungles. Where apes live. With frauds and wild unfounded speculations among these tweedy gents adopted eagerly, if they support their civilised prejudices. Like Darwin’s, expressed in his The Origin of Species and The Descent of Man:

The variability or diversity of the mental faculties in men of the same race, not to mention the greater differences between the men of distinct races, is so notorious that not a word need here be said. … We must not judge of the tastes of distinct species by a uniform standard; nor must we judge by the standard of man’s taste. Even with man, we should remember what discordant noises, the beating of tom-toms and the shrill notes of reeds, please the ears of savages. … For my part I would as soon be descended from that heroic little monkey, who braved his dreaded enemy in order to save the life of his keeper, or from that old baboon, who descending from the mountains, carried away in triumph his young comrade from a crowd of astonished dogs – as from a savage who delights to torture his enemies, offers up bloody sacrifices, practices infanticide without remorse, treats his wives like slaves, knows no decency, and is haunted by the grossest superstitions. … Nor is the difference slight in moral disposition between a barbarian, such as the man described by the old navigator Byron, who dashed his child on the rocks for dropping a basket of sea urchins, and a Howard or Clarkson; and in intellect, between a savage who uses hardly any abstract terms, and a Newton or Shakespeare. Differences of this kind between the highest men of the highest races and the lowest savages, are connected by the finest graduations.

By first resisting the pharmaceutical industry’s marketing programme, and then letting on that he had become dubious of Western culture’s sexual superstitions and taboos re-expressed in AIDS medicine, Mbeki re-ignited all this ancient chthonian racial loathing, and it gushed out like a polluted spring. His critics, white liberals most vociferously, with a few black amagqoboka joining in, flogged him like a truculent plantation nigger: he was a savage baby-killer, sacrificing them cruelly, failing to confront his people’s innately barbarous attitude to and everyday abuse of women and children, and exhibiting typical sun-baked, shrunken-brained African stupidity. All for shirking the challenges of this latest offering from the wisdom of the West: AIDS.

South Africa’s most prominent paleoanthropologist, Phillip Tobias, is a Darwin man. During his opening address in Durban in March 2002 at a conference cutely entitled An African Renais-Science – A Shared Vision for Life and Environmental Sciences, he approvingly cited Darwin’s unsupported racist speculation in 1871 that ‘it was probable that our early [ape-like] progenitors lived on the African continent’. Quite obviously to the Darwinian mind: Africans – in their thousands of vastly disparate cultures across the continent – are vicious stupid savages, a far remove from the civilised humanity of Europeans. So Tobias’s hero wrote and signed. (In fact the evidence points to Asia as the home of humankind’s ancestors.)

But in an article in the Sunday Independent on 29 September 2002, about his TV documentary series Tobias’s Bodies, the professor hastened to assure us that, black and white, we are really all the same. As if we needed skulking contrary thoughts dispelled. Later on though we read that what drew him to his vocation was his discovery as a schoolboy of Darwin’s Origin of Species by Means of Natural Selection. However, the full title to the rock of his career, On the origin of species by natural selection, or the preservation of favoured races in the struggle for life, made plain that Darwin had very different ideas – and they were the very stuff of apartheid and AIDS racism today. The great English scientist’s achievement was no more than to provide English bigotry, and Adam Smith’s brutal English economic rationales for the oppression of the poor and the weak, with a new suit of clothes. Positing a startling new theory of biological origins without any evidence at all.

It is interesting that Darwin’s English horror of Africans, and his hateful conceptions about them, extended to the natural world too. There seems to have been something about the vigour, freedom and beauty of life outside the miserable Victorian religious, social and economic system that he found unbearable to contemplate. Instead of nature throbbing and humming vitally as a unified, generally harmonious whole, Darwin saw only the viciousness of his society – spawning his anthropomorphic theory of natural selection determined by the survival of the fittest (albeit that, in actual fact, very few of the earth’s life forms are in conflict). Nature he condemned as ‘clumsy, wasteful, blundering, low and horribly cruel’ with its ‘dreadful but quiet war of organic beings going on in peaceful woods and smiling fields’. His early wonderment at the new creatures appearing before him on his travels gave way to morbid dislike – so extreme by the age of fifty that he should write that ‘the sight of a feather in a peacock’s tail, whenever I gaze at it, makes me sick’. One very sick fellow. Cooking up an equally distempered theory.

Placed above the newspaper article about Tobias was an intriguing large colour photograph. A row of naked men (not a woman in sight) stand side by side, their butts to the camera, all black but for two partially obscured whites. Tobias stands in a white lab coat in front of his subjects, his hands clasped behind his back. Looking rather like a white mine doctor about to record his opinions about whether the young recruits torn from their rural communities and from everything they know and love are fit to spend the rest of their lives picking gems a couple of miles below ground for his wife’s fat fingers. Except that Tobias is a bachelor. To complete the picture, he sports a bright red beadwork AIDS ribbon safety-pinned to the pocket of his white cloak – ignorantly hopping aboard the politically fashionable new American paradigm for professional advantage. In The Apocalyptics, Efron identified Tobias’s scientific mischief and its necrotizing consequences:

in 1980, Philip Handler, then President of the National Academy of Sciences, called upon scientists to combat those very antireason, antiscience trends in the general culture and within the scientific culture itself. … He asked scientists to avow their ignorance, to make no claims to knowledge they did not possess – and to confront the ‘charlatans’ in their midst. … It is a harsh fact that millions ... have been so thoroughly besieged by myths, errors, and falsehoods ... that they have been plunged into a neoprimitive pathology. … When a scientific endeavour becomes the means by which a nation is told grotesque untruths about itself, and the most serious scientists remain silent while such untruths are told to the public for a decade, that is cultural cancer. … The intellectual trash invades the law and the press. The intellectual trash piles up. The intellectual trash becomes the culture.

Cameron’s culture. Tobias’s culture. The South African white liberal culture.

The author of the Sunday Independent piece about Tobias, Heather Dugmore, reverently served a smorgasbord of his professional and personal musings, by turns fanciful, ridiculous and banal:

Women in the main continue to choose to mate with violent, aggressive men … why are men violent? [A single man he certainly is. Never to have experienced the extreme emotional violence that is the feminine speciality.] … I do believe in a supreme creative force or being that has been with the creatures of the earth beyond time. [Who cares? Millions of Buddhists don’t.] … One wonders about bringing descendents into this sick old world of ours.

Who’s sick? But the next bit, paraphrased by Dugmore, is best:

Our closest relative, the pygmy chimp, uses sexual intercourse to defuse tension in the troop. Sex is the collective emotional salve and all members participate willingly. … What the pygmy chimps teach us, says world-renowned human geneticist and paleoanthropologist, Professor Phillip Tobias, is that it is possible to breed out violence, even in a species that is not as aggressive as our own. This is not a call to sexual orgy. [Have lots of sex but don’t have lots of sex. Or only with the mate licensed by the parson. Or miss the point and get all mixed up.] Indiscriminate sexual intercourse has already proved itself fatal to us.

To those of us with brown skins, anyway. The men in the photograph that I study. Who do it indiscriminately. Now they’re all HIV-positive and it’s why we’ve got this terrible AIDS crisis on the go in South Africa. Which we remind everyone about with our AIDS ribbons. Beaded in ethnic chic.

In an article in the same issue of the newspaper, Unicef official leaves with grim warning on Aids, departing United Nations Children’s Fund envoy Jesper Morch of Denmark said that ‘around the corner [South Africa faced] a crisis of proportions barely imaginable’. Sort of like an asteroid hitting us:

The traditional assumption was that the epidemic would eventually even out at a 33 percent infection rate in the sexually active population. But in Zevenfontein – a poor community of 10 000 [black] people next to Gauteng’s luxurious Dairnfern golf estate – the infection rate was 78 percent, Morch said. In many ways the community was condemned. Most people would die and the future of uninfected youths and children was grim.

Not just in Zevenfontein; AIDS orphans everywhere else too: ‘I still don’t think we have the faintest clue what it is going to do to South African society.’ The piece cited Makgoba’s MRC talking alike: ‘The Medical Research Council estimates that by 2014 a third of all [black] children will have lost one or more parents – close to five million.’

James Clarke provided an illustration of the liberal intellectual milieu in a third article in the Sunday Independent issue under discussion, in his review of the papers presented at the Renais-Science Conference, collated as a book, The Rebirth of Science in Africa – rejuvenated by HIV-AIDS. (The correlative implication of the title would seem to be that ancient systems of indigenous knowledge count for nothing. Or just about. Not being ‘scientific’.) Underscoring the title, Scientific illiteracy has caused politicians and citizens fatally to misread HIV, was a brightly flashlit photograph of Tobias’s white face, in his hands an ancient African skull, to drive home whom Clarke considers scientifically literate and who not. (Imagine the fuss were blacks to dig up ancient white graves, and pose for photographs in similar manner.)

So far three million [blacks] have died in South Africa and a further five million [blacks] contracted the disease last year. [Really?] Of the 40 million known to have HIV/Aids across the world (in 2001) almost three quarters are in sub-Saharan Africa and most of those are in Zimbabwe and South Africa. … Scientific illiteracy has caused South African politicians and the public fatally to misread the HIV/Aids situation. Hoosen Coovadia and Prem Gathiram in their paper, ‘The Aids epidemic and its implications for the African renaissance’, warn that it may now threaten South Africa’s social stability. … The trouble with lay persons [such as Mbeki] is that they don’t understand science or scientists and often distrust them. … This is, one gathers, why South Africa’s [black] government has allowed HIV/Aids to eat into the [black] population to such an extent that it now threatens the stability of the state. … The overall impression I received from this selection of scientific papers [kicking off with Tobias’s above-mentioned opening address] is that South Africa, the most advanced and diverse country in Africa, is facing its gravest crisis with a terrible fatalism.

Because unlike you, mister, most South Africans just don’t swallow it. It’s an idea that slots into your world but not theirs. You ‘understand’ it, not them.

Can it really be any mystery why Mbeki so despises the white liberal mind. The sort of putrefied conceptual vocabulary on weekly display in the Mail&Guardian and Sunday Independent newspapers especially. And why the ANC is so eager to shake up the South African liberal press establishment? Its self-supporting social constructs. Its foolish but useful learning. Its dull arrogance. Its ignorance. Its obliviousness to the most obvious ground realities. Its preference for complex towers of special knowledge erected in double Dutch. Dissembling as pure science, but ideologically purposive. So that to ask questions about it is to draw fire. And to investigate it privately is to discover that it’s a load of bull.

As Rian Malan did – in regard to the fantastic numbers being pitched by ‘AIDS experts’ and activists. Hyped to hell, he wrote in noseweek and the Spectator in December 2003. But it was no dissident manifesto he drew: ‘Please don’t get me wrong. I believe Aids is a real problem. Governments and sober medical professionals should be heeded when they express deep concerns about it.’ The AIDS establishment was angered by his impertinent meddling: an article in the Guardian reprinted by the Mail and Guardian on 21 December cited one invested professor after another spitting: his article displayed ‘a complete lack of understanding of data’, said big-time ‘AIDS expert’ economist at the University of Natal Alan Whiteside. ‘It’s always useful to have critical debate but we shouldn’t get tied up in pointless arguments,’ admonished James McIntire at Chris Hani-Baragwanath Hospital. The cleverest of the bunch, University of Cape Town biologist Ed Rybicki, said luminously: ‘I think Malan is extremely well-meaning but has latched onto a conspiracy theory.’ Off record, and unwilling to put their names to their cowardly slurs, offended scientists and activists tried discrediting Malan personally: ‘Quoting others, Malan suggests scientists and lobby groups distort statistics when chasing funding and influence. Privately, some return the compliment, accusing Malan of using Aids to revamp a career largely stalled since My Traitor’s Heart.’ Anton Harber, founding editor of the Mail&Guardian, and now a professor of journalism at Wits, and a big AIDS believer, took the same tack in a personal hatchet job in Business Day on 20 February 2004 – ‘Everything he has done since then has been carbuncular’ – in which he flashed his irritation at Malan’s challenge to think afresh. Incapable of doing so himself.

On 9 August 2002, speaking in Hankey, Eastern Cape at the reburial of Saartjie Bartmann (rechristened ‘Sarah’ on her birth certificate by some British colonial official), a Khoikhoi woman who had been paraded around Europe in the early nineteenth century as a sort of exotic ape, and whose remains had finally been brought home for burial near her birthplace, Mbeki cited more Darwinian talk by leading European scientists, including the famous Baron Georges Cuvier, who dissected her body after her death:

The Negro race is marked by a black complexion, crisped or woolly hair, compressed cranium and a flat nose. The projection of the lower parts of the face, and the thick lips, evidently approximate it to the monkey tribe; the hordes of which it consists have always remained in the most complete state of barbarism. … These races with depressed and compressed skulls are condemned to a never-ending inferiority. … Her moves had something that reminded one of the monkey and her external genitalia recalled those of the orang-utan.

On the other hand,

The white race, with oval face, straight hair and nose, to which civilised people of Europe belong and which appear to us the most beautiful of all, is also superior to others by its genius, courage and activity. [There is a] cruel law which seems to have condemned to an eternal inferiority the races of depressed and compressed skulls ... and experience seems to confirm the theory that there is a relationship between the perfection of the spirit and the beauty of the face.

This ‘rabid racism’, to quote Mbeki, from the scientific expert of his day, was revealed two centuries later for the vicious hogwash it was by a French parliamentarian, Jean Dufour: ‘Enslaved, exploited, shown as an animal, [Saartjie] was dissected by scientists who wanted first and foremost to confirm their theory of the superiority of a race over the others.’ By ‘the others’ he was talking about that crowd referred to by the German priest and art historian, Johann Wincklemann, a little before Cuvier; Mbeki quotes him: ‘The European, called by destiny to run the empire of the globe which he knows how to enlighten by his intelligence, tame by his abilities, is a man par excellence; the others are nothing but hordes of barbarians.’

Such ideas were shared by the most eminent French intellectuals too; Mbeki quotes a few. Voltaire: ‘[Africans] are not capable of any great application and association of ideas, and seem formed neither in the advantages nor the abuses of our philosophy’ (he also wrote that whites ‘seem to be superior to Negroes, just as Negroes are superior to monkeys and monkeys to oysters’); Diderot: they ‘are always vicious … mostly inclined to lasciviousness, vengeance, theft and lies’; Montesquieu: ‘You will find in the climates of the north, peoples with few vices, many virtues, sincerity and truthfulness. Approach the south, you are leaving morality itself, the passions become more vivacious and multiply crimes.’ Hence, Mbeki noted, ‘Baron Cuvier made it a point to pay particular attention to Sarah Bartmann’s private parts as he dissected her body, proceeding to present her genitalia to the Academy of Medicine. … [An example of] the barbarism of “man par excellence”.’

In his study, The Color of Reason: The Idea of ‘Race’ in Kant’s Anthropology, included in his collection, Postcolonial African Philosophy: A Critical Reader (Blackwell, 1997), Emmanuel Chukwudi Eze exhumes the little known historical fact that Immanuel Kant’s principle fascination was not philosophy, as in his Critique of Pure Reason (picked by Mbeki from his father’s bookshelf and read as a boy), for which he is today remembered and studied, but for anthropology and ‘physical geography’. In these new subjects of his invention, Kant elaborated a systematic taxonomy of racial hierarchy, stacking whites, Orientals, native Americans and Africans according to his fancy about the iron and later on the ‘phlogiston’ content of their blood: ‘As all animal blood contains iron, nothing prevents us from ascribing to the different colours of the human races the same cause. In this way the base acid ... reacts strongly with the iron particles and turn red, black or yellow.’ But later: ‘Now the purpose [of race] is nowhere more noticeable in the characteristics of race than in the Negro … Namely, it is now known that human blood becomes black, merely by dint of the fact that it is loaded with phlogiston. The strong stench of the Negro, which cannot be removed through any amount of washing, gives us to suppose that their skin removes a great deal of phlogiston from the blood.’

Kant’s was not the casual racism of David Hume across the Channel but a much more refined version:

The Negroes of Africa have by nature no feeling that rises above the trifle. [A truly Nazi opinion, given the supreme value that Kant placed on human capacity to experience the sublime.] Mr Hume [in his Essay on national character, arguing that ‘the Negro’ is ‘naturally inferior’ to ‘the White’] challenges anyone to cite a single example in which a Negro has shown talents, and asserts that among the hundreds of thousands of blacks who are transported elsewhere from their countries, although many of them have been set free, still not a single one was ever found who presented anything great in art or science or any other praise-worthy quality, even though among the whites some continually rise aloft from the lowest rabble, and through superior gifts earns respect in the world. So fundamental is the difference between these two races of man, and it appears to be as great in regard to mental capacities as in colour.

But in The Critique of Eurocentrism and the Practice of African Philosophy included in Eze’s collation, Tsenay Serequeberhan notes incidentally that whereas Kant considered man’s sense of community ‘the source of one’s humanity and critical capacity to judge and communicate’, Kant ‘makes light of being uprooted’ and transported to Europe, the ‘catastrophe’ befalling the ‘Negroes of Africa’. As his title anticipates, Eze provides a driving, withering critique of Kant’s faux scholarship, all derived from the latter’s impressions of the broken black man in slavery: ‘All inhabitants of the hottest zones are, without exception, idle. With some, this laziness is offset by government and force.’ Africans ‘can be educated but only as servants’; beating them into this station requires ‘a split cane rather than a whip, because the blood needs to find a way out the Negro’s thick skin to avoid festering’. Such crude racism informed Kant’s erudite disquisitions on human nature, his lessons on ‘talent’ (Anlage) or the lack of it among the lower races, and so on – all tacitly affording a rationale and justification for slavery.

In keeping with such thinking, Georg Hegel dismissed Africans as ‘mere things, whose lives are of no value’. Karl Marx disparaged the German labour organizer Ferdinand Lassalle as ‘the Jewish Nigger’ and in a letter to Freidrich Engels on 30 July 1862 wrote: ‘It is now perfectly clear to me that, as the shape of his head and the growth of his hair indicates, he is descended from the Negroes who joined in Moses’ flight from Egypt (unless his mother or grandmother on the father’s side was crossed with a nigger). This union of Jew and German on a Negro base was bound to produce an extraordinary hybrid.’ A hybrid of his son-in-law’s sort: Marx referred despicably to his daughter Laura’s husband Paul Lafargue, a Cuban mulatto, as ‘Negrillo’ and ‘the Gorilla’.

The sort of people about whom even John Stuart Mill had written in On Liberty: ‘Despotism is a legitimate mode of government in dealing with barbarians, provided the end be their improvement.’ Since they were incapapable of governance, he said.

But of relevance to our topic, such foul ideas seething in the heads of Europe’s leading intellectuals have contributed to the development of a dominant Eurocentric outlook in formerly colonised countries like ours, based not just on technological and industrial achievement, but further upon a powerful assumption of white metaphysical superiority over black. Mbeki’s bucking against this, particularly in the context of the AIDS controversy, is ubiquitously evident in his speeches and remarks – intensely sensible as he is to the negative racist motifs about the supposed essentially inferior nature of the black man with which AIDS ideology is laden.

Even that great icon of the brotherhood of man, Mahatma Ghandi, thought that next to Indians Africans were rubbish.

Ours is one continual struggle against degradation sought to be inflicted upon us by the European, who desire to degrade us to the level of the raw Kaffir, whose occupation is hunting and whose sole ambition is to collect a certain number of cattle to buy a wife with, and then pass his life in indolence and nakedness. … One can understand the registration of Kaffirs who will not work, but why should registration be required for indentured Indians who have become free? … Why, of all places in Johannesburg, the Indian location should be chosen for the dumping down of all the Kaffirs of the town, passes my comprehension. Of course, under my suggestion, the Town Council must withdraw the Kaffirs from the Location. About this mixing of the Kaffirs with the Indians I must confess I feel most strongly. I think it is very unfair to the Indian population, and it is an undue tax on even the proverbial patience of my countrymen. … We believe as much in the purity of the races as [Europeans do], only we believe that they would best serve these interests, which are as dear to us as to them, by advocating the purity of all races, and not just one alone. We also believe that the white race of South Africa should be the predominating race.

Just in case you were wondering about the terrific appeal to South African Indian doctors of the idea of that AIDS is everywhere among Africans, and why they dominate the local scene as ‘AIDS experts’ and are so enthusiastic about their calling. Helping the Kaffirs.

Few will need reminding that virulent racism flourished everywhere in the US for much longer than it did in Europe, and persists vigorously into the present. Before losing his heart to a coloured woman and fathering several children by her, Jefferson justified the exclusion of blacks from the Constitution by explaining: ‘Negroes have a strong and very disagreeable odour. They seem to require less sleep. Their love is ardent but it kindles the senses only, not the imagination. In reason they are much inferior to whites. In imagination they are dull, tasteless and anomalous. Their griefs are transient.’ Efron provides some examples issuing from educated minds in high places later on: In 1898, ‘Rep. A. Dearmond of Missouri described Negroes as “almost too ignorant to eat, scarcely wise enough to breathe, mere existing human machines”’; in 1900, ‘the American Book and Bible House published The Negro, A Beast, which depicted God as an idealized white man, along with a white man made in his image and a caricature of a Negro intended to show that the Negro was “simply a beast without a soul”’; in 1915, ‘an army surgeon informed people that “many animals below man manifest a far greater amount of real affection in their love-making than do Negroes”’; and ‘in the early 1920s, a doctoral dissertation in Columbia University’s Department of Studies in History, Economics, and Public Law presented as “scientific” fact that the Negro was “as destitute of morals as any of the lower animals”’. Efron mentions that in the Rodney King trial in 1991 we heard a tape ‘crackling radio jokes about “gorillas in the mist” from the white Los Angeles cops’.

The painful core of Mbeki’s speech went:

The story of Sarah Bartmann is the story of the African people of our country in all their echelons. It is the story of the loss of our ancient freedom. It is a story of our dispossession of the land and the means that gave us an independent livelihood. It is a story of our reduction to the status of objects that could be owned, used and disposed of by others, who claimed for themselves a manifest destiny ‘to run the empire of the globe’. It is an account of how it came to be that we ended up being defined as a people without a past, except a past of barbarism, who had no capacity to think, who had no culture, no value system to speak of, and nothing to contribute to human civilization.

I suggest that these thoughts lie at the throbbing heart of Mbeki’s outlook on Western culture, his sense also of the inherent brutality and inhumanity of the European economic system – thoughts absolutely absent from white liberal consciousness, hence the unfamiliar and disconcerting passion of his Africanism, and the liberal response to it that he has race on the brain.

That most flatulent of white liberal columnists, William Saunderson-Meyer, took a liberal view of the Saartjie Bartmann affair in his Jaundiced Eye column in Cape Town’s Weekend Argus on 17 August, dismissing Mbeki’s obituary as ‘over the top ... railing’. Using a used car salesman’s bait and switch trick, he distracted from the unbearable memory of how she had been abused and then cut up in Europe, by setting up a vicious decoy – Efron’s black man as ‘mythic sexual beast’:

While it might suit Mbeki’s Africanist propaganda to build a mythology of an innately kinder, more noble instinct, compared to the crassness and materialism of the northern countries, what happened to Bartmann is considerably less serious than what our supposedly humanitarian ubuntu society is doing every day to thousands of women and children. South Africa has the world’s highest incidence of child abuse and rape. Uniquely, this is the only country where the two outrages are combined in that savage speciality, the rape of babies in the belief that it will cure Aids. … Of course, it is politically embarrassing that this is almost exclusively a black South African practice. And of course, many in the ANC do not believe that Aids exists.

Nor do they believe white liberals’ implacable conviction that the prevalence of rape in this country is internationally top of the pops. And that black South Africans are uniquely savage child abusers. Should they? Merely because white liberals like Saunderson-Meyer say they are? At their dinner parties. I was once stuck with him at one I attended. Sounding forth in his plummy colonial voice. Like this: ‘Nevertheless, it would contribute far more to improving the existence of ordinary South Africans if the president could find the humility and grace to rail against such present abuses, rather than froth about the miserable show career of one woman 200 years ago.’ It would also contribute far more to the standard of liberal journalism were William to think a bit about the ‘crassness’ of his own facile commentary. With ‘humility and grace’. And maybe some Hail Marys.

It’s not only the faceless black mob that has this barbarous propensity for sexually abusing children – their kings too. So suggested a piece of inflamed cultural disdain, Tenth wife for Swazi King, wired not by the Christian Women’s Institute, but by the South African Press Association. The Saturday Dispatch published the article on 31 August 2002, charged with liberal indignation at the timeless custom of the lucky indigenous elites:

As the HIV-Aids scourge sweeps through tiny, impoverished Swaziland, its absolute monarch, King Mswati III, is expected to take his tenth wife on Saturday at the close of the country’s traditional reed dance festivities. [Sexual coupling by the natives is a bad thing, even in matrimony. An unholy sort, not being blessed.] The festivities started in earnest on August 23, when thousands of young girls were released to go out and cut the reed, which will be used to build the fence of the Queen Mother’s homestead. Mswati is widely expected to pick a wife from among these girls, some of whom are as young as seven years old.

He duly did so. The ripe young woman was pleased over the plucking, but not her mother, and the next thing there was a constitutional tussle in the courts over competing indigenous and European legal norms.

Once you’ve pushed a black man’s humanity out the frame, by conceiving him in his interactions with women as predatory and heartless, and conversely you reify their women, as Cameron and McNeil do, and Darwin, Cuvier, philosophers of the Enlightenment and eminent Americans did before them, chains and cages and even bullets easily follow – metaphorically speaking nowadays. I think there’s a pinch of this in the shockingly hateful and contemptuous animus that white liberal journalists consistently display towards Mbeki in their editorials and columns. Mixed into their snarling resentment over his intellectual and ideological independence. He doesn’t buy their goods. He won’t be led along. Tied to their leash, circumscribing the parameters they dictate of acceptable and unacceptable thinking. He walks where he pleases. Thinks and says what he likes. And leads accordingly. Where his confident African mind takes him. Not where he’s told, like a servant. They can’t abide it.

Of all the country’s liberal newspapers, the Johannesburg published but nationally distributed Mail&Guardian is the most obsessed with AIDS, with an AIDS story, until quite recently, on the front or second page of nearly every single issue, its HIV/Aids barometer column printing scary numbers about the exploding calamity and little reports under headlines like Skyrocketing, as if we’re on way to Armageddon. Thanks to blacks who can’t contain their lusts. And their chiefs who refuse to enter into trade with the pharmaceutical companies. Diseases of malnutrition, TB, malaria or gut diseases – all rampant in South Africa – never get a note. But AIDS is loudly there, in issue after issue. Nearly every one. It has to do with journalism’s chestnut: the beast with two backs. Concerned only with the pipe laid in Soweto, though. Not in Sandton.

But it’s the Cape Town newspapers, the Cape Times and the Argus, that keep up the most steadily sour anti-Mbeki pitch around AIDS. Part of the reason was suggested by a survey of market sentiment reported in the Weekend Argus on 17 August 2002, Capetonians are more negative than Gautengers and Durbanites – ‘despite the fact that they acknowledge that they are the best off’. Resident in the country’s most racially segregated large city – from blacks. It’s in isolation and an absence of communication that deluded anxious thinking of the paranoid type germinates best, so not surprisingly, whereas ‘In Gauteng, just 50% felt that the epidemic had not really yet affected them, ... in Cape Town, it was a large 91% who felt that the virus had already impacted dramatically on life in South Africa.’ On black life they meant. Victorian England shuddered just the same way as it pondered the sexuality of those dark, shameless, naked people in faraway Africa.

Intellectually inscrutable to white liberals from the beginning, Mbeki’s challenge to their group trance by questioning the safety of AZT – a deadly poison – convinced them that he’d gone off the rails. The question is why among liberal newspapers in South Africa the Mail&Guardian, successor to the Rand Daily Mail as South Africa’s liberal standard-bearer, should be especially murderous in the ferociousness of its antagonism towards Mbeki? Why from the nibs of the country’s most illustrious liberal gazetteers the most poisonous ink should flow. Because apart from shooting a leaden bullet into his head, what could be more deadly in intent than repeatedly stating or insinuating that he is mentally unwell, lacks ordinary judgment, and is accordingly unfit for his office? Possibly it has to do with the fact that, like Buthelezi’s Inkatha movement, the liberal press was unthreatening as it commented from the sidelines during our country’s struggle against political and cultural white supremacism, so it was largely tolerated by the apartheid regime. All other voices, implying or urging sedition, were suppressed. As it exercised the power allowed it to sound off, it imagined it was in the thick of it, even that it somehow owned the show, normatively defining the moral, political, and logistical shape of the anti-apartheid discourse – halcyon times for the liberal press when it was easy to sound right and feel good. Being on the right side. Painlessly.

Steve Biko described this monopoly of the white liberal/left in Black souls in White skins, a piece he wrote for his I write what I like column in the South African Students Organisation newsletter, highlighting how ‘whites [were] doing all the talking and blacks the listening’ in the public opposition discourse. The accession of the ANC to power in 1994 brought a much more complicated reality into play than had existed during the apartheid era, but liberal journalists generally stuck in their tracks. And persisted in asserting their property aforementioned. Never challenged during the Mandela era, but uncomfortably thereafter. Like Mbeki’s, Lumumba’s and Nkrumah’s, what was so intolerable about Biko’s voice was that, even though he personally held no office of state and wasn’t busy with any armed insurrection, it was defiantly and threateningly intellectually independent. So they silenced it. With boots to the head. As they try to silence Mbeki. With vicious pens. Drawing crude, shallow caricatures – thoroughly detailed by sociologist Lucky Mathebe in his survey and analysis of media representations of Mbeki by the white press, Bound by tradition: The world of Thabo Mbeki.

Mbeki’s all but open rejection of the Americans’ infectious AIDS model rocks South African liberalism’s broader paradigm and threatens its ideological hegemony because more than just engrafted onto post-1994 white liberal ideology as a subsidiary issue, AIDS has become integral to it, and not merely integral, central: a kind of secular pious cult, a mania of the sort that has visited Europeans regularly over the centuries, catalogued in 1841 by Charles Mackay in Extraordinary Popular Delusions and the Madness of Crowds – perhaps because many of AIDS’s ugly presuppositions about black people quietly sit well with liberal whites, mostly descended from colonial stock. Guys like Edwin Cameron. Who articulate them shamelessly. The upshot of it is that in its attacks on Mbeki, the Mail&Guardian comes over like the Graham’s Town Journal in the 19th century, serving the English settler riff-raff in the Eastern Cape (later to become liberal in their prosperity, since principle flows from power, and power flows from property) – mean, low, pusillanimous, heartless, and constantly calling for the military punishment of the Xhosa people. (Round after round of brutal ethnic cleansing followed.)

The opacity to the liberal media of Mbeki’s reservations about their obsessional AIDS panic was illustrated by a cover-page article in Newsweek on 4 March 2002. Not a single line in the 2700-word piece sought to weigh the intrinsic merits of Mbeki’s aberrant thinking about the subject. The whole story was devoted instead to a nauseatingly American pop-psychological analysis, arguing a multilayered case that he has mental problems – what else can explain his reluctance to believe? The piece was entitled South Africa’s Lonely Rebel: Thabo Mbeki is feuding with allies, fighting his cabinet and losing international friends. How his dissent on AIDS is unraveling his presidency. It’s difficult to imagine that such low punching would have passed in relation to any European head of state. Tom Masland who wrote it hadn’t encountered Schopenhauer, apparently: ‘To be alone is the fate of all great minds – a fate deplored at times, but still always chosen as the less grievous of two evils.’ Masland had been perplexed from the start: On 17 April 2000 he’d written that Mbeki ‘is Washington’s favourite African leader – urbane and brainy, the West’s best hope for a continent mired in poverty, corruption and disease’. (Unlike the US – the bits on TV.) All the more puzzling therefore, why concerning AIDS, he should be Flirting with strange ideas – as he called his piece.

But in his article for Newsweek two years later, Masland really went to town:

The president is in big trouble over his obstinate refusal to acknowledge the gravity of the AIDS crisis in the world’s worst-hit country. [Makgoba admitted at the second meeting of the AIDS Panel that there are no real statistics at all.] … The rand has crashed and neighboring Zimbabwe is headed off a cliff. None of this compares to the damage he’s done himself by questioning the medical basis of AIDS. [Medical theories in the secular age being as off-limits to lay inquiry as religious dogma. We still need something fervently to believe in.] Mbeki thinks anti-retroviral drugs are poison, and claims privately to have saved friends by getting them off treatment. … comedians are flaying the president alive. ‘Not everyone regards you as a pretentious, arrogant, paranoid, heartless, ruthless Stalinist,’ wrote Evita Bezuidenhout, the alter ego of gay satirist Pieter-Dirk Uys, in a letter to the Cape Times. [Not everyone regards you as a ridiculous, invective-shrieking sugar mama, Pieter.] … Why is Mbeki willing to wreck his presidency over AIDS? … A more likely explanation lies in Mbeki’s life story. [‘Psychobabble personal history.’] He comes by his paranoia honestly. [‘Internal ANC intrigues.’ Made him mentally ill.] Mbeki also is used to feeling like the smartest person in the room. [‘Distinguished family background.’] The ANC had become his true family. The South African writer Mark Gevisser, Mbeki’s brilliant [?] biographer, observes that the elder Mbeki passed on a kind of ‘martial stoicism’ in the service of the anti-apartheid cause to his eldest son. Gevisser calls this ‘a family that sublimated all its emotions into the struggle’. [I call Gevisser’s silly summation the reduction of an extraordinary life to fit a cosseted white suburban consciousness.] … ‘To understand Thabo Mbeki, one needs to recognize that he still bears scars from these battles and that he has developed, as a result, a carapace of caution, even ... of paranoia,’ writes Gevisser.

Mbeki would answer that it’s a lot less complicated than that. To understand his AIDS scepticism, you need only ponder the obvious anomalies of the infectious AIDS model, and then perhaps look over the challenges of the Perth Group. And recall his expulsion from Lovedale College as a high school student. Bucking against the system as a youth. Not just the system of missionary schools, but against the system of European ideas and values propagated there, negating and seeking to supplant indigenous ones.

I once met a white English-speaking magistrate in a Transkei country town with something of a reputation for lording it. I’d been surprised to hear that although he’d held his post for twenty years he’d never learned to speak Xhosa, so I probed lightly: ‘How do you get on with the Xhosa people?’ His answer was: ‘You have to understand the Xhosa. You have to know him better than he knows himself.’ Of course you could have knocked me down with a feather – talking like Gevisser, claiming ‘to understand Thabo Mbeki’. Better than he knows himself.

Newsweek slashed away:

Still he saw threats. And there were early warnings that he might not be entirely rational about them. [‘Mbeki was startled by the “red mercury” story’ – as all the journalists were; ‘he was hopeful about a locally developed AIDS drug’ – backed by medical academics at the University of Pretoria.]. … Trolling the Web on his laptop, he somehow connected with the tiny scientific minority that claims AIDS is a gigantic medical hoax [In fact it was Debating AZT that did it, followed by a wad of dissident critiques given to him by former Star journalist Anita Allen.] … a new, closer relationship with Western intelligence agencies opened his eyes to their bag of tricks for manipulating public opinion. In a bizarre address last year to the ANC’s parliamentary caucus, the president claimed that the CIA and big pharmaceutical companies were planting stories aimed at destroying him because he had thwarted plans to foist expensive AIDS drugs on the country. [The Mail&Guardian story about this turned out to be a mischievous fabrication by disgruntled MPs.] … For all his proven survival skills, Mbeki now is without a tool to free himself. [He won’t recant.] … He loathes the modern political arts of image and spin. [The Americans consider his integrity and frankness personal deficits.] And yet, as former American U.N.Ambassador Richard Holbrooke [and currently an international AIDS missionary] said before the Mandela awards ceremony, ‘A leader’s job is to lead.’ [The American way, doing the bidding of one’s corporate backers.] Mbeki may be apartheid’s ultimate victim: a bright, cultivated, intellectually curious man turned inward [everything Bush isn’t], driven by his unique history into a job for which he is not suited. ‘Thabo belongs to himself,’ said a woman who has known the president since he first came to Johannesburg. She added: ‘He doesn’t have the personality to be a president.’ In a 1999 NEWSWEEK interview, Mbeki mused wistfully about how he might someday teach at a university. On campus, chasing a red-herring AIDS theory would have done him little harm. The tragedy is that he couldn’t follow his own star.

And all because he doesn’t buy the Yankee line on AIDS.

The Mail&Guardian naturally repeated Newsweek’s slick imprecations with the whooping joy of black South Africa on learning that Tsafendas had stabbed Verwoerd. In its immediate response, on the other hand, the ANC rightly described the article as an attempt at ‘character assassination’, with Newsweek joining the ‘“omnipotent apparatus”’, in letting loose ‘missiles of attack’ against ‘Africans who think independently’. The quotation marks around the former expression, and the next – ‘President Mbeki will not be sidetracked from dealing with real issues, like poverty affecting our country by submitting to “third-grade movie scripts fit only for the dustbin of history”’ – suggested that Mbeki had rendered his own verdict on Masland’s sad portrait of him, and about the phoney South African AIDS crisis alleged by the report. And they revealed his appreciation of the Orwellian power of the liberal white media, functioning pre-eminently as a reactionary agency, and flexing its brute muscle against him for pouring cold water on the hysterical but profitable American superstitions.

In their letter to the British Medical Journal on 1 March 2003, Fassin and Schneider had a further go at explaining Mbeki’s heresy in terms of a benevolent pop-psychological analysis of the understandably mentally affected black man. Some delicious giblets, in earnest formal language:

A political economy of HIV/AIDS falls short, however, of explaining the suspicion in South Africa of science and orthodoxy – a suspicion that is widespread and not confined to the president and his advisers. … In ... the virus versus poverty controversy from 2000, two closely linked features appear. The first is the racialisation of the issues, with the government accusing its opponents, whether activists or politicians, of racism. The second is the theme of conspiracy against Africans … In South Africa racialisation and conspiracy are rooted in history, and the realm of public health is not exempt from their effects. … An understandable defiance is thus an important element of what is usually termed denial. … It is difficult for anybody – even a state leader – to fully comprehend the magnitude of the epidemic and its demographic consequences, such as the loss of 20 years of life expectancy within two decades. Also, it is seen as morally unacceptable that a plague can affect the population so massively when democracy has at last been achieved – in what seems a remorseless prolongation of the suffering of the weakest people in society. … Clarifying the objective and subjective dimensions of the reality of the epidemic can help people understand otherwise incomprehensible issues … understanding people’s suspicion and denial is vital in the management of the HIV epidemic. An effective politics of AIDS entails a ‘politics of recognition’ … But a better understanding rooted in history does not mean indulgence of errors or acceptance of conservatism. … In South Africa, AIDS is not just a tragic and dramatic phenomenon: through the mobilisation of activists as well as lay people and through the fight for social justice it has also come to be a resource for democracy.

It has also become a resource for political kitsch. Like Fassin and Schneider’s. An armory from which to draw conceptual weapons of ideological warfare. For keeping blacks in their place.

CHAPTER

As if we weren’t already sick to death of all these gay white guys leading the charge in the fight against black AIDS, the Daily Dispatch gave us a few more on 18 July 2002. Ivan Toms, one-time apartheid draft resister, now Cape Town’s director of health, announced the day before that the city had committed R12.5 million to the fight for the coming financial year, and that it led the rest of the country in the administration of nevirapine and other AIDS drugs for the ‘prevention of mother to child transmission of HIV’: ‘According to our latest statistic, a total of 18 209 pregnant women throughout the Cape Town metropole benefited from the prevention programme in nine months. The Western Cape and Cape Town health departments were the first in the country to institute a prevention of mother-to-child transmission programme in 1999 in the Khayelitsha district.’ Giving AZT to pregnant black women – former Western Cape Health MEC Nick Koornhof told the London Independent proudly on 4 September 2000. For two years already, the only province doing so at the time, he said .

Toms doesn’t have the same objection to being impressed into service of the drug industry, we note. To deliver its toxic drugs to blacks. Preferring his oppressive ideologies more subtle, more nuanced, to sit better with his liberal turn of mind. He was quoted further by the Mail&Guardian the next day: ‘We couldn’t stand by and do nothing while the AIDS timebomb ticked away. In Cape Town alone, an estimated 45 people are being infected every day – this is one person every 30 minutes.’ All those natives tupping like its going out of fashion.

At an AIDS briefing conference held at Western Cape Premier Martinus van Schalkwyk’s official residence on 18 September 2002, provincial deputy health director Fareed Abdullah promised him that the province’s progressive treatment policy would ensure that ‘In two years it will be a rare event for a baby to be born with HIV in Western Cape. We could call it the elimination of paediatric HIV/AIDS. We are well on target for this. More than eighty per cent of pregnant women are agreeing to be tested for HIV – the highest rate on the continent.’ Abdullah was no doubt banking on the truism that the public is famously forgiving of politicians’ broken promises and pleasing lies. Unless he’d actually swallowed the TAC line.

On the same day as Toms’s announcement, the city’s auxiliary Catholic bishop, Reginald Cawcutt, said he had resigned following a complaint by conservative Catholic groups in the US that he’d featured on a website for gay clergymen with some raunchy content, run by a priest they’d already got fired. During his ‘40 years of what I believed to have been service to God’ he’d got into ‘AIDS work’ before it became cool, and had helped set up the AIDS Office of the South African Bishops’ Conference. So it was all very unfortunate, he thought in his statement to the Cape Town archdiocese, especially since he’d ‘consistently promoted celibacy’ to his fellow gay clergy. Being God’s way. For self-confessed mortal sinners especially. Since, according to the Levite priests anyway, God told us in no uncertain terms in Leviticus 20:13, ‘If a man lie with a man as with a woman, both of them have committed an abomination: they shall surely be put to death; their blood shall be upon them.’ From pelting with stones. Has the Big Guy changed his mind? And granted a general reprieve? Or commuted the sentence? I hadn’t heard.

Another abominable bloke prominent in AIDS propagandising in South Africa is veteran AIDS educator and consultant David Patient, who’s been HIV-positive in perfect health for 20 years, he says, except for the time he took AZT, which made him very sick and nearly killed him – so he complained in The AZT Debate screened on Carte Blanche on 7 November 1999, reciting all the standard deadly side effects. And repeating this a month later on in The Truth on AZT, broadcast on 12 December 1999: ‘In hindsight, when I look back at the fact that when I went off the drug I suspect that it did actually save my life because everybody else who was on the drug has subsequently died.’ So why after two decades he should continue billing himself as an AIDS survivor, instead of turning his back on the whole shebang is something for a psychiatrist to explain. Like Schmidt. Or more prosaically his accountant, since he does very well pulling condoms onto dildos at public presentations, to educate us how to do it. To protect ourselves against the sex-virus. That doesn’t seem to be doing him any harm. Although he knows from personal experience that AIDS drugs are deadly, he doesn’t keep his own counsel, telling You in mid-December 2002: ‘What I suggest to those living with HIV is to go on medication as and when your doctor advises you.’

When in a post to AF-AIDS four months later he proposed, ‘Can we not keep applying pressure to Government for access to treatment while at the same time teaching [nutrition etc]?’, I asked him about the tension between his personal knowledge of the harm AZT does, and his public position on the drug. He explained quite frankly that he’d built up a nice AIDS consultancy operation in fourteen countries including ours, Mozambique, Kenya, Senegal and India, in all of which he was ‘rolling out’ his Vida Positiva programme,

in essence ... in its diverse activities, trainings, forums, and discussions ... promoting a process (versus short-term intervention) of behavioural and social change ... with the help of the BBC/CBS/SCB and 14 donors, like DFID, Danida, Ireland Aid, USAID. … We support any and all medical interventions aimed at alleviating the suffering of those affected and infected by HIV, within an ethical and medically controlled framework. This includes Antiretroviral therapy (nevirapine for MTC transmission, and combination therapy for those infected).

He said he’d grown ‘tired of being one of a handful of people, swimming up-stream’ against AIDS drugs. But more to the point:

I am very aware of the side effects (more so than most people), and the numerous drawbacks around ARTs, however in order to achieve my objectives and based on sound knowledge and experience, I have opted not to be anti-ARTs as it does not serve the ‘greater good’ and the work I am doing. And what we are doing is working and it is ONLY because I backed down on my hard line approach to ARTs, that I was given the platform to work at a global level. Call it a compromise if you will, however my agenda is very clear. … It was only when I formed (forced) partnerships with the likes of MSF and the Clinton Foundation and the World Bank, that we were able to get into these countries and do what we do, which is nothing to do with medical treatment, per se, however we do advise on the nutritional components when a person is on ARTs. … Reality is that so few people, in the countries I work in, ever come forward for treatment, that I figured that I might as well say, ‘Yes, ARTs are part of the solution, despite their side effects, and we need to also address the issues of a) compelling future, b) behaviour change, c) nutrition, d) food security, etc, etc’. … Am I selling out? I don’t think so.

We do.

Patient’s lover is psychologist Neil Orr, with whom, Patient said in You, he wrote Positive Health. (Patient’s name doesn’t figure on the title page, but he gets an authorship credit in an opening ‘Message from Mr Peter Doyle’.) The title of the booklet suggests its contents: a guide setting out dos and don’ts for ‘those infected with HIV, and those affected by it’. A copy was given to me in December 2002 by two AIDS counsellors working in the Maluti district near the Lesotho border, who told me that it’s distributed by their colleagues countrywide. When they asked me what I thought of it the following day, I admitted that I’d burst out laughing. Reading priceless titbits of advice such as: ‘The semen (sexual fluid) of a man contains high levels of the important substance of ZINC. A man who has frequent sex should eat PUMPKIN SEEDS (a tablespoon), or take 15 mg zinc pill after each time he has sex to place this substance back into his body.’ It’s an unbelievably stupid little book, full of mistakes – ‘HIV is an abbreviation for Human Immune Virus. A virus is a kind of germ. … AZT Medicine: Helps your body for a while. Then it can become poisonous to your body’ – and arbitrary assertions, with an unwitting gag on about every page:

Most long-term survivors have at some stage had a conversation with the virus in their body. … 1 Close your eyes and pretend that you can see the virus in front of you. … 2 Tell it how you feel about it being in your body. Listen to what it says in reply. 3 Make an agreement with the virus so that you could both respect each other, within certain limits that are acceptable to you. 4 Have this discussion with the virus as often as you feel it is necessary.

But as ever, the basic message on the first page is terrifying: ‘Presently, about five people out of a hundred HIV-positive people do not get ill from AIDS, even 15 to 20 years after infection. … If you take care of yourself, you may be one of those who stays healthy for many years.’ But your chances are small, as the numbers alleged unmistakeably imply. For a book dished out mostly to the black poor, the grossly insensitive Eurocentric spin at all levels is staggering – from the graphic illustrations to the marvellous specialist dietary advice: ‘Take selenium every day. … It is worth ordering selenium from your chemist.’ Best though was the psychologist-turned-dietician’s ‘eating plan’:

The eating plan is the minimum amount of different kinds of foods that an HIV-positive adult need to eat on a daily basis. … You are encouraged to eat more than the amounts listed. … EAT EACH DAY *Protein TWO of any of the following: A large piece of meat, chicken or fish (100g) or Two large eggs or One cup of beans or peas or lentils (plus one tablespoon of uncooked sunflower oil) *Fruit THREE whole fruits (or) one-and-a-half cups fruit (Can include canned fruit in natural juices – not syrup) *Vegetables One-and-a-half cups of vegetables (Can include one cup of salad) *Grains and nuts FIVE of any of the following: One slice of bread or A small bread roll or Half a bun or Half a cup of pasta, rice sorghum, maize or Three quarter cup of cereal (cooked or ready made) or One tablespoon of sesame, sunflower or pumpkin seed (not peanuts) *Dairy products TWO of any of the following: One cup of milk or Three-quarter cup of yoghurt or Big piece of cheese (100g).’ Try that in a destitute rural ghetto. Try following the thoughtful ‘EXAMPLE OF A DAILY MENU: BREAKFAST Breakfast cereal – one cup Pronutro® One cup milk (eg., with cereal) Two slices toast One glass of fruit juice (or two fruits) LUNCH Two boiled eggs Two (preferably four) raw carrots A small bread roll One fruit – guava, orange, apple, etc DINNER A small salad of lettuce, tomato, onion (half cup) Two portions of vegetables (one cup together) One baked potato or sweet potato or ndumbi [sic], or a half cup of rice One cup of cooked beans, with one tablespoon sunflower all (or one piece of meat/chicken/fish).

Remember through to ‘AVOID EATING LEFT OVER FOOD Food that has been cooked and then left to cool down can gather many germs’.

It all leaves one with the clear impression that apart from being a wanker, a necessary requirement for a successful career in ‘AIDS education’ is to be mildly mentally retarded. At least never to have travelled off a tar road in South Africa. But top ‘AIDS expert’, Ashraf Grimwood, yet another South African Indian thriving in the AIDS business, commended Positive Health in a foreword: ‘What Positive Health successfully achieves is to provide a self-help guide toward hope and harmony. … [It has] borrowed extensively from the ancient art of healing called Ayurveda.’ In prescribing an American diet? And so, sickeningly, he goes on. Metropolitan Insurance CEO Peter Doyle speaks alike: ‘The book offers all sorts of useful information, from easy ways of getting your daily dose of selenium and zinc without breaking the bank, to spending a few minutes a day getting your mind and spirit in tune.’ Perhaps as you prepare the day’s menu with all the Woolworths food you visualise stacked against the wall in your empty mud and straw hut. Next to the bright little plastic kitchen scale on the cow dung floor. Bought from Boardmans in the chrome and marble shopping mall. Or plan your ‘swim in a pool to cool down on a hot day’. Or decide to ‘save money for a holiday at the sea’.

Shaun Mellors, a white gay founder member of the National Association of People Living with AIDS, complained to the Sunday Independent on 29 September 2002 that the Canadians had refused him a two-year visa to take up a contract job in Toronto as HIV vaccine and biocide coordinator for the International Council of AIDS Service Organisations. He was being ‘unfairly targeted’, he said, because his CD4 cell count was normal and his ‘viral load’ undetectable. Even though he’d been HIV-positive for fifteen years. Some virus! It was ‘nothing short of a nightmare … legalised AIDS apartheid’, he quivered. Talking like Cameron – with whom he’d previously collaborated at the Aids Consortium at the University of the Witwatersrand. Travelling the world, ‘a delegate to several world conferences on the topic of Aids’. Sure beats working for a living. In the same camp as Peter Busse, gay founding director of NAPWA – HIV-positive since 1985, AIDS drug-free and, predictably, like Patient, healthy.

John Kane-Berman, president of the Institute of Race Relations, and part of the gay white set prominent in liberal politics in Johannesburg, argued in Business Day on 22 April 2003 that we Make AIDS an issue at general elections. The ‘large percentage increases in budgetary provisions for fighting AIDS’ have been

undermined by Health Minister Manto Tshabalala-Msimang’s continuing hostility to antiretrovirals and sympathy for AIDS dissidents. … Moreover, every time government proclaims that its policy is based on the ‘premise’ that HIV causes AIDS, it signals its doubts about this link, as if to say: ‘We don’t actually believe this but for argument’s sake are prepared to concede the point.’ The country faces a human catastrophe requiring public education in clear language, but government takes refuge in hypotheses about ‘premises’ that belong more to academic debate. Flirtation with dissident ideas may have begun as a presidential frolic. It has now become the collective responsibility of the ruling party both inside and outside parliament. … A general election has to be held sometime between June and September next year and the mishandling of AIDS can, and should, be turned into an election issue. … Opposition parties in SA, along with institutions in civil society, working together or separately, can make use of the election to raise the price to the ruling party of the government’s continued mishandling of AIDS. … The object of turning its failure into an election issue is to mobilise voters to force it to do so. What a glorious victory for both humanity and democracy that would be!

If only these gents could try our some fresh ideas.

Gay AIDS activist David Pasquarelli (recently late) of ACT UP’s dissident San Francisco chapter pithily accounted for the appeal of the AIDS paradigm to such guys in an interview by Mark Conlan in the April 2002 issue of the radical gay journal, Zenger’s, ‘a monthly newsmagazine, providing a viable alternative to the corporate domination of gay and lesbian publications’. Asked, ‘If the HIV/AIDS model is a propaganda weapon aimed at the Gay community, why is there such near-total Gay community support for it?’, he pointed out the massive ‘financial corruption [of] AIDS organizations, and virtually all Gay organizations’, the incessant media bombardment of the public with the HIV-causes-AIDS line, and, most tellingly:

Third and last, I’m sorry to say, is that the AIDS model, the HIV model, really fits in to the victimization we have all been subjected to as Gay men and Lesbians. Since we’ve been born we’ve been told that we need to be ashamed. We’ve been told that we need to be lonely, and that we’re sick, depraved individuals and if we don’t change our ways, we’re going to die a terrible, lonely death because of our ‘sin’. That’s just been transferred onto the HIV/AIDS model. It’s only now that some people are beginning to get out from under it and say, ‘If we’re ever going to have self-esteem, if we’re ever going to have sexual freedom, then we’re going to have to relinquish this HIV/AIDS lie.’ And I think it’s incumbent upon all young homosexuals to do that: to reject it and resist it. Because ultimately I think it’s going to lead to our community’s annihilation.

The implication of Pasquarelli’s analysis is that in openly living out their chosen lives gay men have successfully resisted internalising the Judeo-Christian canon that homosexual intimacy is immoral – and will be punished with death – they have fallen victim to it in its re-expression as a Western medical doctrine. And have died in droves from despair and poisoning, as they used to do from being shunned and stoned to death.

The most thorough psychological exploration, however, of why gay men are drawn to the AIDS gestalt, are so animated by its tenets, are so eager to become its choirboys and sally out to persecute nonconformists, was charted by Casper Schmidt, himself gay, in his brilliant The Group-Fantasy Origins of AIDS treatise – way back in 1984, just a few months after all the excitement about the idea of a new virus began. In The AIDS Cult (Asklepsios, 1997), a collation of essays (including Schmidt’s), co-edited with Ian Young, John Lauritsen (like Young, also gay) praises Schmidt’s seminal head-map: ‘Every time I re-read it I am impressed by the grand depiction of historical circumstances, the wealth of anthropological and psychological analogies, the keen insights, and the unique combination of irony and compassion.’ The sweep and the depth of Schmidt’s essay make it impossible to synopsize with justice, but in the next few paragraphs I’ll highlight a few of its salient points.

Schmidt tables a rich heap of evidence to support his hypothesis that

AIDS is a typical example of epidemic hysteria [with] an unconscious group delusion ... at its core, which can be called the group-fantasy of scapegoating, according to which the poison feelings of the entire group are injected into containers who are called scapegoats and whose destruction rids the group of these bad feelings and insures its purification of guilt and sinfulness; … that the proximal and distal causes of the tensions giving rise to the epidemic can be found in the group psychology of the United States and (to a lesser extent, inasmuch as [it follows] the cultural lead of America) the West since World War II; that among the more important distal causes are the effects of the following drastic changes in cultural ethos: the development of nuclear arsenals with a potential for obliterating the world, and the changes this has forced in the psychology of warfare; the introduction of birth control and the invention of ‘recreational sex’; positive changes in the mental health of American women; that the proximal cause can be found in a vast society-wide conservative swing ... in public opinion since 1977, culminating in the Reagan years… ; that the combination of these unconscious group tensions brought about a subtle and sophisticated ... sacrificial witch hunt in which the participants were the Moral Majority and an assortment of other conservative groups (as hunters) and the nation’s drug addicts and homosexuals (as hunted); that both of these subgroups are acting out group-sanctioned and group-delegated rôles, which acting-out takes place largely outside of awareness; that these attacks resulted in an epidemic of depression based mostly on shame; … that most of the members of this group (the U.S.A.) are in regression vis-à-vis this phenomenon, a trance state which is noticeable in a certain suspension of logic in the lay press and in the medical literature.

Citing numerous historical precedents, modern and ancient, in the West and in the Orient, Schmidt makes the crucial point that epidemic hysteria is especially prone to occur in group members of lower status or those in positions of relative powerlessness. Also that ‘these epidemics follow the divisions of class, ethnic groups and other cultural differences’. He mentions Sirois’s theory that such

epidemics represent a contagious type of psychopathology, where the contagion is ‘a wish whose vector is a fantasy that circulates in a reservoir of susceptible persons.’ … An epidemic of hysteria develops ... due to three factors: (a) the group regression; (b) identification with the index case; and (c) the unconscious nature of the underlying conflicts or fantasies. ‘This last aspect [Sirois explains] is a crucial factor in fostering the manifestation of the conflict through displaced, symbolic or alternate channels.’ … In time all of these epidemics come to be organised around – and retrospectively explained by – a core fantasy, which may be called the fantasy of a poison threat. It belongs to the psychology of belief systems, and we have to look to the dynamics of delusions for an explanation. Just as with individuals, the delusions shared by groups are reparative mechanisms: attempts at making sense out of inchoate or incoherent preverbal or affective experiences, or out of a poorly understood reality. … once the delusion is formed ... the person experiences a sudden and remarkable sense of relief … The confusion subsides. Especially in hypochondriacal and melancholic delusions, the formation of the delusion and its psychosomatic expression permits massive relief from psychotic anxieties.

That’s why Cameron and Achmat are so happily confident in their scene. As cognitively adamant as they are emotionally regressive – like evangelists insisting joyously, ‘Jesus loves you’. And getting aggressively het up when you smirk.

Schmidt documents the rise of the New Right in the seventies, functioning as a sadistic, freedom- and pleasure-averse cultural super-ego, its leaders haranguing homosexuals and illicit drug users during the intense and sustained moral backlash to the permissiveness of the sixties – encapsulated in the bumper sticker: ‘Kill a queer for Christ’. ‘It was as if everyone had become involved in a pleasurable picnic since the 60s, and all of a sudden simultaneously started waking up from the trance, shamefacedly scrambling for their clothes and hurrying home. This was the conservative clampdown.’

I suggest that another ingredient in the brew was that apart from visibly ‘coming out of the closet’, gay men had also started organising politically, and making challenging demands against discrimination – and, even worse, for equal rights. The hounding of minorities perceived to be the most conspicuous protagonists of the hedonistic trends that Middle America turned its face against, and the intense, illiberal cultural atmosphere of the day, ‘created a wave of reactive depression’, Schmidt explains,

caused by the repression of the retaliatory fury that the shamed person feels. Three group-fantasies of a poison threat were evolved along the way, which in turn confirmed the delusional thinking and accelerated the epidemic. In fantasy, AIDS was thought to be caused by (a) promiscuity or, in the case of drug addicts, the abuse of drugs (fantasy of moral corruption and decay); (b) viruses contained in blood and blood products (fantasy of poison blood) and (c) viruses contained in bodily fluids (fantasy of poison sperm). These fantasies dictated the epidemic aims: (a) to reduce sexual activity or drug use to the point of abstinence or celibacy … (b) to stop the exchange of bodily fluids ... and (c) to avoid the giving of or receiving of blood.

Schmidt explained this in an interview by Young (included in The AIDS Cult): ‘The viral etiology of AIDS ... should be seen as part of the unconscious group delusion of a poison threat.’

In his Group-Fantasy piece Schmidt found a clue to the error of the viral-AIDS model, beyond the fact that virologists had hitherto always associated the appearance of retroviruses with proliferating and not dying cells. What caught his eye was ‘the immoderate enthusiasm’ that Gallo’s HIV claim generated, psychologically vindicating all the aforesaid fantasies, and clothing them with the get-up of scientific certainty. And referring to a case reported by Mausner and Gezon in the American Journal of Epidemiology in 1967, Schmidt demonstrates that scientists are no less susceptible than anyone else to delusional ideation: ‘So strongly can a fantasy press upon the minds of scientists and laymen alike that evidence is frequently misinterpreted in order to fit in with comfortable notions, or, as was pathetically and poignantly done in the case of a phantom epidemic of gonorrhea in a primary school, the wished-for evidence can even be hallucinated.’

On the other hand, there’s another kind of poison to which gay, unconscious victim-players like Cameron and Achmat are powerfully drawn, and conversely it’s a very real one: Lauritsen tells in his essay, Psychological and Toxicological Causes of ‘AIDS’, included in The AIDS Cult, how one evening as he and Schmidt were leaving a meeting of ACT UP’s Treatment and Data Committee in New York, the latter told him that he’d finally figured out the psychology of gay AIDS activists who lobby for AZT: ‘They know it’s poison; they know it’s poison and they want it because it’s poison!’ Lauritsen suggests why:

Casper Schmidt’s depiction of gay men as ‘willing sacrificial victims’ is one I have observed in person more than once, an uncanny experience. An HIV-positive man in his thirties will be speaking to me. He seems to grasp my arguments, and then suddenly a meek and stubborn fatalism takes over – he dons the Mantle of AIDS – his aura becomes fey, bleak, withdrawn. Communication is over, and anger will flare up at any attempt to awaken him from his trance. He will not be dissuaded from proceeding with his cohort to the sacrificial altar – which in practical terms means taking the latest [AZT-based] drug ‘cocktail’ being touted by the drug establishment.

For the reasons Pasquarelli suggested.

But possibly also for one proposed by Christine Maggiore, founder of the Los Angeles-based dissident group, Alive and Well: AIDS affords an exit. In a private note she wrote:

This month [January 2003] marks the two-year anniversary of my friend Kim’s passing. I met him in 1993 and he’d just gotten an AIDS diagnosis based on his T cell count (which never went over 200), but he’d never been sick. In the seven years I knew Kim, his only complaints were things like a rash or a cold which would clear up in a normal manner. Then in early 2000, a very dear friend of his died and Kim went into a serious depression. He felt guilty about the money this man left him, and bad that he hadn’t tried harder to help him. He started having panic attacks that he now was dying. At the same time, he lost his job, he was lonely (without a relationship in many years), couldn’t sleep, and started lamenting the loss of his ‘youthful beauty.’ I got a sense he was doing what I’ve seen many gay men over age 45 do – check out of life through the AIDS system. To make a long, tragic story short, he started taking all sorts of mood drugs, quit eating regularly, and lost so much weight and life energy that his family intervened by putting him an AIDS hospice even though the hospice confirmed he had no AIDS disease. After about two months of laying about on pain pills and mood regulators, refusing to eat, he took the AIDS drugs and died of pneumonia in January of 2001.

In the second part of The AIDS Debate on the front page of the Boston Dig on 14 May 2003, Liam Scheff asked Darren Main, an author, holistic health practitioner and AIDS educator, who has AIDS by definition – HIV-positive and low CD4 cell count – even though he’s perfectly well: ‘According to Dr. Amy Justice of the University of Pittsburgh, gay men are dying taking AIDS drugs. They’re taking them even though HIV theory is highly debatable, and more supportive treatment options exist. Why are gay men buying into this treatment option, if it causes them so much pain and suffering?’ Main ventured this explanation:

If you look at the history of the gay movement, you’ll find that HIV and AIDS have, ironically, really brought people together. In the early days, gay liberation was a bunch of guys whose main interaction was partying. When people started getting sick, these guys, who’d been rejected by mainstream society, had to support each other. They took care of each other and developed a real community. They supported each other in a way that they’d never been supported by their own families or society. HIV and AIDS became the glue that kept people together. We’ve got a lot invested in AIDS – billions of dollars, AIDS drives, thousands of volunteer hours at community centers, full-time jobs and organizations invested in the notion that HIV is killing gay men. It’s very hard for people to let go of something they’ve put their whole lives into – their hearts, their minds and their beliefs. It’s very difficult. It would be nice if gay men felt that they could find validation, support and community outside of HIV and AIDS. But I think that too many people are too attached to have that happen soon. Which is unfortunate, because that attachment is killing a lot of people.

I’ve even read it suggested (I can’t recall by whom) that another element of the particular attractiveness of the HIV model of AIDS to gay men is that HIV gives them something to transmit, a surrogate for the genes that they’re not passing on, unlike us regular breeders. Indeed, the eroticization of HIV by some gay men has emerged as a phenomenon in the rising ‘bare-backing’ movement – condomless sex between gay men in the knowledge that one is HIV-positive. For a heightened emotional reward.

Maggiore illustrates the immensely powerful psychological pull of AIDS mythology in her summation of an interview she conducted of a female friend for the documentary film, The Other Side of AIDS:

She talks about the euphoria of being told she would die of AIDS and how hard it was to then realize that it wasn’t so. She said she really didn’t want to come back to life. It was hard living with the guilt and sadness she felt having a daughter permanently damaged by the AZT she took during pregnancy. Two years after the interview, she died of untreated hepatitis. … One woman I know from South Africa felt so isolated and ashamed by her diagnosis, it was like she shut down slowly. Her death wasn’t even from any AIDS disease.

In May 2003, having spotted a copy of Debating AZT that I’d lent to her colleague, a Sotho court interpreter confided in me that she was HIV-positive. She was physically well but very forlorn. I did my best to exorcise the hex, but made no headway. In September I was told she was dead.

Aside from the queer spin of Cameron’s head cogs, elucidated by fellow gays such as Pasquarelli and Schmidt, there’s a further rather more prosaic reason why white gays (and non-black gays like Achmat, of oriental slave stock) queue up to enlist in what they call ‘the fight against AIDS’. In their collection of essays, Defiant Desire: Gay and Lesbian Lives in South Africa (Routledge, 1995), Cameron and Gevisser identified its special political utility: ‘[In the US and Western Europe] there was an appropriate gay political movement in place to lead the fight against Aids’ – but not in South Africa, so the value of ‘the fight against Aids’, they astutely calculated, was that it ‘could actually be used as a mobilising tool to buttress and strengthen the gay movement itself’. So when Cameron talks AIDS, it’s worth keeping in mind his principle business. Achmat’s too, as a former director of the National Coalition for Gay and Lesbian Equality.

Also Gevisser’s, when he writes about Mbeki and impugns his sanity on account of his sceptical position on AIDS – antithetical to the biographer’s closet political agenda. Closest to his heart: the promotion of his human rights as a gay man. An agenda that obviously disqualifies him from giving Mbeki a fair shake in his biography (a judge with such overt bias in a court case would be obliged to recuse himself) since by reconceptualising AIDS, not as the price of carnal sin, but as the consequence of economic deprivation and marginalisation, and also toxic drug poisoning, Mbeki runs his self-appointed biographer’s main campaign off the road. For by not taking their sex-plague seriously, Mbeki necessarily poses a tactical obstruction to the promotion of gay rights. Because as guys like Cameron, Achmat and Gevisser have correctly figured, everyone has ears for gays with AIDS, but no one seems to be interested in the demands of gays without. Perhaps because AIDS has made being gay less generally revolting – just as long as you’ve picked up the fatal disease for your immorality. After all, the conventional view has long been that being gay is sick in itself. AIDS has made being gay pitiable in place of damnable. We accept you guys now. Now that you have been stricken with the sort of plague that Jehovah has always visited on the wicked. Sympathy for the unfortunate comes easily. Unfortunates like gays with AIDS.

I propose that the African AIDS construct also provides a home for American psychic disease – offering rest and release. Of all western countries, the US is up and away the most religious in terms of church-attending observance. It is also by far the most sexually promiscuous, as we’ve recently read – a paradox that must generate considerable psychic tension in that country. Which exploded in that psychomimetic inquisition into Monica Lewinsky’s claim that Bill Clinton had tickled her with a cigar. Not complete until the killer pack out to gut him for it had forced him to drop his shorts and show them his one-eyed little guy, the one Lewinsky said she’d devilishly kissed in return. Standing to attention. As the moral hunters stood there with their clipboards, in white coats and rubber gloves, noting the incriminating marks. On the President of the United States of America’s penis. Exposed for study like a lizard on a dissection board. Lifted, examined and discussed by the sex inspectors. Africa, I suggest, is the pail into which the US dumps what Schmidt calls its ‘poison feelings’, its ‘bad feelings’ of ‘guilt and sinfulness’ that spring from the moral-sexual tension created by the distance between the rules and their observance. There’s another element in this too. As Michael Moore’s documentary on gun violence in the US, Bowling for Columbine, makes clear, American society is still riven by racial tension, and a white fear of the marginalized black poor in particular. As the African scapegoat is perceived to be destroyed by the new plague – brought down on itself, let us not forget, by untrammelled black satyriasis, so the thinking goes – the excitement in the newspaper gossip about it rises. The tone of American journalism, even in the most august press, becomes more agitated, its imagery more apocalyptic. Ideas, being more contagious than anything else, catch on. Amongst the culturally receptive. So the English, in South Africa and in England, cleave to them enthusiastically too. Charged, as they are, with the élan of AIDS.

CHAPTER

What of the ready acceptance of AIDS ideology by South African blacks? Some anyway. The African AIDS construct, as we’ve noted, is laden with negative Western stereotypes and assumptions about black people, and in their most private moments in particular. As a belief system, AIDS dovetails seamlessly into colonial and apartheid ideologies – damaging ones against which Biko spoke so forcefully. Drummed in over centuries, and inevitably internalised by many. Which kept apartheid going, since, as Biko put it: ‘The most potent weapon in the hands of the oppressor is the mind of the oppressed.’ After sudden political liberation, those negative self-perceptions needed a place to go. For some, AIDS as a new belief system provides a home for them. In his essay, Black theology and African theology: Soulmates or antagonists?, published in John Parrat’s collection, A Reader in African Christian Theology (SPCK, 1997), former Archbishop Desmond Tutu wrote: ‘The worst crime that can be laid at the door of the white man ... is not our social economic or political exploitation…; no, it is that his policy succeeded in filling us with a self-disgust and a self-hatred. This has been the most violent form of colonialism, our spiritual and mental enslavement.’ The marvel of it then is that when AIDS arrived in South Africa, more or less as apartheid ended, Tutu should have stepped right into the shit he’d just pointed out – this root idea, identified by Mbeki with mocking bluntness, that to the African AIDS construct’s agitated white subscribers, Africans are uniquely ‘promiscuous carriers of germs … human beings of a lower order [and] that our continent is doomed to an inevitable mortal end because of our unconquerable devotion to the sin of lust’.

As we’ve seen, blacks who’ve bought into AIDS are wont to react as violently to challenge as whites. For instance, for many months the Mail&Guardian had a cringing Lord Haw-Haw on board, Sipho Seepe, who seems to hate his own for any move it makes off the farm. Writing stuff like The President has delusions of intellectual grandeur:

Mbeki’s dubious grasp of the classics and his penchant for misquoting or quoting out of context are a source of ridicule in many circles, where he is regarded as an intellectual poseur and a fraud. … Mbeki has become a prisoner of the misconception he has about himself, or that he believes we should have of him. That he is erudite, an intellectual, a philosopher-king. … For his part Mbeki can always count on the intellectual ineptitude and academic handicaps of many of his followers. The thunderous applause from ANC parliamentarians following his infamous declaration that ‘a virus cannot cause a syndrome’, is a case in point. ... trouble comes when ignorance and mediocrity either supplant or pose as knowledge and excellence. Let us free Mbeki about the illusions he has about himself.

Let us pity this damaged servant. His boss-boy’s chest swelling, his abusive shouting getting louder, with every approving look from the master. We fancy the ‘misconception he has about himself’ to be Seepe’s reflexively. His artless spleen spattering across his unreadable columns certainly hasn’t created any illusions in us about his own cognitive acuity. Other than to Barrell apparently, to whom he’s as smart as a whip.

In another white liberal gazette, the Helen Suzman Foundation’s Focus, ‘Professor Sipho Seepe, scientist and newspaper columnist’ spoke more in the September 2001 issue, his puffy-eyed choleric visage glowering like a ‘surly tribesman’, to recall RW Johnson’s imaginatively insulting tag:

Mbeki conflates and confuses his political authority with intellectual authority. He needs to be liberated from this misconception. … In the correspondence between him and Mbeki on HIV/Aids [actually on AZT for rape], Tony Leon exposed a frightening intellectual dishonesty by a head of state [in fact, GlaxoSmithKline’s local CEO confirmed that Leon was wrong and Mbeki right]. … When someone is as stubborn as the president about a field he is not expert in, it makes one wonder how reliable his opinions are in the areas he is supposed to know about – such as economics. … At the same time that white intellectuals were exposing Mbeki’s methods, the president was attacking black intellectuals. In an interview with the Sunday Times Mbeki accused them [Makgoba] of not reading books [a seminal scientific paper actually, A critical analysis of the pharmacology of AZT and its use in AIDS by Papadopulos-Eleopulos et al. – which, unlike Mbeki himself, Makgoba indeed hadn’t read], which I see as a projection of his own inadequacies.

Funny, Sipho, the words right out of my mouth. About yours. Upstairs.

There’s nothing accidental about the white liberal press persistently showcasing such low opinion. Newspapers function in a supply and demand environment, supplying wares just like any other commodity producer in the market economy. The articles they publish are symbolic consumer goods, as distinctly coloured and textured as the designer curtains displayed for sale at the Orange Apple. If they’re unappealing, they don’t move. In the liberal press, kaffir-bashing sells. Best by another. Because we liberals don’t talk quite that way. Openly, ourselves.

CHAPTER

As intriguing as why gays love AIDS, and why white liberals universally do too, along with a sprinkling of blacks with university degrees, is why the HIV-AIDS hypothesis seeded and germinated in medicine, and grew into such a towering tree – so tall, so wide, so deep, so suddenly.

First of all, Western doctors have historically had a curious thing for blood: draining it out of us for two and a half millennia for just about any reason, as if too much of it was bad for us. And keeping it pure and undefiled was very much the fixation of the Reich Doctors medical union led by Gerhard Wagner. Who petitioned Nazi Interior Minister Wilhelm Frick in 1935 to legislate ‘the heaviest punishment’ for sexual conversation between ‘a German woman’ and a Jew, to prevent ‘further Jewish racial poisoning and pollution of German blood’. Leading to the passage of the Nuremburg laws. It was the doctors who lobbied for the extreme ‘quarter-Jew’ definition for exclusion from German citizenry when the Ministry proposed at least two Jewish grandparents, and even Hitler was undecided.

Looking beyond the marvellous pecuniary bounty AIDS has reaped, some further answers to the question may be found in medicine’s receptive sexual ideologies. Martin Fido’s discussion of clitorectomy in The World’s Worst Medical Mistakes (Parragon, 1996) points to religious ideas founding them. According to the chronicles, Christ

had little to say about sex as such, being far more concerned with integrity and benevolence. But the founder-theologian of the world-wide church, St Paul, was deeply concerned about sexual morality. He insisted that ... Christians must adopt rigid Jewish prohibitions of fornication and homosexuality as well as adultery. In language that is often implicitly anti-feminine, St Paul’s writings frequently return to his anxiety that Christians should not contaminate themselves with sex.

But given that the Christian Jesus reportedly taught (Matthew 5:27-29) that it was better to blind yourself than fancy a dame, never mind how much trouble she’d taken to look fanciable, or risk ‘that thy whole body should be cast into hell’, just for thinking, let alone groping, Fido understates the basic antipathy of Christianity’s Jesus himself to the experience of normal human sexual attraction, a sad and pathetic perversion perpetuated by Paul. ‘It is good for a man not to touch a woman’ (Corinthians I, 7:1), he says at the start of his lesson about celibacy as the premier option, sex in marriage as a barely tolerable concession to human weakness, and sex outside it as bringing big trouble, all springing from that opening negative premise. Thomas Aquinas agreed: ‘Virginity alone can make men equal to angels.’ The hypocrisy in human conduct necessary to survive these unnatural strictures was apparent from the beginning. Even as he was censuring desire (the highest truth), Jesus was going steady with a prostitute. It seems. The histories are replete with records of how numerous monasteries in the Middle Ages became frank brothels, with fornication and infanticide commonplace inside their walls. Incest between priests and their sisters and mothers was such a problem that special edicts were issued ordering separate living quarters. The higher the celibates ranked, the more they fucked. And illegitimate children they spawned. Today among the Catholic clergy, buggering pretty choirboys is still the rage.

Fido mentions how, starting with the imposition of compulsory celibacy on the clergy in the eleventh century, and the idea that ‘complete detachment from all desires and pleasures leads to the highest spiritual experience ... Christian moral theology rapidly took on a lunatic fascination with restricting normal sexual activity’. The under-the-table response of nineteenth-century society was to resort to flagrant sexual hypocrisy – to which the Church responded with redoubled determination to deracinate it, thereby amplifying the sick moral currents. Since doctors performed their work and developed their ideas in this mad atmosphere, it was inevitable that they would be infected by it.

But it didn’t start with the Christians. Sacrificing sexual pleasure or least a good helping of it for divine reward long antedates the invention of their faith. The Old Testament affords a mythical account of the history of Jewish circumcision that I told earlier. It relates how some disturbed person called Abraham went around making the bizarre claim that he’d heard God assuring him that should his tribe henceforth sexually mutilate its children, He’d reward the dreadful sacrifice by granting his people His special favour and protection. And that instead of kicking him in the arse, everyone believed him:

And God said unto Abraham ... That is my covenant, which you shall keep between me and you and thy seed after thee. Every man-child among you shall be circumcised. And ye shall circumcise the flesh of your foreskin; and it shall be a token of the covenant betwixt me and you. ... And the uncircumcised man child whose flesh of his foreskin is not circumcised, that soul shall be cut off from his people; he hath broken my covenant.

Although, according to Paul, Jesus tried calling off this dreadful habit, his followers continued to think diminution of men’s sexual capacity spiritually meritorious. In his gospel, Mathew praised blokes who castrated themselves in a fit of holy inspiration, men who ‘have made themselves eunuchs for the Kingdom of Heaven’s sake’. (Some Bible commentators, understandably unable to stomach the rotten history of their religion, assert that Matthew 19:12 really meant such saints were living celibately. For Heaven’s sake.)

Breathing in the austere religious mists of the nineteenth century swirling about him, the eminent Victorian urologist and venereologist William Acton proposed that prostitutes took to the streets on account of their unnaturally excessive and unhealthy sexual desires. Not because they depended on the money for their physical survival. The result of their affliction was plain to see: it drove the unfortunate women into squalor. He extrapolated this medical insight to women generally, suggesting that they might be spared much distress if they could be relieved of their discomforting libidos. Like the current sexual transmission of HIV theory, Acton’s ideas won ready acceptance in Victorian society, and came to be propounded in medical schools, because they were in tune with the moral thinking of the time. But also because, as the HIV-AIDS model in Africa does similarly, Acton’s theory served handily to distract from the root problem of poverty as the cause of widespread prostitution in Victorian society.

In A Practical Treatise on the Diseases peculiar to Women, etc published in 1844, Samuel Ashwell, a lecturer in midwifery at Guy’s Hospital, London, described a solution for the trouble with women that Acton had identified:

Sometimes an enlarged clitoris is marked by exquisite sensibility of its mucous membrane … It frequently gives rise to sexual passion, and subdues every feeling of modesty and delicacy. … The health soon becomes impaired, constant headaches [follow, and] sometimes frequent attacks of hysteria. The mind loses all discipline, and thoughts and expressions assume a sentimental and amatory character while compassion and pity are sought from the attendants. … If the growth is insensible, and relief is sought for its mechanical annoyance ... the best way is to excise it. … Excision is also required when the growth is attended with undue sensibility. A few leeches may be applied near the part … Hydrocyanic acid in solution will be found very efficacious as a lotion.

In 1866 Isaac Baker Brown, a prominent surgeon later to ascend to the presidency of the Medical Society of London, reported the success of snipping it off with scissors in his book, The Curability of Certain Forms of Insanity, Catalepsy and Hysteria in Women – forty-eight of them in the wards of his London Home for Surgical Diseases of Women. Seeing one of his young patients go on to become a ‘happy and healthy wife and mother’, and five others returning meekly to their husbands having earlier threatened to leave, Brown was thrilled by the possibilities: ‘If medical and surgical treatment were brought to bear, all such unhappy measures such as divorce would be obviated.’ The Prince and Princess of Wales thought clitorectomy a jolly good idea too, endowing twenty-five guineas on each bed in his surgery. So did the Church Times, in an article about Brown’s work. Emboldened by his success, Brown committed the grievous offence of advertising his professional services, for which he was struck off. He then set up shop in the US, where clitorectomy took off big – ‘dictated by the loftiest and most moral considerations’, he explained. Doctors started practising it all over the country, exalting it in their textbooks and in a dedicated Journal of Orificial Surgery, published until 1925. Holt’s standard Diseases of Infancy and Childhood was ‘not averse to circumcision in girls or cauterisation of the clitoris’ right up until the 1936 edition.

Peter Feibleman recounted his mother’s pained recollection of being clitorectomised at the age of five by a leading Manhattan gynaecologist in his article, Natural Causes, published in DoubleTake magazine in the winter 1997 issue. In his haunted quest to uncover the history and extent of this medical horror, he interviewed a second-generation gynaecologist in his eighties, who told him that the practice had been ‘a lucrative industry in the United States from 1867 until at least 1927, and possibly much later – a thriving business few people spoke about afterward’. In fact, for the excellent effect on their moral and social characters, American doctors continued using their scissors on females up to the middle of the century, albeit less frequently. Still do, incredibly, but for a different reason now, namely, if they deem a baby girl’s clitoris offensively protuberant at birth – in hundreds of cases a year.

But even more popular than severing the clitoris of troublesome women was spaying them. ‘Battey’s operation’ was pioneered by the distinguished American military surgeon Robert Battey in the 1870s as a somewhat rough cure for heavy menstrual flow. (Lopping off a man’s balls was unthinkable, but doctors never stinted at ripping out a woman’s ovaries.) In 1886 Battey told the Continental Medical Congress that he was satisfied that oopherectomy could also cure epilepsy and hysteria. A new disease was instantly born: ‘ovaromania’. Whose symptoms were shows of noisy and rebellious discontent. Or merely lugubriousness in the performance of uxoral duties, indolence in domestic chores. For which doctors had just the cure. Administered to hundreds of thousands of women. Average age thirty. When the wedding roses were wilting. The requisite heir had been born. And the women castrated were feeling trapped and cheated by the false expectations and promises of the industrial bourgeoisie.

As the medical vogue for amputating the clitoris and extirpating ovaries waned, English and American doctors gave vent in new ways to their aversion towards female sexual liberation from Victorian constraints. Another Brown, a contemporary one, explained in his study, The Name Game, published in the Journal of Mind and Behavior in 1990: ‘Psychiatry’s response to the new sexual morality of the time was to target it as a mental disease.’ Sexually active women, who were thought insufficiently modest and discreet, were diagnosed as ‘psychopathic’, and committed to mental institutions. Such women, guilty of ‘hypersexual behaviour’, were typically working class and living independent lives – widowed, divorced, or defiantly showing no interested in hitching to a husband. Respectably. Indeed, the feminist perception that politically and ideologically medicine has overtaken the Church as an instrument of female oppression is reflected in the order of Germaine Greer’s counsel in The Female Eunuch (Paladin, 1971): ‘The revolutionary woman must know her enemies, doctors, psychiatrists, health visitors, priests, marriage counsellors, police, magistrates, and genteel reformers, all the authoritarians and dogmatists who flock about her with warnings and advice.’

So much for the girls; for the boys, Acton, the clitorectomy guy, had another grand idea. He called it ‘spermatorrhea’, a malady evidenced by stains on boys’ bed sheets (a terrible sight to Victorian eyes), which led, he said, to ‘debilitation, loss of concentration, spinal weakness, poor vision, palsy, drooling, and ultimately madness’. Even if the young accused had merely leaked from their eager sticks as they slept. Helplessly dreaming about the junior new help in her frilly pinafore. Or out of it. Deadly bromide drugs, among others, were administered to abate the disease until well into the twentieth century, but it took another stern Victorian gent, a Dr Athol Johnson, to come up with a radical cure suggested by the Jewish rite just discussed: one simply cut off all the loose pleasure-giving flesh. He published his proposal in Lancet in 1860 under the title, On an Injurious Habit Occasionally Met with in Infancy and Early Childhood, making the original punitive rationale for the surgery perfectly clear:

In cases of masturbation we must, I believe, break the habit by inducing such a condition of the parts as will cause too much local suffering to allow of the practice being continued. For this purpose, if the prepuce is long, we may circumcise the male patient with present and probably with future advantage; the operation, too, should not be performed under chloroform, so that the pain experienced may be associated with the habit we wish to eradicate.

And that said, Dr Johnson doubtlessly nipped into the corner stew for a quick screw before trotting home to high tea. Patting down and straightening his handlebar moustache after pulling up his breeches. Reinstalling his monocle. And then driving down the price.

Johnson’s idea particularly captured the American medical imagination, commencing with a supportive article in the New York Medical Journal in 1871; and for the next century the professional literature, both general and specialist, spilled a profusion of treatises extolling it as a cure-all for an expanding range of ailments of every description. Advocating Immediate Circumcision of the Newborn Male, Miller and Snyder wrote in the American Journal of Obstetrics and Gynecology in 1953: ‘Longevity, immunity to nearly all physical and mental illness, increased physical vigor, etc., are all attributed to this practice.’ ‘Malnutrition, epistaxis, convulsions, night terrors, chorea, and epilepsy’ were illnesses that could be avoided with circumcision, noted Campbell’s Urology in 1970, published by the eminent medical publishing house, WB Saunders Company in Philadelphia.

The moral benefits were frequently vaunted too, codified, so to say, by the 1897 edition of Holt’s Diseases Of Infancy And Childhood: ‘Circumcision should be done if phimosis exists, and even where it is not, the moral effect of the operation is sometimes of very great benefit.’ The moral effect flowed naturally from the physical effect: Dr Hutchinson spoke On the Advantages of Circumcision in Medical News in 1900:

The only physiological advantage which the prepuce can be supposed to confer is that of maintaining the penis in a condition susceptible to more acute sensation than would otherwise exist. It may increase the pleasure of coition and the impulse to it: but these are advantages which in the present state of society can well be spared. If in their loss increase in sexual control should result, one should be thankful.

Writing in Lancet in the same year, Dr Freeland over in England agreed:

It has been urged as an argument against the universal adoption of circumcision that the removal of the protective covering of the glans tends to dull the sensibility of that exquisitely sensitive structure and thereby diminishes sexual appetite and the pleasurable effects of coitus. Granted that this be true, my answer is that, whatever may have been the case in days gone by, sensuality in our time needs neither whip nor spur, but would be all the better for a little more judicious use of curb and bearing-rein.

Thirty years later, Dr Cockshut (his real name) wrote along the same lines in the British Medical Journal:

I suggest that all male children should be circumcised. This is ‘against nature,’ but that is exactly the reason why it should be done. Nature intends that the adolescent male shall copulate as often and as promiscuously as possible, and to that end covers the sensitive glans so that it shall be ever ready to receive stimuli. Civilization, on the contrary, requires chastity, and the glans of the circumcised rapidly assumes a leathery texture less sensitive than skin.

In 1971, the year that the American Academy of Pediatrics finally admitted that ‘There are no valid medical indications for circumcision in the neonatal period’, ninety per cent of male babies born in hospitals in the American North East were butchered. Although it’s waning, circumcision still remains as popular among American doctors as apple-pie. The same dudes who came up with HIV-AIDS. It prevents this, it prevents that, they say. It also results in a couple of hundred neonatal deaths in the US every year from bleeding and complications. But more importantly, we make about $50 million a year from it.

It’s in the nature of things that such dark ideas, once so pervasive in medicine, should linger in vestigial form, even as their brutal manifestations in male and female sexual mutilation recede. Medical doctors’ aversion to natural, unfettered and open sexual expression and experience finds its second wind in the HIV theory of AIDS. The new model sits perfectly on pre-fabricated foundations. Class difference contributes too: doctors invariably from the upper-middle classes silently deplore what they imagine to be the frightful sexual indiscipline of the lower. Hence the moral agitation with which they fuss over their new sex plague.

Apart from their deeply rooted cultural biases, doctors naturally support the virus/chemotherapy model of AIDS because they are strictly schooled within a germ cause/drug fix paradigm that supports a capitalist model of merchandise-based medicine. The reason for this is to be found in the creation of

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CHAPTER

With dehumanising, racist attitudes about African sexuality like Cameron’s, shouldn’t the Mail&Guardian ask on its front page, as it did about Mbeki on 26 April 2001 on account of his AIDS scepticism, whether he’s fit for his office? As Business Day suggested concerning Mbeki in turn on 8 May. Then again sacked for what? For thought crimes – like mine from his angle? Best rooted out. This heretic with them. Although going after thought criminals is nothing strange to the Mail&Guardian. It even prosecutes accidie – the ancient Catholic charge of insufficient pious zeal. Perhaps sensing its irrelevance and impotence in influencing government AIDS policy in the slightest degree, on 1 December 2001 its front-page headline piece denounced Human Rights Commission director Barney Pityana for changing his mind about supporting the TAC’s case against the government to compel it to supply antiretrovirals: How HRC’s Pityana buckled on Aids.

A purge of government and its auxiliaries of people who think like Cameron would never end. Even a white ANC MP I know, a genuinely dedicated democrat who was locked up during apartheid, harbours Cameron’s notions of licentious libidinousness among poor black men, and got agitated when I called them into question a few years ago. His smart law professor wife too. I became the patronising racist, told more or less to ‘get real’, because they thought the facts too notorious to admit challenge. There’s no television or other modern distractions out in the country, they said, so there’s nothing to do but roll in the hay. Their only recreation. It’s why they’re at it hammer and tongs. With anyone, they meant. They really said it – my oath to God. Our Nobel Prize winning novelist Nadine Gordimer took a similar view in the New York Times on 11 April 2000 in her article, Africa’s Plague, and Everyone’s. African promiscuity, wrote the left-winger sensitively, ‘is difficult to condemn when sex is the cheapest or only available satisfaction for people society leaves to live on the street’. Sweet old white lady that she is.

Criticising Mbeki in the December 2000 issue of the Helen Suzman Foundation magazine Focus for having ‘blamed Aids on poverty’, foundation director Lawrence Schlemmer proposed in the same sort of language that since ‘at base the epidemic is driven by sexual behaviour’, Mbeki ‘missed … the opportunity’ to have better argued instead that ‘deep poverty and hopelessness causes self-destructive hedonistic tendencies, coupled with claims of the destruction of African family authority by apartheid’. They screw around more because they’re poor. It’s what destroys them. They get sick and die.

Gordimer’s thoughts about Mbeki’s doubts were revealed in a rare interview given to the Guardian’s Rory Carroll on 22 May 2003: ‘I’m very critical of the president’s stance on Aids. I’m very disappointed in it because I respect him highly.’ How AIDS addles brains she illustrated in the same paper on 29 November 2004, talking about Telling Tales (Bloomsbury, 2004), her anthology of short stories by twenty-one eminent writers, which she’d published to raise funds for the TAC: ‘There is a tendency in the West to think Aids is only really in Africa and doesn’t affect me personally. This isn’t true. Everyone travels all over the world now [everyone?], and this awful disease travels with us.’ Like how, baby?

What would we think were Cameron to start gibbering unstoppably about, say, his alien abduction experiences, gaily chatting on television about an alien probe rammed aft, associating publicly with a bunch of like-minded witless cranks, and carrying on forever about the end being nigh for all of us? Everyone being at risk if we step out of our houses after dark. Routine stuff like that. Were he to adopt their programme to get ‘star wars’ defences in every home and make it his life’s work; and install such gear in his own garden, a hissing, crackling, smouldering Heath Robinson contraption of hydrogen cyanide tanks, high voltage generators and plutonium? Invented forty years earlier to kill river eels. But abandoned as ineffective. And thereafter confirmed over and over to be very dangerous. But fine for women and children. Black babies especially. And were he to criticise the government at every chance for not sharing his enthusiasm for his machine, and his project to get one for everyone?

Or, instead of flying saucers, were he to go on about terrifying unseen miniature hobgoblins attending and polluting life’s most intensely meaningful experiences – the acts of making life, carrying it, delivering it and nurturing it. In the timeless history of man, in the last twenty years only. Out the blue. (Or rather, just as the once dominant retroviral theory of cancer was becoming a scientific joke, and retrovirologists were looking for new jobs.) To be purged with fire. The chemical way. A suddenly unique way of getting sick and dying, with nothing like it among any other mammal.

Interviewed in the November 1999 issue of Modern Maturity, primatologist Jane Goodall was describing the brutally inhumane yet typical conditions in which the pope of AIDS, Robert Gallo kept caged chimpanzees in the underground basement of his National Institutes of Health ‘AIDS research’ laboratory complex at Bethesda, Maryland, US – before he resigned in disgrace over his frauds in the great ‘first discovery of HIV’ sideshow, to cop a gig as director of the University of Maryland’s Institute of Human Virology. She pointed out: ‘Since the early ‘80s they’ve been doing everything in their power to give chimps AIDS. They’ve injected them in the spinal cord, in the brain, in the blood, in the muscles – but they have not succeeded in giving a single chimp AIDS. Even Gallo now says chimps are useless in AIDS research.’ 

Since ‘Scientists believe that HIV, the virus that causes AIDS, originated in apes or monkeys and was transferred or mutated its way into the human population about 50 years ago’ – reported the San Francisco Examiner on 30 August 2002 – but ‘modern chimps are largely immune’ to it, Dutch ‘AIDS experts’, led by Ronald Bontrop, brilliantly proposed that ‘an AIDS-like epidemic wiped out huge numbers of chimpanzees 2 million years ago, leaving modern chimps with resistance to the AIDS virus and its variants. If true, the hypothesis would explain why chimps, which share more than 98 percent of their DNA with humans, don’t develop AIDS.’ A more far-flung attempt to ease the pinch of the shoe around the basic paradox is hard to imagine. There’s a simpler explanation: AIDS isn’t infectious.

But back to judges, tiny, invisible devils and cell-poisons: What would we make of such a phenomenal exhibition of off-the-wall gullibility? Such a weak-headed penchant for being swept up in mass hysterical fervour over a superstitious fantasy? Fanned daily by shit-brained journalists? And by ‘AIDS experts’, reaping the lucre spun by the propagation of their new sex brings death credo like river crabs feasting silently on a drowned dog.

What conclusions should we draw from his persistence in extolling his mad machine, having been sent a full brief on its desperate hazards by a fellow lawyer? The same docket that made the President, the National Minister of Health and our country’s top investigative journalist nearly jump out of their skins. His failure to enquire what scientific literature the President was referring to when proclaiming on record that a great stack of it warned that the machine was extremely unsafe – to mothers and their babies most of all. A machine packed in a box with a yellow nuclear label and frightening safety warnings when shipped out to kill eels. But with smiling Aryan families depicted without such warnings when sold for use at home.

And what score would we give him for his public responsibility in raving on as he does, knowing that a lot of humbler folk will hang on his every word? Being an important guy. Who’ll be assuming that he knows what he’s talking about. That he’s taken the trouble to familiarise himself with the facts. And not just passing off the machine’s manufacturer’s sales propaganda as such. As well as that of the craven priests in its pocket or under its sway. Disregarding the government’s urgently expressed concerns about its safety and efficacy. Suggesting that it is disingenuous, callous, and mean in announcing them. And should be ignored.

At the March 2000 national conference of his ‘AIDS movement’ convened by NAPWA, Cameron made another pitch for the provision of ‘antiretrovirals’ to pregnant women at Tshabalala-Msimang, who was present there: ‘Since 1994, very detailed and careful scientific and medical studies have been done on how to reduce the risk that a mother with HIV will transmit it to her baby during or after birth.’ Dare we ask which of them his Lordship read? In order to have judged them very detailed (wot’s that?) and very careful (like how?). And might we ask whether Cameron has ever reflected, just for a moment, on the inherent plausibility of a new medical doctrine holding that a mother can sicken her baby by carrying it, bearing it, and feeding it? And that it is better off poisoned in the womb, cut out, sexually mutilated, denied its mother’s milk, and poisoned some more. Bearing in mind that medical experts are always wrong in hindsight. And that they can be reliably counted on to fuck everything up. As the embarrassing history of medicine both ancient and recent tells. You can bet your blue bootees he didn’t. Being intellectual and everything.

Incidentally, when I asked the curator of the Aliwal North Museum in mid-2003 whether she had any old medical textbooks (I collect them) to go along with her century-old medical display, she answered, ‘No, we throw them out. They’re dangerous.’ Which explains rather well that old joke about doctors burying their mistakes.

There’s a striking thing about all Cameron’s ‘very detailed and careful scientific and medical studies’. Not a single one of them establishes that a baby given a blast of transplacental genotoxic, carcinogenic, teratogenic and cytocidal antiretroviral treatment in the womb does better after birth. Obviously. The studies are all about the effect of AZT and related drugs on indirect laboratory tests. Of course what these test results mean, and why they might be modulated by the chemicals, is hardly a closed book. But when we go looking for the clinical effect of exposing babies to the poisons, their actual physical effect, we find that numerous papers, in the last couple of years especially, have shown that such children have much higher rates of serious disease, serious congenital malformations and early death. As we read in Debating AZT, and in the latest research reports discussed above. Knowing what we do about the drugs, should this surprise us?

The overdue question someone needs to ask Cameron is whether he gives a drop of piss about any of this? As he utters no end of high-sounding inanities about the ‘life-saving drugs’, in the manner of an apartheid ethnologist preaching the marvels of separate development, and bugger the human cost. Or is he going to continue stepping over the blood on the floor, his eyes fixed on the stars, cajoling like Jim Jones: ‘Drink up, mums. Anoint your babies with the modern unction. For a miraculous salvation, absolution of the new generation from the sins of the old. As they swim inside you before their first breath. Have them taste the body of Christ that they might join it.’

When AIDS treatment activists like Cameron claim the drugs are safe, they are relying for the most part on American ‘AIDS experts’. In the government health services and its adjuncts, employed by AIDS research institutions, and living off grants for AIDS research. From the government or the pharmaceutical industry. The kind of guys whose careers are really going to take off should they talk frankly about the emperor’s finery. His bloated, poxy birthday suit. And what a horrible Pied Piper’s tune they’ve all been whistling. But far be it for us humble guys to wonder and judge, because as Pope Leo XIII cautioned: ‘To despise legitimate authority, no matter in whom it is invested, is unlawful; it is rebellion against God’s will.’

Geshekter made much the same point about the effect of AZT on children, as I did above concerning babies, in a letter to Cameron after he’d ‘disclosed his HIV status’ and shared with us that he was ‘living with HIV’:

As for AZT, there are six major research studies, published in refereed scientific journals that are often cited as providing the evidence for the benefits of AZT and protease inhibitors. I have pasted in the complete citations below the double line. … These papers were cited as central documents in the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection that were developed in March 1999 by the Working Group on Antiretroviral Therapy and Medical Management of HIV-Infected Children that was convened by the National Pediatric and Family HIV Resource Center (NPHRC), the Health Resources and Services Administration (HRSA), and the National Institutes of Health (NIH). The amazing thing is that not one of these studies showed that the therapies had any proven clinical benefits when compared to the kids who were not treated with them. Although extensive references are made and claims propounded about changes in a patient’s surrogate markers (e.g. viral load, CD4 cell counts), none of the papers provided any evidence of clinical benefits – i.e., that the patients’ health was shown to actually improve – but they do show ample evidence of toxicity and horrible side effects.

Geshekter’s letter sailed over the intellectual’s head and into the bin.

That AZT had killed her daughter Tia was the essential defence of Valerie Emerson to an application by the welfare authorities in Maine in the US in 1998 to force feed it to her son Nikolas, after she had discontinued giving it to him following Tia’s death on it. The Maine Department of Human Services’s response was to charge her with ‘serious parental neglect’. On 14 September 1998, after an exchange of expert opinions for and against AZT in court, Judge Douglas Clapp threw the state’s case out. Clapp J held that the authorities had

not sufficiently proved what the benefit will likely be and that no significant injury or harm may ultimately befall the child if that therapy is now commenced. The [AZT] monotherapy, which the best doctors told Ms. Emerson was appropriate for her daughter many months ago, failed fatally and is not now recommended by the same experts. Instead, they have recommended a more aggressive and powerful therapy. They may be right in this advice. Current statistics can be interpreted that they may also, just as likely, be wrong. She has discontinued her own treatment with no apparent present ill-effects. She has observed an outward improvement in her sick son’s condition with a discontinuance of drug therapy. The State of Maine is now in no position to tell her in the face of her unique experience that she is wrong in her current judgment. … the current body of information available to any mother in her situation is limited or conflicting. … She feels that she has willingly and in good faith surrendered up the life of one child to the best treatment medicine has to offer and does not want to do the same with the next. Nikolas has made significant strides recently in gaining weight and overcoming developmental deficits, and appears happy and healthy. She does not want to see this child take on the pallor and pain of a sick and dying child. … [Her rejection of AZT was] rational and reasoned [and did not] place Nikolas’ health or welfare in jeopardy.

The Maine Supreme Court unanimously agreed when the matter went on appeal two months later.

No doubt the harm AZT does to growing foetuses isn’t noticeably obvious in every case. Indeed, a bunch of American ‘AIDS experts’ led by Culnane published a paper in the Journal of the American Medical Association in January 1999 that came up empty-handed. As did Chotpitayasunondh et al. reporting zip in Paediatrics in January 2001, as we read earlier – in contrast with all the others we read about in Debating AZT and reported in this sequel and in Poisoning our Children: AZT and nevirapine in pregnancy. But think of a platoon of soldiers passing through a minefield. They get to the other side with no one blown up. Because they’ve missed the mines. Actually they’re not specifically looking for any. They’re certainly not sweeping as they cross. They report from the other side: ‘Mine-free zone.’ But numerous other troops crossing the field get their feet blown off. They report: ‘The field is littered with mines.’ Well, is it or isn’t it?

Mixing up his medicine with our policies at the March 2000 meeting, Cameron carried on: ‘The overwhelming scientific consensus is that effective anti-retroviral medication can be made available in a developing country to reduce transmission.’ The ‘effective’ measure of ‘AIDS experts’ we’ve disposed of already. ‘Transmission’ of what? Because there is no evidence that anything is being transmitted. None at all. And the trouble with sloganeering about an ‘overwhelming scientific consensus’ is that it suggests so much, tells so little and conceals such a lot. The statement rests on his implication that all the studies in this affair have produced consistently clear positive results. They haven’t, as paper after paper in Papadopulos-Eleopulos’s et al. ‘mother to child transmission’ literature review (discussed below) spells out. Hard to believe, because Cameron’s scientific la-di-da is intended to sound decisively authoritative rather than just emotive. But this is the very idea of bandying it around. It’s the kind of talk that’s meant to impress and delegitimise dissension. It’s a technique that judges are well practised in – this trick of papering over gaping logical cracks, pinching their noses firmly past rotten premises, and abusing the English language generally with big words to put ordinary people off their main business: guarding their suburbs and nightwatching the bank. Preserving the status quo.

‘Every month in our country, approximately five thousand babies are born with HIV. Medicines exist that, now, can reduce this figure by half.’ If you still think the tests mean what ‘AIDS experts’ claim – ja well no fine. And if you’re content to peddle guesses passed off as epidemiological data – whatever you say, M’Lord. On a cursory look at the numbers though, like the one we took in AZT: A Medicine from Hell, an entirely different picture emerges, and suddenly the drugs just aren’t that great. We see how corrupt the phrase ‘reduce by half’ is. And how hopeless the judge’s arithmetic is.

‘Economists have done detailed studies that show that this medication can be made available cheaply and affordably. Their studies have also shown that, from a purely economic point of view, it is better to save young babies from getting HIV than to let them fall sick and die of AIDS, and that intervention will save the country money.’ This is the Nicoli Nattrass thesis. Our AIDS enthusiast with a chair in the economics department of the University of Cape Town. Doing her sums on the premise that a neonate whose blood lights up an HIV test is imminently on its way to join the angels. Without a shred of evidence – but plenty disconfirming. By far the majority of babies testing HIV-positive at birth spontaneously serorevert to negative by their second year. And not a single controlled study has ever been done reporting how the persistently HIV-positive children do – whether they do any worse than the HIV-negative kids.

There’s a puzzle in this spontaneous seroreversion business, and to some of us it’s a major hole in the HIV theory of AIDS. All doctors accept that babies inherit their mothers’ antibodies, and have similar levels of them at point of birth, declining at an exponential rate as they are broken down, to the point where, by nine months, they have been cleared completely from their blood. In a study reported in Lancet in 1988 as Mother-to-child transmission of HIV infection: The European Collaborative Study, two hundred and seventy-one children born HIV antibody-positive were tracked over twenty-one months to monitor the rate at which they seroreverted to HIV antibody-negative. The investigators accepted that inherited maternal antibodies caused the babies’ blood to light up the tests at birth. By nine months, they found that about a quarter of the children had seroreverted to HIV-negative – explained by the disappearance of maternal antibodies. Which means that the antibodies detected in the three quarters of them who were still HIV-positive at nine months were their own. On a conventional interpretation, this meant they were infected. But strangely, the children continued seroreverting, until, by twenty-one months, only fifteen per cent of them were still HIV positive. Which raises more questions than there are answers in the world of AIDS science. What was going on in the sixty per cent who seroreverted between nine and twenty-one months? Did they cure themselves of HIV infection, without doctors’ help? Or are the antibodies detected by the tests not specific to HIV? For ‘AIDS experts’ the problem presents the most awkward of Hobson’s choices. To those of them who have ever got as far as thinking about it.

Apart from spontaneously seroreverting babies throwing the reading of ‘HIV antibody’ test results into question, there’s another oddity in the world of AIDS medicine: the curious affair of HIV-positive haemophiliacs. Who got it from contaminated clotting agent, say ‘AIDS experts’. Factor VIII, they call it – extracted from bought or donated blood, and supplied in the form of a freeze-dried powder. But according to the US Centers for Disease Control’s 1994 factsheet on HIV transmission,

studies have shown that drying of even ... high concentrations of HIV reduces the number of infectious viruses by 90 to 99 percent within several hours. Since the HIV concentrations used in laboratory studies are much higher than those actually found in blood or other body specimens, drying of HIV-infected human blood or other body fluids reduces the theoretical risk of environmental transmission to that which has been observed to essentially zero.

Which blows out the possibility that completely sterile, freeze-dried Factor VIII, sitting on a shelf in a glass ampule for several weeks or months, transmits HIV, doesn’t it? It’s something ‘AIDS experts’ haven’t ever thought about either. But it’s another reason to reappraise the conventional interpretation of reactive ‘HIV antibody’ test results. And henceforth to substitute a diagnosis of ‘HIV-infected’ with: ‘Your blood contains a more than usual level of proteins in a class we call antibodies. Our formal name for this condition is hypergammaglobulinaemia, or polyclonal gammopathy. It may, but not necessarily, signify some form of health stress. Since all antibodies are inherently non-specific, we can’t diagnose infection by any specific pathogen, nor any other condition. We suggest you treat the test result as an amber light. Perhaps look a bit further into what might have caused this. But if there is nothing you can think of and you don’t feel unwell, don’t worry about it.’

Cameron continued: ‘So overwhelming is the medical, scientific and economic consensus on these points, that many people find it almost impossible to understand why our Government is still delaying the immediate implementation of programs to prevent mother to child transmission of HIV.’ Many people were persuaded once that the Jews sold Germany out in the First World War, among other sins. You just had to claim it often enough through the loudspeakers for it to became the overwhelming consensus. And look what happened next. Likewise the ‘population explosion’, supposed to have finished us by now. Cameron should know that the very first lesson learned by litigating lawyers is that the most certain cases often fall to pieces at trial or on appeal. As their root flaws are exposed, not immediately apparent. And as we’ve mentioned, the history of medicine, indeed of the world, teaches us that the overwhelming consensus on nearly everything has been wrong. Even in regard to the most mundane medical protocols such as for the management of diarrhoea. Or the once standard disinfection of children’s grazes with mercurochrome. Now banned in the US. A dangerous neurotoxin, doctors now agree, even in the tiniest amounts. Then there’s the disappointing Hepatitis C virus. Whose virulence, urged doctors with worried frowns, necessitated taking potent chemotherapies in the AZT class. Only to turn out to be a mirage. After innumerable poisonings.

For instance we read in the 32nd edition of Martindale: The Complete Drug Reference published in 1999: ‘Treatment options for patients with HIV infection are changing rapidly with a trend towards initiating therapy with combinations of antiretroviral drugs at an early stage of the infection. Until recently zidovudine was given as monotherapy.’ But just a year or two later, top US government ‘AIDS experts’ were urging the delay of treatment initiation for as long as possible. The hard fact having eventually reached them that the therapy was proving to be not as good for their patients as it was for the undertaking business. So treatment protocol is now ‘changing rapidly’ in the opposite direction:

Whereas the US Public Health Service (PHS) announced in its 1993 Guidelines for the treatment of HIV-positive people that AZT monotherapy was the way to go, its revised 1997 Guidelines said no, combinations of AIDS drugs were – but only when patients’ CD4 cell count dropped below 500 cells per mm3 or their ‘viral load’ rose above 10 to 20 000 ‘copies’ per mL. The next retreat was in 2001 when the Guidelines were changed again, recommending raised criteria before intiation of treatment to 350 cells and 55 000 ‘copies’ respectively. The bar was raised even higher in 2002, when the recommendation that all people with ‘acute primary HIV infection’ be treated was dumped.

Another example: ‘AIDS experts’ have persistently frightened their patients into staying on their drugs, notwithstanding their terrible ill effects, by threatening that unless they do, drug-resistant strains of HIV will appear, due to their ‘propensity to induce resistance when not taken with absolute consistency’ as Professor Susan Ball put it in Patients Who Want to Stop Their Medications: Treatment Interruption in HIV Infection, published in the AIDS Reader in August 2003, in line with the revised Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents released by the US Department of Health and Human Services in January 2001. Said co-chairman of the panel that drew then, John Bartlett, chief of the division of infectious diseases at the Johns Hopkins University Medical Center: ‘Extraordinarily high rates of adherence to an antiviral drug regimen are necessary to maintain control over HIV replication. HIV is very unforgiving in this regard. It is impossible to over-emphasize the importance of maximizing adherence once the decision is made to begin therapy.’ But Accrued HIV evidence turns treatment dogma on its head, wrote Erika Check in Nature in the same month as Ball’s article appeared: ‘A series of studies has dispelled the widespread notion that patients who don’t take every dose of their anti-HIV medication create a public-health risk by helping to nurture HIV strains that resist therapy. The findings suggest instead that some patients who do not take all of their medicine are actually less likely to become resistant to therapy than those who adhere rigidly to their doctors’ instructions.’ Unreal.

In the AIDS age it’s important to bear in mind that the overwhelming consensus derives from the opinions of a small oligarchy, rather like a society of wizards, with their claims for their opaque arts percolating into general acceptance only because in the prevailing climate hardly anyone dares taking them to task. They’re second-raters one and all. But in all professions it’s invariably the most crass careerists who make it to the top of their trees, ahead of more careful, thoughtful types – particularly contrarians, critics and dissidents. Hence the War on AIDS – the most lavishly funded medical research effort ever. Massively disproportionately subsidised in relation to the big killers like heart disease in the First World, TB and malaria in the Third. But achieved by endless high-volume fear mongering. Pounding all day like political lessons barked from horns at the top of poles in Chinese villages during the Cultural Revolution.

Cameron concluded his March 2000 appeal for AIDS drugs by urging, ‘If government commits itself to helping pregnant mothers, it will throw a beam of hope onto the entire epidemic. It will throw a beam of light onto all our lives. If babies can be protected from exposure to HIV by giving medicine to their mothers, then all of us can hope that progressive implementation of an accessible drugs programme will save many more lives in South Africa and in our continent as a whole.’ Shall we now lower our heads and pray? For the happy pills. Our hands pressed together in piety. Like Mark Heywood’s.

Full of righteous Christian anger, the Faculty of Health Sciences at the University of the Witwatersrand demanded on 29 November 2001 that the government profess ‘publicly and in press statements that HIV causes AIDS’ and that ‘unsafe sex was overwhelmingly the main mechanism of transmission of HIV [without any evidence, not a crumb, we’ll see] … The University, and opinion leaders in the field of HIV/AIDS, state unequivocally that HIV is the cause of AIDS and request Government to ensure that no statements are made that might confuse the public about the nature of this disease.’

This was just the kind of language used by the pellagra experts in the US to slap down Goldberger’s doubts about their advice to dry out puddles and close windows to minimise bites from bacteria-spreading insects, to shoot blackbirds carrying them, to use more soap, and to swallow this and that poisonous medicine to kill the germs. In Politics and Pellagra: The Epidemic of Pellagra in the U.S. in the Early Twentieth Century in the Yale Journal of Biology and Medicine in 1995, Bollet noted the appeal of the germ theory of pellagra to have been that it masked the hard facts: in a time of widespread poverty and malnourishment, ‘Editorial pages and speeches by congressmen criticized and condemned such insulting inferences concerning the contentment of the people of the South.’ The germ theory of AIDS serves exactly the same function: ‘The story of the epidemic of pellagra in the United States ... may remind people of contemporary events surrounding the AIDS epidemic, when social and political forces drove medical research. To a very real extent history has been repeating itself.’ The New Shorter Oxford English Dictionary tells us that pellagra is a medical term for a ‘condition caused by nicotinic acid (niacin) deficiency, characterized by dermatitis, diarrhoea, and mental disturbance and common where maize is the staple food’. Well known now. But not then.

‘How gladly would we if we could say that this disease was due to some particular form of diet alone. Then our task as a Board of Health would be comparatively easy,’ scoffed Dr Hayne, South Carolina’s Health Director; Goldberger’s proposal that pellagrins eat more beans was ‘an absurdity,’ he thought. ‘Pernicious,’ damned Dr Leroy from Memphis, about the same. Only insect carriers could explain the spread of the disease ‘like a prairie fire,’ said Dr Townsend of the segregated black National Medical Association’s Pellagra Commission. Going along with the white doctors, an Uncle Tom like Makgoba, tap-dancing for the drug executives, flashing his whites in a fixed, shit-eating grin. Even as Dr Peterson wrote in the Journal of the American Medical Association that blacks migrating up from the South would spread pellagra to whites in the North, Townsend’s society stated: ‘... that pellagra is a communicable, and therefore, preventable disease, is abundantly evident to anyone open to conviction.’ Like those hundreds of similarly convinced university academics in Johannesburg and Cape Town, who signed up to recite equivalent fables and demand that the government declare it believes them too. Goldberger’s famous prison diet experiment, proving his malnutrition hypothesis, was slammed as ‘silly’ by Dr Perdue of Kansas City; in fact it called for ‘the execration and scathing denunciation of reasonable men’.

In a striking coincidence of similar problems in debunking bad medical ideas – in the AIDS veld fire today, and the pellagra prairie fire then – Goldberger spotted the blocks: ‘an unthinking public and a half-educated commercialised medical profession’. He mentioned in a letter to his wife that a doctor had complained to him that his patients going along with the better food cure were refusing to take his medicines. From which fortunes were being made as quack cures proliferated. Along with electric shocks diligently administered. In quarantined wards in specially built pellagrin hospitals that mushroomed up all over the South. To contain the contagion. Causing the minds of the malnourished poor to go. Who were thereupon locked up in mental asylums. So Goldberger pulled Galileo’s move, the trick I adopted in pitching Debating AZT to the lay press, and then, in extended form, directly on to government: he bypassed the learned scientific journals, and publicised his discoveries in the newspapers. That’s how they eventually got noticed by the authorities, and why everyone knows today that pellagra is a disease resulting from the bad diet of the poor. And not what the ‘overwhelming consensus’ held.

Elizabeth Etheridge’s 1966 PhD dissertation on pellagra for the University of Georgia, published in expanded form as a book, The Butterfly Caste (Greenwood Press, 1972) (from which I have largely drawn), tells how more than six hundred rival theories and attacks on Eijkman and Grinjn’s malnutrition theory of beriberi (that it was caused by polished rice as a staple) were published around the turn of the 19th century before general acknowledgement. And how fifty years passed before the British Royal Navy accepted James Lind’s citrus fruit cure for scurvy, proposed by the Scottish surgeon in 1753. Before which, she could have added, some stern captains had been throwing the guys overboard before they infected others. What she also omitted is that Lind’s discovery was thereafter lost, because clever doctors in the admiralty started rationing out stored limejuice from barrels instead of fresh whole fruits. Quick to go mouldy. When that didn’t work, because the juice fermented, and scurvy took off in a big way again, they concluded: ‘See, Lind was wrong. It’s germs after all. Back to arsenic.’ Only to be put right when vitamin C was crystallised between the Great Wars by the Nobel laureate Albert von Szent-Gyorgyi.

Since the thirties textbooks typically now say, as the 24th edition of Hale-White’s Materia Medica in 1939 does: ‘Pellagra results from vitamin B2 lack. It occurs extensively in the Southern States of America where the diet of the poorer classes consists largely of maize-meal, molasses and meat (salt-pork).’ Switch a few words and Hale-White would tell of scurvy: ‘Scurvy results from vitamin C lack. It occurred extensively in the navy and in the trenches during the First World War where the diet of sailors and soldiers pressed from the lower classes consisted largely of biscuits and corned beef.’ But that’s not what they said when the evidence ‘overwhelmingly’ supported an infectious explanation. Deduced from the fact that people were getting sick in clusters. Not unreasonably actually. Only completely wrong. British soldiers who got scurvy in the trenches in the First World War didn’t exactly arrive a picture of health; even by the Second World War they were still a sorry lot. Shirer described them: ‘One saw the contrast between the German soldiers, bronzed and clean-cut from a youth spent in the sunshine on an adequate diet, and the first British war prisoners, with their hollow chests, round shoulders, pasty complexions and bad teeth – tragic examples of the youth that England had so irresponsibly neglected.’

The Wits medical academics pressed on for the government to recant its heresies and demanded a public declaration that it had adopted the popular superstitions: ‘This will end the deepening division between the top levels of Government and the rest of the country, allowing the campaigns to move forward collectively’ to address the ‘national emergency’ with a programme to provide AIDS drugs to rape victims, and ‘implement national voluntary testing and counselling as a national priority’. Along with the University of Cape Town, Wits further demanded that the government make AIDS drugs generally available to all South Africans, but urgently to pregnant women and children. And do you think you could cut your prices some more please, pipped UCT to the drug companies. To sound relevant. In the political picture, like.

On 21 August 2001 the TAC finally launched a long threatened application in the High Court against Tshabalala-Msimang and most provincial health ministers, launched out of the Transvaal Provincial Division of the High Court of South Africa, essentially claiming an order compelling her ministry to provide nevirapine to HIV-positive pregnant women and their babies. The TAC’s Siamese twin, the AIDS Law Project (of which Achmat was director before Heywood, who is simultaneously a director of the TAC), had started mumbling about bringing such a case in 1998. The following year the Sunday Independent formally announced Zuma faces court action on AZT: ‘The AIDS Law Project at the University of the Witwatersrand is to take Health Minister Nkosazana Zuma’s department to court to challenge its decision not to give the AZT drug to HIV-positive pregnant women.’ By now, however, the call was for nevirapine.

As Director General of Health Dr Ayanda Ntsaluba summed up in his answering affidavit to the TAC’s case: ‘Public pressure for a cure and for quick solutions, while understandable, could contribute to hasty decisions to assuage the sentiments of the public with extremely negative consequences.’ A relentlessly propagandised public, he might have added, judges included. The application was opposed on the basis that it was not the province of the courts to make policy decisions about what drugs the government should dispense to the populace. A point so obvious and a defence so complete that in any other atmosphere there would have been no need to get into the merits of the drugs themselves. Which Tshabalala-Msimang could have done in the answering papers had she wished to. Because no sooner had she been slapped with her papers than Papadopulos-Eleopulos armed her with a complete answer to the TAC’s case. Many months in sedulous preparation, Mother to child transmission of HIV and its prevention by AZT and nevirapine: A critical analysis of the evidence was delivered directly to both Mbeki and to the health ministry shortly after the case was instituted. It reads like a nuke dropped dead centre on an enemy garrison. It takes everything apart, the fundamental non-specificity of all the ‘HIV’ tests, the useless toxic drugs, the lot. But for reasons best known to themselves, the government’s lawyers avoided putting the claims of the nevirapine advocates in issue and stuck to arguing the case on constitutional law grounds. It proved to be a fatal miscalculation. Judgment was given against the government on 14 December and an appeal to the Constitutional Court failed the following year. (The case, and the single study on which it was based, is dissected in The trouble with nevirapine.)

Tucked into the appendices of Papadopulos-Eleopulos’s mother to child monograph is A critical analysis of the evidence for the existence of HIV (later summarized in A critique of the Montagnier evidence for the HIV/AIDS hypothesis in Medical Hypotheses 2004;63(4):597-601). In the scientific flux in South Africa brought about by Mbeki’s publicly stated concerns about AZT and then his musings about the integrity of the HIV-AIDS paradigm – in twenty years, yielding nothing but confusion and failure in theory, epidemiology and treatment – the authors offered it to the South African Journal of Science, encouraged by its editor Graham Baker’s claim to want to air ‘the other side’, as he put it to me. And likewise to Turner, co-author of the paper: ‘The sad truth is that there is hardly any informed public discussion of HIV/AIDS in SA, which is why we are determined to do something to correct the situation. … we plan to devote most of an issue to HIV/AIDS in Southern Africa in March [2000].’ He was expecting trouble over this because ‘it’s a minefield out there!’. Trouble for him personally, he told Papadopulos-Eleopulos and Turner at breakfast during the first meeting of the AIDS Panel in May. But Baker’s promises came to nothing. He folded after negative peer-review by such ‘AIDS experts’ as Lynne ‘HIV is easy to isolate’ Morris of the National Institute for Virology in Johannesburg, and Caroline Williamson at the University of Cape Town – with egg on their faces inevitable should the paper be published. So they ‘shredded it’, Baker told me. Didn’t bother informing the authors by letter though. Didn’t even provide them with the reviewers’ comments. Their attitude to the paper was of course perfectly predictable. Imagine what would have happened had Einstein’s peers, fellow German Nobel laureate physicists Johannes Lenard and Johannes Starke, been asked to review his tumbling of Newtonian Mechanics into Relativity Theory? After belittling his vast insights as ‘Jewish physics’. And after being quoted in the SS journal Das Schwarzes Korps slating their Nobel laureate physicist colleagues Planck, Shrodinger and Heisenberg as ‘white Jews’ for their endorsement of Einstein’s ideas. And urging the restoration of Aryan physics; no more of this Jewish nonsense. But Baker failed to spot the obvious conflict, the obvious hostile bias. ‘Badly written,’ he said to me. To sound like he was on the ball. With the sensible majority. But sounding instead like Mozart’s clueless royal patron in the movie Amadeus, witlessly sizing up the début performance of another eternal masterpiece: ‘Too many notes.’

Einstein’s early troubles gave Planck food for thought about the applied sociology of science, and particularly the closed-mindedness of folk whom one would imagine, of all of us, to be the most inquisitive and receptive to novel ideas and critiques of bad ones: ‘In science it takes, not thirty, but sixty years before a new, revolutionary insight can take hold. Not only the old professors, but their disciples as well, have to die off first.’ Goethe, long before him, explained why:

But in the sciences as well, that which one has learned and has had passed on at the academies is at the same time regarded as one’s personal property. Now, if someone comes along with a new idea which contradicts the creed – worshipped for years and passed on to others in turn to worship – threatening even perhaps to overthrow it, then all rise up passionately to suppress it by any and all possible means. One resists it any way one can: pretending not to have heard it, or deprecating it, as if it weren’t even worth the effort of inspecting and investigating it. And thus can a new truth have a long wait until it is finally granted recognition.

Kuhn made a similar observation to Planck’s about the need for experts to die before their bad ideas do so too, but provided a more mundane explanation: the paramount concern of such individuals is to maintain their nimbus of authority and the privileges that flow from them. Makgoba’s edgy responses to Mbeki’s questioning of the infectious AIDS paradigm affords a fine contemporary illustration.

Now that A critical analysis of the evidence for the existence of HIV is out at last, anybody who still imagines that there’s a viral tokoloshe running riot in bedrooms (particularly of the black poor) should take a look at this one, unless disposed to swarming with the mob contemplated a hundred and fifty years ago by Charles MacKay in Extraordinary Popular Delusions and the Madness of Crowds: ‘Every age has its peculiar folly; some scheme, project or phantasy into which it plunges, spurred on either by the love of gain, the necessity of excitement, or the mere force of imitation.’ A hat trick in AIDS I think, all three.

On the second anniversary of Mbeki’s startling parliamentary statements about AZT in late October 1999, the controversy was still blazing as hot as ever. On 24 October 2001 he was quizzed in Parliament about AZT and other AIDS drugs by the Pan African Congress’s Patricia de Lille MP: ‘Why is it toxic only for the poor people of this country who cannot afford it, but it’s not toxic for many Members of Parliament who are using the same antiretroviral drugs? Why are we not taking it off the shelves of the pharmacies and the doctors, if it is so toxic, so that nobody can have access to these antiretroviral drugs?’ De Lille was probably responding to Tshabalala-Msimang’s statement in Parliament on 5 June 2001: ‘Our position remains the same. We have no plans to introduce the wholesale administration of these drugs in the public sector. … [They are] not a cure for HIV-AIDS. … In addition, we remain concerned about aspects of toxicity.’

Adverting to the US health authorities’ receding enthusiasm for them, Mbeki replied: ‘Undoubtedly, ... if these drugs are toxic, they are toxic for everybody including Members of Parliament. I do not know how any conclusion can be reached that they are not for Members of Parliament. I don’t think they have a particular biology, the Members of Parliament.’ At which point, DA leader Tony Leon interjected to propose Mbeki’s head was cooked: ‘They have particular psychology.’ Raising a friendly laugh from his benches, Mbeki continued:

Maybe they have a particular psychology, but I don’t think that will save them from particular toxicities. This matter, Honourable De Lille, I really do hope you will study this issue. The US government at the beginning of this year ... radically revised the guidelines for the use of antiretroviral drugs and they said part of the reason they did this was because experience had shown them that these drugs had toxicities which had not [been] foreseen. They radically, I mean radically, revised the use of these drugs. They further issued other guidelines as to what needs to happen before you dispense any such drugs – a very, very detailed brief as to what the doctors should do before they dispense them because of these particular concerns. I can tell the Honourable Member where to get those guidelines on the website of the Centres for Disease Control in the US. She would see that when these matters are dealt with by people who are serious and approach these things from the point of view of health – the health of the people not propaganda, not religious faith – that there are very many complex questions with which we have to deal with regard to this, and that includes the ways and means and the measures and everything that need to be done before any doctor can responsibly dispense these particular drugs. And I would hope that if any Members of Parliament are taking those drugs they need to have a look at that so as to advise their own medical practitioners as to how to proceed. Otherwise they are going to suffer negative consequences, and that is real and that is actual. It is not a matter of propaganda. Thank you.

But de Lille didn’t bother.

Answering a friendly question from ANC MP Dr Abe Nkomo, Mbeki emphasized the importance of knowing precisely what illnesses

our people suffer from. It is important because, because our responses have to be governed by that reality. The health of our people should not, I believe, become a matter of political, ideological campaigns. … I do not believe that we should treat any health condition as a matter of superstition or religious belief. The science is important with regard to this. … Reference was made to treatment with regard to AIDS, a very contentious question. I’ve said to the Minister of Health: have we looked at the radically revised guidelines from the US government issued at the beginning of this year, about treatment with antiretroviral drugs, where they have said that these drugs are becoming as dangerous to health as the thing they are supposed to treat? We have to look at all these matters, not as matters about which you campaign in the street, but as matters on which you focus properly and accurately in order to save our people from ill health and to save them from unnecessary disease. I that is important.

Howard Barrell’s unbelievably badly drawn, self-pitying Christmas 2001 editorial, Here’s to Survival, on the second page of his Mail&Guardian (lauding ‘hard-pressed’ Makgoba) contended again that Mbeki was ‘in denial’ about AIDS (that fatuous Americanism that Cameron likes so much), ‘which we have everything but political will to eradicate’. Likewise those of his view:

Yet others have been willing to make themselves intellectually and morally insensible in order to survive. Over the past year, the upper ranks of the ANC and government have shown us just how easy it is to achieve this state of grace. They have either been prepared to believe the nonsense spoken by President Thabo Mbeki about HIV and Aids, or the have been willing to pretend they do. In the process they have not only made cowardice the principal virtue of their organisation. They have also gravely endangered the survival prospects of tens of thousands of South Africans, overwhelmingly poor and black. And it is debatable how well the credibility that these ANC and government leaders once enjoyed among us [white liberals] has survived the year.

As if the ANC cares. Or should. As if poor black South Africans need Barrell and company to race to their protection. Offering their vacuous Johannesburg liberal spume. Their preoccupations prioritised at the start of the piece: ‘There are only rape survivors, AIDS survivors, racism survivors, assault survivors – you name it.’ In that order. Not a peep about unemployment, hunger, tuberculosis and cholera survivors. The troubles affecting the majority of poor black South Africans who live outside of Bryanstone.

In The real report card in the same issue, the Mail&Guardian gave Mbeki a D+, principally for his ‘most signal failure as president – on HIV-Aids’. It mocked his ‘racial insecurity’ underpinning his approach, his ‘constant minimalising the threat posed by the disease’ (I’ve rephrased slightly), charged him with obsessing about antiretroviral drug toxicity, and conspiracy theorizing, not only about ‘greedy pharmaceutical companies’ but even with the CIA having a hand in HIV origination or spread. (Only in your tea-leaves, Howard. You weren’t listening.) And on it oozed. Mbeki’s government’s

foot-dragging on the rollout of anti-retrovirals has its deepest roots in his classic ‘denialist’ view that Aids drugs do more harm than good. His Aids stance has deeply dented him abroad and overshadows his advocacy of third world economic interests. A New York Times journalist [Donald McNeil,] recently told the M&G that he is known even in small towns in the United States [where TV-gaping, Bud-quaffing crackers live, whose opinions really matter to us] as ‘the African leader with the funny views on Aids’. … his obduracy on South Africa’s most pressing crisis raises grave questions about his judgement.

I suggest that white liberal journalists’ obsession with their AIDS fantasies to be a rather revealing clue to the quality of their own – revealed for how feeble it is in a fantastic editorial in the Mail&Guardian on 31 March 2000: ‘We are faced with the greatest threat to public health in this part of Africa since smallpox and other imported European diseases decimated the indigenous black tribes in the early years of colonialism.’ This time brought in by gay airline stewards. Originating in monkeys. Mutated somehow. Scary stuff.

Tshabalala-Msimang scored an ‘F for HIV-Aids. …not only does she have to deal directly with the tragedy of HIV/Aids but she also has to cope with the maverick approach to the problem publicly pursued by Mbeki and a coterie of merry Internet-surfing dissidents. The list of embarrassments to the government’s reputation at home and abroad on the HIV/Aids front continues.’

But the Mail&Guardian outdid its closing note on 2001 with an even better one on 11 January 2002, its front-page headline screaming Government blocks AZT to raped babies, on account of Northern Cape Health MEC Dipuo Peters’s criticism of doctors who gave the drug to a raped child, dubbed ‘Baby Tsepang’ by the press. However, in their extensive entries on AZT the authorities writing in the bibles of pharmacology, Martindale: The Complete Drug Reference, 32nd edition, 1999, and the 1998 American Hospital Formulary Service Drug Information manual (‘the most comprehensive authoritative source of evaluative drug information’) say nothing about using AZT for sexual exposure prophylaxis. You page back and forth through the Indications chapters in vain.

Tshabalala-Msimang had made the same point in Parliament on 1 November 2000. SAPA reported her responses to a question on the subject by Democratic Party AIDS boff Sandy Kalyan MP. She pointed out that there was ‘no scientific evidence to support the use of the anti-retroviral drug AZT for rape survivors … Glaxo Wellcome had never applied for the drug to be registered for use by rape survivors’ and ‘the Medicines Control Council had only registered AZT for the prevention of mother-to-child HIV transmission’. She accordingly challenged the DA ‘to explain what the party hoped to achieve by propagating the notion that the drug was effective in such cases’ and condemned its policy of administering AZT after rape in the Western Cape, asking, ‘Who are they using as guinea pigs? Our people?’ That the DA’s undisclosed principals are the international pharmaceutical corporations and not the South African electorate was revealed in her next complaint about DA leader Tony Leon and Western Cape Health MEC Nick Koornhof’s trip to Europe the week before to talk to the drug companies. Shaking a collection tin with promises of unremitting pressure on the government to buy AIDS drugs, you can be sure.

Their AIDS junket was a flop though. In an official rebuke on 29 December 2000, published by Independent Newspapers, Joel Netshitenzhe placed on record:

Remember the trip to Europe by Tony Leon and Nick Koornhof, to confer with pharmaceutical companies and UN bodies on HIV/AIDS drugs? In Geneva they wanted the SA Head of Mission to arrange meetings with the World Health Organisation and UNAIDS. In the event, the Department of Foreign Affairs had to turn down the request in order not to promote what they considered to be a partisan election gimmick. What is striking is that the DA emissaries had not consulted the Minister or Department of Health (of all of South Africa, by the way), or of Foreign Affairs. The saga seems to have ended with the letter from the Executive Director of UNAIDS [to Koornhoff, dated 30 November 2000] saying that ‘UNAIDS needs to be in contact with and respect the policies of national governments … It is not open to [UN agencies] to bypass central government …’ In other words, the DA leadership had to be reminded from Geneva, by a foreigner, that they are part of this South African state, and should respect their elected national government.

A few months after Moore’s unambiguous AZT-for-rape disclaimer, his CEO John Kearney claimed the contrary, before finally agreeing that Moore – and Mbeki and Tshabalala-Msimang – were right after all. In a trenchant résumé, How Mbeki Won The Great AZT And Rape Debate, in the Star on 9 October 2000, Robert Brand recounted the story. In the course of his parliamentary and then written challenges to Mbeki’s assertion of GlaxoSmithKline’s position regarding AZT post-rape HIV prophylaxis (dealt with in Debating AZT), i.e. that rape is not an indication, Democratic Alliance leader Tony Leon put up a letter dated 27 June 2000 from the company’s chief executive officer, John Kearney, in which he stated:

I am pleased to confirm that your reply to the president is essentially accurate on the scientific aspects of using AZT as post-exposure prophylaxis in individuals who have been raped. Together with you and your party, we look forward to the day when all individuals who have been subjected to the horrific crime of rape will have the opportunity to access anti-retroviral prophylaxis.

We look forward to the ringing of our cash register most of all.

Brand pointed out:

Anyone who followed the debate this far could be forgiven for thinking the scales had tipped in Leon’s direction. Kearney’s letter is a confirmation of Leon’s statement that AZT can prevent HIV infection in rape victims … What’s more, Kearney’s letter did not deny Leon’s [false, unfounded] contention [cooked up by Charlene Smith out of thin air] that Glaxo Wellcome had offered the government low-price AZT for the treatment of rape survivors, and that the government had turned the offer down. The inescapable conclusion is that it must be true. On July 1, however, Mbeki replied in writing to Leon that the scientific literature did not support his, and Kearney’s, contentions. Quoting at length from a report by the America’s Centres for Disease Control (CDC), Mbeki pointed out that no scientific data existed to support the theory that AZT can prevent transmission of HIV to rape survivors, and that the CDC in fact cautions against the prescription of AZT as a ‘morning-after pill’ because it is a dangerous drug with severe side-effects. ... Mbeki concluded, ‘I am very disturbed at Mr Kearney’s statement that your incorrect statements about AZT and rape are “essentially accurate on the scientific aspects.”’

But in a sarcastic editorial, Friends, Romans, countrymen ..., in the Mail&Guardian three days later, Barrell found quite differently from Brand, and convicted Mbeki of dishonesty: ‘“Brutus,” said Mark Anthony in that famously duplicitous speech, “is an honourable man.” And so we come to praise President Thabo Mbeki for the contributions he has made to the battle against HIV/Aids this week.’ After this smarmy introduction, Barrell turned to the

exchange of letters published at the weekend, between Mbeki and the leader of the opposition, Tony Leon. The correspondence, for those who missed it, turned largely on a report issued by the Centers for Disease Control in America on the suitability of the anti-retroviral treatment, AZT, for rape victims. Mbeki uses it to justify his government’s failure to supply AZT to rape victims. He does so on the grounds that there is no evidence that AZT prevents transmission of the HIV virus and that anyway its toxicity is so high and the risk of transmission by rape so low that the treatment is not warranted. An analysis of the president’s letter by Leon, in response, points to a distortion of fact by way of contextual manipulation which, if used by a second-hand car salesman, would verge on the fraudulent.

GlaxoSmithKline, however, dissented.

Following publication of Mbeki’s written exchange with Leon on the issue in the Sunday Times, Kearney did a skidding U-turn. He forwarded a statement to the weekly in which he retracted big-time:

Glaxo Wellcome first offered preferential pricing of its two anti-retroviral products, AZT and 3TC, to the South African government for use in the public sector in 1997 ... The exchange between the President and Leon implied that this pricing was also offered for use following rape, causing concern at Glaxo Wellcome because AZT is not registered for this purpose. The company has not engaged in any price or supply negotiations to provide AZT for use in rape survivors, nor does the company promote the product for that indication. Leon has therefore misinterpreted the company’s offer. President Mbeki is correct in pointing out Glaxo Wellcome’s package insert for AZT does not mention the medicine’s use in rape situations ... it has not thus far been possible to carry out clinical studies relating to the use of anti-retrovirals in rape survivors.

Notwithstanding that GlaxoSmithKline ‘emphatically’ recommended against it for rape; it wasn’t licensed anywhere in the world for this; the leading pharmacology textbooks didn’t so indicate it; there was no evidence for post-rape efficacy; the fact that the US Centers for Disease Control had warned against it as a dangerous ‘unproven clinical intervention’ in a low risk situation, doctors had a discretion to prescribe it after rape anyway, Kearney said.

A low risk situation means regular sex, since ‘HIV’, ‘AIDS experts’ all agree, is hard to transmit sexually, with your chances of getting the virus being between 0.1-0.2 per cent, says the Centers for Disease Control, i.e. it takes a woman five hundred to a thousand lays on average with an HIV-positive man to pick up the lurker. The CDC’s wisdom about the very low sexual infectivity of ‘HIV’ derives from a ten-year study it funded by Padian et al., published in the American Journal of Epidemiology (146(4):350-7) in 1997: Heterosexual transmission of human immunodeficiency virus (HIV) in Northern California – ‘the largest and longest study of the heterosexual transmission of HIV in the United States’, as epidemiologist Nancy Padian and her colleagues billed it. In other words, the best. In fact the usual trash from American ‘AIDS experts’. But mighty surprising were its results in any event.

Fred Cline in San Francisco pointed out in a private note that for a start, the original purpose of the study was not epidemiological – to establish HIV infectivity in condomless sex; it was evidently a behavioural study to investigate what it called ‘behavioral obstacles to use of condoms’ – being what intensive ‘counselling focused on’ throughout the study. He quotes further from the report: ‘In addition to the scheduled counselling, study staff were available to participants at any time by telephone via an 800-number. Other sources of social support included a “buddy” system in which individual participants were matched with other participants, and phone numbers and addresses were exchanged. Quarterly social gatherings, information nights, and a quarterly newsletter were also initiated.’ All to drive home the CDC’s scary new message: if you light up the HIV test, wear a condom, because loving kills. Had the study been designed to track HIV seroconversion, strenuously counselling couples ‘together regarding safe sexual practices’ (the use of condoms) would have been to confound it. Obviously.

Although the researchers reported that ‘Significant behavior change over time in serodiscordant couples was observed’, their safe-sex message fell on deaf ears much of the time: seventy-five per cent of couples (one partner HIV-positive) were not using condoms when recruited to the study. But of that lot, a quarter continued practising ‘unsafe sex’ throughout the study. Of a ‘total of 82 infected women and their male partners and 360 infected men and their female partners … We observed no seroconversions after entry into the study.’

In plain talk, nobody was seen to infect anyone. The minute risk for a woman to become HIV-positive after sex with an HIV-positive man (and it’s eight times lower vice versa) was inferred by Padian et al. from the small number of couples who entered the study both HIV-positive – on the assumption that one had infected the other. And nothing else. In sum, ‘the largest and longest study of the heterosexual transmission of HIV in the United States’ provides no evidence that HIV is sexually transmitted – instead, it adduces evidence that it isn’t.

Two years earlier Stuart Brody had noted in Archives of Sexual Behavior (1995 Aug;24(4):383-93): ‘... there has been the assumption in both scientific and lay communities that vaginal HIV transmission commonly [occurs. But] the basis for this assumption rests on data that are unacceptably weak or flawed. The need for sexual behavior change that has been claimed by public health and other authorities is not supported by the scientific data.’ Brody elaborated the point in his book published in the year that Padian et al. published their study, Sex at Risk: Lifetime Number of Partners, Frequency of Intercourse, and the Low AIDS Risk of Vaginal Intercourse (Transaction Publishers, 1997).

But let’s allow for argument’s sake that the Padian study definitively determined the risk of catching HIV. From lovemaking. In a letter to the British Medical Journal on 27 April 2002, Heterosexual transmission of HIV in Africa is no higher than anywhere else, Papadopulos-Eleopulos et al. pointed out that at such an extraordinarily low transmission rate, ‘it would take 770 or 3333 sexual contacts [male to female] ... to reach a 50% or 95% probability of becoming infected. If sexual contact were to take place repeatedly every three days this would require a period of 6.3 and 27.4 years respectively. Based on the estimate of female to male transmission by Padian et al. it would require 6200 and 27000 contacts and a period of 51 and 222 years, respectively.’ Which reduces the very idea of heterosexual transmission of HIV to a joke.

No, say the ‘AIDS experts’, blacks in Africa are full of syphilis and venereal diseases; HIV passes much more readily via their open sores. (Syphilis researcher Allan Pillay at the Nelson Mandela Medical School in Durban – like Coovadia and Karim, another South African Indian expert on the supposed prevalence of venereal diseases among blacks – claimed in NU Focus in 2000 that ten per cent of people in KwaZulu-Natal are syphilis infected. And he didn’t mean white or Indian people.) But Gray et al., reporting the Probability of HIV-1 transmission per coital act in monogamous heterosexual, HIV-1 discordant couples in Rakai, Uganda at the 8th Conference on Retroviruses and Opportunistic Infections in Chicago 2001, and later that year in Lancet, put paid to the theory that blacks infect one another with HIV more readily than whites. Papadopulos-Eleopulos et al. pointed out: ‘The probability of transmission per sexual contact was 0.0009 for male to female and 0.0013 for female to male respectively … The authors concluded that the probability of HIV transmission per sex act in Uganda is comparable to that in other populations.’

Kearney’s statement to the Sunday Times about AZT for rape, implicitly admitting that he’d told a barefaced lie, was dressed in the entertaining protesting-too-much of a preacher caught with his hand up a stripper’s dress. And prefaced with some Robert Maxwell slime:

Glaxo Wellcome is concerned that it has become a subject of last week’s correspondence between President Thabo Mbeki and the Leader of the Opposition, Tony Leon, as reported in ‘AIDS: Mbeki versus Leon’ (July 9), when South Africa and the world battle with a serious AIDS crisis. This should be a time for stakeholders to come together to find common ground rather than a time to polarise the debate. There were a number of misconceptions and errors contained in the two letters printed in your newspaper, and thus, to correct the misunderstanding and make a meaningful contribution to the discussion, Glaxo Wellcome wishes to put on record the following points: [‘quoted above’].

But the sweets, as always, were for last. Having just let on that he was a bigger liar than an insurance salesman, Kearney concluded:

Glaxo Wellcome is proud of the highest ethical standards of its operation in South Africa and worldwide. Glaxo Wellcome SA does not engage in any direct or indirect support for political parties, as it believes that healthcare needs to transcend political discussion although the company does provide information and assistance on its products when these are requested by a legitimate source. Glaxo Wellcome’s excellent track record was this year once again confirmed when 151 general practitioners and 35 managed healthcare leaders in South Africa voted Glaxo Wellcome as South Africa’s most ethical pharmaceutical company. We trust this clarifies the issue. John Kearney, CEO, Glaxo Wellcome South Africa, Johannesburg.

It certainly does, John. We think you’re a bunch of murderous rogues. We think you should be put up against a wall. And your goods trucked off and burned.

But propaganda triumphs over the facts. As we saw in the Mail&Guardian’s AZT-treated raped baby story. And the hoopla earlier in the year when a bunch of charitable ladies got together to form an outfit called the Greater Nelspruit Rape Intervention Project (GRIP). The intervention being the ‘clinically unproven’ one. Justin Arenstein wrote up GRIP’s woes for African Eye News Service on 25 February 2001: reporting that Mpumalanga health MEC Sibongile Manana had just kicked them out of provincial hospitals for giving free AZT and 3TC to rape victims, and had banned it for this indication, having ‘insisted during a series of public tirades late last year that the drugs endangered black lives’, he concluded, full of liberal human rights aggrievance, that the AIDS Law Project had run off to tell: ‘Manana has also forbidden doctors in the hospital from writing out prescriptions for AZT for rape survivors. GRIP cannot provide the AZT without a doctor’s prescription. The AIDS Law Project (ALP) has reported this to the Law, Human Rights and Ethics Committee of the SA Medical Association and requested that they investigate the ethical dilemma which these doctors find themselves facing.’ If they read more than shiny drug advertisements, and Mercedes Benz and BMW brochures, they wouldn’t have one. And they might have come to similar conclusions as Manana – HIV had nothing to do with AIDS anyway, and it was unconscionable that black women be used as guinea pigs for testing antiretroviral drugs in an unproven application. GRIP, she said, was placing ‘the health and lives of our poor black people … under serious threat … [by giving them] poisonous drugs’. She was absolutely right, but AIDS activists and journalists went into a moral frenzy. Aids angel faces ‘Dr Death’ witchhunt, reported the Star on 4 March 2002 in a typical article.

The ANC Women’s League joined the fray, circulating a petition in which it noted that

as card-carrying members of the ANC and the ANC W/L, we distance and dissociate ourselves from all activities of GRIP … those who buy AZT to poison and kill our people. … As members of the ANC, we cannot defy our government and its policies. We cannot defy our President Thabo Mbeki in his call against the use of AZT. We cannot defy our national MEC Manto Tshabalala. We cannot defy our provincial MEC Sibongile Manana.

Tshabalala-Msimang supported Manana’s decision to evict the kindly white women, but the latter was forced to concede the unlawfulness of summarily locking the GRIP ladies out, and had to let them back in. An application for an ejectment order bombed in May, but she didn’t give up, and tried again early in 2003 on amended papers.

Liz Clarke on the Saturday Star nearly spilled her tea when she read the Mail&Guardian’s outraged AZT-treated raped baby article. She reported in turn the ‘Official censure of doctors who gave the antiretroviral medicine AZT to the 9-month-old Upington baby who was gang-raped last year’ (all accused were cleared by DNA test results showing them innocent after several months in gaol) and quoted Zackie Achmat with sympathetic nodding in her front-page headline article, Ethical war looms on HIV. Drama queen at every opportunity, he flapped: ‘It can only be Thabo Mbeki’s belief that antiretrovirals like AZT are toxic and destroy the immune system. There is no other explanation for the paranoia that’s going on. … The unthinkable [has happened] … If the government wanted a public relations disaster – one involving a horrifically abused baby – then this it is. I can’t imagine what they think of us overseas. … We are already the laughing stock of the world when it comes to official Aids policies.’

Gales of laughter will be billowing in your direction, buster, when word starts getting around about how you’ve been foolishly comporting yourself as GlaxoSmithKline’s backroom concubine. Doesn’t the FDA itself (in its press release on 5 March 1990) say: ‘The drug can inhibit the production of red blood cells and may reduce white blood cell counts to the point where the drug has to be discontinued to avoid infections’? In other words it’s ‘toxic’ and can ‘destroy the immune system’? That AZT destroys all types of white blood cells (leucopenia, granulocytopenia) is warned against in GlaxoSmithKline’s AZT Product Information advisory in bold capital letters: ‘WARNING: RETROVIR (ZIDOVUDINE) MAY BE ASSOCIATED WITH HEMATOLOGIC TOXICITY INCLUDING GRANULOCYTOPENIA AND SEVERE ANEMIA.’ Neutropenia gets a special mention – the suppression of a class of white blood cells named neutrophils, essential for overcoming bacterial infections. Harrison’s Principles of Internal Medicine explains: ‘Leukopenia, and particularly neutropenia, increases the risk of infections complications in patients receiving chemotherapy. Fever is the hallmark of infection. Any patient with neutropenia ... and fever requires a prompt medical evaluation and subsequent administration of empirical, broad spectrum parenteral [injected] antibiotics.’

In AIDS Inc., Farber explains Achmat’s moral tone:

AIDS Inc. has proven vastly profitable not just in terms of money, but perhaps more importantly, that invaluable commodity: Glory. The opportunity to be in a position of perpetual Rightness, commenting publicly on others people’s perpetual Wrongness. If it sounds like religion, that’s precisely, in my opinion, what it is. We do live in a secular age, and we have no war, no global threat, no communism or fascism to direct our “moral” energies toward. Something had to spring up in the cultural and political void that opened up in the mid 1980s, and AIDS – with all its attending politics and phraseology – fit the bill precisely, because it offered something to believe in, something to ‘fight’ for, something to measure one’s goodness by. Suddenly, there was a fixed set of political mandates: Get tested, have compassion, be educated (terrified), use a condom (no, beyond ‘use a condom’ – consider sex deadly, consider latex political etc.), raise awareness (what is awareness?), fight discrimination, raise money for ‘AIDS research’, and finally save lives. All of this sounds benign and sensible enough on the surface of things, but like with so many righteous cultural movements, one is struck by the sheer nastiness of the do-gooders in charge, particularly if one dares hold a different opinion, or hold up some fact that conflicts with their world view.

It’s this grand religious dimension of AIDS ideology that makes it so attractive to clerics, just as similar baits drew German and Austrian doctors to Nazism in droves – almost half of them, with nothing like the rush among teachers and lawyers. So we have Anglican Archbishop Ndungane pulling open the shingle curtain at new premises for HIV research at the Chris Hani-Baragwanath Hospital, reported in the Daily Dispatch on 26 January 2002, and scolding, Gov’t stance on Aids drugs ‘a sin against God’:

Government was sinning against God by denying life-saving medication to mothers and children facing the threat of HIV-Aids. … When government stands in the way of our right to life, then government has overstepped the boundaries. Withholding truth and maintaining the silence is sinful. The current policy of silence and denial, which withholds life itself, is unacceptable. It violates our Constitution, which guarantees life to all citizens and for which many have already died in the struggle for our freedom. … we are frozen in the headlights of bureaucratic stubbornness.

A soul converted by the TAC, the Most Reverend reads life in skulls and crossbones. As he does in the lynching of maverick moral prophets. And complains about official silence in regard to the drugs despite Mbeki’s and Tshabalala-Msimang’s repeated precise detailing of their reservations about them in Parliament and to the media. Just as AIDS activists chant about ‘Breaking the Silence’ – the official slogan of the 13th International AIDS Conference in Durban in July 2000 – while their mass hysterical epidemic saturates the newspapers and airwaves.

To my knowledge, the only dissenting cleric in South Africa, alive to the essential racism of the African AIDS construct, the scientific humbug it all is, and the horror of its medical management is the Reverend OJ Tselapedi, former Speaker of the North West Province Legislature, now MEC for Education, his blood iced by Debating AZT, and tracking the controversy closely since.

Belinda Beresford’s article in the Mail&Guardian on 1 March 2002, Nevirapine is a Godsend, provided an interesting illustration of the confluence of Western religious and medical ideas around AIDS; how religious and medical hierarchies synergistically reinforce each other’s power when invoking its terrors; how the Church enforces medicine’s new dogma and thereby lends it credibility; and how medicine’s AIDS model in turn legitimates the Christian religion’s repressive sexual rules. Archbishop Njongonkulu Ndungane actually writes from this rubric in his book, The World with a Human Face: A Voice from Africa (David Philip, 2003): ‘We must develop new respect for the ancient wisdom of the Church about monogamy as being crucial for our survival. We must acknowledge that the Church’s traditional teaching of fidelity is about life not limitation. We must accept the responsibility of the larger community for our sexual behaviour.’ We must take instruction in sex. Not to have it. Without approval. From the authorities. That this is what he meant, and not just faithfulness between lovers, was explicitly spelt out in his response to Being Human, a report released in mid-2003 by the Church of England’s Doctrine Commission, which declared after seven years of vexing deliberation that it no longer considered pre-marital sex a sin. You magazine sought Ndungane’s response for an article about it on 21 August, Sex and singles: it’s okay. ‘Local Anglicans are sticking to their point of view, which is no premarital sex, says Anglican Archbishop Njongonkulu Ndungane. “Anglicans are obsessed with sexuality. It detracts attention from so many more important things – poverty, Aids, war and peace...” he adds.’ Best pretend that good Christians don’t share humankind’s strongest and highest impulse. Call it wicked. Without a ring. And enforce the ban on it by threatening the death penalty. With the support now of the doctors.

In early July the second Christian Leadership Assembly met in Pretoria to discuss what it called the giant ‘Goliaths’ staring down on ‘David’, the new South Africa: crime, family breakdown, HIV-AIDS, poverty, racism, sexism, unemployment and violence. The first meeting in 1979 had concerned the church’s response to the humanitarian and political crises caused by apartheid, and AIDS aside, the issues on the agenda of the second meeting were real enough too. But none mattered to Ndungane, who descanted in his address that AIDS was the ‘prime Goliath that all God’s people need to tackle’ (as Bishop Suffragan Thabo Makgoba of Grahamstown reported his speech). Caused by too much sex, they implied. With which ‘Anglicans are obsessed’ as Ndungane told You a few weeks later. Everybody else too.

Instead of snorting in her article, we see Beresford, the hip liberal journalist, reverentially quoting some shrivelled white vestal virgin in her lifeless black and white smock at a Catholic hospital clinic, talking ugly about blacks: ‘The focus on the prevention of pregnancy has not stopped the killing of our women, because they go from partner to partner and get this terrible disease.’ Being especially promiscuous, being black. ‘Two lines almost certainly mean an early death; one means life. And the few minutes spent waiting for the telltale marks are often an epiphany for the watchers.’ Notice how she delights in the dance with death. ‘They are the women, and the occasional man, being tested for HIV at St Mary’s hospital in Mariannhill [Catholic monastery] near Durban, KwaZulu-Natal. Whatever the result, watching their blood being tested in front of them means there is no denial: no protesting that the wrong blood was tested or the results mixed up.’ You’re going to die from all that shagging around in the locations; get used to it. Beresford reported gaily: ‘Unlike government officials who have questioned the toxicity, efficacy and use of nevirapine, [Sister Christa Mary] Jones has no reservations about the use of the drug. Fully versed in local and foreign research into transmission of HIV from mother to child, she says: “Nevirapine is a godsend.”’

Just as the Church in South Africa has opportunistically sniffed out and ridden the cultural and political up-draft presented by the bush-fire spread of AIDS ideology to buttress its behavioural prescriptions and proscriptions, both the Catholic and Protestant faiths identified with the rising tide of Nazi spirit in Germany. Though their relationship was complex, and not infrequently averse – increasingly as the romance aged – much was enjoyed in common. Grunberger quotes Bishop Bürger: ‘“The aims of the Reich government have long been those of the Catholic Church”, and much was made of Catholic concurrence in the Nazi anathema on Communism, Liberalism, Atheism, Relativism, and Permissiveness. Burger’s brother in Christ, Bishop Gröber of Freiburg, invoked venerable traditions in support of Nazi racism by referring to the Jesuit Order’s stringent exclusion of applicants of Jewish ancestry. Other theologians became quite lyrical in their apotheosis of Hitler. [Professor Adam of Tübingen praised the Führer:] “Now he stands before us, he whom the voices of our poets and sages have summoned, the liberator of the German genius. He has removed the blindfold from our eyes, and through all political, economic, social, and confessional covers has enabled us to see and love again the one essential thing – our unity of blood, our German self, the homo germanus.”’

In a parallel with AIDS ideology and the Christian religion’s disapproval of sexual connection outside tightly constrained limits, ‘Antisemitism,’ Grunberger noted, ‘provided a tempting point of convergence for Nazi dogma and a deep-seated Catholic animosity’. Protestant animosity too, because ‘When Nazi Germany startled the world by a countrywide boycott of Jewish shops in 1933, Generalsuperintendent Dibelius lent the moral support of a leading Protestant dignitary to the boycott as a means of reducing “Jewish over-representation in business life, medicine, law and culture”. … German patriotism represented another – and less contentious – area of agreement between Church and State. When Wehrmacht units re-entered the demilitarised Rhineland in 1936, they were met at Rhine bridges by censer-swinging Catholic priests who conferred blessings on them.’

For black folks not naturally taken by the loving-equals-dying dogma propounded by doctors and priests, the Catholic clinic resorts to deceit. Beresford approves the trick:

Slightly set aside from the main waiting area is a table laden with newspapers and books for clients to browse through. But even here ignorance and isolation are not safe. For lurking among the reading matter is at least one counsellor, trained in the art of striking up conversation. This, says Jones, means that even the shyest of women can find themselves chatting to a counsellor outside the more formal setting of the treatment room. The three counsellors are carefully chosen to appeal to a wide range of patients. The one is a nun, the other is an older, married woman with several children, and the third is a young single mother who is due to be married later this year. This attention to human psychology led to the routine of people being tested for HIV during the counselling process, so they can see the results. Positive tests are given a second and even a third confirmatory one. Negative patients are given a certificate to that effect and intensive counselling to try to ensure they stay that way.

The noteworthy thing about Beresford’s contemptibly reactionary pabulum is that it passed as liberal-left journalism. Nobody wrote in to the Mail&Guardian to deride it. Or comment that, compared with Christianity’s rules, AIDS ideology’s new sexual codes taste remarkably like old wine in new bottles.

The mutually handy alliance between doctor and priest in colonial penetration and cultural domination was noted by Doyal and Pennell:

Initially medical missionaries were concerned only with the health of their fellow evangelists, but the proselytising potential of the ‘signs and wonders’ used to reinforce the gospel soon became clear … The ‘kindly influence’ of medical work was, as one missionary noted in 1899, considered most effective in preparing the ground for imperialist domination: ‘The usefulness of the medical arm of the missionary service is indisputable. It breaks down opposition, dissipates prejudice, and wins its way to the hearts and homes of the high and low, the rich and poor.’

Like the Mormon one, the American medical mission is alive and well in modern times: the Atlanta Journal and Constitution reported on 5 June 2002 how the CDC is sending out increasing numbers of its staffers

for two-year stints on the front lines of disease detection. They arrive in July and go through three weeks of basic training. And then they wait, hoping to be deployed to a disease outbreak somewhere in the world [in places such as] Latvia, South Africa and India. … Being sent abroad by the CDC can mean dropping in to a country for several days to gather data on a disease outbreak. Or it can mean digging in for intensive work on a problem: The chief of the CDC’s AIDS project in Botswana, for instance, has been there for seven years. … Four years ago, Congress allowed the agency to begin a Global AIDS Program. Funding has gone from $35 million in the program’s first year to $145 million this year. The program is operating in the Caribbean and in 25 African and Asian countries, employing 100 CDC staff and more than 300 foreign nationals. … In Africa, the Global AIDS Program is working with the governments of 17 countries to develop programs that encourage voluntary HIV testing, prevent mother-to-child transmission, treat secondary infections and develop the country’s capacity for laboratory analysis and disease detection. … Photo: A baby with AIDS at the Cotlands Children’s Hospice in Johannesburg, South Africa.

We’ve got Canadians coming over to join the fight too:

The Eastern Cape Technikon,’ reported the Daily Dispatch on 11 October 2002, ‘is developing an HIV-Aids health education programme with the help of two young Canadian women. Kathleen Saurette and Melanie Talson will be ... working at the Butterworth campus with the newly formed HIV-Aids Unit … The Canadian International Development Agency will be providing funding.

No matter how hard the Church tries, though, it can’t seem to sell its new scare story to rural men in KwaZulu-Natal. They’re just not convinced, and it’s all Mbeki’s fault. This was the protest of Anglican Bishop Peter Lee in a letter to the ANC’s head of religious affairs Cedric Mayson in late 2001. Mbeki’s doubts about the link between sex and AIDS – not surprising, because there’s no evidence for it whatsoever, just passionate belief – ‘is the message that is destroying human lives across this country, and for which President Mbeki is being daily judged at the bar of history’. So reported Beresford’s colleague on the Mail&Guardian, Jaspreet Kindra, mournfully on 9 November 2001. The bishop’s daughter in her mid-twenties wasn’t having any joy getting the message across to these guys, he moaned. Whenever she tried to ‘counsel them around issues of sexual behaviour, there has been one constant response: “The big man says there is no connection between sex and Aids – so I will carry on as before.”’

One can just picture the scene: some twerpy pale nerd in a pink jersey, full of the Lord, a Bible in one hand, a condom flapping in the other, with a spiky little gold crucifix mounted between her tits like suburban razor wire, announcing hands off, vainly lectures a pack of stout black country dudes, telling them that their vital appendages don’t actually plant life and bring happiness all round, as nature and experience have taught them, but instead sow and gather death – and after a moment for Prissy Missie’s funny lesson to sink in, they all look at each other quizzically and then laugh their heads off.

Xhosas have a wry aphorism: ‘Iintsholongwane ize nabelungu’ – germs arrived with white people – and Zulus would see it alike: ‘Sisi, we know you Europeans are fixated on germs, but really you are now taking this thing too far.’ Of course, Kindra didn’t see the joke either. She carried on, reporting the bishop complaining that Mbeki’s thoughts about AIDS have ‘been universally construed as fudging the causal link between sexual behaviour and the disease’. Unlike other African leaders, he had not declared that that ‘personal behaviour change is the key to cracking the epidemic’.

Misguided Mbeki thinks that better living conditions will alleviate the disease burden of the poor, rather than chastity belts. Can AIDS missionaries like Bishop Lee and his geeky daughter refer us to any study showing that in regions in Africa where the incidence of AIDS-defining diseases is high (formerly called diseases of poverty), celibate spinsters and prepubescent children are notably spared the Grim Reaper’s scythe?

Apart from AIDS ideology’s quasi-religious characteristics, we earlier read philosopher David Mertz laying out its parallel socio-political functions. Greg Nigh, a scholar of naturopathic and Chinese medicine, also described them, with an emphasis on their American manifestations, at the launch of an Internet forum in 1999 for the discussion of these dimensions:

I have long believed that AIDS is a political issue, not a biological one. … AIDS is being used as an instrument of social control. It justifies laws and jail terms, forced drugs and toxic babies, suicidal guilt and mandatory name reporting, etc. … AIDS justifies foreign intervention, though not by military means, yet. AIDS exports Western drugs, Western science, Western values, Western ‘expertise’, Western economics and Western development. AIDS serves one function nationally [in the US] and quite another function globally. … Locally, AIDS ‘tags’ a population already labeled as deviant, dangerous, and diseased. Globally, AIDS offers a medical justification, or cover, for processes which are economically motivated, not health motivated. … I am inclined to liken HIV to a state-sponsored mythology, much like other useful mythologies such as the myth of the Soviet Union during the Cold War, the myth of the Welfare Queen in the Bush years … Data show them all to be insubstantial, but they all serve a ... valuable and socially coercive purpose which benefits the various powers that be. … HIV has good staying power because it also serves very powerful economic interests. If it didn’t, it would be a passing fancy like the rest.

‘An instrument of social control.’ Think about all those AIDS counsellors fanning out all through our country, terrifying people with information sombrely imparted, which they picked up from the AIDS education pamphlet. Like the Roman Catholic Church at its peak asserting its creepy doctrines through priests in every village. Controlling sexuality, since pent up primal energies are always fruitful to tap. Amplified and repeated daily on billboards, the radio, television, newspapers and magazines. So that you begin to think, ‘If there’s so much smoke there must be some fire.’ Forgetting that there’s a paper trail. The kind accountants keep. And it leads back to the drug companies. Or to enormous foundations converted to the faith. Like Bill and Melinda Gates’s. Themselves propaganda coups. Or ‘aid’ organisations. Private lives regimented. Groups mobilised. Everyone cowed. Obedient. Disciplined. Medical power intruding into the most private of private domains. Swelling its fortunes with the new tithes it draws thereby. Personal power and riches aggregating around those who contend for these peculiar new ideas most stridently. Modern sorcerers proclaiming knowledge about a hidden malevolent agency, and the power both to sniff it out and curb it. The Western diviners – ‘those who know’ as Xhosas call them. Throwing hi-tech shells, stones and bones. Followed by the occasional blood-curdling shriek. Because as soon as you look closely at all the tests, you realise aghast that that’s about all they amount to. Props to modern necromancy. And all this going down in the clever age.

Writing anonymously in a dedicated HIV/AIDS in Africa issue of the South African Catholic journal Grace and Truth in August 2001, ‘John’ said it like it is:

In the seven years since my diagnosis, AIDS has grown into both a major public health issue, and a multi-million rand industry. Doctors and clinics are making a fortune by conducting clinical trials. Hundreds of NGO’s are dependent on AIDS for continued funding. Thousands of individuals have built careers for themselves as activists and consultants in the ‘AIDS Service Sector’. The whole circus is driven by lavish funding from pharmaceutical companies, who have a vested interest in promoting a scenario of disease and death.

Beginning early too: the South African National Curriculum prescribes that from as early as the ‘Foundation Phase’, pupils must be able to ‘identify and explain how to protect themselves from at least three infectious and contagious diseases, including HIV/Aids.’ The Life Skills and HIV/Aids Education, Primary School Programme, Grade Three Activity Book, prepared by the Department of Health, runs a comic strip explaining that

HIV is a very powerful germ [a germ?] that attacks the white blood cells. [Not according to Hoxie et al., who reported Persistent Noncytopathic Infection of Normal Human T lymphocytes with AIDS-Associated Retrovirus in Science in 1985 – meaning, in plain terms, that cultured immune cells purportedly inoculated with HIV, and expected to die, did just fine.] The battle between the white blood cells and the HIV germ can last many years. HIV eventually kills the white blood cells and other germs can then enter the body. [Ho’s new model of massive, prolonged immunological warfare, as alleged here, was shot down on the pages of Nature in the mid-nineties by his fellow ‘AIDS experts’ themselves no sooner than it was published.] The new germs can now attack and kill the body. [So how do we account for ‘AIDS sufferers’ with high CD4 cell counts?] We call this illness Aids.

Measles and ‘cold germs’ are included in the graphic. So if you’re HIV-positive and have a runny nose, wow, you’ve got AIDS, mister. Likewise a child with measles. In South Africa, if nowhere else in the world. Courtesy of South African ‘AIDS expert’ consultants to the Department of Education.

Kgobati Magome, Minister of Education Kader Asmal’s advisor on HIV and AIDS, told Parliament on 3 September 2002 that Asmal would be launching a new series of Takalani Sesame later in the month, featuring a Sesame Street puppet character ‘living with HIV’, the idea being ‘to model caring environments, so that children whose parents have died of Aids, or are themselves infected, are normal and are just like everyone else’. Aren’t they supposed to die soon? With the grown-ups infecting everyone they love? Between the sheets, I mean. Speaking at the launch of the new show two weeks later, Asmal said, grinning as ever, that not only was South Africa the first country in the world to feature Kami the infected muppet, but that we were also the first to broadcast a radio version of the show too: ‘As many of our children live in featuring, rural areas, often with no access to television or electricity, we needed to make it possible for children to have access to the programme through radio.’ So that the children can be taught that intimacy can kill you.

Those officials in the Department of Health who’ve made AIDS their business appear not to have thought very carefully about the message they’re sending to kids at African primary schools in the Eastern Cape, and, I imagine, in other provinces. Where nurses call, without consulting parents, to distribute boxes full of condoms. Presumably the kids edging into adolescence are not intended to use them as party balloons.

CHAPTER

In Manufacturing Consent (quoted by John Lauritsen in The AIDS War (Asklepsios, 1993)), Noam Chomsky and Edward Herman give a good account of the rut Howard Barrell led the Mail&Guardian into, cut by its coverage of AIDS – an age away from what it used to be under Anton Harber when the newspaper articulated our country’s conscience during the late apartheid era:

In contrast to the standard conception of the media as cantankerous, obstinate, and ubiquitous in their search for truth and their independence of authority, we have spelled out and applied a propaganda model that indeed sees the media as serving a ‘societal purpose’, but not that of enabling the public to assert meaningful control over the political process by providing them with the information needed for the intelligent discharge of political responsibilities. On the contrary, a propaganda model suggests that the ‘societal purpose’ of the media is to inculcate and defend the economic, social, and political agenda of privileged groups that dominate domestic society and the state. The media serve this purpose in many ways: through selection of topics, distribution of concerns, framing of issues, filtering of information, emphasis and tone, and by keeping debate within the bounds of acceptable premises. … The U.S. media do not function in the manner of the propaganda system of a totalitarian state. Rather, they permit – indeed, encourage – spirited debate, criticism, and dissent, as long as these remain faithfully within the system of presuppositions and principles that constitute an elite consensus, a system so powerful as to be largely internalized without awareness.

The Mail&Guardian, leading other media in South Africa, has consistently reported on AIDS drugs from the assumed and frequently expressed premiss that they are ‘life-saving’, thereby entrenching a superficial Coke/Pepsi paradigm for the discourse, with any enquiry into their benefits strictly off-limits.

Goebbels explained the effect of successful propaganda: ‘This is the really great art – to educate without revealing the purpose of the education so that one fulfils an educational function without the object of that education being in any way aware that it is being educated … which is also indeed the real purpose of propaganda. The best propaganda is not that which is always openly revealing itself; the best propaganda is that which as it were works invisibly, penetrates the whole of life without the public having any knowledge at all of the propagandistic initiative.’ Hence the almost universal belief that AIDS drugs are good for you.

Having lived in the Nazi state, Shirer described in The Rise and Fall of the Third Reich the effect its propaganda had on him:

I myself was to experience how easily one is taken in by a lying and censored press in a totalitarian state. Though unlike most Germans I had daily access to foreign newspapers, especially those of London, Paris and Zurich, which arrived a day after publication, and although I listened regularly to the BBC and other foreign broadcasts, my job necessitated the spending of many hours a day in combing the German press, checking German radio, conferring with Nazi officials and going to party meetings. It was surprising and sometimes consternating to find that notwithstanding the opportunities I had to learn the facts and despite one’s inherent distrust of what one has learned from Nazi sources, a steady diet over the years of falsifications and distortions made a certain impression on one’s mind and often misled it. No one who has not lived for years in a totalitarian land can possibly conceive how difficult it is to escape the dread consequences of a regime’s calculated and incessant propaganda. Often in a German home or office or sometimes in casual conversation with a stranger in a restaurant, a beer hall, a café, I would meet with the most outlandish assertions from seemingly educated and intelligent persons. It was obvious that they were parroting some piece of nonsense they had heard on the radio or read in the newspapers. Sometimes one was tempted to say as much, but they responded with such a shock of silence, as if one had blasphemed the Almighty, that one realized how useless it was even to make contact with a mind which had become warped and for whom the facts of life had become what Hitler and Goebbels, with their cynical disregard for the truth, said they were.

David Beresford similarly responded to my deliberately offensive identification of the soul of AIDS, its outlandish core organising creed, as the proposition that ‘fucking can kill you’ by tut-tutting in the Krisjan Lemmer column of the Mail&Guardian: How could this self-proclaimed scientific genius (or similar phrase) make such a stupid remark? Everyone knows it can.

In his essay, The State and Social Transformation – Observations on the South African Development State Since 1998, published in Umrabulo 10, concerning the ‘influence of global mass culture’, Peter Mokaba observed:

We will have to contend with the global mass culture driven by information imperialism, the power of advertising and mass communication through radio, television and cinema which promote the consumer ideal for which one is to strive, the dreams one is to have, the books one is to read, the way one is to behave, the style in which one is to dress, to treat one’s friends, relatives, neighbours, visitors, strangers, and to react to this or that report of event. The result is a massive stereotyping of every aspect of the citizen’s everyday life, including emotions and mentality. In South Africa these are informed, mainly, by the media which forms part of the most reactionary forces among those offering consistent ideological resistance to transformation. It is a powerful tool of manipulation, information and propaganda. For example, in the 1995 Media and Market Research of Jocelyn Cooper it was indicated that 70 per cent of the people North of the Parktown Ridge get their information from the newspapers only. They normally do not consult other sources of information

– newspapers like the Mail&Guardian, the Star and the Sunday Independent, and so on, all stuck like a gramophones in their HIV-AIDS grooves. Which is why mention of the model’s obvious paradoxes and anomalies to educated people always startles them. Folk from the Parktown Ridge classes especially.

And whose opinion gets expressed in the media, the newspapers especially. A discussion document published in Umrabulo 16 in August 2002 on the need to transform the media answers incontestably:

Too often we are provided with expert analysis exclusively from white men, sometimes white women, occasionally black men and very rarely black women. This is not because black women (or men) lack insight or are unwilling to express their views, but because we have not worked hard enough to break down the racist and sexist intellectual hierarchy in the country. The media need to analyse very critically the race, gender, class and age profile of the people it gives voice to. … in broad terms the mass media in South Africa is still shaped by the same political and economic forces which existed under apartheid. As a result, it tends to reflect the interests, views and political aspirations of those who benefited from apartheid. … Because the mass media has such a profound effect on shaping public opinion and has such a great capacity to disseminate information, this bias distorts the democratic process and limits public debate and broad access to information.

About the AIDS controversy, the facts about AZT and nevirapine. About which there’s been but one line. Explained by Gore Vidal: ‘The corporate grip on opinion in the United States is one of the wonders of the Western World. No First World country has ever managed to eliminate so entirely from its media all objectivity – much less dissent.’ It’s even worse in South Africa for as Mbeki pointed out in the launch issue of the weekly online journal, ANC Today, on 26 January 2001:

We are faced with the virtually unique situation that, among the democracies, the overwhelmingly dominant tendency in South African politics, represented by the ANC, has no representation whatsoever in the mass media. We therefore have to contend with the situation that what masquerades as ‘public opinion’, as reflected in the bulk of our media, is in fact minority opinion informed by the historic social and political position occupied by this minority. By projecting itself as ‘public opinion’ communicated by an ‘objective press’, this minority opinion seeks to get itself accepted by the majority as the latter’s own opinion.

Hence the ease with propagandists for AIDS drugs have established their case in the public mind. How AIDS careerists, relying on compliant and uncritical journalists, have succeeded in persuading everyone that having sex can make you sick and die. But that swallowing deadly chemicals make you live.

AIDS reporting in the South African newspapers has largely the beat of a closed shop of pious, industry-sweetheart, trendy-leftie Stupid White Women, all of whom employ a similar breathlessly dramatic and sentimental style: Lynn Altenroxel, Belinda Beresford, Claire Bisseker, Caroline Hooper-Box, Di Caelers, Liz Clarke, Kerry Cullinan, Jillian Green, Yolandi Groenewald, Maureen Isaacson, Pearlie Joubert, Claire Keeton, Carol Paton, Antoinette Pienaar, Christina Scott, Jo-Anne Smetherham, Charlene Smith, Adele Sulcas, Christina Stucky, Lauritz Taitz, Cristelle Terreblanche, Anso Thom, Sue Valentine, Christi van der Westhuizen etc – with some fiery pepper in the salt: South African Indians Jaspreet Kindra, Nawaal Deane, Tamar Khan and Ferial Haffejee – and all fawning on Zackie Achmat clutching his pillbox, like those middle-aged Afrikaans ladies from conservative platteland towns who used to let their hair down at the town hall concerts of the overtly camp Portuguese-Afrikaans singer Manuel Escorcio. But then as Orwell noted in 1984: ‘It was the women, and above all the young ones, who were the most bigoted adherents of the Party, the swallowers of slogans, the amateur spies and nosers-out of unorthodoxy.’ And historians have likewise noted that voting for the Nazi party was disproportionately female.

In a private note, Fred Cline in San Francisco cites Arthur Danto in his recent book Philosophising Art, in turn citing Sarte, to make part of my rude point about the heart of AIDS ideology rather more elegantly:

Sartre once said, with characteristic brilliance, that we are not sexual beings because we have sexual organs but – on the contrary – that we have sexual attributes because we are deeply, ontologically, in our ultimate nature, sexual beings – that sexuality is our being-in-the-world, the moral center around which the entirety of life is radiated with meaning. To change the meaning of sex is then to change the whole tone and color of the rest of existence, construed as a system of meanings.

As AIDS ideology does. By polluting it with negative values – as loveLife propaganda does: ‘Everyone he’s slept with is sleeping with you’. Intimacy is to be contemplated with the fear of death; women who take lovers (immorally) spread disease to men, who pass it on to other women in turn; men are hyenas, women pristine. Men are promiscuous, women faithful. (Especially black: the billboard with the just-mentioned logo features the upper buttocks and back of a black man covered in women’s hands, reinforcing the racist myth of the black sexual predator.) But worse, and more profoundly: AIDS apologists expressly or tacitly endeavour to rationalise and contain sexuality, conceptualise it as a system of rational choices rather than what it ultimately is: an attractive force as impenetrably mysterious as gravity, with its own lawless trajectories. The reason why, when and how people have sex or don’t, on what terms and with what expectations, to what recipe and in what pattern, is infinitely varied. LoveLife endeavours to reduce human sexuality, black principally, to the confines of a few McDonalds slogans. Thereby diminishing it. And subtracting from the experience of being human. In all its range. The better to market AIDS merchandise and keep AIDS careerists in work.

Concluding her essay AIDS as Metaphor, reflecting on ‘the idea [in the AIDS age] that physical contact and intimacy can kill you’, Farber tells an amazing story in point. A guy she knows related how he’d got the hots for a young woman he met at a festival in the Nevada desert:

They went back to his tent. She asked him to massage her. They were both on ecstasy. And what does she do? ‘She insisted I put on a pair of rubber gloves before I could touch her,’ my friend said. I lurched forward. ‘You are kidding.’ ‘I kid you not.’ ‘Why?’ ‘I don’t know. She thought I might give her some disease or something.’ ‘Just by massaging her?’ ‘Yep.’ ‘But where did she get the gloves from?’ I wondered. ‘She had a whole box of them.’ ‘A box? In the middle of the desert?’ ‘Yeah.’

CHAPTER

AIDS has metastasised into the South African arts too: The National Arts Festival in July in Grahamstown in 2002 featured a special run of no less than eleven films and documentaries ‘to promote AIDS awareness’ – on top of Pieter-Dirk Uys’s play, Foreign AIDS, billed virtuously in the festival brochure: ‘Pieter Dirk-Uys points out that whereas in the past the government killed people; now it just lets them die. And in retaliation, he cocks the sure-fire weapon of humour at denial, drug companies and President Thabo Mbeki’s head-in-the-sand position.’ Called ‘Dr Thaboo MacBeki’ in Uys’s own blurb, among other ‘comrades, kugels and clots [and] the hypocrisy and ignorance surrounding the HIV/AIDS crisis’. The revue played, we’re told, ‘to huge acclaim in London and the Netherlands, with articles about it in the New York Times, Time magazine and the International Herald Tribune’. They didn’t say what a fine job the white gay satirist made of putting his own foolish ignorance on display.

Effervescent with his ‘most significant inspiration’, Uys went on air in TV and radio ads around this time saying: ‘Parents ask me, “Who are you to talk sex to my child? We’ll talk sex to our child when we’re ready.” Yes. But by the time you’re ready it’s too late. [Etc.]’ Going around like a travelling Dutch Reformed dominee hitting Karoo boarding schools during apartheid. Contumacious of any parental disquiet. Spreading nasty stories from Joshua 9:21, 23 and 27. About Ham and hewers of wood and drawers of water. High on moral purpose. As Uys himself has remarked: ‘Aids will succeed where apartheid failed.’ How right he is. Doing four hundred schools in 2003, he said. Achmat is also sermonizing about drugs and condoms – twice at my sons’ high school in Cape Town in early 2003.

Uys provided the Weekend Argus’s Quote of the Week on 13 April 2002, suggesting the kind of thing he’s inculcating in the kids he’s preaching to: ‘Sex is not only the nicest, easiest, most common hobby, it is also the most dangerous. … sex is the machine gun and a billion bullets are shooting out of it, each with the HIV stamp on it. And every one with a name. My name. Your name. His name.’ Nobody stops to ask Uys: What kind of sick pervert goes around planting the idea in the young and suggestible minds of captive boys and girls that for them to fall in love with each other one day and then do what comes naturally could kill them? And that sperm cells aren’t life’s most dynamic joyful sparks, but bolts of death. Don’t we usually jail child molesters like you? For sowing corrosive, poisonous anxieties? For the enduring harm you do? Instead, Uys’s informative instruction of our children was adjudged tops by the Institute for Justice and Reconciliation, which in the same month awarded him the Reconcilation Award 2001. The Mail&Guardian said on 3 May 2002 that the prize was ‘for his contribution to reconciliation and, more importantly, to the fight against HIV/Aids’.

In a programme about his mission broadcast on on 28 April 2003, Uys informed us – talking over a clip of him holding an erect plastic penis on the stage of a school assembly hall – that he’d lectured half a million school children in the past three years:

A six year old says I’m scared of sex, please talk to me. Ek will weet want ek is bang [I want to know because I’m scared]. I say if there’s a snake in the grass, you don’t pat it on the head, you must stay away from it. … The safest sex is no sex but sex will happen. … Barbie [one of his stage personae] can talk about sex because she knows what sex can do. … It’s the cleverest virus; it can reinvent itself every day.

Perhaps subliminally appreciating how extremely stupid he sounded, he then took a swing at the man who laughs at him, not with him: ‘We don’t have leadership. We don’t have a President who embraces the people. … AIDS is the worst thing that has happened to this country. … Sixty-eight per cent of the armed forces is infected.’ Rolling his eyes for effect like an operetta singer.

Uys recycled his sonorous apartheid line as the title to an opinion piece that he wrote for the Sunday Times on 1 September 2002, Don’t allow Aids to succeed where apartheid failed:

we in the Third World are burying our babies. There is no cure for HIV/Aids – no vaccine or pill. There is just care. … The [World Summit on Sustainable Development] started well, with former Minister of Health, now Minister of Foreign Affairs, Nkosazana Dlamini-Zuma, stating categorically that HIV leads to Aids. The present Minister of Health, Manto Tshabalala-Msimang, has to date refused to answer yes or no to that question. … And in his speech to open the summit, President Thabo Mbeki didn’t even mention our Third World War. HIV/Aids is the worst thing to happen to Africa, which has had its share of horrors – colonialism, famine, corruption, war and exploitation.

Now all worked up, Uys decided that the AIDS pills do save you after all:

When Mbeki focussed on the global apartheid of rich and poor, he forgot to mention being party to the creation of a new a new apartheid in South Africa today – between those who can afford drugs and treatment for HIV/Aids and those who can’t. Because of his government’s carelessness, the ‘have-nots’ will die. Whatever has been discussed and structured during the past few days will mean nothing until the HIV/Aids genocide is addressed as a war against terror.

Yes, George.

Another of Uys’s contributions to AIDS awareness takes the form of a humorous video, which he launched at the Cape Town Press Club on 9 July 2002, entitled Having Sex with Pieter Dirk-Uys. His pitch was a gem. AIDS on his brain, the usually razor-sharp satirist sounded off like a low-class Afrikaans bureaucrat in Connie Mulder’s Department of Information during the old order, badly translating his small thoughts for English radio:

We are not laughing at HIV/AIDS, we are laughing at the absurd attitudes and dangerous taboos that stop people receiving the information that could save their lives. Everyone is responsible for their own lives. People have choices and must be empowered with knowledge of sex and safe sex so that they could live, even when they love. The video is one way of encouraging people to stay alive through knowing how. If forty per cent of our workforce is already HIV-positive in 2002, half of them will be dead in 2006. Investment will dwindle, business will shrink. Fears will again reign supreme. AIDS takes no sides. It chooses no colour. Everyone is a target. And the message is a simple one to all ages, to all races, and all cultures: Come to terms with the reality of HIV/AIDS. It’s not about death, it’s about life.

Was he saying all this tongue in cheek? Another of his clever parodies? Copying Edwin Cameron or Zackie Achmat? Because let’s grant him: he’s a brilliant mimic. The hilarious speech patterns, the junkyard grammar, the disconnected themes, the cracked logic, the mystical paradoxes, the doomsday talk, the flapping hysteria? Sounds like it.

Can this really be the wit who cut apartheid culture to ribbons in his revues before 1994? Once so keen. Now so dull. Projecting his hang-ups onto bright-eyed young children. His writing as conceptually as flaccid as his wrist. For instance, from his Sunday Times article:

Development! If we are to encourage young people to understand that the safest sex is no sex, we must also respect them enough to prepare them for the eventuality that sex will happen. If condoms are the only protection against infection, then condoms must be made a normal part of survival. The churches must back off with their useless advice to abstain, to pray and to trust. [Weren’t you yourself urging young people to abstain, a moment ago?] Businesses must focus on the needs of their workers to be able to confide their fears. Corporate companies must make HIV/Aids the focus for their future success. There will be no sustainable development in South Africa until we are assured that HIV/Aids is a life sentence, not a death sentence.

But my dear, when Mbeki says as much, people like you scratch and screech.

Chatting about his new book, Elections and Erections, published in December 2002, Uys shared his excitement with the Sunday Tribune in the middle of that month. AIDS, he said, was ‘one moment of fun followed by a life of misery’. The wages of sin. By the time the 2004 elections come around, ‘A quarter of the voter population will be dead.’ You bet, Pietie. Or maybe you wish: In his essay, A nation in need of therapy, posted on litnet.co.za, Sieraaj Ahmed mentions that ‘Uys says that every morning, he looks at himself in the mirror and says “I am a racist. Today I am going to try harder not to be a racist.”’ If only you would, boet.

Two months later, in a letter to the editor of Business Day in mid-March, Uys repeated his genocide talk, and called for the prosecution of Mbeki and Tshabalala-Msimang in the World Court at The Hague. The accused responded formally on the 25th by way of a press release issued by the Government Communications and Information Service. Describing Uys’s letter as ‘flippant’ and ‘overstated’ it answered:

We would have thought that Pieter-Dirk Uys would realise from his own experiences in AIDS prevention, as most South Africans do, that searching for scapegoats and instant solutions is not the correct response to the challenge of HIV/AIDS. Working with partners from all sectors of society, government will continue to implement the national comprehensive strategy on AIDS, in all its elements, as the most rational approach to the pandemic.

But Uys pressed charges, making his case further in March in a thoroughly appropriate forum, the blue-collar weekly, Huisgenoot, and its translated English language equivalent, You. Liberal commentator William Saunderson-Meyer loved it though. As much as he did an apparently coincidental similar call made simultaneously in Business Day by ‘human rights activist’ windbag Rhoda Kadalie for the trial of Mbeki, Tshabalala-Msimang and Mpumalanga Health MEC Manana by the International Human Rights Tribunal on a charge of practising genocide. Peering owlishly through coke bottle glasses alongside his article praising the ‘final breakaway of an articulate, organised intelligentsia that has hitherto been contained within ANC ranks’, Saunderson-Meyer concluded, ‘If Mbeki were not so divorced from reality, he would take note at the caverns of disillusionment that are opening.’ The question is, of course, what ‘reality’ Mbeki is ‘divorced from’? Or rather, whose?

Uys’s attack on Tshabalala-Msimang and Mbeki in Huisgenoot and You seems to have been an instant hit among South African white and ‘coloured’ lumpen. Because the following week, on the 27th, the magazines had another go in Manto’s muddled, Trevor’s tops:

Yet no matter whether she’s making a laughing stock on the international stage or wasting millions of rands of taxpayers’ money on Aids court cases she just doesn’t seem to be held accountable. One reason for her remarkable survival skills ... is that despite all the criticism that comes her way she only has to keep one man happy. That man being our president of course. As long as Thabo Mbeki is behind her, you can do what you like [but it make no difference].

But happy the President undoubtedly is with his Health Minister. Staving off the pharmaceutical industry. Answering questions in Parliament on the 26th in regard to whether Cabinet members in South Africa resigned when things in their departments went awry, as in other Western democracies, Mbeki replied that he was quite satisfied with all his Ministers. Including the scapegoat onto whom the media have transferred their spite for persisting with the heresy that food and warmth rather than toxic chemicals are best for a healthy life, and best for recuperation when fallen sick.

Mark Gevisser gave a talk at the National Arts Festival in 2002, Writing the Past into the Present: On being Thabo Mbeki’s [self-appointed] biographer, telling us, no doubt, more of what he’d preciously told Newsweek: ‘To understand Thabo Mbeki, one needs to recognize that he still bears scars from [political] battles and that he has developed, as a result, a carapace of caution, even ... of paranoia’ – ‘a mental illness’, the Shorter Oxford English Dictionary explicates, ‘characterised by delusions of persecutions, unwarranted jealousy, or exaggerated self-importance’. Borne out, Gevisser meant, by his coolly unimpressed response to the AIDS panic – which has seeded and thrived in this country in particular like none other, like so much foreign bugweed. Also by his complaints about the vicious personal criticism he has drawn for his scepticism. And by his vanity in thinking that he might have one up on the ‘AIDS experts’. Suggesting they’ve got it all wrong. Not only mentally disturbed, but weak and insecure too: for simply exercising his Presidential prerogative as new incumbent, and selecting a fresh Cabinet of his own choosing, as opposed to his predecessor’s, Gevisser judged Mbeki a Stalinist sort in the Mail&Guardian on 9 June 2000 – ‘deposing comrades not because they are corrupt or inefficient, but because they threaten him’.

The astonishing want of regard, contempt even, that Gevisser evinces in these lines for the subject of his book is a doleful portent of what we can expect when it eventually hits the shelves. And the conceitedness of his implication that he ‘understands’ Mbeki is astounding, until you reflect on the mediocrity of his little résumé. Instead of looking for psychiatric disorders to attribute to Mbeki in namby-pamby argot, Gevisser needs only to do the reading into the history and the scientific foundations of AIDS that Mbeki has. But that would be too much trouble – as it was to read and digest Debating AZT, which I sent him – for, as Thomas Edison saw: ‘There is no expedient to which man will not resort to avoid the hard work of thinking.’ And he might have to rewrite his nearly finished book – sprung from a completely different premise: Mbeki’s not cracked, damaged, flawed, irrationally obsessed, etc, after all. He’s an extraordinarily brilliant leader, who has acted with uncommon integrity and courage in defence of the South African common man. And African values. Against the new mission. Issuing from America. A horribly destructive one. Opening up, as missionaries always do, the trade routes for the merchants, and delivering a subjugated people to the farmers. As servants. Not selling square brick houses, work (for whites), money, germs and Jesus to folk who lived very happily without, but, in common with Christian proselytisers, gloomy new canons to spoil their intimate lives with deathly anxieties. Thereby creating markets for the merchandise. As drug dealers everywhere call their stuff.

Which Gevisser roots for as ‘the drugs needed to keep them alive’ in AIDS: The New Apartheid in the Nation on 14 May 2001, referring to them as ‘life-saving medication’. The drugs’ leading champion, he wrote, were

ordinary South African men and women … the foot soldiers of the Treatment Action Campaign … the first seriously effective social movement since South Africa’s transition to democracy in 1994. … The TAC’s brilliance was in recognizing that it had an issue that would appeal to the broad left wing of South African society not only because of the government’s manifest ineptitude in the face of a horrifying pandemic (4.7 million infected out of a population of 40 million) but because the battle for treatment was a perfect vehicle for taking on the heartlessness of global capital and the perceived wrongheadness of the ANC government’s neoliberal macroeconomic policy. … The TAC’s battle could provide the same brand of moral leadership in the global struggle that the antiapartheid movement did in decades past.

CHAPTER

It’s noteworthy that from all the world’s leaders a Xhosa should emerge to question and resist the dark notions that make up AIDS – like the 19th Xhosa mystic Nxele-Makana recommending to his people that instead of listening to the missionaries, and sitting ‘praying with their faces to the ground’, they should rather ‘dance and enjoy life and make love so that the black people would multiply and fill the earth’. Sounds much better to me.

Mostert points out that historically, before the shattering of Xhosa traditional society in the 19th century by round after round of genocidal English military aggression – completed finally by the hopeless, mass-delusional, millenarian, and in its result, national-suicidal cattle slaughter of 1857 – the intellectual, cultural and spiritual confidence of these ‘irreclaimable savages’ had presented a notoriously impregnable defence to the missionary endeavour. It was both their abiding belief in and satisfaction with their own cosmology, and their famously clear Xhosa logic that thwarted it: ‘Have you seen this God of yours? How do you know the Bible came from him? Did it drop from the sky?’ – questions, a missionary conceded, that presented ‘no little difficulty’ to the clerics to answer.

The similar root question that Mbeki implies is: ‘Has HIV been seen?’ That’s where the trouble starts for the HIV theory of AIDS. It’s why he asserted during an official visit to Brazil in mid-December 2000: ‘... scientists don’t know what they are looking for when testing for HIV’, and it’s why (I can confirm on the best authority) he is currently pressing his AIDS Panel scientists to do what they undertook at their second meeting – to attempt to isolate ‘HIV’ from the blood of a person diagnosed HIV-positive. And by ‘isolate’ we don’t mean finding one or more equivocal clues. Like the police announcing the arrest of a suspect when they’ve merely found some blue jeans. We mean isolate, in the manner that other viruses have been successfully isolated, separate from everything else, a mass of objects fitting the description given in the textbooks, and drawn so imaginatively in accompanying little pictures. That’s what we mean.

In response to Mbeki’s funny AIDS talk in Brazil, the Democratic Alliance’s sitting ‘AIDS expert’, Dr Kobus Gous, volunteered cluelessly: ‘Every time Mbeki makes a statement on this topic he put his foot deeper in his mouth. … The president would be well advised to leave medical matters to the medical experts, and to refrain from making any more statements on HIV and Aids, which could damage South Africa’s reputation – and his own – even further. [His] continuous flirting with Aids dissidents puts him increasingly out of touch with the rest of the world.’ Gous, we gather, hadn’t read that towering historian of science, Thomas Kuhn, who observed that the most important and successful challenges to decaying but still entrenched scientific paradigms have come from people ‘almost always ... either very young or very new to the field whose paradigm they change. ... These are the men who, being little committed by prior practice to the traditional rules of normal science, are particularly likely to see that those rules no longer define a playable game and to conceive another set that can replace them.’ Men like Mbeki.

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Just when you thought the Mail&Guardian had hit rock-bottom, the suburban hill-billies running it drove it even lower, chasing their opening headline in 2002 with another the next week: Manto: AIDS drugs do work for rape. Charlene Smith cited a study conducted at a Johannesburg hospital. Golly, one hundred per cent of rape victims had been saved. Do we have to start all over again? Pointing out all the cracked bricks? From the foundations up. But the fiery lady preacher with the glazed eyes of the medical dependent wouldn’t be interested: ‘Remove me from your mailing list’, was her response to my Open Letter to John Kearney, Chief Executive Officer of GlaxoSmithKline, South Africa, which I copied on to her. (The correspondence is set out in Is AZT a DNA chain terminator?) Not what she wanted to hear at all – firmly yanking the chain on the biochemistry of the pills she carries tucked next to her flaming heart, for just in case. The ones she dishes out to the sisters. Packaged for animal research labs with a skull and cross bones embossed on their orange label. That’s orange for dangerous chemical toxin, honey. Not your Minute Maid. Although it’s not unlike that other cooling aid – with the Jim Jones spike, as 25 out of 30 mice discovered when nibbling human-equivalent AZT doses, pound for pound. Also promptly departed to meet Jesus. Thompson et al. reported this in Hematologic toxicity of AZT and ddC administered as single agents and in combination to rats and mice in Fundamental and Applied Toxicology in 1991 – as well as their finding that those left behind all suffered nonregenerative anaemia, lymphocytopenia and thrombocytopenia (irreversibly depleted red, white and clotting corpuscles). Numerous other AZT studies on dogs, monkeys, rats and mice, reviewed by Duesberg and Rasnick in The AIDS dilemma, have found similar extreme toxicity within a couple of weeks of administration, and in some cases days.

Like Thompson’s rodent study, in Didanosine Compared with Continued Zidovudine Therapy for HIV-Infected Patients with 200 to 500 CD4 Cells/mm3, published in Annals of Internal Medicine in 1995, Montaner et al. similarly reported that ‘Seventeen patients died during the extended follow-up period’ on AZT or ddI, a closely similar drug. But not necessarily of an ‘AIDS-defining illness’ since ‘The primary clinical end point was the occurrence of a new, previously undiagnosed acquired immunodeficiency syndrome (AIDS)-defining illness or death.’ Or death! In other words people in good health diagnosed HIV-positive, put on AZT or ddI, and folding into the ditch, even before developing ‘AIDS symptoms’, was read as a drug failure. Not a toxic drug fatality.

All inconceivable to swarms of visitors from all corners of the globe to GlaxoWellcome’s enormous display at the 13th International AIDS Conference at Durban in 2000 for the marketing of its leading AIDS drug. With crates stacked in the centre, not of the sombre product on sale, but of bottled spring water on free offer, to cool pilgrims’ parched lips and bring rejuvenating relief healthily, a little tag hanging around the neck of each one: ‘ADVANCING HIV CARE Glaxo Wellcome.’ As in ‘SEPARATE DEVELOPMENT Sharpeville and Limehill.’

And inconceivable to Charlene Smith, marketing AZT and similar drugs after rape on her Speakout website, reviving swart gevaar tactics used to sell apartheid, drawing from every white suburban nightmare, and alleging fantastically: ‘In South Africa most rape is gang rape … true for 75% of women.’ On top of which, ‘more than one of her attackers may be HIV+, their viral loads will tend to be high, she may be infected with more than one strain of the virus, it is likely the assailants have sexually transmitted diseases and it is unlikely they are on treatment for HIV’. By which she means black men going around raping in gangs. All spurting plague. But as silly and ugly as Smith’s sort of talk might be, it’s endeared her to South Africa’s anxious white ladies. All this talk of rape, the highest rate in the world and everything. Because for them it fits. And it has boosted Smith’s AZT campaign bountifully: paid speaking tours, unlimited newspaper column space, lots of TV time, a website, a ludicrous book, the lot. Nobody says, ‘Look, we’re very sorry about what happened to you, but really, have you now lost your marbles?’

CHAPTER

As mentioned earlier, local folk-hero Zackie Achmat, from South Africa’s ‘most effective opposition party’ (I’m translating from the Afrikaans), got a hand-job from Hanlie Retief in Rapport on 10 February 2002 – the interview appearing alongside a big colour poster of Achmat holding his despairing head. His permanently neurasthenic expression aside, I couldn’t help noticing how nice and plump he’s become since he first hit the scene. Bearing out the Ugandan street quip about fat AIDS and thin AIDS. The fat guys like Achmat being its beneficiaries, the thin the sick poor. The guy with the deadly illness. Supposed to be on his way out. But hale and hearty like the exuberant dancing crowds he marshals for his street rallies. Meant to be sick. With ‘HIV disease’. Achmat thinks he’s ‘been HIV-positive for more than nine years’. Unlike Cameron talking on MNet, Achmat didn’t detail how he took his shot of poisoned spirit. And unlike Cameron, he evidently can’t finger the culprit. Suggesting that he’d been out and about like a caterwauling feline. For which he is now paying the holy price. Having regard to the arithmetic of the time frame he didn’t suspect one of his paying customers at the Observatory Station toilets, back when he was a teenager, apparently. Assuming he’d changed professions, that is. At least in a physical sense. Just like the rest of us, ‘sometimes he gets sick and takes medicine for infection’. Big deal. Before anyone got suspicious though, and started wondering how his health was any different from ours, he informed us that his CD4 cell count is lurching so low that he’ll need to see his doctor soon. This was the signal for our tears to well up.

In 1994 the Concorde trial overseers reported your CD4 cell count to be about as significant as the colour of your hair. Two years later Fleming and DeMets agreed, describing CD4 cell counting in Annals of Internal Medicine as being ‘as uninformative [an indication of immune status] as a toss of a coin’. Achmat, like Cameron, hadn’t got the news. They wouldn’t want to know, anyway. They celebrate ‘living with HIV’, like ‘consumptive’ romantic poets in England and ‘syphilitic’ novelists in France, all going to pieces, one after the other, on mercury salts and arsenicals. They like being HIV-positive and flirting with death. There’s a certain power in it. And let’s face it: where would they be without it?

Not only are they lovingly and resolutely married to ‘HIV’ themselves; they want others to be HIV-positive too. To become fellow ‘career patients’. Go out and get tested, they encourage. And if you are one of those special few like us, to whom the doctor says, ‘I’ve got bad news’, then you can join our ‘AIDS movement’. Join the terrified queue on the railway platform. Clearly and distinctly marked. Separated. Minds kept tuned to mortal resignation by incessant barking dogs. In the media. A ghetto enclosed by ideas, just like electrified barbed wire. Led by us. We like having a constituency to pander to. Looking up to us. We like being adored. It’s only natural. We like paying visits through the spiked steel gate, bringing little humanitarian parcels, marked not with a red cross but a red ribbon. Containing cheap nooses. The kind that strangle slowly, not snap it. Except that we assure the desperate recipients that they offer a way out. Because that’s what the manufacturer said. And we believe everything we’re told by anyone in charge. When they’re Nordic. But not when dun and curly-haired. We like strong authority figures looking after us, protecting us. Telling us what’s right and what’s best. We remember how our mums fussed over us (when our dads were remote and reproachful, suspicious too). We liked our childhood far too much to move on. As you can gather from the inanity of our public pronouncements. We may be a bit simple, but we’re very chatty all the same. We like talking about the doomed inmates’ human rights especially. That’s our favourite past-time. It’s nice riding a moral high horse. Beats thinking. Especially against the popular grain. Too much like hard work. We simply go along with the official view of things announced daily in all the media that the frightened people whom we champion are a verminous lot who represent a deadly danger to all with whom they come into contact. Even though they look like anyone else. It would be much too much trouble to look into the scientific track records and personal credentials of the originators of all these peculiar ideas. Let alone the credibility of the ideas themselves, their history and their foundations. But don’t stigmatise these people we say. As we increase the voltage of the fence around them with endless ‘awareness’ campaigning. Don’t treat them any differently from the pure-blooded. As if there really is something rotten about them. Indeed we write up an elaborate jurisprudence about this and present it seriously. Instead of just tearing down the wires. A single public announcement would do it. There’s been a terrible mistake. You can all go home now, and start rebuilding your shattered lives. You’re not going to die early after all. We were wrong. We bought into it. We became part of it. We perpetuated it. We’d heard that there were dissenting scientists of the highest rank with no stake in the issues at all, and certainly no financial or professional interest, who were saying that Jewish blood isn’t inherently different from any other kind, but we didn’t bother looking into what they were saying and why. We dismissed them as discredited cranks, just like everybody else, even though we didn’t know what they were writing. Carefully, meticulously, exhaustively referenced. Because we’re mob types, mob leaders. Also because a general liberation would have put us out of our jobs. Important ones. Filling our life with purpose. Which we share with journalists at every turn. Because if we’re not busy helping with the extraction and collection of gold fillings for those in charge what would we do? And it’s so gratifying working close to death all the time. Not that there’s anything funny about us. Celebrating our necrophiliac medical cult. Always looking jolly pleased with ourselves. Like Christians grinning at a Southern lynching. The strange dark fruit hanging from trees, scorched with blowtorches, flayed by dragging behind farm trucks, fingers and ears cut off as mementos. The happy guys and broads regrouping on Sunday around another drooping corpse. Nailed down, not twisting in the wind. We’re not warped deep down. We’re not fucked up. Not us. Why, everyone respects us. We win prizes and awards. We’re important philanthropists. In the moral stakes only Mother Teresa outdoes us, but we’re working on it.

Achmat explained how it all started in the PBS Frontline television documentary The Age of AIDS screened in the US on 30 and 31 May 2006: ‘Mandela was released, and a few months later, I discovered I had HIV. I’d been very active in politics, and our slogan was “Freedom in our lifetime”. And here the possibility of freedom was beckoning, and what happened was, in fact, at that time, a death sentence.’ His emotional reaction to being diagnosed HIV-positive in 1990 he described in the New Yorker on 13 May 2003 (he was ‘a former male prostitute’, he told author Samantha Power): ‘First I went into denial. Then I fell into the most profound depression. We had just won our freedom ... and I was preparing for death.’ ‘To discover you have a life-threatening illness when you fought for freedom is a cruel irony of history,’ he lamented in the Los Angeles Times on 24 November 2003. ‘A country that fought hard against apartheid, and triumphed, now must fight this battle.’ He stayed in his room waiting to die, he told Rory Carroll of the Guardian on 10 December 2002. ‘The doctor said I had six months to live. I went home and took out every film I could – I had always wanted to make films. But instead of getting worse, I got better.’ What he figured next, he related in the New Yorker: ‘When I looked around after six months and noticed I was still alive, I concluded that it might be time to leave the house.’ I didn’t conclude that it might be time to question the doctor. Since I never did get to finish school.

Hanlie asked Zackie what he’d do if he ran into Mbeki in the street. ‘I’d have to bite my tongue so hard that I’d have to go to hospital,’ he said, in a snippet from a schoolgirl’s diary. ‘Because I’m afraid that I’d be very, very rude to him.’ But then Achmat broke his promise to bite his tongue off, and proceeded to let Mbeki have it with both barrels: ‘He’s playing with other people’s lives,’ he railed. He’s dishonest for not being absolutely explicit about not buying the HIV-AIDS theory. And ANC policy is ‘foolish’. Painful to say, he said, because he’s a member. Who isn’t? He confirmed his refusal to take antiretroviral drugs himself.

Yes, it’s probably a dumb thing to do. But it’s a decision I took. The lives of people who can’t afford antiretroviral medication have been stolen. … If I die, it will be from a disease that the government has failed to recognise. … What disillusionment, what a price society pays. And this is a government born from a party that always fought for human rights. Now black people must hear: Your lives are not worth anything. Just think: A whole generation of ten million orphans, without income or job security, knowing that their parents could perhaps also have lived had they been able to afford the AIDS drugs.

Just think: one of our country’s top judges is a friend of this guy. Actually endorses his outfit. Talks his language. Ten million orphans! Where?

Forgetting that Tshabalala-Msimang’s predecessor Dr Nkosazana Dlamini-Zuma had started his troubles by taking the original decision to spurn AZT, Achmat sang her praises; she had vision, he said:

In contrast, Minister Manto Tshabalala-Msimang lacks vision. Her grasp of the science is limited. On top of that she’s arrogant, and if you include that with all her other shortcomings, it’s just one too much for me. I no longer have any respect for her. She simply lacks the guts to stand up to her President. … I’m aware that there are deliberate attempts by the President and those who support him to discredit us. Why? It would have been so much easier had the government recognised that the TAC is actually an asset to it. No country in the world has such an inspired group of people as the TAC [concerned with] AIDS and its destigmatisation, especially now that the AIDS epidemic is really starting. In the next five to eight years many, many people will die.

You wish.

Never quite make up their minds, these boys. Whether we’re all, all dying, or about, about to. ‘With great honesty the TAC has always tried to understand medical science. And this is something with which all South Africans have always struggled. We are scientifically illiterate.’ You can say that again, pal. I mean speaking for yourself. ‘The TAC’s starting point has always been the prevailing scientific view.’ In other words, we’re politically illiterate too. ‘I want to change the government’s policies with it. This is the big, big challenge.’ All very sincere. Only, ‘Sincerity is the worst vice of the fanatic,’ noted Oscar Wilde; and as American inventor Charles Kettering once reminded us: ‘You can be sincere and still be stupid.’

To read the interview was to wonder what could have left Achmat, so, well, challenged. The arrested childishness of his emotionalism pumping in place of reason – ‘always’ this, ‘always’ that; ‘very, very’ this; ‘many, many’ that; ‘big, big’ this, give us a break, that – making his statement of his cause sound pathetically maladroit. The answer was in the interview itself. And here we end our little jokes. At the age of fourteen, he tells us, Achmat torched his school, or tried to. It was during the struggle. At that vulnerable age, he was held in prison for three and a half months. And was then sent back so often that he spent almost ‘half his eighteen years in prison’. (The arithmetic is cockeyed, but we get the picture.) What happened to him in there is no puzzle to anyone living in the real world. Leading to his discovery of his homosexuality. Or to state the more likely scenario, that’s where his homosexuality was discovered for him. After his release, he wrote in Cameron and Gevisser’s Defiant Desire, ‘I had sex at the toilets every day, sometimes twice or three times a day. I had sex with anyone who wanted to: old, young, black or white, fat or thin, it did not matter.’ What mattered was getting paid. Interviewed by You on 28 February 2002, he said that after dropping out of school in Grade Nine, he took to the streets to make his living as a fourteen-year-old punk. Didn’t mind the work at all. On the contrary, he told in his essay, My Childhood as an Adult Molester, in Cameron and Gevisser’s anthology, Defiant Desire: ‘Almost all the men were scared to touch me because of my age. But once they discovered that I was into it, they enjoyed themselves.’ Too.

Achmat’s account of coupling furtively for money in a public lavatory, bending over for all comers, tells of a profoundly degraded sense of self-worth. Which he’s been trying to recover since, if in a rather roundabout sort of way: On 20 September 2000, the Panafrican News Agency reported that he’d ‘told journalists in Cape Town Tuesday that he demanded the dignity of knowing that there is recognition at top levels in the government that there is a disease in this country that is affecting millions of people’. (Cameron also likes to demand dignity, dignity, dignity, we’ll soon see. Which one can understand since he’s not entirely comfortable with being gay – as he told Carte Blanche presenter Ruda Landman in May 1996: ‘I think that I’ve fully accepted myself – or 85 percent accepted myself as a gay man. I think the lingering effects inside oneself of social hatred and ignorance are still there.’) And it didn’t help, when Achmat declared his newfound squiff preference, and later his HIV status to boot, that his father, brothers and relatives all shunned him, being ultra-conservative Moslems. But not his mother. Of course. Mum’s always there for these guys. A considerable basket of emotional stresses, all in all. It all makes sad sense now – why the TAC campaign is so feverish, so full of sturm und drang. Achmat trying to redeem himself from a psychological gutter. With a deep-seated and continuing need to be used. These days felching fat American businessmen. Gumming rival Indians selling cheaper generics. Another life derailed during apartheid. Craving middle class normality. Even yearning to meet a nice man, settle down and adopt some kids, he said.

Cute. Interesting too. Because at an ideological level, part of the tremendous appeal of AIDS to the white middle class – with its contemporary revanchist drive in the post-modern world to recover and reimpose fraying strict Christian heterosexuality – is its implicit affirmation of bourgeois sexual morality. As advanced by the heavy radicals in the TAC. Led by Achmat. It’s one of the reasons why the newspapers love him. Like Mandela, he’s safe. And about as politically threatening as a hairdresser. In tight red trousers.

CHAPTER

Having flown in without having had the manners to make any prior arrangements with the government, Jimmy Carter pressed for and had been granted an audience with Mbeki and Tshabalala-Msimang on 9 March 2002 – having given the assurance that, although ‘aware that there was some controversy in the country about the issue of anti-retroviral drugs … he had no desire to enter the debate. This was because he did not believe that drugs were central to the fight against AIDS.’ So an ANC press statement the following day complained. But the former President who’d promised never to lie was lying. Pushing drugs was very much on his mind. Which had been ignorantly made up before he arrived. Carter told the journalists:

One of the things we discussed with President Mbeki was if there is a determination of things that have worked in poor countries that might work here, how can they be combined into a cohesive programme, with full and unequivocal support from the top leaders, that is the President, and then what would it take to finance them. What we thought was, once a comprehensive programme could be evolved, which might be the best ever, we would be glad to help find sources of funding.

Carter said Mbeki and Tshabalala-Msimang responded that ‘they’re doing all they can, that they have a very fine programme’. About which Carter passed the dismissive remark: ‘I think that still remains to be seen.’ In fact, Mbeki had said rather more, according to the ANC’s press statement: ‘President Mbeki and his delegation informed President Carter of the country’s comprehensive programme on AIDS of which he was not aware and requested him to raise international awareness of the programme.’ Carter didn’t reject this to Mbeki’s face. He waited until he had the ears of the journalists after the meeting instead: South Africa had not made ‘adequate progress’ in preventing new cases of AIDS, which were increasing ‘by leaps and bounds every day’, he said. Mbeki’s attitude to AIDS and his aversion to the drugs had ‘grossly distorted’ the issues. ‘The bottom line was that we regret seeing South Africa stigmatised based on the debate with which you are well familiar, that is the issue of antiretroviral medicines.’

Carter told the journalists that he’d asked Mbeki why Gauteng Premier Mbhazima Shilowa had been reproved for announcing his intention to expand the number of pilot sites in his province for nevirapine administration. ‘They responded that they have fifteen places in the country [eighteen actually] in which they are testing this drug and their response is the same as has been made many times, that they want to prove the drug is effective and safe before they authorise it on a wider basis.’ Clearly Carter was having no truck with that lame excuse. Just like the High Court and the Constitutional Court later on. He said he hoped that Mandela’s recent public statements might make the ANC ‘more eager’ to give nevirapine to pregnant women and their babies.

That Carter had arrived not only full of preconceptions, but charged full of the swirling emotions of the Western AIDS missionary, was indicated by his statement that he and Bill Gates’s dad, who was accompanying him, had been ‘very touched’ by their visit just before the meeting to a clinic in Soweto where they watched pregnant women being told they were HIV-positive. (What a thrill for them, watching the natives being condemned.) They told Mbeki of the ‘emotional impact’ of their visit where they sat with HIV-positive children. Black naturally. Wondering why the strange white people were looking at them with such sad eyes.

In view of Carter’s stated purpose in seeking the meeting, ‘to offer the assistance and support of the Carter Centre and the Gates Foundation in our campaign against AIDS … [to help] us to generate additional resources especially to intensify our public awareness campaign, [and to] help in changing any existing negative perceptions of South Africa internationally’, and his dishonest prior pretence not to be interested in the drug controversies, the ANC complained:

We are therefore very surprised at the public comments made by President Carter after this meeting. We believe that honesty should characterise the conduct of public affairs. We are also surprised at the comments made by the delegation about anti-retroviral drugs in general and nevirapine in particular. We find it alarming that President Carter is willing to treat our people as guinea pigs, in the interest of pharmaceutical companies, which he would not do in his own country. We do not understand why US citizens urge this drug upon us when the health authorities in their own country do not allow its use for mother-to-child-transmission. One of the reasons for this is that these authorities say that there is insufficient data about issues of the safety of the drug. For this, we do not need the interference and contemptuous attitude of President Carter or anybody else. As South Africans, we have the possibility to find solutions to our problems, as the people of the US have. We are not arrogant to presume that we know what the US should do to respond to its many domestic challenges. Nobody from elsewhere in the world should presume they have a superior right to tell us what to do with our own challenges.

Carter hit back from Kenya saying, ‘In most countries where Presidents stand aloof, the rate of infection continues to increase.’ In other words Mbeki stands aloof, doesn’t care. But Kenyan President Arap Moi has the right idea he said – having asked Kenyans in 2001 to abstain from having sex for at least two years to combat AIDS: ‘It is often not realised in Kenya the extraordinary leadership that President Moi has taken in declaring several years ago that HIV is a national disaster.’

Carter had the last word at a church service in Nigeria the next day: ‘You have 3.6 million HIV-positive people in Nigeria, held under reasonable control by the enlightened and aggressive leadership of your President. We came earlier this week from another country which I won’t name, where the President has avoided this responsibility completely and AIDS is rampant and growing every day.’

CHAPTER

Starting on 15 March a three-day AIDS policy conference of the Tripartite Alliance of ANC, South African Communist Party, and Congress of South African Trade Unions was held, at which a discussion paper, Castro Hlongwane, Caravans, Cats, Geese, Foot and Mouth and Statistics: HIV/Aids and the struggle for the Humanisation of the African, was presented for debate. The Mail&Guardian has it posted on the Internet. It’s a masterpiece, a must-read. And I don’t say so only because it cited a passage on AIDS racism from Debating AZT. But Achmat’s didn’t like it at all: ‘On the record, you had, for the first time, an indication of the madness, the irrationality, the blindness, the willfulness, the vindictiveness of Mbeki on this question.’ Achmat’s pitiful ideological and scientific myopia in his comment, rather.

Much of the prose in Castro Hlongwane comes from the quill of vocal ANC AIDS dissident activist, the late Peter Mokaba MP. Mhlongo advised. But Mbeki’s fingerprints are all over it: his favourite Irish poets and radical social analysts quoted, and his hallmark sarcasm – along with his elaboration of his castigation, begun during his ZK Mathews Memorial Lecture, of the ‘native petit bourgeoisie, with the native intelligentsia in its midst, that, in pursuit of well-being that has no object beyond itself, commits itself to be the foot-lickers of those that will secure the personal well-being of its members’. Some prominent black members of the Anglican clergy spring to mind. Working as pharmhands.

The thrust and tone were captured in an ironic paragraph:

Yes, we are sex-crazy! Yes, we are diseased! Yes, we spread the deadly HI virus through our uncontrolled heterosexual sex! In this regard, yes, we are different from the U.S. and Western Europe! Yes, we, the men, abuse women and the girl-child with gay abandon! Yes, among us rape is endemic because of our culture! Yes, we do believe that sleeping with young virgins will cure us of AIDS! Yes, as a result of all this, we are threatened with destruction by the HIV/AIDS pandemic! Yes, what we need, and cannot afford because we are poor, are condoms and anti-retroviral drugs! Help!

It wasn’t only characteristic literary style that linked Mbeki to Castro Hlongwane. In an electronic version that fell into the Mail&Guardian’s hands, ‘Author: Thabo Mbeki’ and ‘Company: Office of the President’ was found in the document’s ‘Properties’ folder. Although, as the newspaper conceded in an article about this on 19 April 2002, such information can be faked. (Or can simply be imported when the text of a document is deleted and the computer file is used to write another.) Mokaba was open about having been ‘involved in writing this, but it is part of a collective, like any other of the ANC documents. I was not the sole author,’ he told the Star’s Glynnis Underhill on 4 April 2002:

The President was not involved at all. It is a compilation of scientific material that we have read, and we have presented an interpretation of that material to explain where we stand as a developing nation, as an African nation and what is now happening to us and what will happen in the future it we don’t take issues up. We have seen colonisation, we have seen imperialism, we have seen apartheid ... and all of them used against us as a people. One of the things that we are really talking about is that if liberation is going to be meaningful to us, then it has to return to us our humanity denied to us by all of these other systems before us. That is why, once we realised what is behind the whole story, once we realized what is behind the industry an industry that is based on no fact at all, then when we look at the story as it unfolds, where you see racism coming in and becoming the real problem. We decided we cannot allow this to happen. … [Africans had] won their liberation and now they are fighting another war and they are being psychologically terrorised once more because people want to sell and make profits. And there is no benefit in those products. The only thing that can really happen is that once you touch the antiretrovirals you can go one way.

Castro Hlongwane’s title derives from the case of a black schoolboy of that name on holiday with his white school friends, kicked out of a caravan park by its yobbo white manager because, she explained later, she’d assumed that he had AIDS (being black), and would rape other campers (all white) – an example of the kind of extreme white thinking about blacks that the AIDS construct inspires. On the right. But the thinking of the liberal/left, with its concern about ‘safe sex’, bubbles up from essentially the same subterranean springs. ‘Foot and mouth’ in the title anticipates a discussion of the equal non-specificity of the antibody tests used by veterinarians for sniffing out the alleged disease with those used to diagnose ‘HIV infection’. A sore point, because rural blacks suffered the brunt of the mass culling of cattle herds by stupid white veterinarians in South Africa a couple of years back in the ‘Foot and Mouth disease’ mania – marching around with their test kits and rifles, emulating their European colleagues, shooting cattle driven into dongas, men weeping at the sight of their beloved animals being needlessly killed. (As a diagnostic construct, ‘Foot and Mouth’ is as empty as ‘AIDS’.)

The animal allusions are otherwise literary, lampooning Makgoba, Ramphele and the like – sucking up, fat and vain, to their superiors in the American and European academic, bureaucratic and professional medical establishments:

All the human race loves a lord – that is, it loves to look upon or to be noticed by the possessor of Power or Conspicuousness; and sometimes animals, born to better things and higher ideals, descend to man’s level in this matter. In the Jardin des Plantes I have seen a cat that was so vain of being the personal friend of an elephant that I was ashamed of her

– per Mark Twain in Does the Race of Man love a Lord? And a ‘goose’, a minor archaic nickname for a simpleton, is given a special meaning by WB Yeats, namely the kind of local dude fattened by European institutions. (A ‘colonial goose’, interestingly, is an English nickname for a stuffed mutton roast.)

ANC health secretary and chairperson of its national health committee Saadiq Karriem, medical doctor, was outraged, especially at not having been consulted before the release of the document – deliberately, said Mokaba: ‘This is a political document. It is based on science. It then extracts from the conclusions of science and looks at the developmental issues, also the political issues. Let me just point out too, that if you look at the health secretariat, we have no scientists, what you have are doctors who are doing applied science.’ Naturally Dr Karriem hated Castro Hlongwane: ‘Anyone who believes the claims made in it might as well believe the moon is made of green cheese.’ An editorial in the Sunday Times on 31 March expressed a similar sentiment, regretting that Tshabalala-Msimang had been ‘immersing herself in the gobbledygook that masquerades as the AIDS debate within the African National Congress’.

Makgoba hated it too. That’s because Castro Hlongwane pricks his bubble:

We too have our own geese, posing as writers, thinkers and scientists, who have been fattened by the equivalent of the India Society. To justify their feed, they work hard to build repression from within our ranks. It would be good if we could assist them to return to their ponds as quickly as possible, taking their goose brains with them. These are the same cats that seek to befriend the elephant, of whom Mark Twain was ashamed. Whether cats or geese, one purpose they serve for those who fatten them, is to medicalise poverty and underdevelopment. Thus problems that require a determined global effort to end African poverty and underdevelopment are presented, with African acquiescence, as problems that can be solved with condoms and drugs.

Bull’s-eye.

The ‘repression’ mentioned echoes Herbert Marcuse, who is cited repeatedly in the document: Marcuse speaks of ‘repression from within, the unfree individual introjects his masters and their commands into his own mental apparatus. The struggle against freedom reproduces itself in the psyche of man, as the self-repression of the repressed individual, and his self-repression in turn sustains his masters and their institutions.’ Our era is ‘a period when the omnipotent apparatus punishes real non-conformity with ridicule and defeat’. Castro Hlongwane sums up: ‘And so it has come to pass that anybody who has dared to question any of the above allegedly established scientific truths, has been confronted by this omnipotent apparatus. Accordingly, it has punished non-conformity with ridicule, defeat and worse.’ Recognising the same process noted by Fanon and Illich, Marcuse is then quoted offering a stinging riposte for Makgoba: ‘What started as subjection by force soon became “voluntary servitude”, collaboration in reproducing a society which made servitude increasingly rewarding and palatable … Today, this union of freedom and servitude has become “natural” and a vehicle of progress.’

Makgoba has completely blown it among black intellectuals alive to the hostile ideological forces driving the AIDS model. Mokaba openly called him ‘third rate’ in Business Day on 15 April 2002, reflecting Mbeki’s and his inner circle’s deep disappointment, resentment even. And as far as ‘returning to his pond’ goes, Mhlongo has suggested to Makgoba – to his face – that he should seek a job with a drug company. No shortage of Roman gold for him there. Or slickly managed feeds into the media for vengefully bashing his new enemies. Enemies like Mbeki.

Makgoba’s biggest local fan in journalism, Pat Sidley on Business Day, rushed over to get his comment on Castro Hlongwane, and published it on 25 March 2002 in an article subtitled, Research chief urges scientists to oppose ‘Soviet-style’ science: ‘The meeting preceding the release of the [Castro Hlongwane] document was dominated by “denialist” politicians, who do not accept that HIV leads to AIDS, a view apparent in the document,’ she wrote.

Head of the Medical Research Council (MRC) Malegapuru Makgoba has come out in public for the first time in opposition to the ANC’s stance on AIDS. He accused government yesterday of a ‘Soviet-style’ approach to science, and urged scientists to speak up on the issue. Silence would result in scientists being associated with ‘genocide against humans’, he said, ‘and that day is not far away’. … Makgoba, who has faced the wrath of the ANC and government over his refusal to bend his scientific principles to fit political needs, said SA scientists had been threatened and harassed for their views for two years by government. He and colleagues in the scientific world were ‘sick of debates that are unwarranted and unnecessary’. The ‘obvious and excellent high quality of science’ in SA was simply not being accepted. ‘We have allowed professional politicians to become the high priests of science and to determine policy from a false position,’ he said.’

As he left the MRC at the end of August, after Mbeki had made sure his contract was not renewed, Makgoba incoherently knocked him in MRC News along much the same as his earlier lines. First of all, he set himself up as noble defender of good science against the ignorant barbarians: ‘The major issue of my time was HIV/AIDS. I took the stand that I took for my scientific and academic ethos as a matter of honour and a matter of integrity, and as a matter of protecting the quality and excellence of science in a developing country.’ Then, after repeatedly telling everyone what wonderful scientists his AIDS expert colleagues were, he complained that the MRC was under pressure to cave in to the ANC’s ‘political interence and manipulation’ and become ‘the trusted scientific voice that justifies unscientific findings or pseudo-scientific ideas … The politicisation of scientific research, trying to do research according to political ideology and along party political lines, and trying to manage, recruit and appoint staff along these lines have never worked successfully anywhere where excellent science is being done.’ Alluding to the kowtowing of scientists under the Soviet communist, Nazi, and apartheid regimes, he said he intended to ‘nip this pernicious problem in the bud … Finally, let us also remember what happened to science in post-colonial Africa – it has been decimated by uninformed and foolish political decisions and choices. African political leadership should be ashamed of itself.’ I’m ashamed of being African. I’m filled with self-worth when I’m with ‘talented and committed colleagues’ such as ‘Prof. Wally Prozesky and Mr Org Groenewald’. And ‘Profs Marian Jacobs, Kerneels Keel, Christa van Wyk’ and ‘Professor Cleaton-Jones who chairs the Ethics Committee’, but especially ‘Debbie Bradshaw, David Bourne, Rob Dorrington and their colleagues’. All full of ‘passion, commitment and loyalty’. Did I mention ‘Dr Nico Walters, Prof. Koos Louw’ and ‘Prof. Terry Jackson’? And ‘Ms Denise Nefdt who actually ran and carried the spirit of the MRC daily’? ‘She is the real president of the MRC!’ They’ve all made me feel so at home here. They all smile so nicely at me in the morning. ‘It’s not every day that a young shepherd from rural Sekhukhuniland gets to be President of a national asset such as the MRC. For this I thank my lucky stars. … You cannot survive today in health research if you don’t have the passion, the commitment, the integrity, the honesty, valuing excellence, and wanting to be Number One.’ You really cannot. Even if it’s obvious that I’m the token darkie here. Appointed to create the impression that the MRC now serves the interests of the majority in the democratic era, and not merely those of the white professional and commercial classes as before.

‘Mandela made a passionate plea’ at the AIDS policy conference ‘for the government to distribute the anti-retroviral drug nevirapine to all HIV-infected women at state hospitals,’ notes William Gumede in his dismal Thabo Mbeki and the Battle for the Soul of the ANC (Zebra Press, 2005). The ‘government was being perceived as uncaring by stubbornly refusing to roll out the desperately needed drug’ – as Gumede recounts Mandela’s pitch. But it was met with contemptuous jeering. And rightly so. Writing full of sympathy for what he presented as the brave prophet alone among the craven, hostile yes-men around Mbeki, Gumede added: ‘Ironically, just a few weeks earlier, Mandela had complained at a meeting of the ANC’s national working committee that there seemed to be a lack of internal debate within the party. Not a single Cabinet minister, he pointed out, had opposed Mbeki’s views on Aids.’ What Gumede missed was the possibility that the ANC’s leadership shared Mbeki’s insights into the real dynamics of the controversy, centring on the forced dumping of a useless drug that had flopped in the First World, and that Mandela, like Gumede himself, had foolishly bought all the propaganda about it. There being no fool like an old fool. Into whom Mokaba, Deputy Speaker Baleka Mbete, Safety and Security Minister Steve Tshwete and KwaZulu-Natal leaders S’bu Ndebele and Dumisani Makhaye tore hotly, once he’d finished speaking. For Boehringer Ingelheim.

On 20 March, three days after the AIDS policy conference at which Castro Hlongwane was discussed, the National Executive Committee of the ANC released a press statement that came out solidly behind the government’s approaches – criticising local ‘AIDS experts’, GlaxoSmithKline and the TAC on the way:

Government is duty-bound to pose scientific questions on this and any other matter that affects public policy. In this regard, the NEC welcomes the continuing work of the Presidential Advisory Panel on AIDS, and urges that these matters under investigation should be handled with the urgency they deserve. We wish to emphasise however, that neither the ANC nor government are protagonists in the intense debates surrounding this matter. Rather, what we seek to achieve is the establishment of knowledge that will help us and the nation to fight the epidemic even more effectively. At the same time, we shall not be stampeded into precipitate action by pseudo-science, an uncaring drive for profits or an opportunistic clamour for cheap popularity.

Supporting the government’s appeal against the High Court’s nevirapine order, the NEC press statement scored another hole-in-one: ‘We are convinced that it is incorrect for anyone to prescribe a specific drug from the Bench, let alone one whose efficacy is still under investigation.’ Obviously, to most of us, but not to the AIDS activists, who had squealed and oinked in joyous response on the front page of the Cape Times in its report of the judgment.

The ANC NEC had clearly taken onboard Castro Hlongwane’s unmasking of the scientific and ideological foundation of the infectious AIDS model, because several months later, on 30 November, ANC Today published a briefing document, HIV-AIDS in South Africa: Challenges, Obstacles and Responses, listing a set of ‘key questions that remain in HIV/AIDS’, namely whether ‘an infective agent’ even existed; whether it was a virus; whether HIV caused AIDS; and whether the tests used to detect the virus, if it existed, were reliable. That is to say, the national leadership of the ANC shared Mbeki’s scepticism of the virus/immune deficiency model, and did so at the same, most fundamental level.

On 5 April, the day after the Constitutional Court dismissed the government’s appeal against the High Court’s order that it roll out nevirapine country-wide, irrespective of its main appeal still pending, Mbeki fired another shot at the TAC in his Letter from the President in ANC Today, noting that

some in our society and elsewhere in the world, seem very determined to impose the view on all of us, that the only health matters that should concern especially the black people are HIV/AIDS, HIV, and complex anti-retroviral drugs, including nevirapine. … The majority of our people are poor. Necessarily, therefore, our policies are focussed on the issue of the alleviation and eradication of poverty. We are implementing many programmes aimed at ensuring that we lift the burden of poverty that weighs heavily on the shoulders of our people. … There is a determined and aggressive attempt to hide the truth about the direct and immediate relationship between poverty and health. Huge resources are devoted to the accomplishment of this objective. There is virtually no discussion in our country about the diseases of poverty that regularly claim the lives of hundreds of thousands of our people. Some individuals, engaged in politics and public health, have achieved and seek to obtain public prominence, on the basis of leading an extremely harmful and unacceptable campaign to deny our people all information and knowledge about the incidence of diseases of poverty in our country. We are told that we must accept the harm these persons cause, and their insult of an entire people, as the very essence of free democratic expression. Despite the propaganda offensive, the reality is that the predominant feature of illnesses that cause disease and death among the black people in our country is poverty. This poverty impacts on health in a variety of ways, all of which are well known and recognised throughout in the world. This impact ranges from poor nutrition, unavailability of clean water and proper sanitation, unhygienic environmental conditions, unaffordability of drugs and medicines, inadequate or unavailable health services and infrastructure, low levels of education, the effect of rapid urbanisation, to social breakdown within communities. The truth is that poverty causes illness and death. The truth is also that ill-health causes poverty. … We will not be intimidated, terrorised, bludgeoned, manipulated, stampeded, or in any other way forced to adopt policies and programmes inimical to the health of our people. That we are poor and black does not mean that we cannot think for ourselves and determine what is good for us. Neither does it mean that we are available to be bought, whatever the price. Health Month must help us to form and strengthen the partnerships of which the WHO DG spoke, based on commitment to poverty reduction, the improvement of the health of the poor and human dignity. Thabo Mbeki.

Citing one medical authority after another, Mbeki elucidated the point, obvious to everyone but the ‘AIDS movement’, that poverty in its various manifestations is the cause of broken health among the poor, and he detailed government’s strategies to alleviate it. He concluded by highlighting the politically obfuscating and essential racism of the TAC programme:

Because of the pursuit of particular agendas, regardless of the health challenges facing the majority of our people, who happen to be black, in our country there is a studied and sustained attempt to hide the truth about diseases of poverty. If we allow these agendas and falsehoods to form the basis of our health policies and programmes, we will condemn ourselves to the further and criminal deterioration of the health condition of the majority of our people. We cannot and will not follow this disastrous route. We are both the victims and fully understand the legacy of centuries-old and current racism on our society and ourselves.

But you are wrong, Mr President. You ‘will … be … forced to adopt policies inimical to the health of our people’. Get used to it. See, the whites who drew the Constitution made damn sure that ultimate power wouldn’t go to the natives, but would remain in the hands of the white liberal judges dominating the Constitutional Court. They’d have the final say about ‘what is good for us’, and they’d even have the power to force you ‘to adopt policies’ that your democratically elected government didn’t want. Since everyone knows blacks can’t think for themselves. And that whites always know what’s best for everyone.

Mbeki’s new rant over Aids in the weekend was the Sunday Argus’s contemptuous cover-story report of it, quoting the ‘We will not be intimidated’ bit, but leaving out all the rest. Heywood said he found Mbeki’s remarks ‘demoralising’. In fact Mbeki was a liar: ‘Having an HIV child creates new poverty in African women. Therefore to suggest that people who fight for medicines to interrupt it, are blind to all other diseases of poverty is a patent falsehood.’

I consider that it is precisely because the TAC’s agenda is diversionary and politically anaesthetising that it has such runaway appeal among whites and other elites, both liberal and conservative. It masks the conditions of the poor, and deposes the programme for their alleviation from the top of the list of social priorities to somewhere off-screen. And it’s racist in essence, because the TAC’s cause is predicated upon a sex-disease model, with the fantastic prevalence figures it bandies about to whip up support from funders implying that South African blacks, the poor especially, spend their lives irresponsibly going about rutting all and sundry. That’s why they wind up in the TB wards. Why they die ‘like flies’.

In an interview on 4 April 2002 in the Star, Mokaba, who ‘played a leading role in the publication of the ANC’s controversial political document supporting the dissident view on HIV/AIDS [with] the backing of President Thabo Mbeki’, spoke for the neo-apartheid victims of this kind of thinking:

They won their liberation and now they are fighting another war and they are being psychologically terrorised once more because people want to sell and make profits. And there is no benefit in those products. The only thing that can really happen is that once you touch the antiretrovirals you can go one way [like ‘Nkosi Johnson’ and Parks Mankahlana, identified in Castro Hlongwane as having succumbed to their toxicities]. … We have seen colonisation, we have seen imperialism, we have seen apartheid ... and all of them used against us as a people. One of the things that we are really talking about is that if liberation is going to be meaningful to us, then it has to return to us our humanity denied to us by all of these other systems before us. That is why, once we realised what is behind the whole story [a pharmaceutical industry driving a medical model in order to sell its goods], once we realized what is behind the industry, an industry that is based on no fact at all [‘we all know that the virus has never been isolated, it has never been seen’], then when we look at the story as it unfolds, [we] see racism coming in and becoming the real problem. We decided we cannot allow this to happen. … I am particularly frustrated by a situation where people test HIV-positive and then they go home and commit suicide. There are more than 70 conditions which can cause a person to [light up an HIV antibody test, not caused by] a virus at all. The way it is being promoted is that these tests are ... virus-specific, which is an untruth. People go there, then they test, and then there is no hope. They say, therefore this will lead to Aids, and then from there I must die.

This was AIDS’s real ‘cost,’ he said, its ‘future cost in terms of lives’. He hoped people would understand ‘the political economy of this assumption we have adopted’ to end this new victimisation.

Mokaba had spoken just as plainly to the New York Times on 19 March:

H.I.V.? It doesn’t exist. … The kind of stories that they tell that people are dying in droves? It’s not true. It’s not borne out by any facts. Where the science has not proved anything, we cannot allow our people to be guinea pigs. … Antiretrovirals, they’re quite dangerous. They’re poison actually. We cannot allow our people to take something so dangerous that it will actually exterminate them. However well meaning, the hazards of misplaced compassion could lead to genocide.

In Worse than the Disease: Pitfalls of Medical Progress, criticising the sorts of medical institutional problems in the UK that Mokaba wanted to avert here, Dianna Dutton expressed sentiments in line with his:

Democracy, whether in medicine or in any other area, remains our best, indeed only hope for achieving lasting social change … Something new must be tried if we are to stem the haemorrhage of public expenditures on high cost technologies of questionable benefit, the denial of care to those in greatest need, the over-reliance on drugs and techniques that endanger patients while leaving the underlying causes of disease untouched [and] the unabashed pursuit of private profits at public expense.

But of course democracy, in the AIDS age, is an anathema. When the wrong leaders hold power.

Mokaba was blunt: ‘The story that HIV causes AIDS is being promoted through lies, pseudo-science, violence and deception. … We are urged to abandon science and adopt the religion and superstition that HIV exists and that it causes AIDS. We refuse to be agents for using our people as guinea pigs and have a responsibility to defeat the intended genocide and dehumanisation of the African child, mother, family and society.’

In September the year before he’d spoken as plainly: asked by a journalist whether he’d come out if ever diagnosed HIV-positive, he answered, sure, ‘but if scientists cannot prove that something like AIDS exists, one would promote lies by doing so’. (From the other side of the fence, Makgoba claimed at the same time: ‘The country is in complete denial. We need to lift the veil of denial.’)

Interviewed by the Financial Mail on 1 March 2002, about the literature that he’d been distributing to the ANC caucus, evidently by the Perth Group principally, Mokaba explained: ‘It’s about this HIV/AIDS thing. It deals with research into HIV, research into treatment, research into the immune system. What it says is that after 20 years of investigation to find the HI virus, scientists have not succeeded in doing so. And it deals with antiretrovirals [because] they can cause AIDS.’ And why was he doing so:

We want our members to appreciate where the science is, what the scientists are saying. ... The issue of HIV/AIDS is being used by those who are HIV-causes-AIDS believers to divide the organisation and the country. There have been various attempts by quasi-scientists to say HIV is a problem of blacks. The story is that blacks are vulnerable to this thing because of their sexual morality. We also challenge the use of all antiretrovirals. If you don’t have the virus isolated, then you can’t have a tablet that cures it.

And what he hoped would come out of it: ‘I want us to take a decision, very firmly, that we are not going to provide antiretrovirals. I have raised this in the ANC NEC and briefed the national working committee and received no opposition.’ Asked, ‘Won’t the President be angry? After all, he seems to want to end this damaging debate’, Mokaba dismissed this widespread myth among AIDS activists and journalists: ‘No. There’s no such thing. It’s not him that’s saying it, it’s the scientists ... we don’t want [him to] be a charismatic leader [with whom] people don’t debate. He wants a debate. It’s not our view – and it’s all in the [AIDS Panel] report. It’s not me, it’s not the President, it’s science.’

The next day, the Mail&Guardian’s Howard Barrell let us know that he was displeased with the news that ‘this idiocy now affects almost the entire ANC national executive committee – bar Mandela and a handful of others’. Barrell referred to ‘Mbeki’s baloney’ and ‘this nonsense’ – his favourite expression – just in case we didn’t get it the first time. Or the second. His editorial, written in that characteristic tone of his, like an old Anglican shrew in lace hectoring the labour from her veranda, was entitled Intellectually bereft, and it made the charge over and over. Amounting really to what stupid muntus they all are. And that Mbeki emulates Idi Amin for the ‘cruel and arrogant stupidity of his denialist position on HIV and Aids’. Barrell’s pinched view cannot allow the possibility that ANC NEC members might have formed considered opinions of their own. Instead, he alleged, with no supporting evidence at all, ‘for reason of fear or ambition, or in the mistaken, quasi-Stalinist belief that party unity discipline is a sufficient reason to hide from the truth, they say nothing’. Also because of their ‘cowardice and unctuous fealty to the leader’. Yes of course, Howard. As you know, the natives, like children, are easily influenced. What else can explain it for you? They might not be living in thatched beehive huts any more, but they’re still prostrating themselves cravenly at the inkosi’s feet. Since you can take a native out the bush, but you can’t take the bush out of a native. As you say.

The New York Times had levelled the same insult in an editorial on 4 November the year before: ‘Many politicians in Mr. Mbeki’s African National Congress disagree with him. But virtually none speak out publicly, a testament to Mr. Mbeki’s unhealthy level of control.’

Stung by criticism in Castro Hlongwane for experimenting on pregnant black women with deadly chemicals at Chris Hani-Baragwanath Hospital, Glenda Gray responded: ‘That’s preposterous. There was no one, no one, who died in my study from the toxicity of the drugs.’ But it’s not only death that we worry about, Glenda. If you were keeping a proper log of how AZT-exposed children in your experiments were turning out, you would likely have discovered the horrors reported abroad (discussed in Poisoining our Children). ‘Should I be held accountable for trying to save people’s lives? Should I be held accountable for trying to prevent women from passing on HIV to their babies? I’m prepared to be held accountable for being outraged that people die when their lives can be saved.’ In your dreams, sweetheart.

Castro Hlongwane went down at the TAC offices like a dose of castor oil, with Achmat’s young satrap Nathan Geffen freaking: ‘The document is evil, totally evil.’ Talking like a medieval clergyman. And when they’re accusing you of being wicked they aren’t smiling. I was berated on and on as ‘evil, evil’ by some super-heated AZT fan at the Durban AIDS Conference, before getting the custard-pie treatment with her dinner-pot of take-away curry and rice. Lucky she didn’t have a gun.

In his furious response to Castro Hlongwane, Cameron predictably got it all arse over tit, inverting its charges, cluelessly counter-accusing black Africans demeaned by the African AIDS model’s racist suppositions, and rehashing, like those dweebs at the gate selling Watchtower magazines, the same tired old fluff that makes them all feel so cosy, the menacing grand Malthusian stuff that they love mouthing. On 15 April the TAC circulated the text of a prepared diatribe that Cameron gave at a book launch for Gideon Mendel’s A Broken Landscape (Blume, 2003), a collection of photos on the theme of AIDS, in Cape Town two days earlier. ‘It is really worth reading,’ commended the TAC. It really is. It’s a scream.

Spouting a slew of delicate cheesy phrases, not unlike, in effect, those lovingly painted Watchtower cover pictures, the judge wins the crowd with some cornpone and molasses. Then he gets political, and delivers his take on Castro Hlongwane, giving his Mr Nice-Guy pose a rest and baring his teeth – the true believer insulted and bruised, mortally offended by Mbeki’s mockery of his precious disease (all in his head), and smarting for revenge. Cameron’s soliloquy is so comically over the top that I’ve not interpolated any comment.

AIDS, he declaims,

is the most urgent current question in our national life. It is true that we have a ‘crisis of AIDS’ in our country. On the one hand that crisis is one of illness and suffering and dying – dying on a larger scale and in conspicuously different patterns from before; on a scale globally that dwarfs any disease or epidemic the world has known for more than six centuries. On the other hand that crisis is one of leadership and management – a challenge to every person with power and resources and skills to use them to alleviate and obviate suffering and death on this scale. But most importantly, and most tragically, in our nation that crisis is also one of truth-telling. The most fundamental crisis in the AIDS epidemic is our nation’s struggle to identify and confront and act on the truth about AIDS. This third crisis in AIDS had been engendered by those in our country who deny the facts about AIDS. There are those who deny that AIDS has introduced disturbingly new patterns of disease and dying to our sub-continent. They deny that these new patterns are the result of an infectious agent, a virus, one that is mostly sexually transmitted; one that enters the human body, and attacks the immune system, and destroys it through retroviral activity, rendering it vulnerable to attack by a host of infections. Crucially, these deniers also reject the most signal truth in the AIDS epidemic. This is that the destructive activity of the virus within the human body can be completely contained by carefully administered and properly monitored anti-retroviral medications. The deniers revile those speaking the truth about AIDS for engaging in ‘scare-mongering’. They attack them as agents of an ‘omnipotent apparatus’ engaged in ‘a massive political-commercial campaign to promote anti-retroviral drugs’. They condemn those speaking the truth about AIDS for a supposed campaign ‘to medicalise poverty and underdevelopment’. They depict the facts about AIDS as a monstrous plot against Africans because they are black. In this the denial of AIDS represents the ultimate relic of apartheid’s racially imposed consciousness, and the deniers achieve the ultimate victory of the apartheid mindset. The cost is immeasurable. The acts and words of the deniers have at every level paralysed our national response to the epidemic. They have confused our planning and befuddled our strategies. They have confounded our insights, sapped our energies and dispirited our determination to act. And, most significantly, they have silenced all too many voices amongst those who are experiencing the epidemic in their own bodies and their own families and in their own communities. The deniers have re-created shame, and re-imposed silence, in an epidemic where the struggle for twenty years has been to create voices and to defeat shame. The denial of the facts about AIDS is not only an outrage against the truth. It is a profound insult to those South Africans who are living with and dying from the effects of the virus. They deny us the dignity of our suffering. They deny us the dignity of our struggle for life against the workings of a viral agent. Most importantly, they deny us the dignity of the truth, and the power and hope, and the opportunities for action, that acceptance of the truth brings. In countless villages and townships and cities and settlements in South Africa, where the virus is taking its toll of health and life amongst our people, the terrible truth about AIDS is being born and lived and died. Our people are being born, are living with, and dying from that truth. They are living that truth in the rising fevers, the wasting of flesh and the slow, agonised cessation of bodily functions that result from the virus. Their suffering is being increased and is being prolonged incalculably by the deniers. But, as we have seen today, from the terrible grief of those affected by the virus a terrible determination arises: a determination to defeat untruth and misrepresentation and distortion, and to assert hope. That is the ultimate significance of the unforgettable images of this exhibition: that untruth and inaction are the greatest crimes of all. Let us take an angry inspiration, and a deep determination, from that.

Is there any hope for this guy? I mean outside his Kingdom Hall. After his righteous temper has cooled. Pressing his pouting, childish self-pity on us. Making lots of noise to get attention, to get his way. Acting up. Displaying an arrested emotional and intellectual development, as might follow some terrible childhood trauma. A contemporary of Cameron’s who hung out with him a bit in his student days once told me, concerning his meteoric rise and all the talk in the newspapers of his brilliance, that he thought him ‘over-rated’. A rather ungracious thing to say, I thought at the time. But to read Cameron’s hot little talk is to get the idea: the utter lack of intellectual rigour in his half-baked homily, the elder ranting before the attentive blue suits and old-fashioned dresses, in short back and sides and pudding bowls. Similarly attired kids fidgeting bored between them. Intuitively recognising what crap it all is.

Makgoba used the same trick in invoking Black Death imagery for its rhetorical pizzazz in an address he gave at Wits University’s Life Sciences graduation ceremony on 19 April 2001: ‘

The plague or Black Death that preceded the European Renaissance reached Europe in 1347 and England by 1348, where it is said to have killed half its population. It was an episode of exceptional catastrophe. People said and believed, ‘This was the end of the world.’ Does this not ring a familiar note with the current HIV/AIDS epidemic in our country? … Africa, particularly Sub-Saharan Africa is engulfed by the HIV/AIDS epidemic. Almost all the socio-economic improvements of post-independent Africa are being reversed if not wiped out by this epidemic.

All of this exacerbated by ‘the current continuing misinformation and miseducation that takes place in the media under the guise of debates, information and freedom of expression; the perceived vacillation and mixed messages from the political sector – the failure to face and speak the truth’. Since when it comes to ideas about health, it’s only players in the medical industry who have the brains and the right to weigh the facts and decide where the truth lies.

Castro Hlongwane pulled the sheets off both the scientific speciousness and the real ideological shape of Cameron’s game. In The Group-Fantasy Origins of AIDS Schmidt, the psychiatrist, explained why that should infuriate him so: there’s ‘a strong unconscious resistance to the examination of one’s own group participation [in epidemic hysteria] since it is both frightening and awesome, and, when known, such awareness interferes with one’s ability to act out the group rituals’. Also because the ‘group trance is at this point heavily upon us ... anyone who proposes that AIDS is not caused by a virus ... is viewed as a threat to the group’s solidarity. … an announcement that any particular epidemic is an example of epidemic hysteria will be met with resistance among those who subscribe to the group delusion, and for whom the epidemic is a golden solution to unconscious conflicts.’

It’s no accident that Cameron carries himself like Jeremiah. It’s a role the ambitious parvenu from the wrong side of the tracks groomed himself for from the start. In 1990 in the Journal for Human Rights he’d prophesied that ‘as a result partly of their judicial position, judges in Western society are in a position to assume, and often do assume, the role of public oracles’. It may be conceited rubbish, but the statement is striking for its presumptuousness. ‘Oracle’! Mouthpiece of the gods? Exponent of divine will? Infallible authority of great wisdom? So which particular Messianic role did Cameron have in mind for himself?

Making it all up for his novel, but nonetheless unerringly on the mark, Defoe described the peril of remaining cool as Mbeki does to hysterical enthusiasms such as Cameron’s:

I could fill this account with the strange relations such people gave every day of what they had seen, and every one was so positive of their having seen what they pretended to see, that there was no contradicting them without breach of friendship, or being accounted rude and unmannerly on one hand, and profane and impenetrable on the other. One time before the plague was begun (otherwise than as I have said in St Giles’s), I think it was in March, seeing a crowd of people in the street, I joined with them to satisfy my curiosity, and found them all staring up in the air to see what a woman told them appeared plain to her, which was an angel clothed in white, with a fiery sword in his hand, waving it or brandishing it over his head. [The assembled mob then claimed to see it too.] But the woman, turning on me, looked in my face, and fancied I laughed, in which her imagination deceived her too, for I really did not laugh, but was seriously reflecting how the poor people were terrified by the force of their own imagination. However, she turned from me, called me a profane fellow, and a scoffer; told me that it was a time of God’s anger, and dreadful judgments were approaching, and that despisers like I should wander and perish.

Cameron was at it again in London on 27 September 2002, addressing a Bar dinner of English barristers upon receiving an award from them for his human rights campaigning, his marketing for the pharmaceutical industry. It was another amazing display of the top judge’s intellectual torpor, and his characteristically cheap rhetorical devices and style, all presented in an evening gown of shimmering emotion. Cranking up the stridency of his vituperations against Mbeki – insulting him directly, personally, and by name – he began with a politician’s lie, accusing him of belief in ‘racial conspiracy’. Quoting his more colourful phrases, Carmel Rickard paraphrased his talk for the Sunday Times on 6 October 2002: ‘In terms of this conspiracy theory, African Aids deniers claimed that well-established facts about Aids were “a monstrous plot against Africans because they are black” and that a syndicate of white Western interests promoted antiretroviral drugs to “degrade, exploit and kill Africans.”’

The July 2000 issue of Poz gave a more honest report of what Mbeki had actually said: ‘Mbeki has accused his opponents of dancing to the tune of Western pharmaceutical companies that are, he says, “enriching themselves from the AIDS epidemic”, comparing them to “warmongers who propagate fear to increase their profits”.’ But in Cameron’s view of it, such matter of fact observations proved Mbeki to be a conspiracy theorist.

Stooping to lower the tone of the controversy to new pits, Cameron hung out his ill-breeding at the London black-tie do by taking to inflammatory name-calling – likening ‘African AIDS deniers’ to ‘Holocaust deniers’, whom the English courts, he said, had declared to be ‘devoid of professional integrity or truth’ (in the Irving v Lipstadt libel case). Mbeki was just such a low-life, he meant, in common with anyone daring to revisit the precise historical shape of the Jewish catastrophe during the Third Reich. ‘South Africa’s own monstrous denial of truth’ had also been examined in the courts, Cameron claimed, in two cases, one concerning discrimination against an HIV-positive man, and the other the supply of nevirapine to HIV-positive pregnant women. Except that the HIV-AIDS model was taken for granted in both cases. The core issues weren’t traversed at all. Sorry.

Quoting Cameron further, Rickard reported: ‘The court’s decisions made it clear that “irrationality and obfuscation” had no place in South Africa’s response to the worst threat to its national life and indicated to the government a direction which, if followed, would lead to the “effective and coherent national response” to the epidemic that until now has been “so tragically lacking”.’ In other words, when assessed against our own frantic convictions we liberals find government policy incomprehensible, we go running to that last redoubt of white liberal power, the Constitutional Court, and ask it to make a new one. The upper class lawyers clapped and cheered. At Cameron’s audacious outspokenness. Showing Mbeki up for the baby-killer he was.

Before spitting it in Mbeki’s face, Cameron had been masticating on the Nazi genocide metaphor for more than two years. Reporting his speech at the Durban AIDS Conference in July 2000, the Poz article went: ‘Justice Cameron ... likened those who sit in silence as millions of persons with HIV go without medications to German citizens during World War II who looked the other way as the Nazis committed mass genocide of Jews, gays, gypsies and those with mental disabilities.’

Considering that Mbeki had formally withdrawn from active engagement in the controversy in mid-October 2000, publicly anyway, and that since the sudden death of Peter Mokaba in mid-2002 the denialists had practically fallen off the map, why Cameron should have had a go at Mbeki in London, and at such screaming queen pitch is puzzling. Perhaps it’s because being HIV-positive has become integral to Cameron’s private personality and public identity, and he lives with the knowledge of Mbeki’s scepticism of his counterfeit ticket much as one lives with a buzzing office light.

Dizzy on his drugs, the neurotoxic ones, he ranted on, and Rickard loved it – but then the girls have always found such ethels entertaining:

In the face of ‘mountainous evidence’ that Aids exists and is ravaging the region, it would seem impossible that the existence of the epidemic and the threat it posed to the lives of millions of Africans and to African civilisation could be doubted. ‘And yet it is. The significance for our country of this denial is momentous. It has to be, since our President has ... officially encouraged it.’

Able kindly whites, as always, looking after the inept uncaring blacks. Helping.

Like Reverend John Hale, characterised by Miller in his notes to The Crucible:

Mr Hale is nearing forty, a tight-skinned, eager-eyed intellectual. This is a beloved errand for him; on being called here to ascertain witchcraft he felt the pride of the specialist whose unique knowledge has at last been publicly called for. Like almost all men of learning, he spent a good deal of his time pondering the invisible world, especially since he had himself encountered a witch in his parish not long before. … ‘We cannot look to superstition in this. The Devil is precise; the marks of his presence are as definite as stone.’ … He feels himself allied with the best minds of Europe – kings, philosophers, scientists and ecclesiasts of all churches. His goal is light, goodness and its preservation. … ‘This is a strange time, Mister. No man may longer doubt the powers of the dark are gathered in monstrous attack upon this village. There is too much evidence now to deny it. You will agree, sir? … Proctor, let you open with me now, for I have a rumor that troubles me. It’s said you hold no belief that there may even be witches in the world. Is that true, sir?’

Miller has Hale hauling in ‘half a dozen heavy books … enormous tracts’ in The Crucible, opening one, and, ‘with a tasty love of intellectual pursuit’, declaring: ‘Here is all the invisible world, caught, defined, and calculated. In these books the Devil stands stripped of all his brute disguises. Here are your familiar spirits – your incubi and succubi; your witches that go by land, by air, and by sea; your wizards of the night and day. Have no fear now – we shall find him out if he has come among us, and I mean to crush him utterly if he has shown his face!’ It’s a remarkable template for the thinking patterns in AIDS medicine.

Considered objectively, Cameron’s ceaseless attacks on Mbeki and his administration make no sense: the South African government spends more fighting AIDS per capita than any other country in the world. Cameron throws such nasty tantrums whenever he can is because Mbeki’s challenge amounts to a religious one, and as the history of European culture amply tells, religiously inspired whites have never been big on tolerating sceptics and dissenters. And although Mbeki has not directly addressed AIDS and its apostles in ages (although they have felt the sting of some indirect but sharp allusions in 2003), Cameron and Achmat continue to denounce him for his heresies – as though he were the Antichrist silently ensconced in his Vatican, the devil lurking in his synagogue. Accounting for the extraordinary shrillness of the senior judge’s language in abusing Mbeki, The psychiatrist Abraham Myerson once explained perfectly in his general observation: ‘The more ignorant the authority the more dogmatic it is. In the fields where no real knowledge is even possible, the authorities are the fiercest and most assured, and punish non-belief with the severest of penalties.’ And as the Tudor artist Hans Holbein noted centuries ago, ‘The truth generates hatred.’

Cameron gave yet another evangelical AIDS speech, ‘The Diana, Princess of Wales Lecture on AIDS’ in The Chamber, City Hall, London on 1 December 2003. Again it was full of syntactically incoherent sentimentality, full of ‘momentous’ and ‘fraught with human suffering’ and ‘earned in blood’ and a ‘hideous and lingering death’ and ‘undeniably grotesque’ and ‘moral repugnancy’ and ‘mass death on the scale of tens of millions’ and ‘poignant’ and ‘a vast inhibition, instilling fear, suffocating hope and oppressing attempts at openness’ and ‘the exultant experience of effective treatment’ and ‘My own country has made a turn-around after a four-year period of nightmare which involved a systematic denialism of fundamental facts of AIDS to which I will return in my conclusion later.’ Which he sure did. Feeling so happy to be among Lady Runciman and Lord Steyn, feeling so accepted. Now that he had AIDS.

Behind all this sombre spectre of AIDS denialism continues to lie the moral ambivalence about the leadership of the epidemic itself. What befell us during the four years of AIDS denialism was worse than nightmare because it had a practical effect on the government’s response to an epidemic which by 1999 was medically manageable. For four years, while 5 million South Africans were living with HIV or AIDS, a number higher than in any other country in the world, our nation’s leadership dithered and dallied, obfuscated and evaded and obstructed effective concerted national action. Despite the elation and the optimism we rightly feel about the momentous commitments of the last few months in South Africa, the continuing question of denialism must be broached, and this is for two reasons: First, underlying denialism in leadership may have the continuing potential to continue to thwart or deflect our domestic AIDS policies. But perhaps more gravely, and certainly more broadly, that continuing ambivalence may have the effect of muting Africa’s own voice in demanding the global justice and equity that I’ve made the theme of this lecture. AIDS denialism sought to controvert the scientifically and medically incontrovertible that AIDS is a virally caused, mostly sexually transmitted disease, that, most importantly of all, can be treated successfully. At the same time, AIDS denialism supposedly sought to advance propositions about the environmental and social vectors of disease, precipitants of unwellness, and their impact on treatment, propositions that were so self-evident that no sane person ever sought to put them in issue. It was a hideous and costly mistake, an intellectual outrage and a moral disgrace. Its effect in delaying a rational, coherent response to AIDS may be counted in the lives unnecessarily lost – more than 600 a day – while the government evaded and avoided the issues. Seen in purely statistical terms, that number – though of course not deliberately intended – may approximate in total some of the more calculated losses of life, such as the Rwandan massacres, to which Africa has so tragically been subject in the last decade. Africa, and in particular South Africa, the most prosperous and best infrastructurally developed country on the African continent, will be able to speak with full moral authority on AIDS once it has purged itself of the intellectual and moral stain of denialism. Africa faced its previous pre-eminent moral challenge – the racist oppression of colonialism that apartheid most viciously embodied – with resilience and courage and inventiveness. Above all, it faced that challenge with moral clarity. It desperately needs the same clarity and purity and resoluteness in relation to AIDS. If we are to attain it, AIDS denialism and its disastrous effects must first be accounted for. It must be acknowledged, disavowed and expunged from our nation and so from our continent. Until this has happened there must be doubt about the moral leadership of the epidemic that puts at risk tens of millions of African lives.

Followed by a big fat slab of icing. About how ‘I want you to witness and to feel; feel anger, but also to feel a sense of potential, of action, and to act.’ It was this kind of prose that earned him his honours at Oxford, apparently.

Why his delirious sermons are so febrile Cameron let on in an essay in 2000, Human Rights, Racism and AIDS: The New Discrimination. Like the early missionaries despairing of their general failure to persuade the Xhosas, he’s losing it: ‘We risk a failure of words, of concepts, of sympathetic insight in the face of AIDS. We need to fight this failure. We need to respond with imagination and compassion to what is happening around us.’ And then he veered off on a tangent, packing it all in while still holding the mike: ‘People with HIV and AIDS must be guaranteed not only the legal protections accorded all members of this society but also a humane share of the country’s resources.’ (That sounds nice. It was meant to.) And how is this ‘new discrimination’ to be cured? Why, with drugs – as he explained in a speech at the Second Annual Conference of People Living with AIDS in Durban on 10 March 2000: ’By preventing through treatment, we give all people affected by the epidemic hope. And when hope returns ... the ignorance, fear and hatred will begin to subside. So, by showing hope through treatment, we will also address the stigma that surrounds this disease.’ 

Don’t you wish you also had such oracular talents for stringing evocative words together without any logical glue? As in later on opening the AIDS in Context Conference at Wits on 4 April 2001:

The [government’s] arguments [about AIDS drugs] are not only illogical. They are demeaning, insulting and disempowering. More significantly, they function to legitimate a collusive paralysis between governments and international drug companies in which blame-shifting, mutual recrimination and evasion of responsibility has taken the place of immediate and decisive action.

‘Collusive paralysis’! A ridiculous phrase he’d invented for the 13th International AIDS Conference: ‘The drug companies and the African governments seem to have become involved in a kind of collusive paralysis.’ Missing only a hick American accent, Cameron otherwise sounds like a television evangelist from International Faith Ministries. Like Benny Hinn or someone.

Or a gay rights activist, fairly wishing ‘the ignorance, fear and hatred will begin to subside. So, by showing hope through treatment, we will also address the stigma that surrounds this disease’ – the profoundly stigmatised disease of homosexuality, pathologised and aggressively treated by American psychiatry right up until 1973, when it was declassified as a mental illness from the DSM III, and similarly abrogated by the American Psychological Association as a form of mental disorder a year later. Which is to say that by medical definition Cameron was already a sick man at university, long before he was defined ill in terms of the succeeding medical diagnostic construct for gay men, AIDS. Before the Americans spread their new idea of AIDS to Africa.

For Cameron and white liberals, Castro Hlongwane went down like John Lennon’s remark about the Beatles being ‘more popular than Jesus’. I surmise that that was the idea. ‘Bigger than Jesus’ cleaved a seismic divide in the Western psyche so deep that nobody was left unmoved one way or the other. Public responses were absolute: you either rejoiced in Lennon’s free-spirited gall or angrily broke and burned the records. The bifurcation between hip and square, fresh and stale, was starkly marked anew. In Castro Hlongwane, Mbeki and his closest aides pull out all stops. They say it like it is, no beating about the bush. The document is so blunt, so uncompromising, that no ambivalent fence-sitting response is possible. It defines the territory absolutely, like a dog pissing on perimeter trees, marking equally absolute ideological hemispheres.

But Mbeki’s case made in Castro Hlongwane is incomprehensible to liberal guys like Peter Bruce, editor of Business Day. His editorial on 16 April 2002, Mbeki’s still the only game in town: Presidential AIDS policy may be a mess, but economic management matters more, put the white liberal obsession with AIDS on the top of the pile as usual, and harped on about Mbeki’s rejection of the claims of those gulled by AIDS as evidence of what a kook he is. Along the way, Bruce alleged that he lost the AZT-for-rape debate to Tony Leon, and that he’d dishonestly wrested his cited sources. Just as Leon and Barrell alleged. Not a very attentive journalist is Bruce. He missed GlaxoSmithKline’s astonishing reversal of its support for Leon, and its affirmation of Mbeki’s position. After Mbeki had publicly caught the company’s local CEO out lying.

Finding himself forced to concede that objectively there’s little mud to stick on him, that he’s beholden to no one, defused the Zulu civil war in KwaZulu-Natal, and has notched up a string of economic successes, Bruce moaned about the fact that, boiled down, he’s not the adorable populist Mandela was; he’s too remote. But what really got up Bruce’s nose was Mbeki’s AIDS agnosticism:

Mbeki’s most serious crisis is the way he has approached the AIDS pandemic [‘grounds for dismissal’] … Serious as the disease is inside his own party. [They’ve all got it, these blacks.] He is an AIDS dissident, believing his foes on the issue are pawns of the drugs lobby. The biggest threat to Mbeki will germinate among black intellectuals like Makgoba (it being important to differentiate between black intellectuals and the black elite).

Bruce couldn’t have read Makgoba’s embarrassing exchanges with the Perth Group on the HIV isolation question, or he wouldn’t still be calling him an intellectual. Nor his falsely hyped CV submitted to Wits, about which guys like him were raising a cadenza just a few years ago. Because look, if there’s one thing we can’t stand, it’s a cheeky kaffir. And too big for his boots. Thinking he’s clever. Cleverer than us. Unless he’ll submit to work. For us. So Bruce and his Press Club friends lionise Makgoba now. And deploy him against Mbeki like a loyal native in the colonial wars. Mbeki’s perception, enunciated in Castro Hlongwane, is that AIDS is just the latest avatar of Western colonialism, and it’s of the most insidious sort. But this is just not Bruce’s scene. He doesn’t even try to relate. Because it’s so much easier thinking and talking in all the stale patterns. The white liberal ones. Set by the newspapers.

We read Bruce displaying the same dismal limits to his ability to weigh and judge Mbeki as at the time the latter warned the world about the dangers of AZT – with Bruce claiming that he was meddling in things he doesn’t understand. In an email exchange with me at the time, Bruce scoffed at a similar suggestion, but from his editorial’s sickeningly patronising tone, it’s not easy to shrug off the sense that Bruce’s underlying mindset remains essentially old white South African, in which, in his experience, the predominant social relationship across the colour divide is that of colonial squire and garden boy. Unable to imagine that Mbeki might have moved beyond his own (Bruce’s) intellectual horizons, by way of careful reflection and rational inquiry, Bruce concludes his piece with an insult: ‘Our past has made an Mbeki inevitable. People who want to read him better should read his favourite book, Frontiers, by Noel Mostert … It charts, meticulously, the rape of SA by a succession of murderous colonisers.’ What Bruce meant was that the brutal subjugation of Mbeki’s Xhosa people has been all too much for him. It’s driven him -phambana – made him mentally disturbed. It’s minds like Bruce’s, who run the fourth estate in South Africa, always commenting on Mbeki’s moves and thoughts in AIDS with that smug, dull moral certainty that makes South African white liberals such a gut-turning lot. What’s ‘inevitable’ is that they should have botched the reporting of the AIDS controversy so badly, failing to report and elucidate its real issues, despite Mbeki’s cues.

In Black Skin White Masks (Grove/Atlantic, Inc.,1976) Frantz Fanon articulated how their writing must read to Mbeki – hostile, flat, lacking any imaginative reach, let alone empathy: ‘I am,’ he realised, ‘being dissected under white eyes, the only real eyes. I am fixed ... I am laid bare. I feel, see in those white faces that it is not a new man who has come in, but a new kind of man, a new genus. Why, it’s a Negro!’

On 6 August 2001 BBC interviewer Tim Sebastian asked Mbeki about a claim made by an ‘ANC spokesman’ concerning a ‘press conspiracy ... organised by certain circles in the media ... involved in a dirty campaign against the President.’

TM: Well I mean a lot of the reporting is wrong, a lot of the reporting is bad, quite clearly informed by prejudice and not fact.

TS: Prejudice – you mean racism?

TM: That’s part of the prejudice yes, that’s part of the prejudice. There is a view among some people that there must be a collapse, there must be a cataclysm, it’s not quite possible that you could have a black government managing a sophisticated country and economy like this.

TS: Do you think these stereotypes persist to this day?

TM: Yes, they do.

TS: And it’s a serious problem now in South Africa still?

TM: It’s a serious problem of perception. For instance there are some people clearly who believe that ... in the future ... there must be some explosion. ... It’s the same situation as happened when we had the elections in 1994. Nothing’s going to happen, no explosion is going to happen. But because there’s an assumption that you couldn’t possibly have situations such as we had ... we’ve had all of these years of apartheid and so on ... surely these black people must want to revenge themselves, there will be some great catastrophe. ... I’m saying it won’t happen.

I’m saying there’s no big plague around the corner. Just because of black majority rule. Just because of white thoughts about blacks. In South Africa crime killed more people than AIDS, he said.

The racism to which Mbeki speaks, and which actuates the African AIDS drama, is not the coarse Afrikaner Weerstand Beweging and Ku Klux Klan sort, but much finer stuff. Efron explains that

racism is an idea, a very old and intransigent idea. That idea exists on an unbroken continuum – all the way from a form that is fully conscious to a form that is unconscious. Its manifestations can range from the most grossly offensive and scornful invective to a compulsive noblesse oblige that cannot permit itself to make any criticisms at all. But whatever the degree or kind of racism, it invariably contains a double standard: The racist simply does not treat black individuals the same way he treats whites. The effect of stereotypes on blacks is a sense of being unseen, as in Ralph Ellison’s Invisible Man. The effect on whites is the corollary: They do not perceive blacks as real or make the same fine discriminations among blacks that they habitually make among whites. In the last analysis, they do not perceive black individuals; they perceive black skins. And this remains true at every step of the continuum.

A couple of months after assailing Mbeki in London, Cameron publicly struck again at another of his opponents. Triumphant after ousting Wits vice-chancellor Norma Reid-Birley in November 2002, in a masterful display of Machiavellian applied politics, Cameron thought he would polish her off by running her down in the newspapers. That’s where it backfired. In his capacity as Chairman of Council, he treated the Sunday Times to an ‘exclusive interview’ to carry his charges in the public mind – published on 1 December under the title, Why troubled university boss had to quit: Full story of Wits vice-chancellor’s odd behaviour comes out. Cameron grinned happily in a handsome accompanying photograph; Reid-Birley looked unattractively disconsolate. But if his intention was to score a win in the court of public opinion, he came a distant second on the facts disclosed in the papers. And smelling like a skunk.

Before going to press, the Sunday Times did the decent thing by inviting Reid-Birley to comment on Cameron’s allegations against her. She did so, but seeing the game he was playing, gave a full account of the affair to the Sunday Independent, and it was published simultaneously, next to a much nicer pic: ‘The entire process was characterised by generalised unevidenced allegations. As recently as the eve of [an aborted investigation of complaints about her to be conducted by Judge John Myburgh, appointed by the Cameron-led Council] ... the legal team team for Judge Edwin Cameron was unable to provide a single specific charge.’ Indeed, we found little meat on Cameron’s bones of contention in the Sunday Times. Which came as no surprise coming from someone as careless with the facts as Cameron has proved to be in his AIDS drug campaigning, with his vulgar predilection for making grand sweeping charges and claims. And his lawyer’s dull reliance on authority in making his arguments: ‘She failed notwithstanding very extensive efforts by senior members of Council and the members of her senior executive.’

But Reid-Birley recounted: ‘... at my installation ... I was affirmed by Cameron, who predicted that I would be “not just a good but a great VC”, and by ... the first-ever standing ovation at a VC installation in Wits’s history.’ As the health of her ailing husband declined, ‘Cameron enhanced my trust in his friendship, encouraging me to share problems and vulnerabilities with him, and showering me with private and public praise until early June’. Reid-Birley’s husband died painfully after several weeks in hospital in mid-May, during which time she continued managing the university, ‘by working far into the night, as I had done since my arrival at Wits’.

Her big mistake during ‘this period [was to convey to Cameron] my longstanding concern about the degree of his direct involvement in the management of the university’. After returning from Ireland to bury her husband’s ashes, Cameron suddenly rounded on her in a series of ‘dreadfully hostile meetings’, his complaints ‘all relating to the period following my husband’s death … letter after letter, appealing for a private internal mechanism to resolve matters with Cameron ... were rejected or ignored’.

Evidently uncertain that his case against her would stick, Cameron tried a bribe: ‘a substantial golden handshake’ to get her out the way, coupled to an ultimatum that if she refused it, ‘a publicly announced high-level quasi-legal enquiry into my performance and conduct’ would follow. She refused – later to resign, tired, unwell and unable to afford the kind of legal fees necessary to defend herself in the courts.

The episode keenly illustrated again Cameron’s ‘vicious tactics’ in his politicking – his heartlessness and ruthless personal treachery too, in relation to a woman in personal crisis, in deep grief. Whom anyone with any feeling might have excused for being somewhat distracted, if she was. But it was entirely in keeping with his astonishing attack on Mbeki in London, a couple of months before finally crushing the woman who’d dared challenge him. The senior judge imputing dishonesty to the country’s President. In the matter of his open-minded position in a public health issue. Unlike his. A purely hysterical one.

Caron Paton observed of Mbeki in the Sunday Times on 14 April 2002 that ‘On an interpersonal level he is seductive, frequently leaving people in awe of his brilliance.’ Treated finally to an opportunity to interview Mbeki in his own words for the Star on 23 April 2002, Sunday Independent editor John Battersby found himself similarly charmed, and went on to write a warmly appreciative piece in his paper that weekend. David Beresford on the Mail&Guardian responded in his Krisjan Lemmer column in the manner of a drunken estate agent snarling at a braai after the bokke have just lost their rugby test on television:

John Battersby’s paean of praise to our glorious leader in last weekend’s Sunday Independent took the whole bakery, never mind the cake, in terms of brown-nosing masquerading as journalism. The Batty one assured us that the reason why we sometimes query what the president is on about (his pronouncements on Aids, for example) is because we’re not on a par with his enormous intellect. In other words, we’re all (Batty aside) too stupid to get it, so don’t question the prez. Oom Krisjan fears he might soon be sent to a re-education school. Worse, he fears that if doctors perchance X-rayed our great leader’s lower abdomen they’d find an outline of Batty’s head in there.

All that Battersby had done was express a kind word about Mbeki in the white liberal media for a change. But to Beresford, any suggestion that Mbeki in the flesh might not fit the mean, low cartoon that his Mail&Guardian had sketched was intolerable. The coarse virulence of the attack on fellow journalist Battersby brings to mind the final paroxysm of bloodletting by German officers in the weeks before defeat in the Second World War, turning on and shooting out of hand any soldiers, and even civilians, showing signs of fading conviction in the Reich. Is it any wonder that both the Presidency and the ANC long ago adopted a formal policy of not commenting on anything appearing in the Mail&Guardian (‘self-defeating’, the paper bleats) – regarding, as they do, the latter-day quality of its journalism much as one regards the squish under one’s shoe. Can you blame them? Everywhere I go, one word crops up over and over in my conversations with black intellectuals when I mention that newspaper: ‘reactionary’.

AIDS hasn’t been a sleepwalk for the liberal media alone. The ANC has entirely lost the institutional left on AIDS too – so Mokaba and Mhlongo agreed with me during a conversation in April 2002. Pallo Jordan MP, for instance, dismisses Mbeki’s opinions outright, because, he says, Mbeki’s ‘not a scientist, and I am not about to give his view serious consideration’. Even though, as Castro Hlongwane noted, you don’t have to be a scientist to appreciate what Richard Strohman, emeritus professor of molecular biology at Berkeley, calls the ‘bankrutpcy’ of the HIV-AIDS model. The Sunday Times’s Carol Paton cited Jordan ‘to illustrate how absurd it is that the ANC should hold opinions in matters of science’. Leave it to the experts, they suggest, overlooking the fact that some of the world’s most distinguished scientific experts don’t kneel in their temple.

As a black intellectual on the left, Jordan abides his faith in Western medical scientism, no less reverentially than a peasant in theology in the Age of Faith, and baulks against Mbeki’s call to examine it – where it dehumanises black people. This is what makes Castro Hlongwane such a masterful piece: it debunks the junk science of AIDS, but as importantly it plays up the essential oppressive racism in the foundations of AIDS ideology, and it does so relentlessly. Because finally, the AIDS controversy is not about science, it’s about ideology. That’s why the discourse is so heated.

This wholly uncritical scientism of the left is well illustrated in An Ordinary Country (University of Natal Press, 2002) by one of South Africa’s leading radical activist intellectuals, Neville Alexander, disparaging ‘what I can only label as a superstitious debate about what causes AIDS’ – which he dramatically paints in blind trust without any evidence as ‘the pandemic spread of AIDS which is decimating the rural and urban population of certain provinces such as KwaZulu-Natal and Mpumalanga’. Understandably he didn’t want to look at this book, since, he later wrote me, ‘I support the fight against AIDS.’ Obviously.

In a delegation led by Deputy General Secretary Jeremy Cronin, the South African Communist Party marched with the TAC for ‘affordable AIDS drugs’ at the start of the 13th International AIDS Conference in Durban on 9 July 2000. Having ignored the disclosures in Debating AZT that I sent him. That shocked everyone else. Explaining the Party’s zeal, General Secretary Blade Nzimande squeaked (he really squeaks!): ‘Let us not fool ourselves – the main barrier to affordable HIV/AIDS drugs is the drug companies through charging high prices for these life-saving drugs. If we do not act now to win affordable HIV/AIDS treatment, then we will condemn millions of poor people to misery, ignorance, disease and premature deaths.’ And when Tshabalala-Msimang criticised Gauteng Premier Sam Shilowa’s popular announcement in February 2002 that his province would be ‘rolling out’ nevirapine for all HIV-positive pregnant women, not to be outdone by KwaZulu-Natal Premier Lionel Mtshali’s same move earlier, Cosatu attacked her for ‘politicising’ the issue. The SACP in turn expressed its ‘dismay’ at the government’s ‘hesitancy, prevarication and lack of decisive leadership on HIV/Aids in general, and the prevention of mother-to-child-transmission in particular’. At a central committee meeting in the middle of that month, the SACP leadership taxed her for pressing ahead with her appeal against the TAC’s nevirapine victory in the High Court, and at a press conference on the Monday following, urged the government and the TAC to ‘patch up their differences’ since the TAC had been government’s friend in the generic drug case against the pharmaceutical sector. In other words on the issue of AIDS drugs, she should just roll over. On demand by the TAC.

A compelling reason attracting the left to the TAC’s agenda to get AIDS drugs to the poor was nicely identified by Mark Gevisser in his essay, AIDS: The New Apartheid: ‘the battle for treatment was a perfect vehicle for taking on the heartlessness of global capital and the perceived wrongheadedness of the ANC government’s neoliberal macroeconomic policy.’ We suburban lefties fight back by pushing global capital’s drugs on the South African government.

The extent to which AIDS mythology has penetrated liberal-left consciousness was evident in an Oxfam policy paper published on 2 July 2002, False hope or new start? It commenced with a tabloid attention grabber: ‘Every day, 14,000 people become HIV positive, most of them in developing countries. In the past five years the number of new cases among women has increased by 40 per cent. Because of HIV/AIDS, most countries will miss the 2015 international development target to reduce by two-thirds the rate of infant and child mortality.’ When Oxfam was founded, poverty amelioration was its mission, deriving from the hard-to-contravert insight that not having enough to eat means not living very long. But today ‘in developing countries’ it’s having too much sex that does it, and as a result children are dying in droves from germs inherited from their irresponsibly promiscuous parents. ‘The Global Fund to Fight HIV/AIDS, TB, and Malaria was set up in response to widespread public criticism of governments’ apathy to the health crisis in developing countries, especially concerning HIV/AIDS’ – particularly and crucially the key South African government’s lukewarm reception of the pharmaceutical industry’s overtures – steamrollered by an infusion of millions beyond counting directly to loyal provincial apparatchiks with the necessary conviction and zeal to set the market up. ‘If the Fund is to achieve its goals’ government adoption of the TAC agenda is essential; among ‘seven pillars’ for action are ‘Treatment programmes which use the cheapest, good-quality medicines, including generics [and a] commitment to effective civil-society participation in decision-making at both global and national levels. This includes giving attention to NGO views in the Board and working groups, as well as helping NGOs play an effective role’ – boiling down to Oxfam supporting the TAC’s demand that as a group of unelected drug lobbyists it should be permitted to participate in – read dictate – government policy formulation as a fifth column for the pharmaceutical industry. It’s not hard to understand why Oxfam should have sold out to the AIDS business. It’s extremely difficult attracting money to feed the poor at the best of times. But nothing pulls cash like an AIDS ribbon. For all the reasons we’ve talked about. Oxfam is moving to shift AIDS to the centre of its activities. On 16 April 2003 it posted an appeal on AF-AIDS for ‘training materials, toolkits or manuals’ that it might use to develop ‘a toolkit to help organisations mainstream HIV/AIDS into development and humanitarian programmes’. 

Incredibly, and to our great disappointment, both Chomsky and Illich, so otherwise perspicuous in their social and institutional analyses, have missed the point too. Illich dismissed the probes of German molecular biologist Stefan Lanka, a radical revisionist of modern biology dogma. And in interviews and discussions, both the late editor of the English AIDS dissident journal Continuum, Huw Christie, and American naturopath Greg Nigh, have drawn equal blanks from Chomsky. Both social critics admitted not to having looked at the science though, which is not surprising since one has to make the special effort – as Mbeki has – but what is remarkable is their shared blind spot concerning the institutional forces that keep AIDS erect, and shut out challenge.

The most striking squint, however, is that of the late Michel Foucault, whose The Birth of the Clinic: An archaeology of medical perception provided an array of the sharpest conceptual blades with which to deconstruct medical power – centring on the medical ‘gaze’, the eyes through which the state monitors and controls its subjects. But when doctors came up with AIDS, Foucault bought the whole basket. Precisely how he died is not generally known, but it’s since emerged that he believed himself to have died of AIDS. Even master-filmmaker David Lynch, with an unrivalled eye for the horrible and the absurd under the veneer of the normal, sports an AIDS ribbon. One of our most thoughtful contemporary balladeers, Michael Franks, too.

In Lefties, Pharmas and AIDS, posted at Redflag on 11 November 2002, David Crowe in Calgary, Canada, wrote:

One of the strangest moments of my life occurred when I confronted Ralph Nader at a public talk on medicine in my home town on the subject of AZT and was accused by him of being a conspiracy theorist. It was particularly ironic because I have been a Green Party activist for several years and, in just about every other way, admire him for his integrity and cogent analyses of all that is wrong with society today. Ralph Nader genuinely believes that, if the rich get AZT, then so should the poor. Arguments about toxicity and ineffectiveness do not appeal to him. Nader likely gets his information on AZT and other AIDS drugs from people like Dr. Sidney Wolfe, the director of the Public Citizen Health Research Group, which Nader helped to establish. Wolfe called the drug a ‘proved treatment’ for HIV-positive pregnant women in a letter to the British Medical Journal in 1998. This, despite researchers at the National Cancer Institute calling the drug ‘a genotoxic transplacental carcinogen in animal models’ in the title of a 1997 article in the Journal of AIDS.

Nigh’s fine essay, On the Death of Skepticism, posted in December 1997 on a now defunct website he ran, examined the cataract over the left’s perspective on AIDS:

What raucous laughter would have arisen through the Halls of Leftism if, 20 years ago, it had been said that all carrying the banner of ‘activist’ would one day support – nay, carry out – a coercive, oppressive, invasive social enterprise at the behest of massive corporations and Heads of State? … The Left is known for its trademark investigative work in the areas of human rights, social justice and capitalist wrong-doing; united by a common mistrust of massive corporate complexes; bound together in ridicule of the propagandizing of the corporate media, with its unwavering support of a pro-business agenda and its failure to offer viewpoints counter to that agenda. … And then there was AIDS. As though skepticism were a bad memory, or even never existed at all, the Left picked up the AIDS ball from the medical-industrial complex and ran with it all the way to the grave. No more healthy skepticism, no more suspicion that a larger agenda might be at work, no apparent cognitive dissonance in working diligently within the belly of the Capitalist Beast. The Left is lobbying with classic Leftist passion on behalf of the pharmaceutical industry and even the Pentagon (when the Pentagon said it didn’t want to be involved in doing AIDS research, activists were quick to bellow for continued AIDS money to the Pentagon). The HIV/AIDS epidemic is an enormous monument to the willingness of Leftists to believe what they are told by medical scientists. … The medical-industrial complex is a massive corporate enterprise. It is second only to defense in the amount of money allocated to it by the government, and it is second to none in the amount of money Americans throw at it out-of-pocket annually. As with any other industrial complex, this one has lobbyists who are protecting interests, spokes-people who work to keep the best image of the complex possible in the headlines, and tens of thousands of honest, hard-working scientists cranking out mountains of data that no one could possibly review thoroughly. … Surely the Left, with its love of analysis and its highly developed powers for spotting conflicts of interest, can see the concentration of power going on within medicine generally, and AIDS science in particular. This is in reference not only to the financial aspects, but the information aspects. Even if all of the data that is being generated really is all in the name of Truth, Science and Good Health – which would be an absolutely astounding concession by the Left to the potential for a massive Capitalist enterprise to act altruistically – wouldn’t a closer eye on the data that is being produced be worthwhile, just as a disinterested outside party? … What happened to the level of skepticism that would have brought the analytical powers of the Left to bear on the scientific data being generated about AIDS, its causes and its treatments? Why is the Left so happy to accept statements from this industrial complex without reservations about its truth? What on earth could possibly justify the Left’s apparent belief that the medical-industrial complex does not produce data which supports its overall interests (which are financial, at least at the institutional level), not necessarily overtly and purposefully, but as an expected component of the institution itself? The Left can see it in the defense industry; it can see it with US foreign interventions; it can see it with domestic policy; it can see it in the public babble about economics; but it can’t see it going on in the medical-industrial complex and the construction of ‘facts’ about HIV and AIDS. … The oversight could not be more glaring. It means that there is a lot of science homework that has to be done. And it is so much more gratifying organizing marches, isn’t it?

Mr Achmat? Like at opening of the Durban AIDS Conference in July 2000. The TAC marching with Médecins Sans Frontières. Their banner announcing how they think guys like us should be fixed. Adapting the guerrillas’ war cry during the second Zimbabwean Chimurenga: ‘One settler, one bullet.’ About which the liberal media got into such a flap when Mokaba chanted it in the early days down here for its nice ring. As if he meant it literally. But reporting the TAC’s adaptation without perturbation: ‘One dissident, one bullet.’

Writing for ZNet on 17 July, shortly after the Durban AIDS Conference closed, the king of radical chic, economics Professor Patrick Bond of Wits (at the time) wrote in A Political Economy of South African AIDS that ‘Up to a point, Danny Schechter is absolutely right to focus on the power and the appalling discursive-policy mistake of a single personality, SA president Thabo Mbeki, in this country’s recent HIV-AIDS fiasco.’ But then look at who Bond’s friends are: ‘(Oh, and thanks much [sic] to Julie Davids and Paul Davis of ACT UP Philadelphia, my houseguests last night, who helped with corrections.)’ But were not very good at spotting his mistakes. Delivering the first Frantz Fanon Memorial Lecture at the University of Durban-Westville a month later, entitled Can Thabo Mbeki change the world? Global strategies, tactics and alliances, Bond dripped a tear over what he called ‘the AIDS treatment tragedy’ and commended the TAC for winning Al Gore’s support for the ‘surrender [by the pharmaceutical corporations of their] patents on life-saving HIV-AIDS drugs’. And luckily for South African babies – he wrote in After the South African Election: Rhetoric and Realities posted online at ZNet immediately after the county’s third general election on 14 April 2004 – the Constitutional Court had ‘helped the Treatment Action Campaign acquire AIDS medicines for pregnant women because the judges agreed the state was needlessly killing tens of thousands of infants each year’.

The hysterical credulousness, the naivety of Bond’s view of the dynamics of the generic drug and nevirapine cases – indeed in missing the ideological, economic and political substructure of the greater South African AIDS controversy – was underscored in his essay, Thabo Mbeki and NEPAD, included in Thabo Mbeki’s World: The Politics and Ideology of Thabo Mbeki (Zed Books, 2002), edited by Sean Jacobs and Richard Calland. Again he spoke approvingly of the emergence of a ‘vibrant Treatment Action Campaign ... in South Africa in 1999 during which grass-roots militants embarked on protests at American consulates in Johannesburg and Cape Town, and began networking’ with American AIDS drug activists. Claiming, like their TAC advocates, that ‘anti-retroviral drugs essential to fighting HIV/AIDS ... would save millions of lives’, Bond deprecated Mbeki’s concerns about their ‘alleged toxicity’ as ‘excuses’, despite my having hand-delivered a copy of Debating AZT to his office at Wits in early 2001, which ought to have removed any doubt. Anonymously quoting the ugly tag attached by Charlene Smith, Bond commented that Mbeki’s authorisation of the state’s appeal against the nevirapine judgment ‘seemed to amplify his extraordinary image as South Africa’s “undertaker-in-chief” … Mbeki quickly grabbed defeat from the jaws of victory, and the broader war against AIDS took a turn for the worse.’ In fact it had been Tshabalala-Msimang, not Mbeki, who’d disappointed the activists at a press conference a couple of hours after the drug companies abandoned their case – ‘We never said we want to use antiretrovirals,’ she said – but Bond found the metaphor too colourful to resist, even if it had no actual historical reference. Or perhaps he just liked Tony Leon’s ‘vibrant’ parliamentary oratory in September 2000, commenting on Mbeki’s irritating statement of the obvious: ‘A virus cannot cause a syndrome.’ Leon, we recall, said Mbeki had ‘snatched confusion from the jaws of clarity’ by saying so.

Especially in the light of Bond’s discussion of ‘hostile transnational corporate and multilateral forces whose interests are directly opposed to that of Mbeki’s South African and African constituencies’, the most breathtaking lapse in his analysis appeared near the end. To exemplify his contentions concerning ‘how far the ANC government has gone to downgrade alliances with the left’, Bond cited its indifference to what he thought should have been its natural allies in ‘local [and international AIDS] activists [who] militantly demonstrated’ in support of the ‘1997 Medicines Act’ to head off the pharmaceutical conglomerates’ bid in the Pretoria High Court to overturn its provisions concerning parallel imports and generic drugs. ‘This is where the argument finally comes to a head. Thus far, we have taken seriously the extent to which Mbeki says he wants to change the world … Central to this problem is the issue of whom Mbeki most comfortably allies himself with. The social forces represented in the AIDS treatment example are emblematic of the challenge, for they evoke enormous potential for real solidarity, for changing the balance of forces.’ As if the pharmaceutical industry’s compradors in the TAC are a left-wing tendency! Do the really progressive thing, Mr President. Go with the TAC. Change the world together. The economic order. By buying drugs. At the best possible prices. And poison the poor with them. Bond’s specious discussion of Mbeki’s conduct in the ‘war against AIDS’, and his penchant for cliché, leaves one wondering about the quality of the rest of his analysis and critique of Mbeki’s economic policy-making. The voluable American provided some more foolish examples in Corporate Cost-benefit Analysis and Culpable Hiv/aids Homicide, published online by ZNet on 25 June 2002: ‘the insanity of Mbeki’s Aids-denialism … the ongoing distractions from loony HIV/AIDS dissidents who continue to have Mbeki’s ear.’

In his contribution to Jacobs and Calland’s collection, veteran Canadian anti-apartheid campaigner Professor John Saul complained:

As president, Mbeki has further centralised matters in his own hands … The fact that no leading ANC politician would publicly critique his stubborn attempt to contradict progressive consensus [it’s cool to believe, uncool not to] on the question of the link between HIV and AIDS may provide some indication of just how far the writ of his authority runs. But his very stubbornness on this issue may also suggest exactly what one would be up against in daring to cross him: in consequence, an air of considerable trepidation scars official circles, with only the occasional bold soul daring to risk career prospects in defence of principle.

Sort of like Christians in the arena? And could we possibly have a concrete example or two? Or are you just recycling the Mail&Guardian’s line. Otherwise thanks for that. Coming to us all the way from the University of York, Toronto. Helping us to understand that over in Africa tyranny is a natural concomitant of obstinacy.

In reality, I can report on the best inside information that since asking Tshabalala-Msimang in Parliament to enquire into the safety of AZT and then launching the AIDS Panel, and despite remaining intensely interested and concerned about them, Mbeki has kept aloof from the AIDS causation and treatment controversies at an executive level. Leaving things to Tshabalala-Msimang, his comrade-in-arms with whom he left apartheid South Africa for exile in September 1962. Whose performance has been uneven, agree AIDS dissidents both inside and outside government – for which she could have been pulled up had Mbeki been the despot that his liberal critics paint him as. For blowing the nevirapine case particularly. And allowing the prescription of AZT to rape victims at public hospitals. In the face of every reason not to. Were we living in a dictatorship rather than a democracy, ‘AIDS’ would have been over by now. The tests and the drugs banned outright, the ‘AIDS experts’ and professional activists looking for new jobs.

Trade unionist Sahra Ryklief incidentally criticised Mbeki’s ‘(real or perceived) personal idiosyncrasies’ evinced by his ‘stubborn defence of a non-orthodox position on the cause of HIV/AIDS, and his ambivalent/ambiguous on treatment of the disease ... [as well as his government’s dragging] its heels over offering treatment to pregnant mothers suffering from HIV/AIDS’. She also made my point, unintentionally I’m sure, that AIDS is largely a white fixation: ‘Besides his idiosyncratic stance on AIDS, the one aspect of Mbeki that consistently seems to rattle the sensitivities of the still predominantly white South African capitalist and middle classes is his espousal of an African identity.’ As did Financial Mail senior editor William Gumede in his contribution: ‘Mbeki’s cosy relationship with predominantly white “big business” took a dip over his handling of ... HIV/AIDS.’

Both Saul and Ryklief’s negative remarks about Mbeki’s conduct in the AIDS controversy illustrated how completely the left has taken AIDS on board. Along with the drug companies’ marketing programmes. How disgracefully it has failed to consider seriously Mbeki’s assertions concerning the abundant medical literature on the severe toxicity of AZT and his challenges of the currently hegemonic sexually infectious AIDS model. How it has responded, not by investigating and evaluating them, but with cavalier dismissals and personal disparagement. A function of its supine, conservative bias to orthodox scientism, as we’ve just discussed.

AIDS otherwise drew a glancing, uncritical mention in the rest of the contributed essays – to the extent that it featured at all. But it was Jacobs and Calland’s biggest bugbear – as they spelled out, in tabloid prose, in their introduction, Thabo Mbeki Myth and context: Of the ‘quartet of issues [that] challenged his political leadership and judgement’, the mid-2000 ‘plot’ and the arms deal ‘pale into relative insignificance when compared with the remaining two controversies that centred on the president. The first – about HIV/AIDS – was largely of his own making, as his romance with the so-called “dissident” theory that questions the link between HIV and AIDS (and, by implication, the utility of anti-retrovirals) deepened throughout 2000.’ In the course of their discussion, Jacobs and Calland approvingly quoted Tom Masland’s portrait in Newsweek in March 2002, which concluded that – as evidenced by his singular, perverse views on AIDS – Mbeki was ‘apartheid’s ultimate victim: a bright, cultivated, intellectually curious man, turned inward, driven by his unique history into a job for which he is not suited’. They proposed that Mbeki’s persistence in maintaining ‘his views on HIV/AIDS was destroying not only his international reputation, but the credibility of the entire NEPAD project. … [His] more and more erratic ... views on AIDS [were] an indictment ... of his own lack of political wit … even the black press deserted him. … It became clear to close observers of the presidency over time that his intellectual roaming was something the country could not afford.’ The remaining big issue of the ‘quartet’ named by Jacobs and Calland was Mbeki’s approach to Zimbabwe, but it only merited one paragraph. Their criticism seemed to imply two liberal injunctions: Conform. Don’t think independently. And political reputation is paramount over truth.

Calland and Jacobs’s concluding essay bore out my point about the ascendance of AIDS ideology to the dead centre of South African liberal/left thought and discourse since the ANC took power. Unlike the order of their names as editors of the book and as authors of the opening essay, the concluding essay cites Calland’s name first as lead author. Indeed, that it was his chiefly his handiwork is apparent from his slack prose style and the same haughty, self-important air that I picked up when speaking to him on the telephone. To talk about some plagiarism. Slashing at Mbeki from the comfort of a plush job in a liberal think-tank – the Institute for a Democratic South Africa in Cape Town – Calland is an English immigrant with a new career as a political commentator. Conveying small, close thoughts. Unimaginative, unsympathetic. Tight, pinched, like London’s terraced houses.

His concluding essay, Thabo Mbeki Politics and ideology, opened with:

Thabo Mbeki’s legacy is in danger; tragically, “the president with the inexplicably contrary views on HIV/AIDS” would be most apposite at this stage. [Nigel Murphy, host of the radio programme, The Editors, agreed on 24 February 2003. AIDS, he said, would be Mbeki’s ‘epitaph’.] This is not a legacy that his central role in the ANC’s struggle for democracy and human rights deserves, nor one that his part in the quest for African redemption and justice implies. [In an undergraduate essay this would be struck out as waffle. In court admired as fine legal oratory. If the accent is fruity.] However, his presidency has been dominated by poor or crude political management ... and an ill-considered obsession with dissident theory, in the case of his government’s HIV/AIDS policy.

Calland’s facile commentary didn’t allow the possibility that Mbeki’s position on AIDS was a thoroughly researched and carefully considered one. ‘We detect that Mbeki sees himself as a historical figure with an important international role to play. There is a certain conceit to his politics (which also finds expression, unfortunately, in his disastrous flirting with AIDS dissidents).’ He dares to think outside Western-defined moulds, move beyond Western-expected roles. He’s Bolshie.

In his final paragraph sizing Mbeki up, Calland shamelessly copied and pasted Bond’s lines – without giving credit – about how Mbeki should kiss and make up to the TAC, interpolating some vicious stings of his own on the way: ‘This is where, finally, the argument comes to a head. [Except that Bond had been making an entirely different argument.] We have taken seriously the extent to which Mbeki says he wants to change the world. … More suited, perhaps, to the responsibilities of bureaucratic management than leadership, Mbeki’s craven wish to participate in a redeeming moment of history for Africa may remain unrequited.’

For anyone who needs reminding, and who isn’t already flabbergasted by the baseness of Calland’s liberal summation, his choice of ice-pick epithet, the New Shorter Oxford English Dictionary tells us that the adjective ‘craven’ means cowardly, defeated and abjectly pusillanimous. But get ready for more:

Central to this problem is the question of whom Mbeki most comfortably allies himself with. The social forces represented in the Treatment Action Campaign, among other examples considered above, are emblematic of this challenge. They evoke enormous potential for real solidarity, for changing the balance of forces, a more profound undertaking for which Mbeki would appear to have neither the aptitude, desire, or vision.

And we sound like those artistic dwarves who presume to critique great films or works of art, and always find a spot to slip in the word ‘flawed’. So as not to feel overshadowed and completely insignificant. In the presence of greatness. The rest of us shook our heads at the cookie-cutter mindset that could have come up with this kind of cheap denigration. Especially after reading the demeaning rider tacked onto Bond’s sentence, following his appealing italicised phrase, ‘for changing the balance of forces’. With its fantastic charge that by spurning the TAC’s claims, its programme and its agenda, Mbeki had decisively signalled his failure to mark a place in history as one of the world’s emerging nations’ most outstanding political leaders.

Dare to be great, Mr President. Think big. Stop denying that between one in ten and one in three of your indigenous compatriots carries the sex plague in their veins and sexual secretions. And everyone knows they are rampantly promiscuous. Confess it to the world. Buy extremely poisonous, expensive chemicals for them from the pharmaceutical industry. Put pregnant women and rape victims ahead in the queue to receive them. Women and children first, as we say back in England.

I asked Calland how he pleaded to the theft of Bond’s thoughts and how he thought I should deal with it in this book. Momentarily taken aback, the former barrister endeavoured to slip out of the impossible corner by resorting to some practised quick-talking: ‘Obviously we’re allowed to borrow from the writers we’ve included,’ he said. ‘You could say, “Patrick Bond, Richard Calland and Sean Jacobs take the view….”’ It didn’t do it for me. Does it do it for you? I pointed out that I’d been surprised to find AIDS heading his indictment of Mbeki’s failure as an African leader, having regard to how little attention his book’s many contributing authors had given it. My point came as news, he said; no one else reviewing the book had made this observation. (Of course not; liberal journalists one and all have AIDS on the brain.) He emphasized that he was critical of how Mbeki had handled AIDS as a political issue. Which is untrue if you look at the thrust of his criticism; Mbeki was being hammered for merely dissenting. When I informed Calland that Mbeki’s ‘political’ position on AIDS derived from a close look at the scientific foundations of the infectious AIDS model, he replied that, well, he hadn’t looked into that. We’d guessed. It’s why he uncritically repeated the AIDS careerists’ cry that ‘HIV is spreading faster in South Africa than anywhere else in the world’. And found Mbeki’s public doubts about it all to be ‘inexplicably contrary’. As Goldberger’s were to everyone when he proposed that pellagra was the result of bad food. (Vitamin B deficiency we call it now.) At a time that American experts, journalists and the public all knew the disease was infectious. Since it was breaking out in white slums.

Discerning a similar mean and vindictive tone in the Mail&Guardian’s editorials concerning Mbeki and AIDS – the aggressive-defensive poise of the English upper middle class – I asked Calland whether he’d ghostwritten any of them. He hadn’t, he said, but he had had many close discussions with those who had. Evidently. From their smell. However he disapproved, he volunteered, of ‘Barrell’s full-page editorial’ in the Mail&Guardian on 26 April 2001, flagged by a front-page headline, Is Mbeki fit to rule?, given his views on AIDS: ‘The underlying cause of Aids is HIV. No one has provided a plausible opposing paradigm. Until Mbeki can either admit it or rebut it, our advice to the president is to shut up.’ The editorial was excessive, said Calland, and it destroyed any possible future relationship between the newspaper and the government. Not that the newspapers should be uncritical of the government, he hastened to add. For my instruction. Ta.

But could some scruple have been troubling him? About complicity in a failed assassination attempt? Despite his disapproval of Barrell’s boorish editorial on the telephone to me, Calland had endorsed it on the first page of his book – citing Barrell’s language even: ‘At the time of Mbeki’s inauguration in July 1999 with a two-thirds victory at the polls behind him, and with his own succession to the presidency of the ANC calmly and decisively secured long before – it was impossible to predict that by just mid-2002 there would be such a vociferous debate in the media and public arena about his fitness to rule.’ And why? ‘By early 2002 Mbeki and his advisors had allowed his controversial views to dominate his presidency, both at home and abroad. [In fact Mbeki had been quiet on the subject for months. It was liberal journalists who wouldn’t put the thing to rest.] Wherever one travelled [cool job], the same – or similar – questions were put: “Why has he got such funny views on HIV/AIDS?”’ For anyone who really wanted to know, and who could be bothered looking beyond the newspapers and the TV set, Mbeki had answered the question himself – eloquently, extensively and repeatedly in his speeches and public statements. Always ignored or skewed by the liberal media. Thereby creating the impression that he’d communicated his position on AIDS poorly. As people are always saying to me. You sure weren’t going to find the answer to the funny question in the country’s liberal journals. Or in books such as Thabo Mbeki’s World – so presumptuously titled, as if its writers had him figured. Exercises in academic incest where they deal with AIDS: shallow, circularly referenced, one writer quoting another, with no evidence of any effort to do any independent research and thinking, and the authors frequently citing the opinions of journalists as authority for their points. In their opening essay, for instance, Jacobs and Calland write:

Mbeki’s presidency comes at a time of intense demands on South African policy-making and governance. The South African government’s mishandling of the HIV/AIDS pandemic and Mbeki’s obfuscation on the crisis is testimony to this assertion (Marais 2000). The HIV/AIDS crisis has emerged as the issue on which Mbeki has revealed himself in ways that appal not just foreigners but many South Africans. The Washington Post has described his policy response and public pronouncements on HIV/AIDS as a ‘series of political missteps, mishaps and misunderstandings’.

‘Marais 2000’ was To the edge: AIDS review 2000, published by the University of Pretoria. Hein Marais contributed an essay to Jacobs and Calland’s book on Mbeki’s macroeconomic policy.

Mandela on the other hand had wisely pointed the way forward, wrote Jacobs and Calland in their introduction: in March 2001 the Mail&Guardian had asked him for ‘two or three aims you can give us around which to organise our future’. His future, at least, back to the gold mace, which he’d passed to Mbeki in mid-1999. Physically if not psychologically. Being of royal ancestry. Who naturally addresses the English queen as Elizabeth. And is called Nelson in turn. And so is having trouble adapting to his abdication, and to the fact that his time is behind him. Mandela answered by putting growing the economy first. (Those were still early days, when his was defining the country’s ‘aims’; AIDS would take priority slot and become his passport back to centre-stage later on.) ‘Then we must build a caring society ... which will be able to address the challenges like HIV/AIDS and other terminal diseases.’ Sure, pops. But Jacobs and Calland liked it. A lot: ‘Mandela’s comments offer a useful basis for framing the key challenges to Mbeki’s presidency.’

Notwithstanding his professed disavowal of Barrell’s stance expressed in his ‘Is Mbeki fit to rule?’ editorial, Calland had a final all-out go at annihilating Mbeki on account of his dissentient stance on AIDS, and for jilting Achmat’s longing suit to be embraced as a progressive partner in shaping the country’s health policy. As a proud member of the ANC too. In the last line of his essay, and of the book, the failed English barrister darted out from behind the cover of the thoughts he’d stolen from Bond to answer Barrell’s question in the negative: Mbeki was a loser, a captain on the bridge with all the levers at his disposal to make a difference to the modern world order, but who ‘appear[s] to have neither the aptitude, desire, or vision’ to do so. Strangely enough though, others to whom I speak consistently sing a very different song. Intellectuals. South African. Black.

It wasn’t only Bond’s lines that the plagiarist helped himself to; Calland also liked the title to Lucky Mathebe’s preceding (and infinitely superior) study, Bound by tradition: The world of Thabo Mbeki. So he pinched it too, moving the words around so we wouldn’t notice: Thabo Mbeki’s World. But then English immigrants have never felt any compunction about stealing from the indigenes.

In musing, ‘What explains apparent embrace of dissident doctrine on AIDS aetiology?’ in his history, Politics in South Africa: From Mandela to Mbeki (David Philip 2002), Wits politics professor Tom Lodge wasn’t snarling viciously like Calland, but, like so many other clueless white commentators, suggested that by questioning AIDS orthodoxy Mbeki revealed himself to be bloody mad:

The public projection of Mbeki as philosopher-king by his supporters, as a prophetic public intellectual, is evidently a reflection of his own self-perception and may help explain his reluctance to make any public concessions to the canonical authority of specialist knowledge. In addition, ostensibly scientifically denial of the AIDS pandemic has very obvious attractions for a visionary leader championing the cause of African rebirth. In the case of his understanding of the AIDS pandemic, intellectual rationalisation may be powerfully reinforced by emotional proclivities as well as an heroic strategic leadership in which ‘new men’ can still make new worlds. If this explanation has any validity, then it suggests to an alarming extent that Thabo Mbeki, like his early mentor, Coriolanus, has begun to inhabit a ‘world elsewhere’ in his imagined community of a nascent Africa.

Right on, Tom. The Madness of King George.

The wholesale purchase by the South African left of the medical-industrial complex’s AIDS project was exemplified in two other bits of writing by the aforesaid Marais and Jacobs – both prominent self-billed political analysts. In the second edition of his book, Limits to change (Zed Books, 2001), Marais whipped himself up into a meringue about the fact that

state funding of AZT for pregnant HIV-positive women was continuously denied, and in early 2000, the president would go as far as questioning the link between HIV and AIDS. Somehow absent from this has been the sophistication that has been the hallmark of politics and ideology in South Africa since 1994. [To Mbeki, hunger and cold – energy depletion – sufficiently explains ill health among the black poor. Marais goes for a sort of recondite medical theosophy. Being more sophisticated.] The consequences defy comprehension. … The miracle of the new South Africa is doomed to be eclipsed

by AIDS. And when it’s Rapture time, we believers will be raised into heaven. Like rockets in slow motion. In writing a tribute to Chris Hani in the Mail&Guardian on 11 April 2003, Jacobs got the same kind of kicks:

Hani-style mass democratic politics would leave no space for the denial, obstructionism, retreat into pseudo-science, stalling and general paralysis that has characterized the government’s response, or lack thereof, to AIDS. By 1990, Hani was already talking about the urgency of Aids, even though rates were still comparatively low … his legacy is also reflected in the resurgence of issues connected with him. New groups emerging with capital and the state are beginning to respond to contemporary events by using mass and internal democracy as well as constructive populism favoured by Hani.

One can imagine the eviscerating retorts springing to Mbeki’s mind as he read this frothy talk, in the same sort of vein perhaps as the censure he meted out variously in 1998 – displaying his flair for more than lyrical prose, the most mordant, nose-crunching rebukes too. At the SACP’s annual congress he lashed the ANC’s communist critics as ‘charlatans’ and ‘confidence tricksters’ indulging in ‘fake revolutionary posturing’, and ‘scavenging on the carcass of a savaged ANC’; addressing the South African Democratic Teachers Union, he responded to the educators’ criticism of government economic policy by calling them ‘a bunch of drunken and ill-disciplined teachers’; and castigating discontented students at the University of the Transkei he mocked: ‘[They] know it as a matter of fact that they are entitled to government funding. If they do not receive such funding, they are obliged to be vexed, to express that anger in any way they choose, to keep in their pockets the money they have to pay their fees, or better still, to spend it on the good things in life and to convey the message in the clearest terms: Deliver, deliver!’

In his speech NEPAD and the New African Dawn delivered in Berlin in mid-2001, Breyten Breytenbach poetically poured out his angst about ‘the disastrous incidence of the Aids epidemic … how whole communities are losing a sense of their worth and their take on reality when apparently inexplicable and random death is everywhere’. Luckily for him, Mbeki didn’t comment.

Allister Sparks published Beyond the Miracle: Inside the New South Africa in mid-2003, completing his trilogy that commenced with The Mind of South Africa and Tomorrow is Another Country, and it again bears out my case that ‘Mbeki’s all but open rejection of the Americans’ infectious AIDS model rocks South African liberalism’s broader paradigm, because more than just engrafted onto post-1994 white liberal ideology as a subsidiary issue, AIDS has become integral to it, and not only integral, central’.

Sparks devotes an entire chapter to An African AIDS Holocaust, and it’s sure to ease his book down American gullets in the bookstores. Invoking biblical and medieval plague metaphors and antecedents, even the Nazi horror, he scatters big numbers and terrible visions to hook our attention ( ‘AIDS is a surreptitious disease. It creeps up on you’), before regaling us with every cliché (‘So rampant is the disease that it is undermining even Africa’s brighter success stories’), every racist and homophobic sex myth:

guerrilla and anti-guerrilla fighters, lonely men with pay, made their way home from infected areas to the north … Indeed in South Africa, according to Tim Tucker, director of the South African Medical Research Council’s AIDS Vaccine Initiative, the disease actually arrived in two forms at different times. The first was when two South African Airways stewards, both male homosexuals, contracted AIDS in 1983, which suggests they were infected in North America or Europe six to eight years before. The much larger heterosexual epidemic started in 1990, as truck drivers, soldiers and other immigrants arrived from infected African countries to the north. … If you don’t believe AIDS is infectious but merely a deficiency disease, you will not practise safe sex. And then the disease will spread exponentially. … an appalling number of people are still going to die, most of them young in the prime of their lives. It is a terrible human tragedy.

Why and how Sparks explains in a potted retrovirology lesson: To write ‘one of the best chapters in the book’, as reviewer and interviewer Archie Henderson estimated it in the Cape Argus on 20 June, Sparks ‘turned himself into a medical reporter and got to understand “about DNA, RNA and the genome” and came away “quite optimistic because I think there is a cure”’. Thus equipped to pass scientific judgment and share his optimistic beliefs, ‘The AIDS dissidents are exposed and their hangers-on ridiculed.’ But sounding like a schoolboy reciting his confirmation catechism for his mum, it was Sparks’s comic-book science disquisition that was ridiculous.

When wondering out loud, ‘How has this highly intelligent man been drawn into this situation that is so damaging to himself and his country?’, nowhere does Sparks bother weighing the dissident critiques that Mbeki had read, and which Sparks himself found archived on the Internet, in what he described as a ‘surreal’ search. That would be too challenging for the comfortable conservative liberal commentator in the sunset of his career, enlivened by a new role as AIDS soothsayer, so he has a go at discrediting their articulators instead. Overlooking dour, straightlaced middle-of-the-roaders like Nobel laureate molecular biologist Walter Gilbert of Harvard – who prescribes Duesberg’s opening salvo in the AIDS controversy, Retroviruses as carcinogens and pathogens: Expectations and reality (in Cancer Research, 1987) as a set-work for his students – he picks on a few of the dillier eccentrics as typical of the whole crazy lot: ‘Friends describe Brink’s commitment to his crusade as obsessive, to the point where he once challenged a group of them who were arguing with him to inject him with HIV-infected blood there and then.’ As he bangs us about, good for a hoot is the complaint from the ‘ageing white male’ – with his Jerry Springer Show marriage to the widow of his close colleague Lawrence Gandar’s late son Mark – about Kary Mullis’s talk in his autobiography of a ‘rollicking sex-life as a surf hunk on the beaches of California [so the fuck what?] … he has experimented with hallucinogenic drugs [who the fuck hasn’t?]’. As if Einstein’s fondness for the vivacity of gamy prostitutes from the lower classes has any bearing on the value of his scientific insights. And without Mullis’s LSD, biology might never have had his PCR.

Just as Calland and Jacobs finally broke with Mbeki over his approach to AIDS as the big issue signally marking his failure as President, and delivered a kick to his face as they disowned him for it in their book, the doyen of South African white liberal journalism likewise took his leave of him in savagely demeaning terms, foretold by the caption to a photograph in the book, ‘Thabo Mbeki, a brilliant mind, with some inexplicable failures’: ‘As the AIDS issue has already shown, South Africa has a strong civil society, backed by a strong constitution and a strongly independent judiciary, which together form a strong counterweight against the kind of egocentric tyranny so many other African countries have suffered.’ This appalling insult from the pedestrian old bore was no late-night, gin-soaked gaffe; he repeated it in another chapter:

Whatever the reasons for Mbeki’s involvement with the AIDS dissidents and his strange reactions to those warning of the awful realities of the disease, it would be difficult to exaggerate the damage he has done to his own image and that of his government, both at home and abroad. The only bright side to the saga is that despite the centralizing of power and control upon himself and his office, the President has been forced to back down. … In other words civil society has shown its effectiveness against misrule. That more than anything else is what distinguishes South Africa from the rest of the continent.

Misruled everywhere else in Africa by megalomaniacs like Mbeki, without the benefit of the white press, the white-dominated courts and the TAC to keep guys like him in check. Natural despots – insolent too, thinking they know better. Than the experts. And the liberals. Going around saying stuff like AZT is poisonous and useless. And that the disease it’s meant to treat is just a textbook invention. How very fortunate we are then. To have a lobby for the pharmaceutical industry commanding national health policy. Journalists to promote its agenda. And courts to implement it. Looking out for us. Protecting us. Making sure we get what we need. From the chemist. And giving the ‘exasperating’ tyrant with his ‘spasms of eccentricity’ what for. Interviewed by Chris Barron for the Sunday Times on 15 June, Sparks bristled righteously some more: ‘... on AIDS ... the present government ... really has behaved very badly, and President Mbeki is personally to blame.’ He really should be punished.

What’s remarkable about the AIDS drugs issue is how it unites so many diverse people and constituencies, often otherwise at political daggers-drawn. From Allister Sparks to Martinus van Schalkwyk. The SACP and the DA. The September 2000 issue of TAGline, published by the New York Treatment Action Group, made the point: ‘

It was no surprise to see left-leaning newspapers like England’s Guardian and Australia’s Green Left Weekly come out against the drug companies and the governments which support them. But it was highly unusual and noteworthy to see conservative newspapers like The Washington Post and The New York Times making similar arguments. The Washington Post said that the fact that effective treatment is available but priced beyond the means of the poor ‘constitutes an outrage against the most basic conceptions of international justice, of human dignity, against the very idea of human solidarity.’

The left shares its enthusiasm for AIDS with big business. At the launch of his company’s HIV-AIDS programme at its Uitenhage plant on 23 July 2002, Hans-Christian Maergner, managing director of Volkswagen South Africa, declaimed in a speech that

The devastating impact of HIV-AIDS is rolling back decades of development progress in Africa and is impacting on every element of our society – from teachers to farmers to workers to managers – all of us are under attack from AIDS. [Not according to Alec Irwin, Minister of Trade and Industry.] … In fact the United Nations has called AIDS the most ruthless and cruel enemy of men and women today.

(Theologians call this anthropomorphizing.) SAPA reported him saying that according to ‘AIDS experts’, ‘not a single company would escape the effects of the disease. It followed that the motor industry in South Africa was going to suffer.’ On one hand telling us the plague was on us, on the other that it was still around the bend, he raved: ‘I want to encourage employees to approach the company health service to undergo HIV testing and pre- and post-test counselling. [‘You’re going to die from a horrible, terminal disease, but try not to worry about it too much. Eat lots of vegetables. Keep it covered when enjoying your sweetie. (Not quite as much.) And there are drugs with poison labels, sometimes, that can extend your life.’] The results of this testing will be confidential and will be the first step towards managing their future.’ Of course the future managed by ‘AIDS experts’ for anyone unlucky enough to light up the test will generally be a short and nasty one.

With similar gusto, First National Bank chief economist Cees Bruggemans likened the future impact of AIDS to a ‘nuclear explosion’ at a business meeting in East London on 29 August 2002: ‘... unless there was a drastic change in sexual behaviour this impact would be felt. And the question is whether the people are capable of such a change.’ The black people. Do you think he really meant his own behaviour? His friends’? Their childrens’?

Reminiscent of the appeal of Nazi policy to an extraordinarily varied array of supporters during the rise of the Third Reich, Achmat has relied on the media-generated public consensus about the lifesaving Western drugs to organise and mobilise crowds made up from every imaginable quarter. Muslims even. TAGline, September 2000 again:

A few days ago, 5,000 people, many wearing ‘H.I.V. Positive’ T-shirts, gathered at the Durban City Hall to demand equitable access to HIV/AIDS treatment. The excited group of nuns, drag queens, sangomas, doctors, communists, teenage punks on skate boards, Pan-Africanists, gay activists, unionists, students and nurses had come from all over Durban, South Africa, and the world to join the Global March for Access to HIV/AIDS Treatment. The march was organized by the Treatment Action Campaign (TAC), a rapidly growing organization with strong support in the trade union movement. It was led by people of the stature of leading Muslim theologian Dr. Farid Essack, Anglican Archbishop Njongonkulu Ndungane and Catholic Archbishop Denis Hurley. The streets of Durban were full of singing, dancing, laughter, warm solidarity and hope.

As I said, Muslims even – whom one might imagine to be wary of American blessings. But Yusuf Nannabhai, an AIDS dissident doctor practising in Johannesburg, tells me that he’s been unable to make any headway in alerting colleagues in the Muslim Medical Association to the dangers of AZT and nevirapine, the futility of HIV testing, and the whole mess. Since their natural allegiance to the Western medical industrial complex precedes any other. On 24 February 2003 Farid Essack, director of Positive Muslims, sent out an email flyer appealing for contact ‘with anyone who works with Muslims – as specific religious constituency – who are HIV Positive’.

On 1 August 2002, Achmat lined up another crowd of ‘organisations and individuals’ to undersign an Urgent Joint Statement on Global Fund Allocation to KwaZulu-Natal. The signature style of the opening paragraph was unmistakably his: ‘One in 4 people in KZN live with HIV/AIDS. It is the worst-affected province in South Africa and one of the worst in the world. Already there is immense suffering and death, especially among poor people, and the public health system in the province is struggling to cope with the burden of this disease. If nothing is done, the situation will become much worse.’ Tshabalala-Msimang should therefore get out the way, and stop being so obstructive about the UNAIDS plan to control the AIDS action in KwaZulu-Natal with its massive cash infusions. Achmat made a few calls, and got the following bunch to agree to the use of their names:

Archbishop Njongonkulu Ndungane, South African Medical Association, Southern African HIV Clinicians Society, South African Academy of Family Practice/Primary Care, Diakonia Council of Churches, AIDS Consortium, AIDS Law Project, Children’s Rights Centre, Durban Gay and Lesbian Community and Health Centre, Southern African Fogarty AIDS Training Programme, Professor Hoosen Coovadia, Victor Daitz Professor of HIV/AIDS Research, University of Natal Durban, Professor Quarraisha Abdool-Karim, University of Natal Durban, SANGOCO – KZN, SANCO – KZN, [and, slipped in quietly at the end, the] Treatment Action Campaign.’ They also made a demand for government jobs, surreptitiously framed as a call for ‘Reconstituting the South African National AIDS Council (SANAC) as a legal, functioning, independent entity that truly represents the interests of people with HIV/AIDS and seeks representation from all sectors of South African society with a real interest in alleviating the HIV/AIDS epidemic.

I watch Mbeki and his inner circle’s engagement with AIDS ideology, deeply sympathetic and able to imagine somewhat, but not feel the offensive brunt of it directly. Being white not black. So my experience and the shape of my perceptions are related but different. I personally find that like an ultraviolet inspection light, AIDS vividly highlights the putrid in Western culture, contemporary and ancient, in its philosophical, social, political and commercial manifestations. I’ve discovered that I do not entertain these strange thoughts alone. Several of my comrades-in-arms agitating against the AIDS construct abroad have arrived at similar insights independently – these ‘culturally impermissible thoughts’ as Farber in New York calls them; AIDS is a ‘microcosm’ of it all, she thinks. Botinas in Barcelona sees festered values infusing and inspiring the whole AIDS enterprise, and works against AIDS as part of a larger social revolutionary agenda. Dunne in Dublin sees it as the key rock on the slope to kick, to rupture the settled ideological landscape and launch a violent cascade, in which all the old metaphysical certainties are revisited. Currently living in Barcelona, dissident German physician Kremer (referring at the time particularly to the blood products trade, but, we gather from his writing about the AIDS industry, perceiving it similarly) talks of the vast ‘criminal energy’ pumping behind it – highlighting the venality of so much of medical practice popularly perceived to be spotlessly respectable.

But not by CNN talk show host Larry King. Agreeing with his guest’s complaint that ‘the field of medicine is very poisonous’, King told us during an interview of Transcendental Meditation movement founder Maharishi Mahesh Yogi on 12 May 2002 that ‘I have ... about eight or ten thousand bad articles on modern medicine. But modern medicine continues.’ To which the guru responded, ‘The whole of science is a big fraud. … The whole thing is sinful.’ It really doesn’t take much scratching into commercial biomedicine to see what he means.

CHAPTER

On returning from a Sunday night jazz concert at a restaurant on 9 June 2002, I checked my email and was stunned to learn that Mokaba was dead, killed at 9.30 that morning by a sudden bout of pneumonia and respiratory failure that had set in at the start of the weekend. Or so it was said at the time. Later I learned that he’d been prescribed a ‘new antibiotic’ over the telephone, and that the look of it was that he’d died of anaphylactic shock in reaction to them. At the worst possible time, a critical one. On Monday morning I walked out of my office, and sat on a kerb out of sight, tears splashing on the concrete at my feet. I was too upset to speak to Mhlongo, to find out more, until the evening. He told me that he had tended to Mokaba after he’d suddenly taken ill, and that had prescribed some antibiotics, but according to his mother, he had not taken them because he’d ‘developed a deep aversion to Western medicine’. After his run-in with Western medicine at its most perverse and lunatic expression in AIDS and AIDS drugs, I understood.

With Mokaba’s death, Mbeki, Mhlongo and I had lost our beachhead in Parliament. And likely a future President. There was no one to replace him. It was a hell of a blow, both personal and political. In the short time that I had been working with him I had grown very fond of him. Like Mbeki and Mhlongo, he understood the HIV isolation problem completely. And blocking the AIDS drugs, he’d announced to the Financial Mail, was his immediate, hard political objective: ‘I want us to take a decision, very firmly, that we are not going to provide antiretrovirals.’ But after tactical business talk, our conversations always gravitated to the real issue, the one driving us. The ideological one. Or rather our endeavour to dissolve the ideology supporting AIDS. Driving Mhlongo too. And of course Mbeki foremost. Generating a powerful camaraderie in the work we were doing.

It was obvious to me why Mbeki had entrusted Mokaba to handle the AIDS controversy on his behalf. Lulamile Feni reflected Eastern Cape ANC reaction to his passing in the Daily Dispatch on 13 June 2002: ‘[He] had a unique gift for uniting and mobilising the youth.’ But he was no mere populist, as Jeremy Cronin of the South African Communist Party had characterised him. (Who marches with with the TAC for AIDS drugs?) Much more than a mere crowd mover, I found him to be a very deep guy. Determined as flint, but quite dreamy at the same time, and sensible to the bigger picture always. And very personally charming: I vividly recall his response to Mhlongo’s housekeeper when she brought in the tea, suddenly realising whom she was serving, and asking in awe: ‘Is it really you, Peter Mokaba?!’ Shaking her hand humbly, smiling warmly, speaking to her in Sotho, their shared mother tongue. He had a lovely speaking voice; it was always a delight to hear his distinct tone when he answered the phone: ‘Ah, Anthony.’

As we grieved for Peter, the Mail&Guardian took to kicking his corpse. The front page of its mid-June issue bore a colour photo portrait, split Rorschach-style, headed, The double life of Peter Mokaba. Claiming there was one. Four stories were flagged, pretending to balance, but Let the truth be told, the editorial flagged below them, read as the last word.

An icon to a generation explained why he had been just that – captured best, I thought, by author Wisani Ngobeni’s observation: ‘When I first saw him, I was struck by his face, so humane and sensitive. There seemed in this man such an obvious integrity that it demanded almost immediate respect; quite simply he was not like other men.’ My impression as well. Rubbish, said Gavin Evans in Two faces of Mokaba; he was actually an apartheid agent – a charge the newspaper revived for Mokaba’s obituary since he was no longer around to answer it. On the evidence tabled by the longest of the four articles, this lawyer wouldn’t have hanged a cat. But in his page-length editorial, editor Howard Barrel banged his take-him-down gavel and judged it a case carried, commencing his speech with: ‘The unqualified praise that political leaders have heaped on Peter Mokaba following his death have been more than a little nauseating. Yes, he had great strengths and talents. Yes, we all want to speak well of the dead. But the conscious amnesia on which this effusion has depended has been insidious.’ And on it went. Putting him in the same boat as disgraced former national cricket captain, the late Hansie Cronje, who’d confessed his corruption on TV.

Barrell didn’t ponder the negative probabilities militating against Mbeki treating Mokaba as his special confidant and entrusting him with handling on his behalf the most serious and sensitive business, the great, fake ‘AIDS epidemic’, and organising resistance to the drug companies and their agents, had there been any possibility of truth in the smears at all.

But naturally: after former editor Philip van Niekerk put in his notice, and all the feeble candidates on the short list to succeed him had been interviewed, it took three weeks before the managing board gave Barrell a reluctant appointment – to the enduring horror of the newspaper’s cofounders Anton Harber and Irwin Manoim. They predicted that Barrell would run the newspaper into the ground, and run it into the ground he did – epitomised by his cowardly posthumous defamation of Mokaba, pissing on his still warm face. Haemorrhaging millions, the newspaper was saved from closure in mid-July 2002 when it was bought out by Timothy Ncube, a press magnate from Zimbabwe. No one here wanted it. (Around Parliament, it’s referred to as the ‘Mail and Garbage’.)

On the 26th of that month, in a piece introducing himself to readers, Ncube had some encouraging things to say. He referred to

widely and deeply held perceptions [that] the paper is out to get President Thabo Mbeki [and is] decidedly anti-African National Congress. … I hold the view that deliberately alienating ourselves from any section of the population is not in our best interest. … A newspaper does not benefit from gratuitous hostility to the status quo. In a young democracy like South Africa, for us to exercise influence we need to engage both the ruling party and the government on issues on vital national importance.

Undoubtedly referring to the TAC, he said: ‘It is also not in our interest to be seen as working in cahoots with any interest or group to the exclusion of the broader community interest.’

Barrell resigned on 3 September – to join his family in the UK, he said. Also: ‘I have suspected for some time now that a fresh set of editorial ideas may be necessary. I am now convinced that only a new editor can provide those.’ Unfortunately nothing changed as Barrell worked on his English moon-tan. And his successor Mondli Makhanya, the white liberals’ imbongi, made no difference at all, except to turn the newspaper’s attacks, with the same sort of maximum prejudice, largely on Tshabalala-Msimang instead. On 14 February 2003, in The bees in Mbeki’s bonnet, senior writer Drew Forrest was still writing in offish pseudo-psychology, in the sort of English that gives one the impression he suffers from piles:

One of President Thabo Mbeki’s complexities is an inner war between tenaciously held ideas and unusual sensitivity to criticism. The stubborn persistence of certain themes, and the slow modification of others under pressure, emerges from an inspection of his past State of the Nation speeches. … Mbeki’s penchant for Aids dissidence is subtly suggested in all three speeches. In 2000 and 2001 this terrible threat to the country’s future is dispatched in a few paragraphs that contrive to smuggle in references to poverty and malnutrition and a ‘whole host of well-known diseases such as tuberculosis, malaria and hepatitis’. In last year’s speech – two months after the high court judgement on nevirapine – the president was still harping on about ‘continuing work’ in monitoring ‘the efficacy of anti-retroviral interventions against mother to child transmission’, while warning against ‘any focus on one issue at the expense of others’.

The third piece in the Mail&Guardian’s special Mokaba commemorative issue claimed, absolutely predictably, that not only was he a traitor, he also had AIDS. Corrupt in both body and spirit. The colonial ‘dirty kaffir’ stereotype in full liberal bloom. Under the subtitle, Peter Mokaba had an obligation to confront not deny, argues Drew Forrest, his piece, A failure of leadership, was given pride of place under a half page cartoon mocking the power salute, with Mokaba’s fist clutching a straw marked DISSENT SCIENCE (sic), defiantly sinking into a pond. ‘True leaders do more than win and exercise power – they show us how to live.’ They declare their ‘status’ and take drugs like Edwin Cameron. The piece was standard Forrest, no factual reporting, all anaemic South African white middle-class comment, wave after wave of mean-spirited innuendo, run off like so much slurry from the chicken coup, exemplifying what makes the Mail&Guardian the hateful neo-apartheid newspaper it has become – peddling smooth, finely ground racist commentary, like the old apartheid radio programme, Current Affairs, which used to drive my late father berserk.

Jaspreet Kindra repeated Forrest’s charge in her piece, A refreshing willingness to engage – happy that Mokaba had always been so personable and approachable, but, ‘Considering his obsession with Aids, I wondered whether he was not infected.’ Really – who’s obsessed? That Mokaba died of AIDS was likewise suggested by the liberal media all over the country, including the Sunday Times, just as Mhlongo had wryly predicted in a private note shortly after he died: ‘There’s very little doubt that the South African print media will ... speculate that he died from AIDS since black people don’t die from anything else.’ Even if in vibrant good health immediately prior, as Mokaba was, when interviewed by Patrick Lawrence for the Helen Suzman Foundation magazine, Focus, a couple of days before the sudden bronchial collapse that took him. When whites go the same way, they call it asthma.

Even during his lifetime Mokaba had had to endure ‘very dehumanising’ rumours that he was dying of AIDS. In 2000, ‘I was ill with something in my lungs and there was no HIV. The reason why that story emerged is that people were fighting with President Mbeki and they wanted to use a person who is regarded to be Mbeki’s man: “But his own lieutenants are dying of Aids.”’

At his funeral on the 15th, Mbeki amplified his tribute made the day after his death – ‘Peter Mokaba stood and still stands for the undying spirit of our movement and our democracy, which he helped to build. The apartheid regime could never bend or bow him, nor could the new challenges daunt him. A fine comrade has fallen, but in victory not in vain’ – specifically refuting the Mail&Guardian’s sell-out claims:

I have known times when some among our ranks accused Mokaba of treachery. Because of his love for his movement, this did not turn him into an enemy of his organisation. I speak of him as a loyal cadre of the movement because however much his own comrades wronged him, he would never lend his voice to the cause of those who seek to divide, weaken and defeat the movement.

Even Mandela put in a word: ‘I wished that I had the energy and the fitness of limbs to do a toyi-toyi today, or the strength of voice to greet this occasion with a roaring war chant, for that is the way many of us will remember the vitality, energy and zest of comrade Mokaba.’

With the death of Peter Mokaba, there was no one in Parliament to hold the line against the TAC’s offensives. Indeed, speaking of him generally during his funeral oration, Mbeki had lamented: ‘Our voice is dead. Who will replace him?’ Following the Cabinet’s April political surrender on the provision of antiretroviral drugs to rape victims, resistance began crumbling like a sandcastle under the waves. On 7 August James Ngculu, chairman of the parliamentary Health Committee, applauded Anglo American’s announcement that it intended providing antiretrovirals to its employees. The committee’s endorsement was described by the Cape Times the following day as ‘an apparent first for the African National Congress’s health study group in parliament [in which] its members have publicly supported the use of anti-retroviral anti-Aids drugs’. On 9 October the Cabinet issued a statement announcing that it was looking into the cost of making the drugs generally available, and that a task team from the Department of Health and the National Treasury was examining the cost question. The slide continued with a meeting on the 15th between Achmat and Heywood, and Deputy President Zuma and Health Director General Ayanda Ntsaluba. Agreement was reached, recorded in a joint statement released the next day, on the need for a national treatment plan. The ‘TAC and the Deputy President recognised the need for urgency based on the impact of the disease and the suffering and death in the communities’, said Zuma’s spokesperson Lakela Kaunda afterwards. Achmat and Heywood clinked their Fanta glasses.

CHAPTER

‘Counselling’ is as central to the AIDS cult as catechism is to the high churches of the Christian religion. The expression, ‘testing and counselling’, has the same sort of positive, authoritative taste, and accordingly comes banging everywhere through the Constitutional Court’s nevirapine appeal judgment like a steam-hammer. Over and over. With nary a frown from any of the justices over what such PC talk actually entails.

So what is this American ‘HIV counselling’ that the Constitutional Court goes for? In such a big way. Without a thought for how it sits in African cultures. Just what do trained AIDS counsellors tell you? You can get an idea from the notions propounded on any ‘Informed Consent’ form that you have to sign before undergoing an HIV antibody test, or from any popular statement of the myths of AIDS in AIDS education pamphlets, such as is set forth in Just the FACTS, appearing in Ubomi in the Daily Dispatch. Or in AIDS in Focus, a leaflet thoughtfully put out on a rack by the household goods discount chain, Clicks (‘Caring for the community’), for customers to pick up on the way past the till with their Shield and Aquafresh and Durex Ultralite. It’s all about preparing the diagnosed to die without unseemly resistance, perhaps postponing the day a bit with AIDS drugs and an upright life. Deadly Counsels: The necrophiliacs of ‘AIDS’ by Cass Mann, first published in Mainliners in London in November 1991, took the lid off what AIDS counsellors do during ‘voluntary and confidential counselling’, to quote the Constitutional Court – which didn’t demur to ponder, before quoting in turn from a draft policy document prepared by ‘AIDS experts’ for the Department of Health. Pleasing adjectives like ‘voluntary and confidential’ ahead of ‘counselling’ elevate the legitimacy of the power play, masking and distracting from what’s actually sold in these sessions. So that to those in the know, but not the judges, the judgment reads with the vague stink of a thoughtfully crafted apartheid statute. Deliberate. Full of clear purpose. Formal and horrible. Because it’s not as if those guys in Pretoria drawing up those laws back then actually envisaged the human desolation they were planning. Nor the judges what ‘counselling’ involves. Mann gives a good account of it.

He mentions an event entitled ‘Celebration of Life’, part of the Fifth International Conference for People with HIV/AIDS, staged on 13 September 1991 in Westminster Abbey. A not inappropriate venue given that death is stultifyingly ritualised in such places. During the show, sponsored by GlaxoSmithKline’s antecessor, Wellcome Pharmaceuticals, there was a reading from ‘the bible in “AIDS counselling”’, AIDS: The Ultimate Challenge by that ultimate pop-psycho phoney, Elizabeth Kubler-Ross: ‘Is it possible that people with HIV and AIDS ... chose to contribute their short life spans on planet Earth to help us to open our eyes, to raise our consciousness, to open our hearts and minds, and finally to see the light?’ With an implicit underscore below the word ‘short’.

Kubler-Ross’s assumption that a diagnosis of HIV-positive invariably anticipates disease and early death was articulated on 26 March 1991 by Peter Johnson, a co-editor of Body Positive Newsletter, an English rag to encourage HIV-positive gays: ‘HIV begins a decline in the immune system that results in increasingly serious diseases. You can think of it as a slide down a slope from healthy mountain air at the top to a polluted soup at the valley bottom.’ What to expect when you land in the soup BPN explained on 18 June 1991 in a piece promoting The Natural Death Centre: ‘The Centre hopes to break the taboo around death and encourage people to prepare for death in workshops, literature, will-creating and a support network.’ AIDS counselling to encourage people to prepare for death!

The mission statement of the UK’s leading AIDS counselling and training centre rings alike: ‘London Lighthouse’s main aim is to offer an integrated range of services to care for people from their initial diagnosis of HIV infection through to providing a supportive and loving environment where people can die with dignity.’ And don’t you dare come casting doubt on the creed that HIV-positive means dying soon: ‘The primary focus of London Lighthouse’s work is the empowerment of people affected by HIV and AIDS ... [and] to change ingrained social attitudes which collude to deny that death and dying are central facets of life and living.’ Because nothing gets AIDS activists more annoyed than the denialist information that you can do fine without drugs, and that the weight of epidemiological data tells that people who disregard the diagnosis and avoid the drugs do best of all. Since that would put them out of their jobs. To AIDS activists like Cameron there’s only one kind of hope, packaged (for laboratory workers, but not him) with a skull and crossbones on the label, and none without it. Yet their top scientist sees differently: Montagnier told Positively Healthy News in March 1989:

AIDS does not invariably lead to death, especially if you suppress the co-factors that support the disease. [You won’t die from having freckles, as long as you don’t jump out of an aeroplane without a parachute.] It’s very important to tell this to people who are infected. [‘Who have been diagnosed’ would be more accurate.] Psychological factors are critical in supporting immune function. If you suppress this psychological support by telling someone he is condemned to die, your words alone will have condemned him. It simply isn’t true that the virus is one hundred per cent fatal.

As we read in the appendices to Debating AZT, even Gallo, that most corrupt Pope of AIDS, has uttered similarly.

There’s another negative dimension to ‘voluntary and confidential AIDS counselling’. It takes place with the secrecy of a Catholic confessional. The ‘counsellor’ proceeds by weaving an hypnotic net of alarming quasi-scientific facts around the diagnosed victim, conveyed in medical jargon, and combined with kindly platitudes about the need to exercise regularly and eat lots of fruit and vegetables along with the tough chemotherapy to be taken bravely and with personal discipline right until the end. Which may be postponed a bit thereby, they say. The relationship is inherently disempowering for the client so tutored. As the medical relationship is. (Remember Alice James quoted in Debating AZT: ‘I suppose one has a greater sense of intellectual degradation after an interview with a doctor than from any other human experience.’) The essential dynamic of AIDS counselling is to cast the subject into the child role, with the ‘counsellor’ in loco parentis, prescribing a host of dos and don’ts. In ordinary times, grown-ups will themselves to health autonomously. In the AIDS age the big thing is to be told what to do to be well. By ‘counsellors’. But the difference is that you usually leave the confessional feeling relieved. Not after a visit to the ‘AIDS counsellor’. You always leave under a terrified spell.

Mann asks: ‘How many of the deaths, especially the suicides, of people with ‘HIV’ or ‘AIDS’, have been caused by the deadly psychopathology underlying most ‘AIDS’ counselling? It is a terrible thing psychologically to present someone with the expectation that, from the moment of his diagnosis, he is one of the living dead, awaiting only the formalities of cremation and memorial service.’

I was personally carrying a big worry, someone else’s, for a couple of months during the writing of this book. The stress had me feeling constantly sick. Glands in my neck swelled up and down continuously. Sometimes protruding alarmingly. So I can just imagine the experience that Mann describes, and how one’s health can thereafter go to pieces, presenting with all the signs and wonders that doctors seek, playing into the pattern they crave: HIV-positive, get sick, exhibit impressive symptoms, take drugs, get sicker, die.

The drugs will rapidly accelerate your departure, but they’re not essential: George Hazelhurst mentions in his essay, Lessons from Hiroshima, included in The AIDS Cult, that as a doctor working among nuclear bomb survivors, he was intrigued to discover that they had twice the early death rate of the rest of Japanese people – and from a variety of causes, not necessarily fatal leukaemia, which medical experts were fallaciously but relentlessly pumping in the media as the inevitable consequence of radiation exposure. In interviews with many survivors he found that all had developed a deep conviction that they were living in injury time, even though quite healthy, and that they were certain to die early. Which, having lost hope, they then tended to do. Thanks to spurious medical information killing off their basic will to live, like a soil-poison seeping down into the deepest recesses of their psyches. Like aboriginal bone pointing. Like AIDS doctors selecting patients for death from the waiting-room queue. Like AIDS counselling.

In my own experience of criminal trials in some far-flung spots I’ve seen rural black men identified by a complainant, and thereafter the community, who might then burn his house, as the perpetrator of a certain crime. But wrongly, quite clearly from the evidence. Or lack of it. Nonetheless, the accused assumes a hopelessly resigned affect. The forces against him are too strong. He’s been singled out to take the blame. He mumbles. He shows little interest in disputing the evidence. It’s been decided long before the trial that he’s going down, and he stops resisting. He accepts it and gives up completely. When he’s acquitted he can hardly believe it, and leaves the dock in a daze.

In HIV/Aids: Listen to Mbeki, published in the Kenyan Sunday Nation on 12 November 2000, Raymond Downing, a hospital doctor in that country, made a series of points with the cooling clarity of mountain water. Opening by noting that in the media barrage about Mbeki’s initiatives concerning AZT and the AIDS causation question, ‘The real news story is that Africa is beginning to think about its own response to Aids – and that story has been ignored by the international media houses’, he asked, ‘

What ... is the dissident group saying? I don’t know, because it hasn’t been reported. I can only imagine what some of their questions might be, based on my own experience treating Aids patients in Africa – and treating them surrounded by assumptions imported from the West. The most obvious import concerns the way we test (and counsel) people for Aids. For no other disease do we use ‘pre-test and post-test counselling’. We test for all other sexually transmitted diseases and all other fatal diseases without ‘informed consent’. Consequently, the added attention (whispered requests for permission, secretive trips to the pastor’s office for counselling) only serves to stigmatise the one being tested – the reverse of what was intended. ‘Confidentiality’ is another Western import. All disease, especially in rural Africa, is a family matter. To tell the diagnosis only to the one with the disease does not make sense in Africa, and does not, therefore, make sense when we use this confidentiality for one disease only. It becomes the opposite of ‘breaking the silence’. … Another place where my Western training clashes with my African experience is the request from families that we don’t tell their patient the diagnosis, and even the reluctance of staff members to carry out the post-test counselling. My assumption is that all people want to know their fate and that hiding the diagnosis only postpones their ‘dealing with it’. I need to listen. When a family requests that their relative not be told, or even when a patient chooses not to hear, it does not necessarily mean they are denying the problem. I don’t yet fully understand the reluctance, but I’ve heard it often enough to at least try to find out what it means.

Downing concluded by asking:

My experience tells me that there are many reasons to question the applicability of the West’s Aids dogma in Africa, and I am a Westerner. Why are so few people listening to Mbeki, who has a far better grasp on which Western imports are appropriate? I don’t know; I only know that it is very difficult for Westerners to listen to voices that come from a different paradigm. The Guardian voices questioning economic globalisation, eloquent in their exposure of how Third World countries are hurt, are Western voices. The West talks about Africa, sometimes accurately. But is the West able to talk with Africa; is the West patient enough to listen to Africa? Does the West think there is anything to listen for?

No it doesn’t, Raymond. Western reaction to Mbeki calling into question Western notions and prescriptions about AIDS, both from abroad and locally from the white suburbs, has left no doubt.

My research for this book concerning the political fallout that resulted from Mbeki’s AZT and AIDS-causation enquiries entailed a review of hundreds of local and foreign newspaper articles. It was as pleasant as opening a garden soak-pit. Peaking in 2000, no story rivalled the affair in the volume and persistent prominence of newspaper reporting about it. Mostly delivering Mbeki a knife in the ribs, a kick in the head. The low-water mark of the press that Mbeki received, for its most vicious, most contemptuous tone, was set by the Mail&Guardian’s Howard Barrell, David Beresford and Drew Forrest. The writing of the former two also surfaced in the London papers, variously the Guardian, Observer and Independent, but those papers had their own AIDS-crazed journalists to crusade against Mbeki – the Times too.

White liberal journalists whipped themselves up into a frenzy with their fantasies about the great South African AIDS epidemic, the worst in the world, they liked to say, and how it had to be dealt with; and they weren’t going to have some African politician coming up with his own ideas, implying that he was cleverer than they were, and saying it was all poppycock, and worse: racism and neo-colonialism and the dumping of bad merchandise. Because liberals like to care about blacks. It’s nice being nice to them. For as long as they dance to their tune.

The lesson of Mbeki’s challenge to their beliefs about their sacral African AIDS plague, and all that it implied about African people, was that dare an African assert, directly or implicitly, his own alternative but equal voice, humanity, history, culture, value system, social system, political system, justice system, healing system, cosmological belief system, then it’s no more charming chit chat, tennis party chuckles and little fingers in the air drinking tea. No more kindly smiles. You’re in a pit of spitting striking snakes.

CHAPTER

At the opening of Parliament on 8 February 2002, Mbeki delivered his State of the Nation speech. It was long and wide-ranging, but it was on his statement on AIDS that his critics homed in:

With regard to AIDS in particular, our focus remains: a massive prevention campaign directed at ensuring that the high rates of awareness translate into a change in lifestyles; care for the affected and infected; treatment of all diseases including those associated with AIDS; and research into a vaccine – a programme described by the head of UNAIDS, Dr Peter Piot, as the largest and most comprehensive in Africa and one of the largest in the world; a programme, he says, with very high levels of government investment, which is starting to show results. Proceeding from the accepted premise that there is no cure to AIDS, we are convinced that, besides the individual and collective responsibility for us to take care of our own lives, protection and enhancement of the immune system is a critical intervention in both the prevention and management of AIDS. By implication, therefore, poverty reduction and appropriate nutrition constitute an important front in this campaign. At the same time, continuing work will be done to monitor the efficacy of anti-retroviral interventions against mother-to-child transmission in the sites already operational and any new ones that may be decided upon. Our partnership across society should advance these multiple interventions required for us to deal with this epidemic. Any focus on one issue, at the expense of the others, may have the effect of undermining what we all seek to achieve.

Keeping AIDS at the leading edge of DA criticism of the government’s performance in office, Tony Leon commented: ‘I thought that it was a massive missed opportunity’ to get to grips with AIDS. As illustrated by Mbeki’s failure to declare that two hundred and fifty thousand South Africans died of AIDS the year before, and that and five million more would go the same way without drastic action, he alleged. Proclaiming the need for absolute faith ahead of practical policy he declared: ‘What we need is an unequivocal, unambiguous statement that, as a matter of fact, not assumption, HIV causes AIDS. That must be the foundation of our prevention campaign.’

Home Affairs Minister and IFP leader Mangosuthu Buthelezi ‘publicly broke ranks with Cabinet colleagues and criticised President Thabo Mbeki’s policy on Aids, saying it was time children were not born with a death sentence’, reported the Daily Dispatch on 13 February 2002. His thirty-five minute parliamentary speech was spoken ‘from the heart ... as an honest man beholden to no one [but enthralled by his media-fed imaginings, the media themselves scooped by the AIDS industry]. South Africa, he said, ‘was in a very precarious state. Our nation is dying of AIDS. We can no longer hesitate or falter.’ This is why his IFP had ordered KwaZulu-Natal Premier Lionel Mtshali to distribute nevirapine to all HIV-positive women in the province, he said. Working a up a sweat (his pitch raised, his eyes closed, his English more ornate than a New Delhi daily), he raced on: ‘KwaZulu-Natal had the greatest HIV infection rate, with 80 000 people dying of Aids-related diseases [what’s that? – either the illness is AIDS by definition, or it ain’t] and 40 000 babies born with HIV’ (per the report). ‘All these children could easily have been saved; for this reason my party had to do what it did.’ Now at full boil, and we know how excitable he can get, he surprised us with a novel approach, a blanket one. The report quoted him proposing that ‘Where testing and counselling was not possible, nevirapine should be given to all prospective mothers regardless of their HIV-status, unless a mother opted out by producing an HIV negative test result. Only when there was logistical capacity to test and provide counselling would the distribution of nevirapine be limited to mothers who were proven to be HIV-positive.’ He concluded: ‘In God’s name, let us recognise our mistakes and correct them as soon as we can before our people pay too dire a price.’ But this is what Mbeki’s been saying all along, Mango. In the name of Christ.

According to a cloudy Newsweek report a month later, Buthelezi’s open criticism followed upon an unsuccessful standoff with Mbeki shortly before his speech. When Mbeki learned that Buthelezi had persuaded the South African National AIDS Council to alter its composition, without consulting him, he pitched up at its next meeting in the company of Essop Pahad. Who promptly challenged Buthelezi over the slight. Buthelezi’s response was that Mbeki himself was the problem and that he should therefore leave the room. A heavy silence then followed as the two glared at each other. Mbeki didn’t budge and Buthelezi’s plans for SANAC folded.

When his turn came to address Parliament, UDM leader Bantu Holomisa got even more carried away than Buthelezi did. The country was in ‘desperate need, socially and economically, for decisive and positive action’. Instead of which, Mbeki had given us ‘hollow platitudes in a meek tone. … The failure to lay to rest the HIV/AIDS issue is without a doubt the biggest blunder of Mbeki’s disappointing tenure. If he continues with his irrationality on this pandemic, there will soon be nobody left to occupy the houses government builds.’ Waxing over an hourglass placed theatrically on the podium before him, Holomisa said: ‘In this hourglass every piece of sand represents the life of a baby dying of AIDS.’ Someone should report him to the Swedes. There’s a major new poet among us. A new Dr Seuss.

Achmat was disappointed by the ‘missed opportunities’ in the speech. ‘We had expected the president to come out clearly and say that HIV causes AIDS. He did not even mention HIV.’ He didn’t even announce the government’s intention to withdraw its appeal against the nevirapine judgment either, he complained. Mandela, on the other hand, said he was happy with Mbeki’s address: ‘I’m confident personally that the government is handling this matter very well.’

On the same day that Mbeki spoke in Parliament, the South African Council of Churches released a statement after a meeting of its National Executive Committee, applauding the TAC’s legal pressure on the government, and,

Similarly, we salute the efforts of those provinces that have decided to roll out mother-to-child transmission prevention programmes in public health facilities. … We recognise that all drugs have side-effects and must be administered carefully. At the same time, we believe that the time has come to act, with the best intentions and using the best information at our disposal. The cost of postponing the provision of drugs has become far too high. … The provision of these drugs can no longer be seen simply as a business issue; it must be regarded as a moral issue, a global crisis in which humanity has an obligation to act if they are able.

The following day, the ANC met Cosatu to discuss their differences over AIDS policy and macroeconomic policy. An ANC press release made plain that this was a high-powered tête-à-tête: ‘Led by (ANC and Cosatu) Presidents Thabo Mbeki and Willie Madisha and secretary generals Kgalema Motlanthe (ANC) and Zwelinzima Vavi (Cosatu), the meeting was characterised by frank, open and robust positive debates in a spirit of constructive criticism and comradeship.’ Interviewed on SABC television on Sunday night the day after that, Mbeki underscored the simple-mindedness of the TAC agenda: ‘The matter is not merely the dispensing of a drug. … That’s one of the issues we have to address: what capacities do we have to assist poor women, who don’t have enough food for themselves to eat, to ensure that they then are able to access the necessary food for this infant?’

On Monday 4 March 2002 the newspapers were all full of a call for AIDS drugs made by Mandela the day before at a press conference flanked by some top ANC party players: Deputy President Zuma, Minister in the Office of the Presidency Essop Pahad, ANC Secretary General Kgalema Motlanthe, and Head of the ANC Presidency Smuts Ngonyama. Mandela proselytised with all the passion of the newly recruited. Pat Sidley on Business Day gave us his warm-up spiel: ‘Both the government and myself are agreed that the biggest threat facing SA and the continent is that of Aids, which is killing many people, especially between 15 and 40.’ Sidley paraphrased:

Mandela said a perception had been created that the government did not care for the drugs or for the babies born every day with HIV, nor for young people dying of Aids. As long as poorer people could not get the drugs they might want, it would be impossible to remove the impression that government did not care about their plight. Mandela said one of the biggest challenges was to change sexual behaviour in the country. The full mobilisation of people, government, parties, workers, religions, women, and youth were needed to fight the ‘war’.

Lynne Altenroxel reported Mandela’s plan in the Cape Times:

My proposal ... is that [people should be told] we are busy researching, but those who feel they can’t wait for the findings must be free to consult with their doctors. [As if they are placed to give advice before the research is complete.] We can’t afford to debate [whether the drugs work and are safe] while people are dying. We must ensure that our people are given the drugs to help them. [We should take the propaganda at face value.] This is a war. [We can’t afford the luxury of thoughtful deliberation before making policy.] The problem is the president is too busy, both with internal and external affairs. [In fact, no one in politics has applied his mind more diligently to the issues, scientific and ideological, than Mbeki has.] The task now of leading on the question of Aids falls on the deputy president. [When it comes to undermining my successor, I just can’t help myself.]

Enough of Mbeki’s obstructionism, his party-pooping.

Sidley let us know, however, that Mandela preceded his call by raising issues Mbeki had articulated: He questioned the safety of nevirapine, claiming that it had been banned by a European country (in fact it isn’t approved for women in labour and their newborn babies in any Western country). He mentioned the dispute about the AIDS mortality rate, and indicated that he shared concerns that South African blacks were being used as ‘guinea pigs’ by drug companies. But he didn’t go with Mbeki’s view that AIDS diseases were largely the lot of the poor, resulting from their poverty. That would take the mystique out of it. And leave us staring at really big problems needing really big solutions. Solutions bigger than popping pills.

Asked to comment, specialist ANC historian Professor Tom Lodge at Wits managed to say nothing at all: ‘All that one can assume is that this is a fairly decisive move by Mandela. It will be rather difficult to talk themselves out of this one. It’s a fairly unambiguous statement and the interesting thing is that he’s done it with very high profile people around him.’ All that we can fairly assume, Tom, is that your lectures are more thoughtful than that. Achmat obviously ‘welcomed’ the proposal, adding lachrymosely, ‘But it shouldn’t be a political decision. It should be a medical decision and one based on whether the country can afford it or not. It is a tragedy that, in this week, when our president has seen significant questioning of his judgement, he couldn’t be seen on the same platform as Mandela. And the same goes for the health minister.’ Ag never mind Zackie, we’re sure that after a disprin and a bubble bath you’ll feel much better.

But Peter Mokaba could ill-conceal his disdain for Mandela’s little show. People like him calling for AIDS drugs ‘mean well but do not understand that they don’t work’, he said. So he’d be sending him some simplified versions of the scientific papers that he’d been circulating in the ANC upper ranks – simplified for the old man.

The Sunday Times revealed the reason for Mandela’s devotion to his new cause a few months later, reporting his revelation on 25 August that three young relatives had ‘succumbed to Aids’: ‘I became aware of my niece’s illness when I came down to the Transkei. I learned that she was in hospital and that she was HIV-positive. I went to see her … I left some money with my brother to treat her. A few days after I got back to Johannesburg, I heard that she had died.’ Two of a nephew’s sons had also gone with AIDS, he’d heard only after their deaths:

I do not know if they had antiretrovirals. The father is a very well-to-do man so they could not have been short of resources to get antiretrovirals. What I want to stress is the devastating effect of AIDS on this country. All of us have to stand up and make sure that this matter is widely publicised. … We must encourage our relatives who are HIV-positive to disclose their status so they can be helped and attended to.

Helped with AZT. Underground. Like his others.

Mandela had been personally recruited to the AIDS cult by Cameron during an evangelical house call. Leaving him infected. By the big idea. Mandela told the Barcelona AIDS Conference: ‘I know, for example, a judge who sits in one of our highest courts who has HIV/AIDS. He came to brief me about his position. His immune system was almost destroyed. He could not walk, but somehow he came to me, to fight back and win this battle. … He is now in the highest court of the country.’ Cameron couldn’t have picked a better man to hook, and hook him good he did. Neville Alexander, who spent eleven years on Robben Island with Mandela, once remarked in an interview that while he had great respect for his character and conviction, he didn’t regard him as a thinker, especially since once he’d adopted a certain view nothing could change his mind. The same stubbornness that made him politically effective also made him intellectually blunt.

The next prominent victim of AZT poisoning was Anneline Malebo, the singer of the struggle song, Paradise Road. The Mercury reported on 16 August 2002 that she ‘died in hospital yesterday. … Malebo recovered briefly from Aids-induced dementia after she began taking the drug AZT. … Malebo’s illness was advanced when she began taking the drug, however, and she was rushed to Somerset Hospital early on Wednesday after falling into a coma. … her weight dropped from 60 kg to just 38 kg.’

That the report was upside down is evident from the fact that a syndrome of diseases quite obviously can’t ‘induce’ an organic mental illness. But AZT efficiently kills brain and nerve cells: that’s well known. Muscle cells too, and its why the drug causes wasting, leading to massive weight loss. As all the research reviewed in Debating AZT tells. Also that in some cases, the poison can set in very quickly. Malebo was reportedly on AZT for only three weeks. From the mixed up report it appears she was already ill. Which would have made her especially vulnerable to AZT’s toxicities as an oxidising agent, as Papadopulos-Eleopulos et al. explained in technical terms in A Critical Analysis of the Pharmacology of AZT and its Use in AIDS in Current Medical Research and Opinion (Special Supplement) in May 1999 – but all summarised, in practical effect, by their note: ‘... the sicker the patient the more toxic the drug. That this is the case was accepted by researchers from the National Cancer Institute, Wellcome Laboratories and Abbott Laboratories as far back as 1988: “Azidothymidine, however, is associated with toxicities that can limit its use. ... These toxicities are particularly troublesome in patients with established AIDS; the use of azidothymidine is often limited in this population” (62).’ (Reference 62 is Surbone et al. in Annals of Internal Medicine 108, 1988.) But ignorant of all this, the report chalked up Malebo’s death to the virus: Paradise Road singer succumbs to Aids. As usual in the age of AZT and ‘AIDS’.

Mandela used the bereavement to pump one of Cameron’s lines. In a public statement of condolence to her four children, he said he admired Malebo for making known that she was HIV-positive: ‘This must serve as an example to other people who live with HIV/Aids. It is only through making their status known that we shall be able to overcome the stigma of HIV/Aids.’ But there’s a contrary argument to be made: stop talking about it all the time, and it will all go away. As the preceding fuss about herpes in the seventies did. IFP Minister of Arts and Culture Ben Ngubane also though Malebo ‘special’ for revealing her HIV status: ‘This is an indication that she was committed to assisting government in fighting the disease.’

Mandela went on: ‘We ... learnt with great sadness that Anneline’s economic position made her unable to take antiretrovirals earlier. This again emphasises the need for us to make treatment available in the public sector and in places accessible to those who cannot afford otherwise.’ This was in line with what he’d told the AIDS conference in Barcelona, a month earlier:

Many children are orphans today because their parents were not able to get access to treatment for AIDS. Is it acceptable that these dying parents have no access to treatment? The simple answer is no. We must find the means to take life-saving treatment to all who need it, regardless of whether they can pay for it, or where they live or whatever reason. … A perception has been created that we do not care for dying babies, dying young people. I want us to remove this perception.

Madiba, you are creating it, you can remove it. Referring to his call for AIDS drugs in April, he repeated, like a Christian before the lions: ‘I have expressed that opinion because I believe in it and I am prepared to defend it to the end of my days.’ As he’d said a bit earlier on radio: ‘That’s not a question from which I can retreat. When people are dying – babies, young people – I can never be quiet.’ But we wish you would, Tata. We really do. You know we love you. We cried when you walked out of prison. And again when the Boer generals saluted you on your way to your inauguration. But everyone around me is saying that it’s time you came to terms with your retirement gracefully, that you stayed home watching Generations on TV. And that you stopped undermining your successor.

Without mentioning him by name, the one-time boxer jabbed Mbeki in his opening words at Barcelona, and then again at the end: ‘There are many issues that I would like to touch upon in these few words ... [among them the] importance of ... rooting out of denial about the cause and consequences of AIDS.’ And the importance of rooting out denialists like Mbeki. Mandela concluded by criticising Mbeki’s lack of commitment: ‘My final challenge today is to the leaders of this world. There is no doubt that strong leadership is the key to an effective response in the war against AIDS. Leadership starts at the top. When the top person is committed, the response is much more effective.’ He then criticised Mbeki for slouching. Unlike the ‘committed’ TAC:

This means not only political leaders, but also business leaders, union leaders, religious leaders, traditional leaders, and the leaders of NGOs. One has to make special mention of the role played by NGOs and the leadership in those organizations. These are often small organizations with meagre resources that have made an impact far beyond what would have been expected from their size. One is often moved to reflect that, if only the big institutions of government and business had made a similar effort proportionately, we might very well already have turned the tide of the AIDS pandemic.

At the AGM of his Nelson Mandela Children’s Fund in Johannesburg on 6 September 2002, Mandela used the podium as an AIDS soapbox again: ‘[Princess] Diana smashed superstitions on HIV-AIDS. … Many people are not killed by the disease as such. They are killed by the stigma. … Our duty is that we give people, even those with terminal [illnesses], love, support and care.’ We encourage them not to feel too downhearted. After we’ve told them they’re going to die young. What the doctors said. And what Mandela himself said at Barcelona:

Regardless of whether they can pay for it, or where they live, or for any other reason, why should treatment be denied? If parents with AIDS can be given a few more years, perhaps several years or even longer, then their children will be given a much better opportunity for nurturing their survival and development. Those few years of additional life will be the most precious for all of those parents and children. For those of us who are more fortunate than those dying parents, it is a timely reminder of the sanctity of human life. We should be prepared to give all that we have got, give those families that are stricken by AIDS, those extra few years. … we should pay particular attention to the poor who are ill, whose immune system is not capable of resisting these terminal diseases.

Mandela met Leon for a private meeting at the former’s house in Houghton on the same day as his Children’s Fund AGM. Leon complained to the media afterwards that he’d never had a formal meeting with Mbeki, whereas, ‘With President Mandela there’s always been a great willingness to work across the political spectrum.’ Work together in fighting AIDS for instance. Good vote puller. But seriously: Could you bear the thought of having to spend an afternoon with Tony Leon? In the same room. His fake smile flickering on and off, like a dying neon tube. His pound-of-flesh attorney style whirring in high gear, conniving to advance his own narrow agenda. Formed by his narrow First World, the crowd he represents: minority white South Africa. (Who’ll ever forget his party’s 1994 election poster, ‘Democracy not mob rule’, summing up its attitude to the new dispensation in prospect, to black government, to the passing of apartheid rule.) Doing whatever it takes. Playing cordial, even convivial. But having displayed his stripes, personally and politically, in his insulting parliamentary and media statements. Basically contemptuous of the host he says he yearns to meet. The kind of guy who, when outboxed, takes to kicking. Incapable of apologising. Like about AZT for rape. Something like, ‘I really messed that one up.’ Why would Mbeki want to confer with a guy like that? What would be in it for him?

CHAPTER

A couple of weeks before its main appeal to the Constitutional Court against the nevirapine order, the government did some soft-shoe shuffling. With the Constitutional Court poised to confirm the High Court’s finding that the Health Ministry wasn’t doing its job, it needed to look serious about fighting AIDS. On 17 April 2002 the Cabinet announced that the AIDS budget was to be trebled to a billion rand annually. A new Presidential Task Team on AIDS was to be established, comprising Cabinet Ministers headed by Deputy President Zuma, to ‘strengthen [the government’s] own contribution’ to the Partnership Against AIDS’s endeavours and to oversee co-ordination and implementation of government’s AIDS programme – based on ‘the premise that HIV causes AIDS’. But the Cabinet also affirmed the work of the Presidential AIDS Advisory Panel, henceforth referred to as the International AIDS Panel – no longer Mbeki’s quixotic solo adventure.

Overcome with glee, activists and journalists completely misread the government’s gambit as a Damascene conversion on Mbeki’s part. Belinda Beresford’s What bent Mbeki on AIDS? was flagged in the Mail&Guardian headline, Behind govt’s Aids somersault. As if Mbeki had been reconverted. Beresford speculated excitedly: ‘Embarrassment, Mandela and internal ANC politics forced a reluctant president’s hand.’ But one read in vain for a fact in the piece to support the claim that he’d changed his mind in the least.

Mondli Makhanya made up a headline story for the front page of the Sunday Times, Mbeki shuns Aids dissidents – a claim repudiated by Mbeki’s spokesman Bheki Khumalo in Business Day two days later. There’d been some discussions in government, Khumalo said, ‘but these discussions did not involve the President’. In fact, he said, Mbeki hadn’t even been aware of them. So much for Mbeki shunning anyone, somersaulting anywhere. In a memorandum drawn just prior to the nevirapine appeal, and addressed to Zuma, Tshabalala-Msimang and Gauteng Premier Shilowa (they wisely didn’t bother addressing it to Mbeki), the TAC stamped their feet like children in a tantrum: ‘In this regard it must be emphasized that the views of the HIV/AIDS denialists are an insult to millions of people living and dying with HIV, as well as their friends and families. Debating life and death questions that have been settled by science is not constructive and we are pleased that Government has disassociated itself from these demeaning and dangerous views.’ Never did. Also,

We truly welcome the Cabinet statement on HIV/AIDS of 17 April 2002. The decisions to implement post-exposure prophylaxis for rape survivors and to roll out mother-to-child transmission throughout the country, as well as the affirmations that antiretroviral therapy is effective when used appropriately and that Government will support scientific efforts, but not be a protagonist in scientific debates, are critical steps forward in the fight against HIV/AIDS.

Mbeki yawned.

Interviewed by the Star a week after the Cabinet statement, Mbeki said ‘It is critically important that I communicate correct messages.’ What they were he wasn’t asked to define. Fortunately, because had he done so the interviewer wouldn’t have left so happy. But in a concurrent SAPA report, its eager AIDS writer described the interview as Mbeki’s ‘strongest personal message yet on HIV/AIDS ... suggesting a change in the government’s approach to the pandemic. … The South African president has come under fire in the past for questioning the link between HIV and AIDS and for claiming anti-retrovirals are as “dangerous to health as the disease they are supposed to treat”.’ Yes indeed. But interviewed by Patrick Lawrence in the June 2002 issue of the Helen Suzman Foundation magazine Focus, Mokaba explicitly refuted the reading that the April 17 announcement evidenced a change of mind by Mbeki and his Cabinet about AIDS drugs: ‘The statement of the government is mainly, really, if we are honest, a political statement. If you look at the ANC statement, if you look at the government statement, you will see that what we are saying is, “If there are people who believe in these things, then, as Mandela says, give them the drugs, let them take responsibility for taking them.”’ Lawrence commented appositely that

his admission on a sensitive and contentious issue during an interview at his home in Johannesburg is at once startling and mind-focusing. He describes the widely acclaimed April cabinet statement on AIDS policy as a political statement designed to defuse growing opposition to the government’s reluctance to provide anti-retroviral drugs to AIDS sufferers in public hospitals. His disclosure reinforces the scepticism expressed by the minority of observers who doubt that the cabinet statement marks a decisive reversal in government thinking. Though Mokaba is not a member of cabinet, his views cannot be dismissed as those of a person of little consequence in the ANC. He is the head of elections in the ANC and thus a party official who plays a central role in determining ANC strategy in the pending 2004 general election.

Media and AIDS activist reaction to what they perceived to be Mbeki’s and his government’s volte-face was just too heady to take any notice of Mbeki’s correction message in Business Day, rebutting Makhanya’s Sunday Times allegations. Internet forums and the newspaper columns and letters pages continued twittering tremulously about the prodigal’s return to the embrace of our Lord. The ‘AIDS experts’ didn’t take any notice either. In a letter to the British Medical Journal on 1 March 2003 Didier Fassin and Helen Schneider claimed that in ‘April 2002 ... Mbeki formally distanced himself from the AIDS “dissidents”’. In their dreamy victory over the government in the fight against AIDS, the downside for the TAC-supporting journalists was that they thereby lost the complaints for which Mbeki had become their daily whipping-boy. At a loss for something nasty to say on 17 May, the Mail&Guardian took to attacking his looks. The newspaper (‘for people who think’, ‘to enhance thinking’, ‘to think again’) ran a piece, heralded on street posters, entitled Mbeki falls short, comparing his height with other world leaders: ‘If a man’s height truly determines his success, President Mbeki is in trouble.’ Does it? Did it ever? Do you think the Mail&Guardian might run a follow-up article, with accompanying photographs, subjecting the size and shape of author Susan Chala’s breasts to a similar comparative analysis to see whether she has any promise as a journalist? After such a flat start. Let’s not forget that erstwhile editor Howard Barrell, who passed the piece for publication, likes to complain that Mbeki lacks judgment. The really big story on the same day was the CDC’s screaming omission of nevirapine from its revised guidelines for preventing mother to child HIV transmission in the US. But this passed without mention.

On 10 June Time magazine thought it would reward Mbeki for coming round by running a friendly feature article. In politics we call this rehabilitation. The caption to a complimentary cover portrait (and another fine one inside smiling with some kids on the contents page) went: ‘Mbeki finally faces up to AIDS’. There was nothing, however, in Peter Hawthorne’s article to bear out the implication that Mbeki had made a confession of any errors. Indeed, it quoted John Kane-Berman, president of the Institute of Race Relations, wondering whether he was just engaged in a political ‘damage control’ manoeuvre, or had really undergone ‘a change of heart’. AIDS being basically a cat’s fur-ball of emotion, let’s face it. Proceeding from hearts not minds. It’s why the Department of Health’s former AIDS Directorate chief, Nono Simelela, was given to bursting into tears at every public opportunity. And why everyone likes to show: ‘We care.’ Especially business types. On their banners and billboards, put up by such caring corporations as electricity suppliers and airport managers. Mastercard boasts on television about supporting St Mary’s Hospital’s black HIV-positive babies. Dettol has identified the selling power of invoking ‘AIDS orphans’: for every bottle of its antiseptic bought, television advertisements currently promise a donation their way. Both Mandela and Tutu have been inveigled to make Dettol’s pitch. Pick and Pay solicits donations for ‘AIDS orphans’, ABSA bank for people ‘living with HIV and AIDS’. Levi’s similarly advertises its jeans; it supports AIDS charities. The national railway parastatal Spoornet cares. So does Waltons the stationary supplier. It’s easy to care in the AIDS age. You wear lapel ribbons and fly flags. As you clutch your wallet and clench your keys. Dishing out small change. Boosting your product’s market profile all the while.

The part in the cabinet statement that got AIDS activists and journalists most excited was the government’s decision to make antiretroviral drugs available to rape victims – coupled to full information about their labelled indications and hazards. Charlene Smith didn’t notice, and posted an eager note on AF-AIDS about the government’s turn-around. I pointed out to her that both Peter Moore and John Kearney, GlaxoSmithKline’s medical and managing directors in South Africa respectively, had emphasized that AZT was not indicated by their company for use after rape, and I quoted their public statements to her in this regard. Smith answered: ‘Ah Anthony, how sad it is that AIDS dissidents still try to claw their way back when government is finally acting to save lives.’ To which I responded, ‘But were both GSK’s managing and medical directors wrong?’ She replied, ‘I don’t waste my time with dissidents Anthony, you should know that by now.’

For her part, Tshabalala-Msimang’s lack of enthusiasm over the Cabinet decision was apparent from her first public statement after the announcement: ‘Cabinet noted that [AIDS drugs] could help improve the conditions of people living with AIDS if administered at certain stages in the progression of the condition.’ She didn’t think so, evidently.

AIDS drugs for rape victims was something that the South African Medical Association had been urging since 19 May 1999 – announced in a press statement a couple of days after a meeting of its Committee for Human Rights, Law and Ethics. After some ponderous cogitation, it decided that ‘rape constituted a form of torture. We believe that the state and society per se have a responsibility to ensure that rape survivors receive maximum priority with regard to medical treatment and moral support. As doctors, we also believe that because of the prevalence of HIV/AIDS, rape survivors should have access to anti-retroviral medication.’ And the basis for this indication? ‘The Committee based their recommendation on current attitudes and protocols regarding the use of anti-retroviral medication. This included evidence that the risk of seroconversion was lowered by about 80% when health personnel exposed to HIV through needlestick injuries were given the treatment. Their risk of infection is only about 4 in 1 000, whereas it is assumed to be much higher in cases of violent sexual assault.’ The doctors didn’t think to reconsider the judiciousness of their advice and issue a fresh press release after the study upon which this eighty per cent salvation rate was based was debunked a year later by Le Grand et al. in a paper in AIDS in August 2000: Post-exposure prophylaxis with highly active antiretroviral therapy could not protect macaques from infection with SIV/HIV chimera. As we read in Debating AZT, the researchers

pointed out that ‘To date, only one study has reported that zidovudine (ZDV) alone may protect from occupational post-exposure infection with an efficacy estimated at 81%. [Cardo et al. of the Centers for Disease Control and Prevention Needlestick Surveillance Group: A case-control study of HIV seroconversion in health care workers after percutaneous exposure in New England Journal of Medicine 1997.] However, a retrospective case-control study is not the optimal design for assessing the efficacy of such strategies, thus limiting the significance of this observation.’ In their experiment on macaques monkeys to determine the efficacy of post exposure prophylaxis following deliberate infection, they found that it didn’t work: ‘This is the first demonstration that post-exposure prophylaxis of HIV transmission with a therapeutic design recommended in humans could not protect macaques from experimental challenge with a pathogenic lentivirus closely related to HIV-1.’

Let me not pretend that I wasn’t nonplussed on reading the government’s announcement of its intention to supply antiretroviral drugs to rape victims. For so many reasons. A month earlier the ANC NEC’s statement pointed out that ‘there was no proof’ that they worked. GlaxoSmithKline had repeatedly. made public statements about the unsuitability of AZT for this indication. ‘I have to state emphatically that AZT is not registered and we do not recommend it for use after rape’ said medical director Peter Moore. CEO John Kearney agreed: ‘The company has not engaged in any price or supply negotiations to provide AZT for use in rape survivors, nor does the company promote the product for that indication. They confirmed this privately to Tshabalala-Msimang: ‘As to rape victims, I have engaged in a dialogue with GlaxoWellcome, and checked their policy documents. Nowhere does GlaxoWellcome advocate using AZT to prevent the transmission of HIV to rape victims.’ AZT is not prescribed to rape victims in other countries nor recommended by the US CDC in the situation. Mbeki’s had trounced Leon in their closely argued debate about it. Tshabalala-Msimang had made a statement immediately after the parliamentary session in which Mbeki ordered AZT investigated that ‘there was a body of scientific research and information which indicated that AZT was indeed a dangerous drug … there was no data proving that AZT was of any use to rape victims’. Speaking in Parliament two weeks later she revealed that AZT was actually a failed chemotherapy, found too poisonous for use as a cancer treatment to kill cancer cells, that it was itself a proven carcinogen in rodent studies, and that it ‘was not registered in South Africa or anywhere else in the world for use by women who were raped … We have absolutely no idea of what the effects are, either short-term or long-term, of using AZT, a known carcinogen, on healthy people. The use of AZT [for HIV prophylaxis after rape] is, at the present time, illegal, aside from it being dangerous.’ In March 2000 the New York Times reported her saying: ‘There is not enough information for me as Minister of Health to expose women to a drug that we do not know about.’ And on 1 November she had reiterated in Parliament, ‘[There is] no scientific evidence to support the use of the anti-retroviral drug AZT for rape survivors … GlaxoWellcome had never applied for the drug to be registered for use by rape survivors.’ This was backed up by her Director General Ayanda Ntsaluba when the generic drug case collapsed five months later: ‘We are not persuaded as government that there is good scientific evidence that AZT is effective in victims of sexual abuse.’ He spoke on good authority. In an article, HIV testing, counseling, and prophylaxis after sexual assault, published in JAMA in 1994, Gostin et al. made the point – and nothing has changed – ‘... the efficacy of zidovudine in preventing HIV infection after initial exposure remains unproven.’ Tony Leon might have lost his debate with Mbeki over AZT for rape, and in the course of it been exposed by him as a special pleader in the style of a typical crooked lawyer acting for a rich client, but he’d won the political battle.

‘Dangerous’ AZT most certainly is – and for a further reason that no one has thought about. In cases where the rape results in conception, and the victim, through choice or circumstance, doesn’t have an abortion, a further potential tragedy awaits – the birth and burden of a child born deformed, stricken with cancer or otherwise gravely damaged. A Guide to the Clinical Care of Women with HIV, published in 2000 by the HIV/AIDS Bureau of the American Department of Health and Human Services, warns that AZT should only be given ‘after the first trimester’ due to ‘fetal malformations’ and ‘squamous vaginal tumours’ noted in animal studies, in which the effect of early foetal exposure to AZT was investigated. The authors of the Guide neglected to mention a human birth defect paper discussed in Debating AZT: In 1994, in the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology (7:1034), Kumar et al. reported, on top of a high proportion of therapeutic and spontaneous abortions, a ten per cent abnormality rate among one hundred and four cases of pregnant women treated with AZT in a hospital in India, including holes in the chest, abnormal indentations at the base of the spine, misplaced ears, mis-shapen faces, heart defects, extra digits and albinism. And in a study published in the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology (24(3)) in July 2000, just after the Guide came out, Newschaffer et al. reported an almost trebled ‘serious’ birth defect rate among 1932 babies exposed to AZT in the womb in the state of New York. And that was after relatively late exposure.

A month’s course of prophylactic AZT treatment taken by a woman impregnated by a rapist exposes the foetus to the drug during its first month of growth, when it’s at its most vulnerable to what Poirer and Olivero of the US National Cancer Institute describe as the drug’s ‘unequivocal transplacental carcinogenicity and genotoxicity’. But the TAC joyously ‘welcomed’ Cabinet’s offer of AZT for rape. The activists reportedly celebrated their victory in the High Court mandating the government’s supply of nevirapine to HIV-positive pregnant women with ‘cheering and hugging’ and the popping of ‘champagne corks’. The question is whether the same merriment will be attending the arrival of rape victims’ AZT-crippled babies? Written off to freaks of nature, since nobody will be keeping tabs on how any babies born to rape victims turn out. At birth, during infancy, and in adulthood.

GlaxoSmithKline, both in South Africa and England, had been quick to repudiate Mbeki’s parliamentary warning about AZT in 1999. But no similar ‘correction’ followed the Cabinet’s surrender to the TAC regarding the provision of antiretroviral drugs to rape victims. Something like: ‘GlaxoSmithKline has repeatedly emphasized that AZT is not intended for prescription after rape because the risk of seroconversion to HIV-positive after rape is negligibly low, and because the drug has not been shown to be effective in such circumstances. Moreover, the study claiming AZT to be beneficial for the prevention of HIV infection after needlestick injuries, on the basis of which some people promote AZT for use after rape, has been disconfirmed. AZT is very toxic, as is 3TC, a closely similar drug that we also manufacture, even taken over short periods, and, in the event that the rape results in conception, it is especially toxic to foetuses, most vulnerably in their first trimester. The Centers for Disease Control issued a statement on 24 September 1998 warning that antiretroviral drugs “hadn’t been proved successful” after rape, that they carry “heavy risks” because of their exceptional toxicity and that that “doctors should not give the treatment to patients on demand” accordingly (per AP paraphrase). We were most surprised that the Medicines Control Council didn’t point out the Cabinet’s blunder, particularly in light of the radically new guidelines for the use of AZT and similar drugs issued by the US National Institute of Allergy and Infectious Diseases the year before, which reversed previous medical policy to initiate treatment with such drugs immediately in view of their of their dangerous toxicities, and now recommend that, even among confirmed HIV-positive patients, the administration of such drugs be delayed until signs of disease or immunological deterioration become apparent. The Cabinet gravely erred in resolving to provide AZT and similar drugs to rape victims, and we strongly urge that its decision be reversed.’ Not a chance: GlaxoSmithKline’s directors were too busy rubbing their hands together.

By November 2002 the drugs were being administered to rape victims in the Free State, Gauteng, KwaZulu-Natal and the Western Cape, but were not readily available – complained Liesl Gerntholtz of the AIDS Law Project – in Limpopo, Mpumalanga and the Northern Cape. In an article reporting this for Health-e on the 18th, Implementing PEP for rape survivors, Kerry Cullinan said that the drug programme was being hampered by many rape victims not starting the drugs within seventy-two hours – ‘too late for the anti-retroviral drugs to prevent HIV infection. … The second big problem is that few of those who opt for the drugs actually finish the 28-day course, which is necessary if the drugs are to be effective.’ On what basis she made the latter claim, of course she didn’t actually say. Because there isn’t any. Other than what the doctor said. And she believes in doctors.

Of one thousand and twenty-two women and children offered the drugs at sixteen centres in Gauteng between July and September, eight hundred and fifty eight had opted to take them. But only one hundred and twelve completed the four-week course. Incomprehensibly to the ‘AIDS experts’. Professor Lynnette Denny of the University of Cape Town, who considers the secondary violation of rape victims by poisoning with an especially toxic form of chemotherapy to be one of their women’s rights, came up with an imaginative excuse: ‘Most rape survivors want to shut out their experience and go on with their lives. But every day for 28 days while they take the drugs they are reminded of what has happened to them.’ That the drugs are unendurably toxic never entered her pretty head.

Mohau Makhosane, deputy director of the Gauteng health department’s medico-legal services was a bit less clueless. She found it ‘difficult to say why so many people don’t complete the course, as there could be a number of different reasons’. But she wasn’t impressed by Cullinan’s suggestion that it was because only a week’s course of the drugs are provided at a time: it is ‘not just a matter of survivors coming back to collect the drugs. … It is also important to check if they are taking the medication and if there are any side effects. They need medical follow-up, such as liver function tests and full blood counts. We are re-looking at our protocol to see if we can improve on it.’

Concluding her article, Cullinan provided an earnestly delivered lesson in boxed outline of How PEP works in sexual assault: For instance: ‘A 1995 review of health workers [‘with needlestick injuries’] in France, Italy, Britain and the United States who had been given anti-retroviral drugs after being exposed to HIV-infected blood found an 81% decrease in risk for HIV, thus indicating that the drugs can be used as prophylaxis (as a preventative measure after exposure).’ The preppy PEP enthusiast hadn’t heard about Le Grand’s et al. debunk of its methodology and conclusions in AIDS in August 2000. Apparently.

The TAC’s memorandum to Zuma, Tshabalala-Msimang and Shilowa again used that winsome expression of which Mbeki is so chary: ‘civil society’. (We recall his rebuke of DA leader Tony Leon for abusing it: ‘The subterfuge of seeking to hide behind the skirts of “civil society” will not pass.’) The words have a nice political use: recasting a narrowly focussed pressure group such as the TAC as the voice of ‘civil society’ invests its agenda with special legitimacy. And correlatively, talking of ‘civil society’ all the time, instead of ‘civic organisations’ more plainly and accurately described, dichotomises the electorate and the elected, devalues the latter, and tends to discredit its claims to democratic leadership.

Achmat first employed the expression in the TAC’s press release after the pharmaceutical industry abandoned its generic drug case against the government: ‘The voice of civil society has been strengthened by the strong alliance of organizations.’ It was repeated in the TAC’s memorandum: ‘Irrespective of the outcome of this case, we must move together beyond the conflict of the last two years. Only by Government working with civil society, can the challenges of the epidemic be met.’ And nothing is off-limits to these shameless pretenders: the Star reported on 2 August 2002 that the TAC had just produced a CD entitled Jikelele – Global Treatment, containing a collection of struggle songs. The beloved melodies and harmonies. Without the familiar words though – new lyrics had replaced them: ‘The songs generally depict Mbeki and ... Tshabalala-Msimang along with Aids as the oppressors and the TAC as the liberator.’ Leading a friend of mine at a Xhosa community radio station to propose a lapel badge: ‘TAC is TACKY.’ To say the least of it.

But even the Constitutional Court has adopted the TAC’s stupid motto, and in its judgment dismissing the government’s nevirapine appeal reproved it for not according itself with the TAC’s drug drive:

no programme [‘to realise progressively the rights of pregnant women and their newborn babies to have access to nevirapine treatment’] has been disclosed by [the government]. This is regrettable. The magnitude of the HIV/AIDS challenge facing the country calls for a concerted, co-ordinated and co-operative national effort in which government in each of its three spheres and the panoply of resources and skills of civil society are marshalled, inspired and led.

We judges must also band together and join in the fight against AIDS too. And by ‘civil society’, we mean the TAC with all its ‘resources and skills’ and those sectors of society that it has co-opted to rally in the streets with it. And because we find the government insufficiently zealous in its duty to fight the thrilling new scourge, we’ve decided to tell it what to do. Since we can’t have the country’s elected leadership making its own policy.

In giving judgment for the TAC, the Constitutional Court endorsed the organisation for a second time: ‘We consider it important that all sectors of the community, in particular civil society, should co-operate in the steps taken to achieve this goal.’ Somewhat outside its jurisdiction, it seems to me, in calling on the government to take the TAC on board in policy-making. Jeez, with a blessing like this from the country’s most powerful lawyers, who’ll dare to call Achmat, Heywood and the rest of their gang the corporate pimps they really are?

Conceptually, the court’s language was all Cameron’s, down to the ‘resources and skills’ bit – the biblical scale, the drama, the imperatives. Cameron again: ‘On the one hand that crisis is one of illness and suffering and dying … a challenge to every person with power and resources and skills to use them to alleviate and obviate suffering and death.’ All to be fixed with the AIDS activists’ ABC formula: abstain, be faithful, condomise. Failing which, the poisonous pills.

Speaking of which, Philip Ochieng explained well why this programme pressed on Africans sits so comfortably in the white mind. In a commentary in the Kenyan Sunday Nation on 15 October 2000, How the racist Aids and abets African deaths, he began by reminding us of the population explosion hoax preceding the African AIDS one – also blamed on

the black person’s ‘peculiar fixation with sex’ … Where are all the dire predictions Western ‘researchers’ on Africa made as the 20th century ended? Hadn’t the Jeremiahs worked it out (by computer!) that everything would collapse ‘by the year 2000’? Africa would simply drown in its own population deluge. Africans were ‘breeding like rats.’ Yet they fiercely resisted birth control. How benighted! For, lo, we would now have not even a standing room, not an ort to eat.

Ochieng made the point obvious to everyone but Western ‘AIDS experts’ and their servant activists that the high incidence of the diseases that take Africans do so

only because Africans are the poorest and those diseases are vitally linked to poverty. … [The] few Western scientists who point these things out are denied research funding and publishing opportunities and dismissed as ‘crackpots.’ When Thabo Mbeki admonishes that this is simply racism, even Africans accuse him of bowing to ‘fringe scientists!’ Only the discerning see what motivates it: commercialism. The yarns are spun to scare us into buying pills, condoms and test kits from Western manufacturers. We know it because the birth control advocates are always the same individuals who make, sell and advertise such products. They are interested only in our money, not in our well-being. Yet family planning need not cost a penny. Our foremothers easily achieved it by child-spacing. And our population spiral has parallels in all societies. To blame it on our fecundity is to confuse cause with effect. The parallels show that, if a society is independent, stabilisation always follows a spurt and that the economy always governs both. An attack on poverty, then, is the only answer to our demographical nip and tuck and the diseases related to it. Of course, given today’s knowledge, we cannot wait for history to take its course. But that’s the whole problem. Given the international division of labour, Africa’s ‘development’ has no course of its own to take. Westerners want us to give only short-term answers to our deep-seated problems. For longer-term answers would put paid to the Western stranglehold on us forever. ‘Humanitarian assistance’ is what creates and re-creates the problem. Charity is the tool by which to perpetuate the conditions that require charity. That’s why the Westerner prescribes only birth-control, not independent production and development. Thus we squander our dwindling foreign exchange on exporting the short-term inputs: medicines, condoms, food relief. I do not deny that we need these. But how much cheaper it would be to manufacture them in our own industries! And isn’t prevention cheaper than cure? Isn’t food security the best preventive? Yet the division of labour forbids all activity that would ensure such security. It confines us to exporting raw materials at a pittance to buy the short-term needs at astronomical prices. Thus we cannot possibly give our population spurt any long-term answer. Our poverty deepens. Our children die. Our families produce more and more children to ensure some survive. To develop at all, we must struggle to be in the international system on our own terms. But, since we are there on their terms, we must find our own short-term solutions if we are to survive. Hence the need for family planning to tap the vast energy our women now waste in excessive childbirth and channel it into social production. Meanwhile, population dances with resources. Aids intervenes to exacerbate the tension. But what tension? Hasn’t it long been shown that population and scarcity have nothing to do with each other? The problem lies only in how the world’s resources are owned, tapped, appropriated and distributed. That is the fact the prophets of doom – in their quest to plunder our resources more easily by keeping us in the jaws of hunger and ‘African Aids’ – seek so assiduously to conceal from us.

By repetition, like ‘The Jews are our misfortune’ or ‘Women and girls, the Jews are your ruin’, the TAC’s claim that it, rather than the ANC in power, represents ‘civil society’, has slipped into the parlance of local political commentators. Shortly before the nevirapine appeal, I overheard a discussion between a pair of earnest Marxist academics at a restaurant table near mine, exchanging ideas about how best to ameliorate the parlous economic state of the Eastern Cape, full of the pros and cons of tolerating the ‘kulak class’ and such stale old talk. When the TAC case incidentally came up, one eagerly applauded the ‘initiative by civil society’ against the recalcitrant government, as if Mbeki, Tshabalala-Msimang, and the rest of the Cabinet were the troglodytes of Pinochet’s Chile. Missing the fact that there was nothing spontaneous about the ‘initiative’. It had all been tightly organised manipulation. By Zackie Achmat. With more foreign money than he can use, keeping paid support staff and office machinery filling offices all over the country.

On radio, ANC-hostile ‘political analyst’ Dumisani Hlophe, political editor of the Sunday Times, also tosses about the cliché that the TAC speaks for ‘civil society’. A boast reiterated again in the TAC’s invitation to attend a ‘National HIV/AIDS Treatment Congress’ at the end of June 2002 – hosted in partnership with Cosatu (in tow) and supported by the Aids Consortium, Médecins Sans Frontières, the Southern African HIV/AIDS Clinicians Society and the Anglican Church – to discuss ways to ‘build common purpose between civil society and government’. Presuming of course that ‘civil society’ and its elected government were at odds. Because the TAC said they were. And overlooking that the ANC is unquestionably the democratic voice, twice elected on an overwhelming, increasing majority. The insinuation instead is that the party is something akin to the geriatric Partido Revolucionario Institucional in Mexico, sclerotic, corrupt and elite-serving. Already, after just a few years in the house. Since this is how the white liberal media consistently portrays it. Whereas they will still be singing of Achmat in dulcet voices when he cashes in his now gleaming political chips and makes a grab for public office. On a populist ticket. Claiming to speak for the poor. Watch.

He’s practising already. On a meander way beyond his TAC’s articles of association as an AIDS drug lobby group, Achmat released one of his regular press statements on 5 June 2002 to welcome this, welcome that; this time: Zimbabwe Declares Emergency To Use Generic Antiretrovirals – TAC Welcomes Step But Urges Democratic Accountability And Return To Rule Of Law. ‘The Zimbabwean government has declared an “emergency” for six months to allow the issue of compulsory licences and the use of generic antiretrovirals as part of its response to the growing HIV/AIDS crisis.’ This Achmat welcomed. Offering a potted political analysis of the trouble with Zimbabwe’s health infrastructure. Thanks to ‘the lack of good governance by Robert Mugabe and Zanu PF, as well as misguided support for the structural adjustment programme imposed by the World Bank and IMF in 1991’. Achmat offered this prescriptive guidance instead: ‘... the Zimbabwean government must support a return to good governance, the rule of law, a social development plan and clear investment in health care services.’ He means AIDS drugs: ‘HIV/AIDS exacerbates inequalities between the elite and the poor, between rural and urban communities. It also underscores gender inequality. But, most starkly, it exposes the fact that the vast majority of Zimbabweans – the urban and rural poor, peasants, workers, professionals and many middle class people die because they do not have access to health care services including antiretroviral medicines.’ He concluded with a string of the usual exhortations, including:

Therefore, we call on the Zimbabwean government to adopt a comprehensive plan to deal with the HIV/AIDS crisis, including a return to democracy and good governance. Without freedom and equality, healthcare will remain the privilege of a few instead of the right of every person. … We urge every AIDS activist to work for democracy, development and access to essential medicines for all people.

 

As with the TAC Pledge, it’s difficult to decide whether this meaningless garbage was written low for the stupid masses or whether Achmat wrote so simply on account of being so simple himself. When I speak of the electorate in this way, I allude to TAC friend Sipho Seepe’s remarkably contemptuous estimation of it, parliamentarians included, in the Mail&Guardian on 14 June 2002: ‘Mbeki can always count on the intellectual ineptitude and academic handicaps of many of his followers.’ As illustrated by the support Mbeki got for noting that a virus can’t cause a syndrome. Fool that he is. Why, he said so himself at the opening of his AIDS Advisory Panel’s first meeting.

Achmat had another go at popular politicking on 3 September 2002, with his TAC literally joining hands with members of the AIDS Consortium, Cosatu, and divers Christian groups to form a two-kilometre human chain in Johannesburg. The plan was to draw attention to poverty, they said. As if the government needed its attention drawn. As if poverty alleviation isn’t Mbeki’s central preoccupation. The highlight of the day was the planned delivery of a memorandum to the Ministers of Finance and Social Development, calling, essentially, for the implementation of an American style social security system.

It’s not just moral support that Cosatu gives the TAC; it’s taken the TAC agenda to the bargaining table. On 26 July 2002 the Mail&Guardian reported that five mining unions, including the dominant National Union of Mineworkers, had clinched a deal with Anglogold for the supply of AIDS drugs to HIV-positive miners at company cost.

That Achmat and his TAC have had more in mind than AZT in African mouths and that they fancy a broader political role for themselves was let on by Cameron in his address at the Durban AIDS Conference in 2000: ‘In the last years of his life Jonathan Mann began speaking with increasing passion about the moral imperatives to action that challenge us all. He well understood that this involves what he called: “A challenge to the political and societal status quo.”’ Achmat’s moves are paying off. The Mail&Guardian reported on 11 October 2002 that his name is

being touted by leftists within the African National Congress for [election to] the party’s national executive committee. … The ANC national executive committee’s perceived failure to grapple with the government’s controversial Aids stance, which led to intervention by Nelson Mandela earlier this year, has prompted leftists in the party to consider pushing in party members with strong activist credentials. … An ANC branch chairperson said: ‘Members are not impressed with ... the things Manto [Tshabalala-Msimang] had to say about Aids and nevirapine.’

Achmat denied being interested in a letter the following week: ‘For the record, I have no intention of standing for any position in the local, provincial or national structures.’ Sounding like an American politician announcing that he’s no intention of standing for the Presidency. Before doing so.

CHAPTER

Looking puffed up in a hideous photograph in the Mail&Guardian on 12 July 2002, his face ever more like that Picture of Dorian Gray towards the end of Wilde’s sordid tale, Achmat was featured in a story made about how he was awaiting the results of TB tests – to tell him, since he was unable to decide on his own, whether he was sick or not – as he feared he might have developed full-blown AIDS. As opposed to half-blown. (It’s nice being full-blown.) He’d consequently cancelled his trip to the Barcelona AIDS conference on the instructions of his doctor. He likes doing what he’s told. He’s a submitting type, as he’s told us. The piece cood over the malingering mama’s boy’s decision not to take the AIDS drugs until everybody had the democratic ability to afford them. Will he or won’t he take his medicine, the article went, serving up some ‘money or the box’ entertainment for the Mail&Guardian’s literati. ‘I don’t want to die,’ Achmat said. Making everyone go: ‘Ag, shame.’ Since the idea of Achmat perennially half-dying is so quiveringly exciting for everyone. As at a yester-year hanging, slowly, in public.

A solitary critical comment in the media concerning Achmat’s thespian charade appeared in Beeld on 15 July 2002: A cartoon by Alistair Findlay depicted Achmat in bed in his TAC tee-shirt, a nurse approaching with a box of antiretroviral pills, and Peter Mokaba (never on them) and ‘Nkosi Johnson’ (killed by them) with cherub’s wings on either side of him whispering past their cupped hands, ‘Take them Zackie! You said they are not toxic’, and ‘Follow your conscience, Mr Achmat. You’re an example to everyone.’ To which Achmat, his right hand raised to signify ‘No thanks’, responds, ‘Let the poor take them first.’

But Mandela fell for Achmat’s cynical show like a feathered lure. On the 27th he paid him a staged house call. Journalists were called out in full force ahead of his arrival, and they filmed the performance for the 8 o’ clock news. By staged I’m talking about the two celebrities sitting at a press conference table, cutting to a shot of the public martyr in bed wheezing out a little cough on cue for the clip, and then back at the press conference table, looking lively again. Lots of hugs punctuating the proceedings. reported that Mandela would urgently be seeking a meeting with Mbeki – a written request was delivered after the weekend – to discuss terms for surrender to the TAC’s demands that the government bulk-buy the drugs and supply them to the public. So that Achmat could feel his way clear to start taking them. Mandela concluded: ‘I think I have a case to take to the President of the country and to acquaint him with what his position is. I know under what conditions he will be prepared to take treatment.’ As if Mbeki needs telling. Achmat, Mandela said, was ‘a role model whose activism is based on principles that are admired way beyond South Africa’s borders’ whom ‘we all admire’, ‘a loyal and disciplined member of the ANC’. Please, Tata, spare us.

The South African Medical Association doesn’t wish him gone as we do. On 29 July 2002 the quacks released a tearful encomium to Achmat praising him as ‘more valuable alive than dead’. Chairman Kgosi Letlape, who drew it, paid grateful tribute: ‘You led the profession in the right direction [as in Germany in the thirties] and the only small gesture we can now give you back is to appeal to you to take the treatment and show all South Africans what a difference anti-retrovirals can really make.’ This would be ‘the most powerful way to challenge claims by some that the drug [AZT] was poison’. Claims such as Sigma Chemical Company’s. Mbeki and Tshabalala-Msimang’s. Supported by loads of research papers.

There was similar talk from Letlape a few days earlier at the opening session of SAMA’s AGM: the medical profession needed to draft its own policy framework for the treatment of HIV/AIDS, because ‘The policy of no treatment is not acceptable. … [Doctors] could no longer be part of a system that commits genocide.’ Boy, we’re lucky a guy with this sort of nous doesn’t have a responsible job like designing bridges or flying planes. Talking just like Makgoba.

In his statement of praise for Achmat, Letlape continued: Achmat ‘could not travel [to sunny Barcelona for the July AIDS Conference] because of an illness which took advantage of his compromised immune system in which his CD4 cell count has dipped dangerously from 275 to 230 this year’. Evidently he hadn’t heard one of Achmat’s intimates breaking the unfortunate news at the Saturday press-fest that Achmat’s tight chest had turned out to be an uneventful load of bronchitis, not TB. But as word of this passed around, Achmat alleviated the general disappointment by assuring the journalists present that his ‘immune system is still seriously compromised’, and ‘My immune system is declining very quickly. If I don’t take medication soon it will be a severe problem.’ However, ‘I’m looking much healthier than anyone can say.’ Yes you are. We can say. We can see. We’re also confused.

Having stayed at home from the Barcelona AIDS conference on doctor’s orders, the professional hypochondriac addressed a plenary session of his fans by way of a projected video recording, whining the usual:

From a purely public health care perspective it is short sighted not to treat HIV, to say that we must focus on prevention and exclude treatment. On the other hand it is unconscionable, because what we are speaking of are not cold statistics [there aren’t any], but our lives. Our lives matter, the five million people in South Africa with HIV matter and the millions of people throughout the world already infected with HIV, their lives matter. And so it is not simply the question of cold statistics that we are putting to you [there aren’t any, just estimates], but a question of valuing every person’s life equally. Just because we are poor [no you’re not], just because were are black [no you’re not], just because we live in environments and continents that are far from you [Cape Town, apartheid perfected, lies in the heart of London and Amsterdam], does not mean that our lives should be valued less.

Just what the pharmaceutical companies wanted to hear: the South African government should take note of the emergency scale of the epidemic and recognise the value of the lives of the poor with expensive drugs. ‘The government’s [he meant Mbeki’s] earlier position on AIDS was scandalous. That position now has fortunately changed, however we still believe that we all have to be vigilant, that we should encourage the South African government and all its officials to maintain a position that HIV does cause AIDS. And more importantly that HIV can be treated as well as prevented.’ Having been taken in by the government’s PR trick. And determined to make sure that it now maintained the faith.

It may sound perfectly pathetic, but Achmat’s talk of dying all the time is actually a potent rabble-rousing device. Citing studies in support, Michael Kearl explains why in the introduction of his Sociology of Death and Dying database online: ‘... when awareness of death is increased, in-group solidarity is intensified, out-groups become more despised, and prejudice and religious extremism escalate. … when reminded of their mortality, people react more harshly toward moral transgressors and become more favorably disposed toward those who uphold their values.’ And we seem to have an enduring, base fascination for the sick, or the idea of being sick – the more lurid, mysterious and insidious the disease the better – exemplified by You and Huisgenoot headlining Fran’s battle with cancer on 26 July 2002, to pull the low-brow crowd to the till. Playing sick to the same sort of mentality, Achmat uses the same ploy, and periodically talks of his CD4 cell count like a London beggar exhibiting his sores. Only he doesn’t settle for farthings for doing so. In his house near the beach. Entertaining Mandela even. Living like a hog in the fathouse. Flying around the world. And the fat priest doesn’t only look increasingly like Oprah Winfrey, he sounds like her too: his claim about ‘five million South Africans with HIV’ resolves to about one in eight of us. Winfrey predicted similarly foolishly on her TV show in 1985: ‘Research studies now project that one in five heterosexuals could be dead from AIDS at the end of the next three years. That’s by 1990. One in five. It’s no longer just a gay disease. Believe me.’ Believe anything.

At a press conference after Achmat’s Barcelona film show, his colleague Mark Heywood edified us with some more of his Oxford erudition:

It is crucial that we [the government and the TAC] work together to strengthen the prevention and treatment plans in the country and we can bring great and powerful forces [the Church and the trade unions] to both campaigns. We do not want to return home and hear the argument that treatment is not relevant because it does not eradicate the virus. We call on the health minister to end her isolationist position. She must stop isolating herself from world consensus.

The Oxford man is a better ‘AIDS expert’ than NIAID director Anthony Fauci apparently, who declared just the opposite isolationist world consensus in early 2001: ‘It’s clear we’re not going to eradicate the virus with the drugs we have now.’ And at the preceding AIDS conference in Durban two years back, Oxford professor Roy Anderson of the UNAIDS Collaborating Centre for Epidemiological Research, Wellcome Trust Centre, said much the same: ‘Even combinations of five drugs do not seem able to eliminate the virus from the host.’ Like Heywood though, Cameron knew better, telling the Durban conference: ‘It is a fact that over the last half-decade, various aggregations of drug types, some old some new, have been shown when taken in combination to quell the replication of the virus within the body.’

At his Barcelona press conference, Heywood then signalled the TAC’s next likely courtroom strike: ‘There is no excuse not to expand our treatment programme, especially in the light of an announcement by an Indian generic drug manufacturer that four of its anti-retroviral drugs had been approved by the World Health Organisation.’ Next, he turned to the government’s continuing objection to KwaZulu-Natal ‘AIDS experts’ having bypassed government in bidding for and copping untold riches from the Global Fund. Health-e reported: The ‘TAC called on the health minister Dr Manto Tshabalala-Msimang or President Mbeki to publicly welcome the U$78 million allocation to KwaZulu-Natal by the Global Fund.’ Like the TAC, the government must also get into ‘publicly welcoming’ stuff now. And stop arguing: ‘There needs to be an end to the South African Government’s ambiguous approach to the money in the fund. There is no time for messing about and controversy on the issue.’ Come on chaps, let’s get on with it. No more messing about. Let’s hit this thing on the head.

It’s incomprehensible how this Tweedledum and Tweedledee pair in Achmat and Heywood could have achieved so much fame and popularity, and how journalists could have made pets of such personally unattractive characters, and adopted their programme as their own – until you remember Chomsky, cited in Debating AZT: ‘If you serve power, power rewards you with respectability. If you work to undermine power ... you are reviled, imprisoned, driven into the desert.’ And, in the case of Achmat and his successful demagoguery, you recall what worked for the Austrian corporal in Germany in the twenties and thirties: an outsider status, a lost dissolute youth, frustrated artistic ambitions, alienation from his father, closeness to his mother, a tendency to depression, an aversion to intimacy with women, a bitter tinge, a ridiculous but forceful bearing, an unpleasant menacing voice, abstemiousness from liquor, a fixed dead gaze as he speaks, a stupid crassness in his public utterances, an aggressive manner, rude public behaviour, theatrical anger displays, violent hand movements, unintellectual and anti-intellectual posturing in favour of rank populism, repeated levelling of accusations of criminal culpability, an intense will to power, adamant resolve, immense ambition, obstinacy, simmering rage, schematic thinking, inflexible commitment to unalterable core beliefs, total control of the party, support of and leverage up to power by the traditional forces of conservative reaction, a retrograde romantic longing, a feeling of being socially under par, a love of cake, resentment, monomania, an appreciation of the importance of the irrational in politics, corporate funding, repeated law-breaking with impunity, contrived displays of heartfelt sincerity alternating with thuggish sentiments and conduct, early recruitment of and endorsement by prominent, influential and respected public figures, massive and vocal support from the medical profession, academia and the clergy, the abuse of democratic tolerance and civil institutions, making promises with the intention of breaking them, treasonable coercion of the government to ram its policy agenda, persistent venomous demeaning of the country’s democratically elected representatives, gross rhetorical extravagance, a subordination of truth to purpose, a visionary claim to redeeming leadership of the downtrodden, mystical language, broken logic, mass-hypnotic skills, a gift for mobilisation and regimentation, a keen appreciation for the importance of rousing primitive emotions in political mobilization, great sloganeering skills, an exceptional gift for making propaganda, emphasis on the leader principle, trading on anxiety, surrounding himself with slavish ciphers to carry out his will notwithstanding their high-sounding formal offices, imperviousness to reason and deaf ears for facts incongruent with the quasi-scientific scheme, playpen tantrum throwing, endlessly repeated fire-calls about a social menace, a fixation on pure and corrupt blood, scapegoats to rail against as hate-figures, constant declamations that the country is in danger, vilification of dissenters, repeated levelling of minatory threats and charges, a fondness for street marching, messianic promise of national salvation, an instinct for political barbarism, profession of simple answers to complex challenges, petulant emotional performances, diplays of public hooliganism to shock the public into taking notice – all sold in grand, fulminant rhetoric, pounded home like a pile-driver, hardly making sense, but resonating deeply with ancient anxieties and prejudices.

Sharing the stage in Barcelona with Bill Clinton, Mandela patted Achmat and Heywood on the heads, so to speak, and in the process got completely carried away: ‘I want to say to all of you who are activists in the war against AIDS, you have my greatest admiration’ – going on to equate their lobbying for the drug industry with his own sacrifices in the apartheid struggle, ‘often against odds that were considered insurmountable’. AIDS is claiming more lives ‘than all wars and natural disasters. … AIDS is a war against humanity. ... this is a war that requires the mobilization of entire populations.’ And the weapon? AIDS drugs should be provided to ‘all those that need it, wherever they may be in the world, regardless of whether they can afford it’. The founder of the Nelson Mandela Children’s Fund then pulled off a cuddly populist trick, coolly contrived to stir everyone’s hearts, a coup de grâce to flatten government resistance to the TAC agenda. He mentioned the plight of ‘AIDS orphans’, of whom we could expect 25 million by 2010, we were told: ‘This is a tragedy of enormous consequences.’ The pharmaceutical industry players running the whole show couldn’t believe their good fortune. Nike shoes would have paid a hundred million for this kind of endorsement.

The rest of Mandela’s Barcelona speech was a regrettable reminder of how the aged grow childlike sometimes:

Business must stop humiliating people and testing them openly whether they have HIV or not. All that is required is to talk to people, constantly, to say, ‘If you don’t go for testing, if you have got AIDS and you don’t know about it, you are signing your own death warrant. The only way in which you can be saved is if you go for a test, and then accept what the doctor says to you.’ I believe that this is the single most important prevention tool that we have, because it is the one that is most likely to change behaviour. My second challenge today is to all individuals: you need to establish where you stand in the fight against HIV/AIDS, and you can only do this by being aware of your HIV status. For those of you who are HIV positive, there is hope. You can live with HIV, and the rest of the world cares about you. The sooner you establish your HIV status, the more you can do for yourself, and the more that can be done for you by others. And if voluntary counselling and testing is not available free of charge where you live, then you must demand it. It is your right to know. In Africa, we have a concept known as ‘Umuntu ngumuntu ngabantu’, based on the recognition that we are only people because of other people. We are all human, and the HIV/AIDS epidemic affects us all in the end. If we discard the people who are dying from AIDS, then we can no longer call ourselves people.

Who would disagree with the first part, starting with the proverb? But Mbeki’s answer to the second is that to describe the broken health of the poor as a sexually spread AIDS epidemic is profoundly dehumanising. And then poisoning them with the best intentions, murder.

It’s about time somebody took Mandela by the arm, sat him down and reminded him of his timeless oratory (ripped off from Nehru, by the way): ‘I have walked that long road to freedom.’ But not so much those famous words as those that followed: ‘I have tried not to falter; I have made missteps along the way.’ Yes, Tata you certainly have.

The popular reading of the Cabinet’s April 17 announcement that it signalled a move towards universal antiretroviral treatment for HIV-positives came up during a special parliamentary debate in the National Council of Provinces on 8 August 2002, with Western Cape Premier Marthinus van Schalkwyk calling on Deputy President Zuma to reiterate its intentions. But Zuma wasn’t playing, and asked that political parties not try for points about ‘life and death matters. … Given the controversy that has come ... certainly we will reaffirm that position. There is no change in government’s stand on that.’

Mhlongo found himself snubbed in being omitted from an AIDS conference in Vanderbijlpark in August, of the sort he’d always been invited to before, described by the Daily Dispatch on 15 August 2002, the day after it ended, as ‘a summit … the government’s historic meeting with scientists … the first meeting between the parties since the controversial Presidential AIDS Panel met two years ago to debate whether HIV causes Aids. This time, however, there were no Aids dissidents. Health Minister Tshabalala-Msimang was also notably absent.’

The initiative, convened by Health Systems Trust, a hugely powerful and influential NGO funded by the American Henry J Kaiser Foundation, amounted to a successful grab by local AIDS careerists for control of government policy on AIDS. Health-e reported:

Within three weeks, the country’s top HIV/AIDS scientists will present the Department of Health with a range of recommendations on how to deal with HIV/AIDS. … Anti-retroviral treatment is receiving the most attention from the scientists, with six of the 16 topics focusing on different aspects of it. Focus areas include drug toxicity, the safety of long-term ARV treatment in children, how to choose patients for ARV therapy and how to ensure adherence to treatment.

Along with ‘post-exposure prophylaxis for rape survivors’.

Among the one hundred-odd government officials and ‘AIDS experts’ appointed to draw the new policies were the usual gang: the

head of the HIV Clinicians Society Dr Des Martin, Wits University’s Prof James McIntyre, Prof Helen Rees and Dr Glenda Gray, UCT’s Prof Greg Hussey, Dr Lynne Denny and Dr Linda-Gail Bekker; the University of Natal’s Prof Slim Abdool Karim, Prof Jerry Coovadia, Dr Anna Coutsoudis and Dr Daya Moodley and UWC’s Prof Dave Saunders.

The meeting was the ‘beginning of a constructive and more structured process for continued interaction between the scientific community and government’, the ‘AIDS experts’ said – code for imposing their opinions and sidelining critical voices. Like Mhlongo’s. There was a ‘wealth of research capacity in this country’ they said, meaning lots of us would be glad to get funding for AIDS research, which should be linked to ‘economic, social science, health systems and policy research’. And blah, blah.

The ‘summit’ was hotly followed on 19 August by another meeting, this time between a delegation led by South African Medical Association chairman Kgosi Letlape and Department of Health officials led by Tshabalala-Msimang. The special meeting was called by SAMA following its national council meeting the month before, at which Letlape had criticised government over its AIDS treatment policy as ‘a system that commits genocide’. SAMA’s demands were unmet, said Letlape: ‘We would like to see the implementation of pilot projects for HIV/Aids treatment in all provinces as a matter of urgency, and will pursue all possibilities towards facilitating treatment through collaborative efforts with other organisations.’ But no joy: ‘We have not changed our position, and neither has the Department of Health.’

CHAPTER

In the second half of 2002 AIDS receded somewhat from the headlines. The Sunday Independent ran a front-page main story on 4 August under the peculiar headline, ‘Bad teeth’ smokescreen for army Aids’: ‘The South African National Defence Force (SANDF) might be hiding a frighteningly high incidence of HIV/Aids among soldiers as “dental problems”.’ And another on 6 October: ‘South Africa is sitting on an Aids orphan time bomb that could unleash a tidal wave of crime and civil unrest: up to three million children will be orphaned within the next ten years ... the Institute of Security Studies said’ – a spectre in line with Unicef representative Jesper Morch’s visions, announced as he left South Africa in September after a four year duty-tour: ‘I still don’t think we have the faintest clue what [the imminent AIDS orphan problem] is going to do to South African society.’ Mandela announced at a news conference in London on 2 November that his children’s fund would be joining forces with the late Princess Diana’s charity to fight AIDS in South Africa, inter alios, by making palliative care grants for the treatment of the sick diagnosed with AIDS. Meaning money for AIDS drugs. Because they certainly didn’t mean food.

With South Africa under Mbeki’s leadership proving to be more difficult than had been bargained on, the Americans turned their attentions to other potential markets. But their attempts to whip up a fresh AIDS scare in India didn’t going down well either. In October US ambassador Robert Blackwell warned that India was on the brink of a huge HIV/AIDS crisis. He was referring to predictions contained in an unclassified report prepared for the CIA by the National Intelligence Council, The Next Wave of HIV/AIDS: Nigeria, Ethiopia, Russia, India and China, put out in September, claiming that twenty to twenty-five million Indians would be infected by 2010, and that India would overtake South Africa as the country with the largest number of AIDS cases. The report was an elaboration of an earlier one, an unclassified National Intelligence Estimate released in December 1999 on ‘the global infectious disease threat and its implications for the United States’.

The spooks appear not to have read the Durex Global Survey 2001. Because it found India to be the second least promiscuous country in the world, whose people had an average of three sexual partners in a lifetime – seventy-seven per cent of whom had known only one sexual partner. And as we noted earlier, the Durex survey put Nigeria and China in the same club as India, ranking next to them at the bottom of the promiscuity pile.

In November, on the strength of the report’s predictions, the Bill and Melinda Gates Foundation allocated $100m to fight AIDS in India. But the Indian government wasn’t much impressed by the report or its new sponsor. Health Minister Shatrughan Sinha condemned Gates for ‘spreading general panic’ by endorsing it, and said he was ‘unavailable’ for a meeting. Prime Minister Atal Bihari suggested that the world’s richest man sod off too, by cancelling a meeting set up for the 11th. (Moved by the media-driven excitement around Gates’s arrival three days later, however, Sinha changed his tune and hailed him.)

Why Ethiopia of all countries in the world should have been included was indirectly answered by an article in the Mail&Guardian on 29 November, and another in the Sunday Times soon after, warning of an imminent repeat of the kind of famine that Bob Geldoff tried to soften in the mid-eighties. Eighty per cent of its sixty-three million people are subsistence farmers, precariously working deforrested small plots and vulnerable to increasingly frequent drought. Again the Americans reconceive hard economic developmental problems as problems of indigenous sexual irresponsibility. Causing a looming AIDS crisis. Since there’s money in the latter but none in the former.

Another paper by the Centre for Strategic and International Studies in Washington, The destabilising impacts of HIV/AIDS, talks the same sort of language as The Next Wave. Calling for ‘global war’ against AIDS, it warned that the imminent Indian ‘epidemic’ made it a ‘security threat’ to the US, because the ‘epidemic’ would result in ‘political instability’ and ‘Law & Order problems’ that will ultimately lead to ‘terrorism’. Those fighting AIDS in India had serious problems, it said:

They face weak institutions, significant cultural barriers to education and prevention and a relative shortage of funds. Above all, they face dense bureaucratic barriers and what is to date a conspicuous lack of leadership at high political levels. Considering India’s military and strategic importance, the United States has a strong national interest in offering technical assistance and friendly persuasion to build the high-level political commitment necessary to prepare a sufficient response.

The kind of ‘friendly persuasion’ Mbeki had experienced?

The cynical might wonder why the CIA should have identified these countries as sites for the ‘next wave’ of the ‘HIV/AIDS epidemic’ – aside from the attractions of the size and lucrative potential of the markets there for the lifesaving western interventions: condoms, test kits, and the most expensive and profitable medicines around, AIDS drugs. And why the world’s richest, most ruthless and avaricious capitalist should suddenly be taking an interest in AIDS? Because he’s actually kind person? The New York Times quoted Gates on 9 November:

India had at least four million people living with HIV and the United States National Intelligence Council predicts that the number of people infected in India could jump to between 20 million and 25 million in 2010. The humanitarian imperative for action is undeniable. Much more needs to be done now to reach the populations that fuel the spread of the disease in India. For example, mobile populations – truckers, soldiers and migrant labourers – have HIV rates up to 10 times more than the national average and serve as a bridge from high-risk groups to the general population.

India cannot deal with AIDS alone, he said. We gotta help.

But although pleading altruism, it turns out that Gates has had other things in mind. Like improving returns on his foundation’s investments. His own too. OutlookIndia pointed out in its November issue:

The $24 billion foundation has been investing in Big Pharma for some time now. This became public in May when the foundation filed its investments with the US Securities and Exchange Commission. The Wall Street Journal, followed by the London-based Guardian, blew the lid off the investments by letting out details: the foundation has invested in multinational pharmaceutical companies like Merck & Co, Pfizer Inc and Johnson and Johnson. The investments were worth $205 million on May 16, 2002. These companies are leading manufacturers of AIDS drugs, related vaccines and diagnostic kits. So by acquiring shares in these companies, the foundation now has a common financial interest and, sceptics may revel in the irony, a seeming conflict of interest. Through its funding of the Global Alliance for Vaccines and Immunisations, the foundation pays for purchases of vaccines from the same pharma firms in which it owns shares. Merck’s chief executive Raymond Gilmartin even sits on the Microsoft board. So, on the one hand, the foundation is pushing – quite rightly – that vaccines and drugs be made available to poor people, while on the other it shares financial interests with companies that strongly advocate the patent regime and sell drugs to poor nations at astronomical prices. ... Gates himself has invested huge sums of his personal money in pharma companies. Media reports appearing in US-based publications in the first week of September quoted the Securities and Exchange Commission records and said that Gates sold nine million Microsoft shares valued at nearly half a billion dollars and invested in Merck, Pfizer and Prozac maker Eli Lilly.

The rapidly accelerating involvement of the US in South African domestic affairs – under the guise of fighting AIDS – was illustrated on 21 October at the award of $21 million to Glenda Gray and James McIntire’s Perinatal HIV Research Unit at Chris Hani-Baragwanath Hospital in Soweto. Announcing the grant, US Ambassador Cameron Hume declared:

South Africa has more HIV positive individuals than any other country and the United States is prepared to help in any way possible to address this health disaster. Without broader access to treatment and more effective prevention, nine million South Africans are likely to die from this epidemic by 2015 – leaving behind more than two million orphans. In this decade alone, life expectancy in South Africa will drop from 59 to 41 years. … Fortunately, South Africa also has tools and resources to be able to respond effectively to this catastrophic epidemic.

To which HL Mencken had a tailor-made retort: ‘The whole aim of practical politics is to keep the populace alarmed – and hence clamorous to be led to safety – by menacing it with an endless series of hobgoblins, all of them imaginary.’ Particularly the whole aim of American foreign policy.

The scale of US funding for the AIDS business in South Africa, and the Americans’ determination to scale up its mad war on AIDS was revealed in the rest of Hume’s speech. He teed off by blessing the TAC:

Energetic non-governmental organizations are working hard to prevent HIV transmission and provide community-based care. Many government health officials are moving to expand HIV/AIDS services. In all these efforts, the United States stands ready to be a full and active partner. The grant we have gathered to launch is one example of U.S. partnership. Over the next five years it will provide over $21 million to support outstanding work in South Africa. This, the second large grant made to South African investigators under the CIPRA (Comprehensive International Program of Research on AIDS) program of the National Institutes of Health, was awarded only after a stiff competitive process of peer review. It represents an investment in research that will better inform our HIV and TB management and treatment efforts particularly in family and community settings in Africa. Also it is an unusual commitment to work with a consortium of universities, including Witwatersrand, Cape Town and Stellenbosch, and with the National Health Laboratory Service. These CIPRA grants are setting a new standard for collaboration in biomedical research and improved clinical care. This is a true investment in the future; an investment in building hope. In addition to this grant, overall HIV/AIDS spending by the U.S. government has increased from $14.2 billion in fiscal year 2001 to a proposed $16.1 billion in fiscal year 2003. That includes an increase in international funding from $726 million to $1.3 billion over the same period. The President’s NIH budget request for fiscal year 2003 includes $2.8 billion for HIV research – a 9.9% increase over fiscal year 2002. Funding for AIDS vaccine research has increased by 185 percent. With this grant, South Africa is even better positioned to compete successfully for a share of this scientific support. Through international contributions the U.S. also is confronting the epidemic with countries that share our concern and our interest in aggressive, effective action. President Bush made the first pledge of $200 million to the Global Fund Against HIV/AIDS, TB and Malaria a year ago, before the fund was even created. Since then, the U.S. commitment to the Fund has risen to $500 million. We are very pleased that South Africa will receive two highly praised awards from the Global Fund – awarded based, again, on a competitive peer review. In implementing these awards, South Africa will be providing an example for others in southern Africa to follow. South Africa also will be doing the most important thing, saving lives and preventing infections. With respect to our cooperation with South Africa, I am pleased to note that four US agencies provide most of the funding. In 2001 USAID spent approximately $10 million on HIV/AIDS related activities in South Africa. In 2002 USAID will spend about $15 million and the planning figure for 2003 is $20 million for HIV/AIDS. In 2001 the Centers for Disease Control and Prevention (CDC) spent approximately $3.7 million and it anticipated obligating $4 million in 2002 and $4.5 million in 2003. In 2001, NIH funded 34 grants, fellowships and studies that involved South African researchers at a total cost of approximately $7 million. This amount is expected to increase in 2002 by at least $8 million, part of which is this grant. The Department of Defence support is about $750,000 per year. Finally I would note that just three months ago President Bush announced a new $500 million International Mother and Child HIV Prevention Initiative, designed to prevent HIV transmission from mothers to their children. In those countries that choose to participate, this program is expected to reach 6 million women a year, targeting a reduction of transmission by 40 percent within five years. To achieve this we will all have to work together with strong leadership at all levels and with unflagging energy. Clearly, today’s CIPRA is the next step in our expanding partnership to help the people of South Africa. It demonstrates that we are committed to a long fight against this virus and a permanent friendship among our citizens. You are facing a health crisis of unprecedented social, economic and political impact. The U.S. Government, foundations, non-governmental organizations and academic institutions are all prepared to be your allies in this war.

Of course like the war on terrorism and against communism before it, ‘this war’ on AIDS was no more than a mythological ideological construct justifying US intervention in the domestic affairs of other countries. To swell the profits of the US medical industrial complex. Completely dominated by the pharmaceutical industry. Pretending, as doctors do, to be helping and caring. The other thing about Hume’s address was that it bore out former Harvard molecular biology professor Charles Thomas’s observation that AIDS would be cured overnight were the funding to be cut off. Everyone would go scuttling for new jobs. Real ones.

By the end of the year, gone were the red ribbons worn compulsorily by every South African Broadcast Corporation television presenter, and they were seen less and less on the lapels of politicians and senior civil servants – only to be revived for a while in November by AIDS crusader Jerry Springer on his new South African TV show, Saturday Night – his celebrity guests sporting ‘ethnic’ beaded AIDS ribbons, like his own, implicitly endorsing the AIDS system. Reminiscent of German businessmen wearing swastika cufflinks. Springer flew over at his own cost, and did the show free – with two provisos only: that the take at the door goes to promoting AIDS awareness, and that an AIDS advertisement to the same end be screened during the show. He débuted by amusing the audience with jokes about how foolish Tshabalala-Msimang was for denying pregnant women nevirapine. Claiming it kills, he said with a bemused smile. Also for distributing condoms stapled, he alleged, to AIDS education pamphlets. In case we missed the implication, he spelt out his opinion of her in a reference, on 26 April 2003, to ‘something smaller than the IQ of the health minister’. The largely white audience laughed on cue. Both times.

But the AIDS ribbon is still emblazoned on the front page of every issue of the Government Gazette, and on government signage (below ‘Department of Transport’ for instance) and on official government stationary. So that the footer on letters from any office in the department of Justice and Constitutional Development reads: ‘HIV/AIDS is a murderer Bring it to justice.’ With an AIDS ribbon punctuating the two declamations.

The machine was far from winding down, though. On the contrary, it was increasing speed. On 21 October, at the site of the Nelson Mandela Museum going up at Qunu near Umtata in the Eastern Cape, Public Works Minister Stella Sigcau launched a Lysenkoist new policy. Mandela was there to cheer it on since, she said,

you are leading in the frontline of the battle against our new enemy, HIV/AIDS and poverty. … The implementation of an HIV/AIDS awareness strategy will become mandatory for all contractors tendering for Department of Public Works contracts. … The Department’s procurement process will be amended to ensure enforcement … Such contractors [caught by inspectors for not complying] will be penalised accordingly. These penalties will be clearly stipulated in the amended contract documentation. … [Construction contractors] will in future be expected to factor in their HIV/AIDS Awareness Strategy as part of their effort to access government construction tenders and contracts.

Sigcau outlined what builders and plumbers and electricians would have to get into if they wanted government work in future:

The campaign is aimed at addressing, together with partners in the construction industry, issues such as HIV/AIDS training/prevention programmes, encouragement of voluntary HIV/AIDS and STD testing, the creation of a non-discriminatory working environment, the establishment of counselling and referral systems for support and care, and the promotion of respect for the rights and obligations of individuals as well as employer responsibility – specifically within the construction industry.

In other words they’d have to buy into the whole AIDS malarkey, hire all sorts of additional staff to handle this stuff, and act as pressed agents for the propagation of AIDS ideology and the promotion of AIDS commerce – something like traditional chiefs under apartheid, those who wanted government salaries. The economic ramifications of this mad new policy was suggested by the scale of the construction industry, worth R37 billion annually, according to an accompanying press release, ‘more than half of which is spent by the government’.

The TAC announced on 6 November that it would be conducting a civil disobedience campaign unless the government implemented an ‘AIDS drugs for all’ programme by February 2003. And picketed GlaxoSmithKline’s Durban and Cape Town offices on the 20th for ‘profiteering [that] continues to needlessly kill millions of people living with HIV/AIDS in Africa’. So went the memorandum delivered. ‘Other generic companies, which are unable to enter the market because of the monopoly that GSK enjoys, are able to produce generic AZT at much lower prices. Your profits are unjustified.’ The complaint, of course, only served to reinforce the holy status of the merchandise.

Following the claim by the MRC’s ‘AIDS experts’ in late 2001, in a report leaked to the media, that AIDS had taken at least forty per cent of people aged between fifteen and forty-nine who died the year before, the Cabinet commissioned a task team made up of delegates from Statistics South Africa, the MRC, and the Departments of Home Affairs, Health and Social Services to research matters afresh. The sense of inviting multilateral collaboration in the study was to limit the scope for dishonest manipulation of the exercise by any particular agency to support butter-cream funding demands. The report, Causes of Death in South Africa 1997-2001, was released in mid-November 2002, and it sure let the air out the MRC’s tires. But nobody in the media saw fit to say so. Instead they milked the aging cow for all it was worth.

The Mail&Guardian found SA’s ‘death report’ makes for grim reading: ‘HIV deaths are rising and has become one of the major underlying cause of death in South Africa.’ But then again, ‘while infectious diseases have grown in prominence as causes of death, unnatural causes such as injuries, motor accidents, suicide and drowning still constitute the highest underlying causes of death among young males.’ The newspaper left out the finding that ‘the highest prevalence of HIV deaths is among African females (13,5 percent). … The lowest prevalence of HIV deaths is among white females, with only 0,7 percent of deaths due to this cause.’ Since white girls don’t fuck around so much. Given that no one has ever died from HIV (doctors say you die of AIDS), the report’s reference to ‘HIV deaths’ and ‘HIV disease’ is confounding. Nonetheless it exposed Makgoba and his fellow ‘AIDS experts’ at the MRC for the frauds they are. Naturally the MRC didn’t see it that way. Quoted in an article in Business Day after the weekend, MRC consultant David Bourne said, ‘Yes we do feel vindicated. … the results are consistent ... we are not going to make the claim that we were right. I think we were right broadly.’ Sort of like being somewhat truthful in giving evidence?

Ranjeny Munusamy on the Sunday Times wrote the day before, ‘The study, released this week, confirmed that the number of HIV deaths were rising, with 95% more men and 75% more women dying of Aids last year than in 1997. The proportion of deaths due to HIV nearly doubled in three years, from 4.6% to 8.7%, the study found.’ All very worrying. In a press release a couple of days later, the MRC’s Debbie Bradshaw explained the discrepancy between its original figures and the report’s; the MRC numbers were based in part on ‘the observed excess mortality among young adults’. Not so, according to Stats SA: drawing figures from the Causes of death in South Africa 1997-2001 report and a preceding one, South African Statistics 2000, Rasnick plotted South African population growth and deaths over the period 1994 to 2001 on a graph:

[pic]

Both the population growth and death rates gently increase in linear fashion, almost exactly in parallel. Crucially, there is no rise in the mortality rate – in fact it dipped in 2000. From which the only conclusion that the numbers admit is that the increase in ‘HIV’ deaths amounts to no more than redescribing deaths, formerly called by their old names, such as TB and so on. So much for ‘the excess mortality’ the doctors ‘observed’. So much for the terrible South African AIDS epidemic – described by Archbishop Ndungane nonetheless at a meeting at Cape Town’s Tygerberg hospital at the start of the month as ‘the worst plague in human history. … there is no crisis as catastrophic as the HIV/AIDS epidemic … Statistics dazzle us like headlights.’ Evidently he didn’t have in mind the statistics reported by Stats SA. The hard ones plotted by Rasnick on that embarrassing graph, rather than the MRC’s wild talk. Or he wouldn’t have been so dazzled.

The TAC got the Nelson Mandela Foundation to host a two-day conference on AIDS drugs in Durban starting on 29 November. On the same day the Mail&Guardian ran an interview of Stephen Lewis, UN Special Envoy for AIDS in Africa, by Claire Keeton – immediate successor to Belinda Beresford as the newspaper’s AIDS bunny. Notable was Lewis’s revealing conclusion, the significance of which he missed:

Suddenly [AIDS] is upon us and the toll is dreadful. Essentially families and communities are disintegrating in a way that is unparalled, unprecendented. There has never been such a desolating assault on a continent, there has never been such a catastrophe. [Not even the slave trade. Or colonization after it.] The death of seven million agricultural workers in twenty-five countries since 1985 has devastated the sector, leading to famine in Southern Africa and is a harbinger of what could happen in areas such as education and security. … Many countries have about a million orphans and the extended family system is in tatters. … We have sibling families forced into survival sex and young boys into grievous forms of child labour. … The worst is yet to come. We are still on the threshold. … I spoke to [HIV-positive] mothers in Arusha [Tanzania], and the first thing mothers always say is that they need food. Next they want education for their children, so they have prospects after they die. Then they ask for drugs. That is always the order.

On the same day, answering a question put by a journalist from Plusnews about why ‘stigma and discrimination [are] still a problem, what is it that people are afraid of?’, Lewis explained that it was ‘Because AIDS is essentially a matter of sexuality, a matter of sexual intimacy, because AIDS results in such terrifying and grotesque death and because families fall apart, [because] everyone who comes in contact with AIDS thinks its a death warrant.’ But isn’t that exactly what you ‘AIDS experts’ want everyone to believe, Steve? In order to keep your jobs? As the AIDS cult’s highest officers?

On 6 December, at the Sandton Convention Centre in Johannesburg, Mandela released a study by the Human Sciences Research Council, which he’d commissioned to investigate public opinion regarding the government’s handling of the ‘AIDS epidemic’. A sample of about ten thousand people were interviewed. It gave Mandela ‘hope’, he said, that ‘in the end we will win the war against AIDS’, upon learning that 57.1 per cent of men in the fifteen to twenty-four year age-group had used a condom the last time they had sex. And 46.1 per cent of the women surveyed too.

Unfortunately the HSRC’s claims about the popularity of condoms, which, like the Holy Spirit, filled Mandela with ‘hope’, were contradicted by entirely contrary findings made by loveLife researchers in a survey conducted a few months earlier, and mentioned in Bona in October: thirty-two per cent of young guys never used condoms, and a further thirty-nine per cent generally avoided them.

Most respondents in the study thought the government committed to the fight against AIDS, but felt more should be spent. The study found 96.5 per cent support for treatment to prevent ‘mother-to-child transmission’, with 95 per cent behind the provision of AIDS drugs to people ‘living with HIV/AIDS’, as the SAPA report put it. It was a vivid measure of Achmat’s stellar success in garnering almost universal public support for his TAC’s programme. In its massive rise in popularity in such a short time, only the Nazis compare.

The other purpose of the study was to ‘determine HIV prevalence in the population ... using linked anonymous HIV saliva tests’. According to press reports, eight and a half thousand respondents submitted saliva samples for testing, on the basis of which four and a half million South Africans were thereupon reported infected: 11.4 per cent of us, and twice as many blacks as whites. But the big surprise in the report of the study was how many children were reported infected: ‘The observation that the estimated HIV prevalence among children aged 2-14 years is 5.6% ... was unexpected.’

In conducting their research the researchers employed a single ELISA test. The novelty was that instead of collecting blood samples for testing with a hypodermic syringe, as usual, they used a new gadget called the OraSure® HIV-1 Oral Specimen Collection Device, described on its manufacturer’s website as a ‘specially treated cotton fiber pad that is attached to a nylon stick. This collection pad draws antibodies from the tissues of the gum and cheek into the mouth and into the pad. The collection pad ... is placed between the lower cheek and gum for 2-5 minutes.’ The idea is to collect the ooze – oral mucosal transudate – exuded from the capillary blood vessel walls in your gums and inner cheeks into their surface mucus. Not saliva. ‘The OraSure® HIV-1 pad is then placed in a vial with preservative and sent to a clinical laboratory for testing with an initial “screening” assay (ELISA).’ (Note that Orasure Technologies Inc. correctly refers to an ELISA test as a screening assay – for excluding possibly tainted blood, not determining infection.) If reactive, ‘a supplementary test, the OraSure® HIV-1 Western blot assay, is performed to verify the result of the screening assay’. But Mandela’s researchers at the HSRC didn’t get around to that. And treated the ‘unconfirmed’ result of a single screening essay as proof of HIV infection.

Another thing: whether the researchers collected OMT samples or mere spit for testing is doubtful. According to the just-mentioned description of one of the study’s aims, the researchers thought they were using ‘saliva tests’. And the report mentions that ‘all children between 2 and 14 years of age were asked for their verbal consent to take a saliva sample’. Not an OMT sample. Apart from their failure to employ ‘a supplementary test, the OraSure® HIV-1 Western blot assay’, there’s a further indication that the researchers never read the collection device manufacturer’s instructions. Which reads: ‘Important Information: OraSure® HIV-1 Oral Specimen Collection Device is intended for use in the collection of oral fluid specimens for testing for antibodies to the Human Immunodeficiency Virus-Type 1 (HIV-1) in subjects 13 years of age and older.’ Mandela’s clever researchers didn’t spot that. Before testing the children ‘between 2 and 14 years of age’ with it. And then announcing that an ‘unexpected’ 5.6 per cent of them were infected.

All of which reduces the value of the HSRC figures on the South African infection rate to Monopoly money. Unaware of this, and making a terrible fool of himself, along with the bumbling incompetents in the HSRC who designed the study, Mandela said the study was a ‘watershed’; it provided data for the country to fight AIDS ‘even more vigorously’. To be helped by his own redoubled war-effort: he was pitching in ten megs from his foundation to fund the South African Medical Association’s scheme to provide free antiretroviral drugs at eighteen sites across the country. The Department of Health responded to the report by promising to increase funding for the fight against AIDS by R3.3 billion over the next three years. While people go hungry everywhere.

I pointed out the basic flaws in the study to Olive Shisana, the principal investigator. She ignored my letter and in May announced a new study based squarely on the findings of the old. Four thousand children in the Free State province would be examined, she said, to determine ‘the role of the healthcare system, sexual abuse and other non-healthcare related events, for instance traditional circumcision ceremonies’ in how they got their HIV infections. Assuming that they were infected – according to the prohibited, improperly used and unconfirmed OraSure® HIV-1 Oral Specimen Collection Device-based test.

There was no letting up on Mandela’s AIDS drugs campaign. On 12 December, with Achmat at his side holding his arm, he announced a new initiative with Médecins Sans Frontières to get the drugs to the people. Since the government wasn’t. Oubaas pulled on a TAC ‘H.I.V. positive’ tee-shirt at the occasion to signify that he also cares. And a few days later let it be known that he was sponsoring a rock concert, Mandela SOS, featuring a who’s who of rock royalty, to be staged on Robben Island on 2 February in order to raise money for the fight AIDS. Mandela was in top gear: an AP piece on 13 December, Mandela has emerged as crusader against AIDS, quoted his aides saying that sixty per cent of his time goes to the fight: ‘“This is a serious matter, it’s a war,” he said on a visit to the Khayelitsha AIDS clinic outside Cape Town.’ As to the government’s insistence that universal access to antiretroviral drugs is beyond its fiscal reach: ‘They are coming round. They are going to do something to show the government cares.’ On 28 January the Washington Post made much the same point about the former President’s new cause: ‘At 84, Mandela, who mostly ignored AIDS during his presidency, has adopted the cause as his final crusade, politely but pointedly rebuking his successor.’ I suppose we should be grateful that he isn’t inspired to saddle up and go riding out under a Christian flag to slay Muslims instead. Like medieval Europeans. And modern Americans.

Not be left out, the New York Times ran a story of its own about the Khayelitsha AIDS drug clinic on 8 February, In Africa, Free AIDS Drugs and Talk of Life: ‘Every Monday morning, patients infected with the AIDS virus come to the red-brick clinic in this impoverished community of dilapidated shacks. … The clinic looks like one of the hundreds of medical centers overwhelmed by South Africa’s AIDS epidemic.’ And so on, entertaining the Americans with the African AIDS apocalypse. Turned around by the sunny American drugs:

This clinic offers a rare glimmer of hope in South Africa, which has more people infected with H.I.V. than any other country. The vast majority of AIDS patients die here because they cannot afford the lifesaving medicines common in the West. But over the last two years, the number of private initiatives offering free or low-cost AIDS drugs has slowly but steadily increased. In this gritty township near Cape Town, the relief agency Doctors Without Borders provides free triple-therapy treatment to about 330 people and reports remarkable results. Doctors treat even the sickest of the sick, patients who can barely walk or swallow. After six months of treatment, most people show dramatic improvements, gaining as much as 20 pounds and the strength to fight off killer diseases.

Like the touch of Jesus. Rising like Lazarus. Suffering neglible side effects – unlike the experience people everywhere else: ‘Doctors Without Borders found that three-quarters of ... patients suffered mild reactions to the drugs, including nausea, rashes and low white blood cell counts during the first three months of treatment.’ The good doctors didn’t spot the stupid paradox in treating immune-suppressed patients with immuno-suppressive chemicals. Causing immune suppression (low white blood cell counts). Those on the drugs to whom Swarns talked to tried to convey a different story: ‘Interviews suggest that some patients struggle to maintain the regimen in the early days.’ But the American preferred the white side. First conceding: ‘Of 159 participants, three dropped out of the program during the first year. Thirteen people, very sick at the onset of treatment [low cell counts, high viral load – or really physically ill – she didn’t say] died that year from illnesses including chronic diarrhea and Kaposi’s sarcoma.’ Then countering: ‘The condition of the vast majority, however, improved greatly. The mild reactions to the drugs, which never resulted in hospitalization, diminished sharply after three months. And adherence to the regimen has been excellent, doctors say. [Unlike everywhere else in the world. As all the studies find.] Within three months, the virus was undetectable in 90 percent of patients. They also got sick much less often. Patients on the drugs, known as antiretrovirals, suffered an average of one illness a year instead of four.’ The most remarkable part of that miracle is that all the studies of AZT’s effect on ‘viral load’ find that it no effect worth recording – we’ll be surprised to read in Is AZT a DNA chain terminator?, and numerous papers report ‘paradoxical worsening’ of disease, ‘paradoxical flares of diverse opportunistic conditions shortly after’ antiretroviral treatment.

Following her jingoistic drug mythmaking, Swarns picked up the familiar theme of Mkeki’s government being a gang of dark killers:

when President Bush announced in his State of the Union address on Jan. 28 that the United States would finance AIDS treatment for two million more people [to be discussed below], most of them Africans, he gave an unexpected lift to a continent where 2.5 million people died from the disease last year. News of the American initiative inevitably focused attention on the groups in South Africa that have started providing free AIDS drugs, frustrated by the national government’s reluctance to provide the medicines in public hospitals and clinics. … The pressure on the government to soften its position is rising as doctors, ministers, trade unions and prominent officials, including Nelson Mandela, the country’s revered first black president, demand distribution of the drugs.

Is this why they call it the ‘New York Lies’?

As Mandela became increasingly involved in pushing drugs as his retirement hobby, his all but open personal antipathy for Mbeki grew apace. The ill feeling was not unrequited. Mbeki reportedly avoids calls from ‘the white man’s favourite politician’, as his father described him, and when in January 2002 the ANC celebrated its ninetieth anniversary, Mbeki astonished everyone by making no mention of Mandela in his long speech. Mandela repaid the slight by sullenly remaining seated when Mbeki walked into the chamber at the opening of Parliament the following month, despite his wife’s tugging on his sleeve to rise with everyone else. And having arrived late for the start of the ANC’s 51st National Conference at Stellenbosch in December, instead of having the good manners to wait until he had ended, Mandela disruptively entered the hall as Mbeki was delivering his address. With rich multiplex Xhosa humour, Mbeki admonished ‘grandfather’ to ‘hurry up’ and take his seat, before picking up where he’d just left off in his speech.

It goes back a way. A generation in fact. I have it that Mandela had annoyed Mbeki Snr on Robben Island by insistently asserting his risible conviction that the ANC could count on the West to come to the country’s assistance in the liberation struggle against apartheid oppression – the Kennedys and so on. As if the West is ever moved by calls to decency when there’s money to be made. Exasperated by his political naivety, Govan Mbeki, the communist revolutionary from the rank and file, took a robust approach to bringing Mandela to insight into his folly by delivering a physical lesson, and boxed his ears. Mandela, the royal-blooded former amateur boxer, was so humiliated and resentful over this that he never spoke to Mbeki again. According to Sparks in Beyond the Miracle, ‘Fellow prisoners described the relationship as “very bad”’ – which Sparks ascribed to Mbeki’s ‘reputation for being a didactic and difficult man’. That there was much more to it than that is evidenced by the fact that when Mbeki Snr died, Mandela stayed away from his funeral. He was cool to his boy too: in The Life and Times of Thabo Mbeki (Zebra Press, 1999) Adrian Hadland and Jovial Rantao mention that during the apartheid’s regime’s initial prison talks with Mandela, National Intelligence Agency deputy director general Mike Louw sought his permission to contact Mbeki in Lusaka as the ANC’s representative on the outside, but, reported Louw, ‘He was not very happy about it. He wanted to leave Thabo out of it.’ When in 1991 Mbeki made a bid for the deputy presidency of the ANC, Mandela prevailed on him to withdraw his candidacy in order that Walter Sisulu might take the post. On the death of Oliver Tambo two years later, opening the post of ANC national chairman, Mandela tried blocking Mbeki’s ascent again by backing Kader Asmal to succeed him. Mbeki deferred to Mandela’s choice again, but after weeks of lobbying by his supporters he changed his mind, decided to run, and won by an overwhelming majority.

Ramaphosa’s public prominence during the negotiated surrender of the apartheid regime, and his right-hand seat next to Mandela during the process with Mbeki kept in the background, generated the general expectation that Ramaphosa would take the Deputy Presidency in the first Mandela Cabinet, notwithstanding Mbeki’s rise in the ANC despite Mandela’s attempts to restrain it. In breach of party culture, Mandela made clear his own preference concerning his succession in his autobiography, A Long Walk to Freedom (MacDonald Purnell, 1994), by describing Ramaphosa as ‘a worthy successor to a long line of notable ANC leaders. He was probably the most accomplished negotiator in the ranks of the ANC.’ Mbeki on the other hand scarcely drew a mention in the book. When it came to the crunch, however, Mandela read the wind – noting particularly Mbeki’s huge support base in the ANC Youth League under Peter Mokaba – and felt constrained to pick Mbeki as his Deputy. Ramaphosa’s reaction was to abruptly leave politics, so soured by his defeat that he didn’t even attend Mandela’s Presidential inauguration. The ANC disappointed Mandela by electing Mbeki as deputy president of the the party in December 1994, and again at its December 1997 congress by electing him its president, thus paving the way for his succession to the country’s Presidency. Mandela responded to the latter with extraordinary churlishness in his address at the congress: ‘He may use that powerful position to settle scores with his detractors, to marginalize or get rid of them and surround himself with yes-man and women.’ Immediately realising that he’d overstepped the mark, he first qualified his ungracious reprimand by adding that he was sure Mbeki understood the problem, before finally retracting: ‘He is not a man who is going to sideline anybody.’ By 1998 Mbeki’s increasing de facto complete control of the executive functions of Mandela’s Presidency was matched by a corresponding disregard for the old man, amusingly limned by Hadland and Rantao in their book:

On one occasion in 1998, Mandela was particularly upset with Thabo and repeatedly tried to call him at home one morning. Time and again, Mandela was fobbed off. ‘Thabo is in the bath,’ he kept being told. Finally, Mandela put on his shoes and his coat and walked up hill from his own residence, Genadendal, about half a kilometre to Thabo’s house. There he rapped on the kitchen door until he was allowed in and allowed a meeting.

The Economist showered praise on Mandela’s drug campaigning in a piece, In Mandela’s shadow, on 12 December, describing him as Mbeki’s

fiercest critic … Appalled by Mr Mbeki’s obtuseness [about AIDS], Mr Mandela has been trying to force him to do more about it. … In the past few months Mr Mbeki has kept silent on the subject … South Africa’s president will not be pushed into a position he opposes, especially not by westerners, the media, the UN or activists. Ultimately, then, the most effective pressure will come from within his own party. And [Mr Mandela] will go on pushing hardest of all, no matter how often his calls are not returned.

Pushing to be in charge again.

AIDS remained top of the hit parade in the Mail&Guardian’s 2002 report card published on 20 December. Curiously AIDS got only a passing mention in the paper’s sizing up of Mbeki (he scored a C-), concluding pointlessly: ‘In the same way that he backed down on AIDS, Mbeki must back down and realise that he is the leader of the nation.’ He’ll be grateful to the M&G for that. He wasn’t aware until then. Tshabalala-Msimang got an F for HIV/AIDS, a D for other health issues: ‘Tshabalala-Msimang might have expected her grade to climb this year. … However an inspection of her record shows a continual failure on South Africa’s most terrifying health problem. She continues to give the impression that she suffers from Aids denialism, an apparently incurable mental disorder. [Elsewhere in the 2002 report card, Tshabalala-Msimang is referred to as ‘out-to-lunch’.] … Aids crackpot Sibongile Manana, MEC for Health in Mpumalanga continues gaily without ministerial censure.’ Deputy President Zuma got an E: ‘The term “presidential” has often been used to describe the deportment of the country’s number-two citizen. He was prepared to say all the right things about HIV/AIDS at a time when many in the ANC’s upper echelons felt bound by the need to echo many of Mbeki’s denialist utterances.’ Do you really want to hear any more?

The Natal Mercury made AIDS its Christmas story. The 24th featured a front-page colour picture in Coca-Cola’s Santa Claus red and white, captioned: ‘A group of Aids orphans at Othandweni Aids Orphanage at KwaDukuza on the North Coast were given a Christmas party by Coca-Cola in Phoenix yesterday. The firm has adopted the orphanage as part of its corporate social investment project.’ The paper’s cover story headline went, Firms will have to report on Aids risks: JSE implements new era of transparency. ‘In the light of frightening new evidence that Aids deaths and sickness are beginning to bite deep into the commercial heart of the country, listed companies in South Africa will from next year be required to focus on the disclosure of strategies and policies to manage the potential impact of HIV/Aids on their activities.’ Like construction companies hoping to gets public works contracts.

Fifteen hunger-striking members of NAPWA celebrated ‘Black Christmas’, as they called their campaign, by camping outside the Midrand offices of GlaxoSmithKline. Ringleader Geoffrey Jewel, with a cushy job in his organisation’s head office, told reporters that he had been living with HIV for twenty-two years. Dating back to before it was even ‘discovered’. Yet he looked as well as can be on TV. And no thanks to AIDS drugs: because they were ‘so expensive’, he wasn’t on them, he said, and took nothing but an occasional aspirin. NAPWA’s memorandum handed to GSK representative Vicki Ehrich ‘surprised’ her, since, she pointed out, none of its demands were directed at her company. Rather at banks, life insurance companies and the government. After being rained on during their first night, ignored by the company, and complaining about all falling sick from the rough living, the delicate martyrs decided to get militant and storm the Pharmaceutical Manufacturers’ Association’s offices nearby. For which they were carted off for trespass. And once settled in, fed their full in the cells.

CHAPTER

2003 began with bad news for the AIDS drug activists. Mandela’s Robben Island rock concert to fight AIDS was cancelled in mid-January over payment disputes, which is to say everyone wanted more money out of it than Mandela had in mind for a charity bash. That setback was followed by another: Tshabalala-Msimang invited Roberto Giraldo, President of the Group for the Reappraisal of HIV-AIDS Hypothesis, and member of the AIDS Panel, to address the Health Ministers’ Forum of the Southern African Development Community on Nutrition and AIDS on the 20th. His subject was ‘nutritional therapy for the treatment and prevention of AIDS’ – the idea that the poor can recover from ill-health by eating enough of the right food. The kind of heretical talk to get activists, ‘AIDS experts’ and opposition politicians hopping mad. And going off in every newspaper. But the SADEC health ministers liked it, and received Giraldo’s address with an ovation. In a statement after the meeting, Tshabalala-Msimang agreed: ‘There is a need to ensure that we strengthen our nutrition and health promotion programmes. Good nutrition is critical ... for success of any medical intervention against diseases including AIDS-related treatment.’

Just as she’s remarked defiantly in her opening address:

This meeting today, the SADC Ministerial Consultative Meeting on Nutrition and HIV/AIDS, is thus the continuation of a discussion we have been having for some time on the importance of, and the role of nutrition in the health of populations, and more specifically, the health of People Living With HIV and AIDS. … During our Extraordinary Meeting in August 2002, the Ministers discussed the role of nutrition, nutritional supplements and traditional therapies in the management of HIV and AIDS. Mention was made of various immune boosters, garlic, micronutrients, anti-oxidants, African Potato and other products that get used by the public to improve health. This should by no means sound strange, as traditional medicines, be they African, Homeopathic or Chinese, have always been part of the response to ill-health in our countries and beyond. It thus became clear at that meeting that countries have anecdotal evidence that HIV positive people are deriving benefits from the use of these products. But there was no adequate information on how and why these interventions work, and how our health systems can make use of them. Ministers thus directed that a meeting be convened to explore the use of these products and the evidence for their use.

A few days after the nutrition conference, GlaxoSmithKline received a backhanded compliment for its AZT. The AIDS Healthcare Foundation in the US announced that in order to widen access to it, it planned to file a complaint with the South African Competition Commission against the company’s monopolistic pricing and supply of the drug. It already had an action cooking in an American court to separate the company from its patent on the grounds that it had been fraudulently obtained.

On the 27th, as he menaced Iraq, George Bush announced in his State of the Union address that he intended allocating an additional $10 billion to fight AIDS in Africa (with black Haiti and Guyana cut in too) on top of the five already slated by his administration:

Today, on the continent of Africa, nearly 30 million people have the AIDS virus including three million children under the age 15. There are whole countries in Africa where more than one-third of the adult population carries the infection. More than four million require immediate drug treatment. Yet across that continent only 50,000 AIDS victims – only 50,000 – are receiving the medicine they need. Because the AIDS diagnosis is considered a death sentence, many do not seek treatment. Almost all who do are turned away. A doctor in rural South Africa describes his frustration. He says, “We have no medicines. Many hospitals tell people, ‘You’ve got AIDS. We can’t help you. Go home and die.’” In an age of miraculous medicines, no person should have to hear those words. AIDS can be prevented. Anti-retroviral drugs can extend life for many years. And the cost of those drugs has dropped from $12,000 a year to under $300 a year, which places a tremendous possibility within our grasps. Ladies and gentlemen, seldom has history offered a greater opportunity to do so much for so many. We have confronted and will continue to confront H.I.V./AIDS in our own country. And to meet a severe and urgent crisis abroad, tonight I propose the Emergency Plan for AIDS Relief – a work of mercy beyond all current international efforts to help the people of Africa. This comprehensive plan will prevent seven million new AIDS infections, treat at least two million people with life-extending drugs, and provide humane care for millions of people suffering from AIDS and for children orphaned by AIDS. I ask the congress to commit $15 billion over the next five years, including nearly $10 billion in new money, to turn the tide against AIDS in the most affected nations of Africa and the Caribbean. This nation can lead the world in sparing innocent people from a plague of nature. And this nation is leading the world in confronting and defeating the man-made evil of international terrorism.

But Bush’s interest in seeing to the provision of AIDS drugs to Africans has nothing to do with solicitude. Because he’s a GlaxoSmithKline man. A Republican Party fund-raising dinner was held on 19 June 2002 at which Bush was the evening star. CBS reported the following day, GOP Bash Rakes In $30 Million – a record-breaker: ‘Among the top corporate donors at Wednesday’s fund-raiser were GlaxoSmithKline, a multinational drug giant, which gave at least $250,000, according to the Washington Post.’ In his dinner speech Bush gave special thanks for the fundraising prowess of dinner committee chairman Robert Ingram – you guessed: president of pharmaceutical operations at GlaxoSmithKline. On an analysis by a political funding monitoring group, the Center for Responsive Politics, GlaxoSmithKline’s Political Action Committee was North Carolina’s top corporate political contributor in 2001 and 2002, with seventy-three per cent of its election campaign contributions going to Republican candidates. As an English-based corporation, GlaxoSmithKline’s donations were within a few thousand dollars of top spot for foreign funders of American politicians, and exceeded the contributions of such major domestic corporations as General Electric and Exxon Mobil. Of corporations with global consumer brands, lists GlaxoSmithKline as the Republican Party’s tenth biggest contributor – $1.3 million in the last election cycle. Just five hundred grand less that the contributions of the collapsed criminal pyramid scheme, Enron (named by Fortune magazine in 2001 as the ‘most innovative company in America’, for the sixth consecutive year in a row).

Bush’s right hand man is a drug industry crony: When he appointed Donald Rumsfeld Secretary of Defence on 20 January 2001, he was Chairman of the Board of Gilead Sciences, Inc., a pharmaceutical corporation big into the development of ‘novel treatments for viral diseases’ (including AIDS drugs), as he put it when he’d taken the job. Before that, from 1977 until 1985, he was Chief Executive Officer, President, and then Chairman of GD Searle & Co, a multinational drug company now part of Pfizer. His business acumen at Searle won him the Outstanding Chief Executive Officer in the Pharmaceutical Industry award from the Wall Street Transcript in 1980 and a similar one from Financial World the following year.

Finding itself fighting on the same side as a guy like Bush, the TAC wasn’t too sure what to do about the promised billions, so it made a show of looking the gift horse:

We welcome the promised financial allocations from the US President for HIV/AIDS prevention and treatment. However, we will be marching on the US Consulate to ask the US President and Congress to ensure that the bulk of the money is channelled through the Global Fund for AIDS, Tuberculosis and Malaria. This is the only way to ensure that no unfair conditions are placed on poor countries and that bureaucracy is minimized. TAC and all our allies also demand that the US government drops all opposition to amend the TRIPS agreements. Such an agreement will allow all poor countries to import generic medicines and save the lives of people living with HIV/AIDS, cancer, heart disease and all other public health problems.

Illustrating the political divide in British medical circles, an editorial in the Tory establishment’s Lancet in mid-February, A positive result for AIDS, also welcomed ‘the President’s plan, which appears long considered and carefully devised by experts, [as] tremendously good news [evidencing] the renewed commitment of the USA to global health’. But the politically much savvier British Medical Journal took an entirely different line in its concurrent issue. In praise of dissent protested Bush’s aggressive intentions with an intriguing historical analogy:

One hundred years ago Germany launched a war against quackery. ‘Public meetings will be held and addresses delivered,’ reported the BMJ. Today Germany leads a campaign to halt the war against Iraq, and anti-war demonstrators will march in Berlin on 15 February. The war against quackery included a strategy to infiltrate the meetings of quacks, ‘in order to confute their arguments and expose their misstatements.’ The organisers of the global anti-war campaign would wish for something similar.

As Bush was talking, the same kinds of brains in the South African Law Commission threw a press conference in Pretoria at which they released their report on the need for the creation of a new statutory crime, making sex with someone without telling her or him you once lit up the HIV test punishable as rape. Attracting a mandatory ten inside. A draft bill had already been drawn. This news was capped by our MRC: a medical student at Bristol University in the UK, Mukai Chimutengwende-Gordon, wrote an article in New African in November, reprinted later in the Sowetan, complaining that African countries’ reliance on a single ELISA to diagnose HIV infection – unlike Western countries which follow up with confirmatory Western blots – meant that most Africans were being falsely diagnosed. Nonsense, said the MRC’s Tim Tucker, a virologist heading the South African Vaccine Initiative. The ELISA test was very accurate, and the medical student and the publishers of New African were just ‘AIDS denialists’. AIDS tests accurate, says council, reported Health-e, referring to a report in the Sowetan on 20 December: ‘The South African Medical Research Council (SAMRC) this week allayed fears that HIV/AIDS tests in Africa were inaccurate.’ It was a relief to have our fears allayed. And learn that a single positive ELISA meant HIV-infected according to the MRC. But not in any other First World country. And not the test-kit manufacturers. Health-e paraphrased Slow Tim rounding off by saying that although AIDS drugs have side effects, they do have ‘a meaningful impact on improving the quality of life of infected individuals’. Like arsenic?

‘It often improves the metabolism, the appetite, and the weight of those whose health is feeble. … at one time [arsenic was] extensively used in the treatment of pernicious anaemia, and appeared to exert benefit. … it appears to diminish the liability to thyroidism.’ So lauded Hale-White’s Materia Medica in 1939 under the heading: ‘ARSENIC Therapeutics of Arsenical Compounds’. The irrationality of giving AZT to people with a low CD4 cell count was anticipated by treating ‘pernicious anaemia’ with arsenic. The 9th edition of Goth’s Medical pharmacology published in 1984 pointed out that ‘Arsenicals containing trivalent arsenic were widely used in the treatment of syphilis in the recent past. … Toxic effects ... consist of ... liver damage, neuritis, and bone marrow depression’. But the 13th edition of Black’s Medical Dictionary, published fifty years earlier in 1936, claimed precisely the contrary; it was good for the nerves and good for the blood: ‘Taken over longer periods, it is used as an alternative in chronic skin diseases [and as ‘a paste’ applied as a ‘cancer cure’], in various nervous diseases, [and] in pernicious anaemia in which it stimulates the blood-forming organs.’ Also ‘in asthma, and in chronic malaria, and is a very powerful remedy. This is one of the drugs which can be given to children in as large doses as to adults. … Salvarsan, or “606” ... was introduced by Erlich in 1910. It was followed by neo-salvarsan, a preparation with less irritating and less toxic properties and in turn by [several other arsenical compounds]. These are administered by injection either into a vein or muscle.’

But the profound toxicity of arsenicals was no new discovery. As with antiretrovirals, doctors knew it all along, but didn’t care. If not arsenic, what else were they going to give their patients? Hale-White’s Materia Medica warned:

Arsenic is so liable to cause sickness, diarrhoea, and other symptoms of poisoning that it is a rule always to begin a course of it with small doses … Blindness may arise from the use of this drug due to cumulative action with the involvement of the optic nerves. In the majority of patients nearly all the drug is excreted in twenty-four hours. In others this is delayed and toxic signs arise. … Usually six to eight arsenical doses are given at intervals of a week; some give weekly intramuscular injections of mercury or bismuth at the same time, others do not begin the mercury till completion of the first arsenical course, which is, after a rest, repeated more than once for a shorter time, and arsenic and mercury are thus given for a year or even two or three years … Given intravenously ... Salvarsan [and] ‘606’ ... in tertiary and nervous syphilis cure cannot be expected.

Obviously, one would have thought, since arsenic preparations were also ‘used to destroy the tooth pulps before stopping teeth [and] to destroy growths, lupus [ulcers], warts &c’. And, as the 23rd edition of Martindale The Extra Pharmacopoeia, published in 1952, advised, arsenicals were ‘widely used as a constituent of weed killers and sheep dips, and for the destruction of rats and mice’. And for putting down no end of disagreeable husbands and wives, as the annals of English criminal law record – noted in the 6th edition of Glaister’s Medical jurisprudence and toxicology in 1938: ‘Arsenious acid, or white arsenic, is the substance most used in homicidal poisoning.’ Arsenic was given to sort out unfaithful partners too. Hale-White’s Materia Medica again: ‘It certainly reduces the tendency to bromism’ i.e. ‘insomnia, delirium, confusion, hallucinations, hysterical manifestations, and torpor’ caused by bromide drugs – general metabolic poisons and neurotoxins, as arsenicals were, once widely used to treat ‘nymphomania’ and its male analogue, ‘spermatorrhoea’ and ‘many nervous diseases’. Doctors, we see, used to poison the sex out of them. Just as they do today with AZT. Fixed the gays good. Now it’s the turn of the African hordes.

Putting the effects of arsenic in the same boat as a better known drug disaster, Grahame-Smith and Aaronson’s Oxford Textbook of Clinical Pharmacology published in 1984 reported under its ‘Adverse reactions to drugs’ discussion: ‘In 1922 there was an enquiry into ... salvarsan, an organic arsenical, in the treatment of syphilis. … There are many other examples but the major modern catastrophe which changed professional and public attitudes all over the world towards modern medicine was the thalidomide incident.’ The only mention of arsenic in the index to the Oxford Textbook is in reference to ‘poisoning by’ – a substance so toxic that in 2000, on the advice of the US Environmental Protection Agency, former President Bill Clinton adopted a new federal standard limiting the concentration of arsenic in drinking water to ten parts per billion by 2006, in line with EU and WHO standards. The decades-old limit of fifty parts per billion was too lax, the National Academy of Sciences reported in 1999 and should be lowered ‘as promptly as possible’. The stuff doctors used to inject into us.

In the month that Bush designated billions of US tax dollars to buy AIDS drugs for Africans, the William J Clinton Presidential Foundation pitched in $35-million for the same purpose – except that the money was earmarked for the treatment of South Africans specifically. Getting wind of the cash that Clinton was doling out, the Universities of the Witwatersrand, Cape Town and Durban banded together to ask him for a research grant to look into the South African government’s concerns about the provision of the drugs to the poor. (That really was their proposal!) Clinton telephoned Mbeki in early February to tell him about their request. Mbeki deferred the matter to Tshabalala-Msimang, who met the universities’ vice-chancellors in mid-February. Shortly before their meeting, the proposed Clinton treatment grant was debated by the Cabinet – the upshot of which was reported by the Star on the 13th: ‘The cabinet has approved a plan to provide antiretroviral triple therapy at six government hospitals, in a further indication of an AIDS policy turn-around. Sources have confirmed that money for the programme, which has been drafted by some of South Africa’s leading AIDS experts, will come from the William J Clinton Presidential Foundation in New York.’

On 11 February, speaking in Boston at the opening of the 10th Conference on Retroviruses and Opportunistic Infections, Clinton said that the goal of his foundation was to meet ‘the absence of systems in the countries with high and growing AIDS rates’, by which he meant the provision of AIDS drugs – ‘one of the single biggest gaps [in] resource-poor countries’. In his chat, he didn’t need to mention Mbeki by name; it was obvious whom he thought had failed in his political responsibilities. From the beginning his AIDS tours of Africa in 1998, he said, he’d been struck by a ‘breathtaking difference among countries that look the same in terms of their per capita income in their organizational capacity’ to address AIDS. ‘I think, by and large, there are systematic reasons to try to come up with comprehensive strategies that would enable every country that has a willing political leadership to get the same results as the countries that have turned the epidemic around.’ Such as Uganda and Brazil, he said, adding that his foundation had signed a memorandum of understanding with fifteen Caribbean and three African countries. Shifting junk was the plan: in the Bahamas, a ‘relatively wealthy part of the Caribbean, that is providing antiretroviral therapy to a percentage of the HIV-infected population’ his foundation had intervened to negotiate better deals. ‘Within a week, we had their price cut down to under $500 a year – so they now can serve seven people for the price they were serving one person.’ Yay.

CHAPTER

About five hundred Rhodes Scholars, most from abroad, attended a centenary reunion at the University of Cape Town on 1 February. As always, misusing whatever nostrum availed itself, Cameron, a Rhodes scholar himself, tastelessly hijacked the event to sell drugs and screw Mbeki yet again. His first manoeuvre was to fix Achmat as guest speaker, with Archbishop Ndungane sharing the stage to bless his words. Like Cameron’s uncouth outburst in London in September, Achmat’s entire speech was directed at attacking Mbeki with the flying spit of a woman ditched. Ever the princess, he jealously complained that Mbeki had ‘spent hours on the phone with people who don’t believe HIV causes AIDS, while intellectuals have been providing cover [and] thinking up excuses’ for him. (The bitching appeared to signal a twinge that whilst attacking Mbeki, disjointedly as usual, Achmat felt seriously outgunned in the upper storey.) But on the other hand, other ‘intellectuals’ weren’t on his side, he said, the guys who work for the Medicines Control Council. (‘Intellectuals’? You must be joking.) To illustrate his claim that the government was pressurising ‘intellectuals’ in South Africa, Achmat said that when the MCC delivered its report on how beneficial AZT was, it had been instructed by the Minister of Health ‘to rewrite it’. And whereas Mbeki had talked on the phone to people he liked, he hadn’t replied to a single letter from his TAC, or ever met with it, with Cosatu or with doctors working with AIDS. Health workers spreading the AIDS gospel were being frustrated in their mission, he said, because Mbeki was not prepared to state conclusively that he believed HIV causes AIDS. He was an ‘AIDS denialist’, Achmat finally charged terribly, but his cabinet lacked the courage to ‘say he is wrong’. And make him feel guilty. Like the women who couldn’t sleep at night with the guilt that they’d infected their children, he said: ‘Yet no one sleeps more comfortably than the minister of health and the President.’ When he was finished, he asked for money. As in the old days. At the toilets. Feeling guilty?

It was classic Zackie Achmat – embarrassingly stupid, effete and uneducated. But there the five hundred Rhodes Scholars had to sit. Being lectured by an hysterically afflicted, scientifically illiterate, former male prostitute with a Standard Six.

As if by inflicting this creep on them he hadn’t already spoiled their evening enough, Cameron wasn’t yet done though. His next move was to foist a petition on them, addressed to Mbeki personally. His hissing in London hadn’t moved him, so Cameron turned to wooing him emolliently in characteristic aspartame prose, his solicitousness stinking of insincerity and hypocrisy. The signatories were ‘willing to learn from your bold experiments in developing a model society’ and ‘willing to share’ the lessons they’d learned abroad. But they were ‘deeply troubled and profoundly unsettled by the increasing devastation across the land caused by the HIV/Aids pandemic’, and so ‘humbly’ requested Mbeki to ‘offer an unequivocal message to South Africa that HIV/Aids is a sexually transmitted disease’ and do ‘everything in your power to make anti-retrovirals available as possible throughout South Africa with structures and systems in place to ensure their effective delivery’. And also do everything in your power to disregard the revised advice announced by American ‘AIDS experts’ two years earlier, summed up by the New York Times on 4 February 2001:

Altering a long-held policy, federal health officials are now recommending that treatment for the AIDS virus be delayed as long as possible for people without symptoms because of increased concerns over toxic effects of the therapies. … More recently, concern has grown over nerve damage, weakened bones, unusual accumulations of fat in the neck and abdomen, diabetes and a number of other serious side effects of therapy.

Leaving out the big ones: liver failure, muscle wasting, red and white blood cell depletion, and wholesale cell poisoning of just about every other kind. ‘Devastating effects’ rued by Professor Richard Beltz, the inventor of AZT, in his communications with me: ‘I hope you succeed in convincing your government not to make AZT available.’ But ‘devastating effects’ of no account to the Treatment Action Campaign, since, as Achmat once put it famously, ‘It can only be Thabo Mbeki’s belief that antiretrovirals like AZT are toxic and destroy the immune system. There is no other explanation for the paranoia that’s going on.’

Just before his Cape Town talk, Achmat announced by email:

On 14 February 2003, the Treatment Action Campaign (TAC) is organizing a “Stand up for your life” march in Cape Town. This march will mark the opening of Parliament by President Thabo Mbeki. This will be one of the last opportunities for the South African government to demonstrate goodwill and to avoid civil conflict on HIV/AIDS. … On 19/20 January 2003, the TAC National Executive and more than 100 activists, trade union, religious and people re-affirmed that if government fails to sign and implement an national treatment and prevention plan that we will start a national campaign of civil disobedience. We ask you to write to the South African government to avoid unnecessary conflict and instead to save the lives of our people.

The shape of the planned civil disobedience campaign was described shortly after by the TAC’s National Manager Nathan Geffen: sit-ins at government offices to disrupt its business, disruption of traffic, and the illegal importation of generic AIDS drugs. In Cape Town everywhere, the public were called to the hustings by ‘Stand up for our lives’ posters featuring Mandela in an ‘HIV Positive’ tee-shirt to catch motorists’ eyes, and demanding, ‘Treat the people’ – not to bread and butter, to AZT.

The professional agitators secured wide support for their march:

Access, AIDS Consortium, AIDS Law Project, Archbishop of Cape Town and Metropolitan of the Anglican Church in Southern Africa, ATTN SA, CARE, Children’s Rights Centre, Combined AIDS Ministry, COSATU, Durban Lesbian and Gay Community Centre, FAWU, FEDUSA, Habonim, HOPSERSA, Jubilee 2000, Kagiso Anglican YCW, Positive Muslims, Positive Wits – HIV/AIDS Campaign, RAPCAN, SA Academy of Family Practice, SACTWU, South African Medical Association, SAMWU, SOHACA, Southern African Catholic Bishops Conference AIDS Office, The Caring Network, The Southern African HIV Clinicians Society, Themba HIV/AIDS Project, Triangle Project, WC-NACOSA, Western Cape Council of Churches, Wits HIV/AIDS Education and Support Project, Wits Perinatal HIV Research Unit, Women on Farms Project and many others.

Forty organizations in all. And about seventy foreign ones too. A veritable Moral Majority.

But excluding Mandela, who said he wanted nothing to do with it. Although he’d given his permission for the use of his picture on TAC posters – claimed a statement issued by his foundation –

it was never anticipated that that it would include the call for a march to Parliament on the day of the opening of Parliament. Although Mr Mandela supports the TAC in its call for treatment, the march is not endorsed by the Nelson Mandela Foundation or Mr Mandela personally. Mr Mandela has made it clear on countless occasions in the past that although he supports the call for treatment he would like to see the government be allowed to conduct research.

Be allowed by the TAC. The reason given for Mandela’s repudiation of the march was false, of course; he had never said any such thing, but the statement signalled that something had changed, and it suggested that Mandela might have got a case of cold feet about supporting a foreign-financed political lobby that was developing runaway power to shove our democracy around. Indeed, he’d also been a guest speaker at the Rhodes Centenary celebration, but in giving his speech was uncharacteristically silent on AIDS. And unlike everyone else who criticized Mbeki’s fleeting mention of AIDS in his State of the Nation speech later in the month, Mandela’s response was subdued: ‘This is a complicated issue. … It is not as easy as some of us think.’ Just about the only wallflower not invited to the TAC’s law-breaking party was GlaxoSmithKline. But it didn’t mind. It was quite happy to stay at home and watch on TV. 

The Academy of Family Practice in South Africa provided a supportive sound-bite:

HIV/AIDS is the single biggest threat to the health and well-being of people living in South Africa. As Family Doctors and General Practitioners who are intimately involved in the lives of our patients and their families and see the destruction that this epidemic is bringing to them on a daily basis, we call on the Government to implement a national treatment plan and the provision of antiretroviral drugs without delay.

Except that what doctors ‘see’ is always a perfectly cultural affair. As Lynn Payer explained in Medicine & Culture (Owl Books, 1996), with German doctors culturally biased to find heart trouble, the French liver problems, Americans viruses, allergies and the need to operate, and the English the need to bear whatever it is with fortitude and a stiff upper lip. And it goes without saying what South African doctors ‘see’ when blacks take ill. Or white men they think a bit queer. ‘America,’ Payer pointed out, ‘has an overall virus mentality. … In the United States the favoured ‘wastebasket explanation is a virus … what doctors don’t know, they attribute to a virus, or when a condition doesn’t respond to treatment, they attribute it to a virus. … American medicine is aggressive partly because doctors are trained to be aggressive but also because patients equate aggressive with better.’ The HIV-AIDS model, obviously, is the perfect fruit of this kind of medical culture.

They weren’t only marching on Parliament, planning to ‘break the law’ by occupying government offices to disrupt the running of the state, blocking the flow of motor vehicle traffic, and dealing in prohibited drugs; the TAC also declared that unless the government committed itself to providing antiretroviral drugs at pilot distribution sites, it would be going back to court for an order compelling it to do so – on the basis, explained Geffen, that it was breaching its citizenry’s ‘constitutional rights to life, dignity and health’. As the nevirapine case foretold, the TAC wasn’t bluffing, and it had limitless cash for big-ticket lawyers.

The CIA was planning to lend a supporting hand. On 11 February Director George Tenet addressed the US Senate Intelligence Committee. Summoned to talk about Iraq, he soon lost interest in that phoney peril, and launched into an even bigger one: the national security threat posed by the African AIDS epidemic. His harangue went on and on: more than forty million people were infected, he said, most of them in Southern Africa. Three million had died of AIDS in 2002. ‘The national security dimensions of the virus are plain: it can undermine economic growth, exacerbate social tensions, diminish military preparedness, create huge social welfare costs and further weaken already beleaguered states. And the virus respects no border.’ All of which told that the CIA was becoming deeply invested, both ideologically and operationally, in AIDS abroad. And in South Africa in particular, being the worst affected and everything.

On 6 October 2000 the Mail&Guardian had alleged Mbeki fingers the CIA in Aids conspiracy:

President Thabo Mbeki suggested to the parliamentary caucus of the African National Congress in Parliament on Thursday last week that he and his government were the target of a hostile campaign by powerful international forces, including the CIA and the big multinational drug companies. This was because he questioned the link between HIV and Aids, and South Africa was challenging the world economic order.

Mbeki repudiated this on the BBC’s HARDtalk programme in mid-2001. Whatever Mbeki had actually said during that caucus meeting, those faithless MPs who went running behind his back to report him to Howard Barrell understood he meant that the CIA was in the game. For which he was derided everywhere. Now here was the CIA boss confirming it on CNN. (The CIA’s official view – we know from its agents’ call on Mhlongo – is that Mbeki is mentally disturbed. As evidenced by his eccentric line on AIDS.)

It surely wasn’t only conspiracy nuts who shivered over the implications. The doubts of a deranged foreign leader about a domestic health emergency threatening American national security were a serious impediment to winning the war. Leading activists were always saying so. A top judge among them. Not only had AIDS become a new ideological front in the CIA’s perennial foreign meddling, but South Africa, said to be the worst-affected country in the world, was inevitably becoming, if it wasn’t already, the latest theatre for the CIA’s covert operations. For every kind of venal subterfuge. Violence and deceit. For which billions were flooding in to pay. (‘Excuse me Sir, we found something in your luggage. Will you come with us please.’ Or: ‘I’m afraid there’s been an accident.’) Who would ever have thought? The intel on which the CIA was relying was abysmal – ‘consensus estimates’ concerning the scale of the epidemic abroad, put up by the usual gang of American ‘AIDS experts’ – but it didn’t matter. As with Iraq, the fact that the threat was bogus was immaterial. What it provided was a pretext for the projection of American power, corporate power. Fortunes lay in wait for the industries salivating in the wings. It was payback time, after all those big election campaign donations. GlaxoSmithKline’s especially. Mussolini, ‘the father of fascism’, preferred a different name for his game. ‘Fascism,’ he explained, ‘should more properly be called corporatism, since it is the merger of state and corporate power.’

Without mentioning AIDS in particular, Mark Crispin Miller suggests an explanation for the CIA’s ready embrace of AIDS as a new arena for war in The Bush Dyslexicon. The Bush administration

is funded, and its larger moves dictated, by the corporate network of big oil and petrochemicals, ‘defence’, tobacco, pharmaceuticals, ... among other industries … [Compounding this, notwithstanding] the fall of Soviet Communism ... the whole bureaucracy of national security is still in place, but lacks a global enemy to satisfy its appetite. That system needs a state of war … And yet the need is not only material, but psychological. … Fifty years of mass mobilization left this country with a boiling residue of paranoid anxiety, that ... had to find some other focus.

The Bush administration’s contemptuous view of Mbeki’s government for its recalcitrance in toeing the US line on AIDS was revealed by US ambassador Cameron Hume on 11 February, in addressing fifteen American students at Rhodes University. South Africa was ‘losing its energy and its intelligence’ due to the AIDS epidemic, he said. Makes Africans stupid? ‘One in six people in this country is HIV-positive. Given the size of the challenge, no embassy can address it. It is like throwing pixie dust at a war. … Sharing experiences does not solve problems, but it can turn on a light.’ On African darkness. Shining down from enlightened America. But funding AIDS prevention was useless if the government did not know how to spend it, he emphasized. On drugs he meant: ‘The government cannot even spend its own money. More resources does not mean they are going to do anything. … local government must take the lead’ in dishing out the billions allocated by the US administration to fight AIDS in Africa. In view of the obstructiveness of Mbeki’s national government. Hume left no doubt that not only was the US government intent on prescribing our domestic health policy, it proposed enforcing it by bypassing a non-compliant central government, and using less difficult provincial administrations to carry it out. Hume’s implication was that Mbeki had to go. Can’t have a trouble-making incompetent lunatic like this as President of the continent’s richest country, president of the African Union and president of the Non-Aligned Movement. Setting a bad example. Getting in the way.

Any prospect of further challenge to the HIV-AIDS paradigm in the world’s leading scientific journals died on 15 February, with the announcement, reported by the New York Times the next day, that

More than 20 leading scientific journals [including Science, Nature and the Proceedings of the National Academy of Sciences] have made a pact to censor articles that they believe could compromise national security, regardless of their scientific merit. The policy, announced yesterday at a scientific meeting in Denver, is one of the first concrete steps to emerge from a fierce debate over how to balance the ethic of openness that has long been the foundation of American science with calls from some government officials for greater secrecy after the anthrax attacks in 2001. ‘We recognize that on occasion an editor may conclude that the potential harm of publication outweighs the potential societal benefits,’ reads a statement endorsed by the journals’ editors, as well as some scientists and Bush administration officials. ‘Under such circumstances, the paper should be modified or not be published.’

Papers impeaching the HIV-AIDS model. Undermining US national security. And after all, as General William Westmoreland, Commander of the US forces in Viet Nam, once cautioned: ‘Without censorship things can get very confused in the public mind.’

This announcement was preceded by a most extraordinary local attempt at punitive censorship earlier in the month. During a debate on between Professor Sam Mhlongo and Mark Heywood on 24 January, the latter announced that he intended applying for the revocation of Mhlongo’s medical licence on the grounds that he was ‘a danger to public health’. It seems that when he tried this, he was told to fuck off. But wasn’t discouraged. On 5 February Professor Mpumulelo Bomela, acting Vice-Chancellor and Principal of MEDUNSA, wrote to Mhlongo:

The national television channel, , attempted to pressurise me to take steps against you ‘for saying HIV does not cause AIDS’. I did not accede to their demand as I uphold the principle of freedom of speech and academic freedom. I am not impressed with the way the press keeps harping at this debate, and frankly I suspect that the political aspects of the debate are befuddling the scientific (academic) and disease prevention aspects.

Here was a news-service doing the bidding of the TAC in trying to suppress heterodox AIDS science and punish its only articulator in South African academia. Our mouths dropped open.

Taking the Americans’ lead, an editorial the following month in the March issue of the South African Medical Journal by its deputy editor and de facto boss, JP de V van Niekerk, his ‘just trust me’ mug smiling alongside his piece, announced that as far as his journal was concerned the debate over here was over too. As a cameo study in stultified medical thinking, Politics must move mainstream on AIDS was richer than tipsy tart:

Medical journals have a responsibility to put all sides of important questions to readers. However, there comes a time when continuing to pander to tangential viewpoints serves no useful purpose and indeed may be harmful. At an early stage of the propagation of the beliefs of the AIDS dissidents it could be argued that those supporting establishment views should be informed of the dissidents’ beliefs in order to test their hypotheses, or blow them out of the water. That time was reached some time ago when the small group of dissidents had spent their tolerance capital for space in mainstream medical journals. With the medical and scientific facts so clearly demonstrated, printing their repetitive arguments detracts from the main task of dealing with the epidemic. It also takes time and effort repeatedly to have to refute outlandish claims. The SAMJ therefore does not accept such material.

Never mind Sir Karl Popper’s vital admonition: ‘The growth of knowledge depends entirely on disagreement.’

But the SAMJ’s in good company: Nature in England therefore does not accept such material either. As it explained its refusal to publish criticism of AIDS orthodoxy on 7 September 1995: ‘... the sad truth about debates on controversial issues in science is that there may come a point at which dissenters forfeit the right to make claims on other people’s time and trouble by the poverty of their arguments and the exasperation they have caused.’ Professor Barry Schoub of the National Institute for Communicable Diseases in Johannesburg expressed the same sort of thoughts in AIDS and HIV In Perspective (Cambridge University Press, 1994):

Yet, despite the overwhelming evidence establishing HIV as the cause of AIDS, a very small number of maverick scientists have persisted to this day in sowing unnecessary confusion in the minds of the uninformed by disputing the role of HIV in AIDS ... While it is true that the ideology of science is founded on the principle of unfettered probing and exploring, these groundless diversions and deviations really serve little purpose other than to cause confusion and to squander valuable scientific energies which could be used for more worthwhile and productive research objectives and goals.

After explaining why his mind was closed, Van Niekerk, the grinning doctor, now climbed into Mbeki and Tshabalala-Msimang, desecrating Mokaba’s grave on the way:

Despite the outstanding contributions of South African scientists, clinicians, NGOs and others, our record in addressing the HIV/AIDS pandemic is not one of the many things that South Africans can be proud of. While the whole of society has a role to play in combating the pandemic, the main missing ingredient is clear and unambiguous political leadership. What is the leadership we so desperately need? First, we need a clear acknowledgement that real people and not statistics suffer from HIV/AIDS. It does not provide comfort if high profile people die early of vaguely defined illnesses, clearly resembling AIDS, while vehemently denying the existence thereof, and our political leaders remain silent. This denial is clearly understood by an intelligent electorate, who deserve better. Many of them have lost loved ones to the pandemic and follow the example of their leaders by embracing the tyranny of denial and silence. [Secondly, politicians must destigmatise HIV/AIDS. Thirdly, deracialise it; it affects us all. Fourthly, heed our own distinguished AIDS experts.] Fifthly, abandon the dissidents and the daft. Human minds are programmed to have beliefs, but regrettably beliefs are often totally irrational. … The beliefs of the AIDS dissidents may be placed in the same category [as the belief that rhino horn works as an aphrodisiac]. … Our world standing is severely dented when credibility is given to dissidents such as Roberto Giraldo. … If we do not abandon the daft, we are likely to be classified with them. HIV/AIDS is the mainstream disease of our times. It behoves our politicians to help our people navigate these difficult waters rather than divert them into dead-end tributaries.

In the Edwin Cameron school of English. Very liberal Cape Town. We grinned too.

The SAMJ’s demand that Mbeki and Tshabalala-Msimang abjure their heresy and repent was preceded by a similar one by Nature in the editorial just cited. The tone and style were identical:

The tragedy, in the case of HIV and AIDS, is that disbelief in the role of HIV in AIDS has spread from beyond a small company in the research community to large part of the AIDS community itself. The reasons are unremarkable and pathetic in the strict sense of that word: it is at least uncomfortable for an infected person to know that HIV infection will lead eventually to AIDS. Not for nothing is the knowledge often called a “death sentence”. The remedy is not, of course, to pander to wish-fulfilment, but to redouble the effort in the laboratory and the clinic. Those who have made the running in the long controversy over HIV in AIDS, Dr Peter Duesberg of Berkeley, California, in particular, have a heavy responsibility that can only be discharged by a public acknowledgement of error, honest or otherwise. And the sooner the better.

Along the lines of: ‘I, Galileo, being in my seventieth year, being a prisoner and on my knees and before your Eminences, having before my eyes the Holy Gospel, which I touch with my hands, abjure, curse and detest the error and heresy of the movement of the earth.’ (Muttering, ‘Yet it moves’, as he was led away.) Would that do?

GlaxoSmithKline, found itself in court – the Supreme Court of the State of New York – along with Pharmacia (now part of Pfizer) on 13 February to answer criminal charges by New York State Attorney General Eliot Spitzer concerning fraudulent misrepresentations to consumers, government agencies and drug price reporting services about the true wholesale cost of its drugs. What you’d expect from the sort of company that sells AZT as a medicine. Being a ‘reputable company’.

Mbeki delivered his third State of the Nation speech on the 14th. Ever the party-pooper for the AIDS crowd, he had only two sentences for the epidemic, and pointedly ignored the marching going on outside Parliament as he spoke. The liberal press didn’t like that. Business Day published a SAPA report on the same day under the heading Mbeki brushes aside Aids issue:

President Thabo Mbeki offered exactly 34 words of comfort in his state of the nation address to the thousands of Aids activists, who clamoured to be heard outside the gates of Parliament in Cape Town on Friday. The Treatment Action Campaign’s march, supported by the Congress of South African Trade Unions and a host of civil society organisations, clergymen and politicians, urged the government to implement a national Aids treatment plan by the end of February. Mbeki – who highlighted his government successes in the last year, his plan to extend social services, improve job creation and prioritise black economic empowerment in 2003 – had few words to say about the killer disease affecting millions of South Africans. ‘Working together with SANAC we will continue to implement the government’s comprehensive strategy on HIV and Aids, relating to all elements of this strategy. This includes implementation of the decisions of the Constitutional Court.’ … In his reaction, Democratic Alliance leader Tony Leon said the president’s address lacked a sense of urgency on a number of issues, including Aids. ‘The battle in South Africa is in the wards of Baragwanath, not on the streets of Baghdad.’

So remarked the white Leader of the Opposition thoughtfully, in response to Mbeki’s passionate urging against the imminent American invasion of Iraq.

The Weekend Argus complained that Mbeki glosses over Zimbabwe, Aids in speech – quoting Buthelezi likening the AIDS epidemic to ‘a raging fire destroying our people’ and lashing Mbeki for not sharing his excitement. IDASA’s Richard Calland also found Mbeki’s pronouncements on AIDS ‘disappointing’. The Sunday Times took a similar line. Once an Mbeki fan, its Ranjeny Munusamy reflected her new appreciation of the side on which her professional bread was buttered, and in a mindlessly superficial, exaggerated and coarsely written review, Mbeki forgets the nation in his address, announced, in as many words, that she’d now taken up with the TAC. The South African middle class obsession with AIDS was in evidence yet again. A pull-quote in bold typeface to catch the eye went: ‘When Mbeki read the two sentences dedicated to Aids, Tony Leon stretched in his seat and smiled.’ Munusamy opened her commentary with:

It was vintage Mbeki and Democratic Alliance leader Tony Leon loved it. As President Thabo Mbeki delivered his State of the Nation address on Friday, Leon smirked and scribbled notes to himself. [Why she should have elevated the ill manners of the silver spoon lout to feature as the highlight of her piece is anyone’s guess.] Mbeki can, at times, be his own worst enemy. Although his 2003 State of the Nation address was a good-news package, it turned out to be a public relations disaster. By yesterday, his announcements on increased social and economic investment, black economic empowerment, job creation and human resource development were already being clouded by heavy criticism of controversial issues – particularly Zimbabwe and Aids. Rarely did Mbeki lift his eyes to look the assembled MPs in the eye. While saying so much, Mbeki failed to speak to the people of his country. And if he can’t relate to them, they can’t relate to him. In his manner of delivery and by dodging issues [Zimbabwe and AIDS], Mbeki single-handedly undid the gains he made last year, and in the process playing straight into the hands of the opposition.

A State of the Nation speech is a serious affair, like the delivery of a judgment in an important case. It’s not meant to come over like a piece of football stadium oratory. That point eluded Munusamy. As did the significance and importance of its content. Her response was to dump a bucket of garbage on it because Mbeki didn’t wish to look up at Tony Leon – confrontationally seated directly opposite him instead of diagonally over in the leader of the opposition’s traditional chair – and to be distracted by his schoolboy smirking, his vulgar theatrics as he spoke. To signify for TV viewers that he thought the President a simpleton. Nor was he disposed to carry on about a fake health crisis. Or about a neighbouring country’s internal problems. Focusing instead on our own.

Mbeki was interviewed on TV2 that night, about a variety of topics. But all that mattered to John Battersby, Group Political Editor for Independent Newspapers, in his report in the Star the next day was that Mbeki insists there is no pledge on Aids. Refuting the TAC’s claim that ‘government negotiators in the National Economic Development and Labour Council (Nedlac) had agreed to sign [a national treatment] plan in November’, he said, ‘There is no such agreement. I don’t know where the idea comes from that there is. It is false.’ Cosatu had put it on the agenda, but that was that. Battersby reported Mbeki’s weariness with all the country’s AIDS noise: ‘Asked if there wasn’t a failure in terms of government communication on its HIV/Aids policy, Mbeki repeatedly asked the interviewer, Vuyo Mvoko, whether he wanted him to spell out every day what the government’s comprehensive policy on HIV/Aids was.’

Mbeki’s denial of the TAC’s false claim concerning Nedlac was preceded by one by Tshabalala-Msimang, two days before the State of the Nation speech. During a visit to the Red Cross Children’s Hospital she responded to journalists’ questions about the TAC’s allegation that the government had agreed in principle to provide AIDS drugs: ‘The Minister of Labour informs me that there is no agreement to be signed and I know of no agreement.’ As Labour ministry spokesman Snuki Zikalala explained, the cost implications of the proposal tabled and signed by labour and community organisations participating in Nedlac, that antiretroviral drugs be provided in the public sector, was still under consideration by government. Having published the draft agreement under discussion in Nedlac in several full-page newspaper advertisements, captioned by the claim that the government, business, labour and community negotiators had agreed to it, Achmat called upon the chairman of the parliamentary Health Committee, James Ncgulu to do ‘whatever needs to be done to get the ball rolling’ – meaning to get the government to sign. The day after Mbeki’s television interview, Ncgulu refused to play ball: ‘It’s not possible for President Mbeki to lie and say there is no agreement [if there is one]. It is not possible for our President to lie.’

Anyone listening to the opposition’s answering speeches after the weekend could have been excused, along with the estimable editor of the Sunday Independent, for mistaking the provision of AIDS drugs to the populace to be the country’s most urgent issue, dwarfing all others. Or thinking maybe Bush’s $15 billion AIDS bribe had done the trick in splintering African opposition to his decision to illegally invade Iraq. As Business Day put it on the 18th: Preoccupation with Iraq dismays MPs: ‘There was dismay on Friday that while thousands of activists were preparing to march in protest over HIV/AIDS, Mbeki dealt with the pandemic in a scant sentence or two. … Opposition leaders took aim during the debate over President Thabo Mbeki’s state of the nation address for the minimal attention he paid to HIV/AIDS and Zimbabwe while devoting a large portion to Iraq.’ Said Leon:

We are watching one of the most extraordinary calamities in human history: the wiping out of millions of people in peacetime by a known cause that has a known treatment. This is a crisis. And it calls for drastic action. South Africa needs radical, fundamental change. … We must begin with the obvious. Our response to the HIV/AIDS tragedy has been one long denial. Our war is being fought in the wards of [Chris Hani-Baragwanath Hospital], not on the streets of Baghdad. Hundreds of thousands of South Africans are dying of AIDS every year: one million by the end of 2003. … Only one thing holds us back: a paralysing lack of political courage.

IFP chief Buthelezi criticised Mbeki’s failure to make HIV/AIDS his main concern, and added, ‘Everyday, I cannot think of anything but HIV/AIDS, and my conscience is torn to pieces because I know that we are not doing enough to deal with the issue. Our people are dying, not by the hundreds or the thousands, but by the tens of thousands.’ The Zulu ikholwa was grateful for Bush’s trinkets, said the report: ‘It was sad, Buthelezi said, that many foreign countries were doing more than elements of the South African government in the fight against the scourge.’ And Mbeki should rather focus on Zimbabwe than worry about Iraq: ‘The irony is that where we have least reach, in Iraq, our voice is the loudest. And where we have direct leverage, in Zimbabwe, we are silent,’ said Leon. Buthelezi agreed, reported Business day:

Buthelezi said SA should be more concerned about Zimbabwe than helping tyrants who blackmailed the world with weapons of mass destruction. SA should also condemn human rights abuses closer to home and should promote and enforce democracy in the region. “Silence and inaction are complicity,” he said. Freedom Front leader Pieter Mulder said there were double standards in world politics, and for this reason SA’s position on Iraq should be determined by what was in the country’s best interests, and that was not to get involved in a war thousands of kilometres away.

Especially not with $15 billion dangling.

The response of the South African Medical Association to the speech was to call on the government to declare a state of medical emergency to halt the ‘time bomb’, the ‘death spiral’. Chairman Kgosi Letlape said the government should come up with a national AIDS treatment programme. ‘People on anti-retrovirals must ensure that their medication is sustainable for life. If that means taking the government to court than that is what will need to happen.’

In his reaction, Brian Brink, director of Anglo American’s HIV/AIDS Programme, somewhat contradicted the SAMA chairman. He said that it was time for the government to ‘share the burden of HIV-AIDS. There is no doubt that there is a giant leap of faith for many of us engaged in AIDS treatment. For humanitarian reasons we have to do what we can – even if it is not the ideal long-term solution. We need to form partnerships with government. Combating this disease can’t be done in isolation.’ Can you make any sense of the doctor’s advice? Do you read any logical flow? The TAC’s Nathan Geffen was full of faith too: despite limited numbers of people offered treatment, ‘many of those who were dying are now back at work’. Sounding a bit like Mathew at the end of his Gospel:

Now when Jesus was risen early the first day of the week, he appeared to Mary Magdalene out of whom he had cast seven devils. … After that he appeared in another form unto two of [his disciples] … And he said unto them, Go ye into the world and preach the gospel to every creature. … And these signs shall follow them that believe; In my name thy shalt cast out devils; Though shalt speak in tongues; Thy shalt take up serpents; and if thy drink any deadly thing it shall not hurt them; Thy shall lay hands on the sick, and they shall recover.

Speaking for his Centre for Civil Society, director Richard Pithouse said ‘Mbeki’s perceived refusal’ to develop a national AIDS treatment plan ‘has spurred a range of organisations and movements to plan a more direct form of opposition to what is widely seen to be culpable homicide on a massive scale’, and added that research revealed that anger was ‘exploding’ in proportion to the increasing rates of sickness and death. ‘We can see it. It’s explosive out there.’ The hard numbers published just before by Stats SA in September showed there wasn’t any spike in the death rate – in fact it was in decline – but to the excited doctors and angry activists the facts were beside their point.

In its editorial Ominous rumblings in its first issue following Mbeki’s speech, the Mail&Guardian complained:

President Thabo Mbeki’s reluctance to offer leadership has been as marked as his silence. On the margins he has again started his babble about poverty causing Aids. He reportedly told the New Straits Times of Malaysia on February 16 that malnutrition and common diseases lead to immune deficiency. In his response to the State of the Nation debate in Parliament this week he referred to diseases of poverty and under-development, including those associated with immune deficiency. His State of the Nation address devoted one vague paragraph to the epidemic. Incorrigible Minister of Health [they just won’t do as they are told, these people] Manto Tshabalala-Msimang has said Aids should not receive special attention and has offered to go to jail in solidarity with a denialist MEC who defied a court order. She has compounded this by insisting she will not sign a National Economic Development and Labour council agreement committing the government to anti-retroviral treatment. It may be uncomfortable for the government to have lobby groups and uppity judges yapping at its heels. But that, unfortunately, is what happens when you have a democracy. There was acclaim when, on April 17 2002, the government appeared to assume its rightful position as leader and partner in the war against Aids. Facing morally irresistible demands for a treatment regime for five million infected South Africans, it must not slide back into its bad old ways.

You can slip out of your dog-collar and blue shirt now, Pastor Makhanya. Your service is done. Amen. Although, I must admit, that sounds rather like a white man talking behind you.

Response to Mbeki’s third State of the Nation speech illustrated yet again the hopelessly divergent visions of the ANC in government, powerfully led by Mbeki, and the liberal opposition establishment. The one broad, bold, creative, outward-looking, and hopeful, the other negative, small-minded, and pessimistic – harping on interminably about AIDS, with their idées fixes about sexually-infected sick Africans and medicine bottles. The mind-set showed up in the Mail&Guardian’s choice of cover for its Mail&Guardian Bedside Book 2002, edited by Shaun de Waal. Three plastic pill bottles decorate it with ominously dense chemotherapy-looking labels, one toppled, spilling its contents into the foreground. This catchy pic was calculated to appeal to the predominantly white crowds milling through Exclusive Books, its branches always situated in the swankier shopping malls. The South African white liberal pessimism sold by that newspaper – dead to the spirit of the revolution – drew comment in two letters published on 25 April 2003. ‘Why ... do I feel so depressed after my weekly read?’ asked Mac Carrim. ‘Is it because the M&G has become part of the problem? I am referring to the spiritually demoralising negativism that permeates our society and that you seem to be party to. Reading the M&G suggests to me that you believe investigative journalism is only about corruption, violence, incompetence, crime, poverty, war and disease.’ In his letter Madoda Sibeko noted alongside Carrim’s that ‘Most white people do not like Mbeki – they hate his clever grasp of their English literature and resent the fact that he runs the country.’ That’s right. My experience certainly.

In mentioning Tshabalala-Msimang, the Ominous rumblings editorial was referring to the newspaper’s main story in the same issue, Manto: What’s so special about Aids?, reporting an interview by Jaspreet Kindra. Concerning the TAC’s demand for the provision of antiretrovirals by the state, she countered: ‘It is not like giving out aspirin, like Jerry [Coovadia] says.’ Her department was already dealing with ‘the already large problem’ of TB medication toxicity. On the TAC’s claim concerning the alleged Nedlac agreement, she asked rhetorically: ‘Why must the government enter into agreements with everyone? Tomorrow I must enter into an agreement with asthma sufferers?’ – her ‘voice dripping with sarcasm’. Tshabalala-Msimang’s passing allusion to asthma was seized by the paper as further evidence of her incompetence; posters on streetlight poles cried, ‘Manto equates Aids with asthma.’

The Sunday Independent’s posters that week reinforced the insinuation in the weekend: ‘Manto in new Aids row’ for accusing UN Special Envoy for AIDS in Africa Stephen Lewis of ‘arrogance in the first order’ following his threatening suggestion that governments not fighting AIDS with sufficient zeal be held culpable for ‘mass murder by complacency’ – their ‘failure’ punished ‘ten or fifteen years down the road’. He was referring, transparently, to Mbeki and Tshabalala-Msimang alone, having completed a ‘four-nation tour of Southern Africa’ the month before, and remarking at the time: ‘Everyone hopes South Africa will, at the earliest possible opportunity, be able to provide anti-retrovirals because of the leadership position South Africa invariably and inevitably has.’ Tshabalala-Msimang reportedly reacted to being accused of being a sort of war criminal in ‘a moment of spontaneity and emotion’ – understandably. Lewis responded to her distressed response by telling a lie a child could see through – but not John Battersby and Caroline Hooper-Box, whose article was slanted against the Minister: ‘My comment on “mass murder” was directed at donor countries. The fact that South Africa felt anxious about these comments is a commentary on South Africa not me.’ And then Lewis explained why he was so keen for the country to toe the line: ‘We all regard South Africa as the heart, the engine-room of the continent. … Everyone looks to South Africa for leadership. It can give heart, courage and focus to every other [African] country’ if South Africa dispenses antiretroviral drugs at clinics and hospitals; it would be ‘a dramatic breakthrough for the whole continent’. And the whole pharmaceutical industry. Water Affairs Minister Ronnie Kasrils was outraged at Lewis’s threat too, calling him a ‘fascist’. Social Development Minister Zola Skweyiya agreed. But the lying ‘AIDS expert’ persisted when he heard this: ‘The statement ... was in reference to countries of the developed world such as the US.’

Despite her previously expressed objection to being disrespectfully addressed by journalists as ‘Manto’, it pleased both liberal newspapers to continue referring to her by her first name. Like Gladness. So good with Mathew and Emma. Been with us so long she’s almost part of the family. (Where her children are? Wouldn’t have a clue.)

Lewis popped back into the country the day before the Sunday Independent hit the streets – ‘for a meeting on mother-to-child transmission of HIV with Graça Machel and other significant women Aids campaigners. The meeting discussed how a programme aimed at saving HIV-positive mothers and their babies “may be promoted and embraced more fully by governments”’. Ours. He didn’t bother meeting the country’s Minister of Health.

As promised for Mbeki’s State of the Nation address, the TAC marched, sang and chanted in a procession that stretched all the way up Adderly Street. Mock children’s coffins carried by marchers made Achmat’s point that everyone present had ‘shed tears for someone who had died’. Standing outside the gates of Parliament, he warned: ‘Unless the government signs the agreement and gives us a clear commitment that the hospitals will have antiretrovirals to distribute, we will fill up the jails. Our people are dying. Treat us now.’ Cosatu president Willie Madisha chimed in: ‘Don’t waste our time. We cannot negotiate for eight months with people who say they have a mandate only not to sign it on the last day because they say they don’t have a mandate.’

The government struck back at a press briefing on the 19th. ‘I would like to categorically and unequivocally state that the assertion that Nedlac parties have reached an agreement on this matter is false, and devoid of truth,’ said Department of Labour director general Rams Ramashia. Cosatu’s allegation to the contrary was ‘despicable’ and ‘unjustly cast aspersions on President Thabo Mbeki who on Sunday denied that there had been any agreement in Nedlac’. Also present at the briefing was Department of Health director general Ayanda Ntsaluba, who confirmed that a task team made up of members from his department and the national treasury was researching the cost implications of providing antiretroviral drugs in the public sector. The reason for several key terms in the draft agreement having been bracketed was because the task team was still busy, and ‘we could not pre-empt the policy process of that task team’.

Achmat pitched up during the proceedings and asked to speak to the press in turn. This was refused, so he threw an impromptu press conference of his own afterwards, addressing journalists already present. Eighty days had passed since the government had last participated in talks, he said, and ‘every day six hundred people die of AIDS’ – an baseless lie, but a winsome, oft-uttered one, made with an appreciation of Goebbels’s elaboration of Hitler’s observation: ‘A small lie may be little believed at all, but a big lie, if repeated with sufficient vigour and frequently, will eventually take deep root in the minds of the uninformed masses.’ In the case of Achmat’s lie, not only take root, but quickly grow to blot out the sun too, because by creating a sense of emergency with such a fire-call, anyone who, like Mbeki, dallies to reflect on it is cast as contributing to the disaster.

Celia Farber described Achmat’s sort of tricks in her essay, AIDS Inc.:

The most insidious characteristic of any righteous new movement is that it maintains its power by employing the twin tactics of terror and guilt. Terror of the ‘great threat’ must first be instilled, upheld by the societal guilt that comes with questioning the validity of the threat. … to discuss actual AIDS figures rather than hysterical projections – becomes equated with badness, wrongness, grave irresponsibility, moral collapse – and in this case, with homophobia, racism, right-wing fanaticism, and ultimately, that catch-all phrase: murder. … In the altered cognitive atmosphere of such an entrenched belief system ... facts have no weight.

Achmat continued n his tirade for the attentive journalists; his TAC was ‘dead serious’ about its civil disobedience campaign. He turned on Tshabalala-Msimang as the ‘biggest obstacle’ to the Nedlac negotiators reaching agreement. ‘All the experts are ready and I beg government, get it done, before there is serious social conflict.’ Tshabalala-Msimang held a press briefing of her own later in the day. Asked a question about the row, she looked to Ntsaluba, who was present in the auditorium, and he answered. Having announced that they’d come to stage a protest, the TAC were refused entry by the police. They liked that. Upped the moral temperature. Made them feel like serious activists. Like in Seattle. Their only regret was that they didn’t get a few bonks on the head. After promising to behave, they were allowed in.

Rebuked by Mbeki and the Department of Labour, and left exposed and looking foolish, Cosatu now decided to take Mandela’s lead and cool it. Following a meeting it called on 27 February between Tshabalala-Msimang and Cosatu Secretary General Zwelinzima Vavi, Cosatu spokesman Vukani Mde announced in a statement that the government had been right after all: there was no agreement about a treatment plan. Achmat answered Cosatu’s U-turn on Aids, as the Sowetan described it the next day, with a spate of petulant recriminations. Cosatu’s statement was ‘misleading and disappointing’, he said.

From our side we recognise how Cosatu may be under enormous pressure from its alliance partners but for us the issue is the six hundred lives lost every day and not comfort with the politicians. We urge Cosatu in its new-found friendship with the Minister of Health to ensure that people have access to antiretroviral therapy at the soonest opportunity. Over the last week TAC has been under severe pressure from utterances by government officials. … It is not very comfortable to have the pressure of the most powerful liberation movement on the continent on us either. But we are not going to be cowed. … We however know that we will not lose our friends within Cosatu.

But Cosatu’s statement wasn’t so ‘misleading’ after all. Pressed by journalist Ido Lekota to tell the truth, Achmat himself conceded that that there was no agreement by the government, and that there was no question of any treatment plan implementation until the government’s task team had delivered its cost analysis. In its statement, Cosatu said there was substantial consensus on the draft proposal for a treatment plan, but the parties at Nedlac were clear that any final agreement was to be finalised by their principals: ‘Until this happened, it does not have the status of an agreement. We regret the confusion and in particular the dragging [sic] of President Mbeki.’ Into the mud – by insinuating in statements to the media that Mbeki was lying in denying an agreement existed – as Nono Simelela, head of the Department of Health’s AIDS Directorate, explained to the Sunday Times on 2 March as the reason for the meeting between her Minister and Vavi.

The fiasco left one marvelling at how Achmat had succeeded in raising a mob to make a noise outside Parliament – and again at Tshabalala-Msimang’s press briefing the next day where they disrupted the proceedings with their chanting – to press his case that the government was welshing on a firm agreement. A mob the Mail&Guardian rushed to join – implicitly calling Mbeki a liar in his repudiation of the TAC’s and Costatu’s original claims. But the liar in the saga turned out to have been none other than Achmat. An impartial press would have pilloried him. Instead, its favourite drip went uncensured. How Achmat had managed to bring Cosatu along on his frolic is readily explained by Cosatu’s loss of its intellectuals to government and civil service appointments after the revolution, leaving it denuded of its thinkers and left in the hands of populists. To whom the TAC’s primitive, emotive agenda evidently has a natural appeal.

On 28 February the TAC released a Short Note: ‘TAC notes with deep regret that Government has missed our 28 February deadline for signing the NEDLAC framework agreement for a national HIV/AIDS treatment and prevention plan. Our plans to begin a campaign of peaceful civil disobedience remain unchanged. Details of further action will be made available in due course.’ The ‘Dying for our Lives’ campaign was shortly to begin.

With tempers inflamed by Tshabalala-Msimang’s insistence that a combination of nutrient-rich foods could be good for the immune system: her statement to this effect at a parliamentary Health Committee in the last week of March had a group of TAC members, who’d been present, walking out in a huff.

The South African AIDS controversy had reverted to the issue around which Mbeki had ignited it in October 1999 after reading Debating AZT: the provision of AIDS drugs. As his resistance to the pharmaceutical conglomerates was being overwhelmed by its proxies, it was hard to find a convincing answer to Miss Martin’s question, asked forty years ago in JP Donleavy’s novel, A Singular Man: ‘Up against a lot of corporations what was the use of struggling. We’re plankton.’

CHAPTER

By 2003 Mbeki’s historic initiative in raising a public challenge to the HIV-AIDS paradigm was assuming the character of a fast-wilting Prague Spring. On AIDS, Mbeki’s government appeared to be folding like a boxer under too many slugs. The inquiry that he ordered into the safety of AZT on 28 October 1999 had been bungled by the Medicines Control Council, which concluded that there was nothing to worry about. As had the Cochrane Institute. The next thing was his government was distributing the drug to rape victims – unaccountably, even in the wonderful world of AIDS science, and explicable only as political capitulation. Unlike the ‘sea change’ in medical orthodoxy resulting from the Henry J Kaiser Foundation’s convention of ‘AIDS experts’ in the US to look afresh at the conventional medical approach to an ‘HIV-positive’ diagnosis – which, until the release of their report on 5 February 2001, had been to ‘hit early, hit hard’ with AZT and similar drugs – the panel of orthodox and dissident scientists and doctors convened by Mbeki in 2000 to debate the HIV-AIDS hypothesis and the safety and utility of antiretroviral drugs, produced nothing in terms of new policy recommendations, and left unanswered the dissidents’ critiques of the orthodox model. And finally, most painfully, Mbeki’s government had been given a humiliating drubbing in the High and Constitutional Courts over its rightly cautious approach to the provision of exceptionally toxic nevirapine to women in labour and their newborn babies. Along with the country’s provincial health MECs, Mbeki’s Minister of Health had been brought to heel and given instructions in how to carry out her Constitutional obligations. Or go to jail. Literally – the TAC’s application to the High Court in December 2002 asked for an order that Mpumalanga Health MEC Sibongile Manana be ‘committed, for a period determined by this Court, for contempt of the order of this Court in TPD case no 21181/2001 as substituted by the order of the Constitutional Court in case no CCT 8/02’.

The TAC had achieved almost complete victory over the government on all fronts in its campaign. It had won a highly publicised suit in the courts forcing the government to administer nevirapine to ‘HIV-positive’ pregnant women and their babies, forced a concession to provide AZT and 3TC to rape victims, and a commitment in principle from the government to supply ‘antiretroviral’ drugs to persons diagnosed ‘HIV-positive’ generally. In these conquests, the TAC was abetted by a Warsaw Pact of irresistibly powerful allies: one of the twentieth century’s most revered statesmen, a fellow Nobel Peace Prize winner in the person of the former head of the Anglican Church, as well as his incumbent successor, and a stridently vociferous appeals judge. Two former US Presidents. Just about everyone apart from the archangel Gabriel.

As the ANC was all to painfully aware. It noted at its 51st conference in Stellenbosch in December that ‘Foreign actors with significant resources are backing domestic organisations in an offensive against the mass democratic movement and the government. Some so-called watchdog groups here have been enticed by funding and other forms of persuasion to act as an opposition.’ But less encouragingly, the party endorsed the use of anti-retrovirals ‘if administered at an appropriate stage in the progression of the condition in accordance with international standards. … Given the progression of the Aids epidemic ... our programme of transformation should not only acknowledge this danger, but ... must put the campaign against it at the top of our agenda.’ To turn down the TAC heat? It wouldn’t work; the TAC wanted AZT or similar nucleoside analogues for all, and would stop at nothing less. Mbeki, re-elected for another five years as ANC leader, gave AIDS a passing mention in his address, and urged that TB was probably a much bigger problem. (But just wait until you lift the lid on that scam, Chief.) ‘On HIV and AIDS’, the conference formally resolved: ‘a. To strengthen and accelerate the implementation of the national AIDS strategy, as amplified in the cabinet statement of 17 April 2002’ and

b. The ANC to be at the forefront of community mobilisation and leadership around HIV and AIDS especially around awareness, prevention, voluntary testing and counselling, treatment and care. This should include clinical protocol guidelines, training programmes and support for health workers, infrastructure for the monitoring and follow up of patients, the treatment of opportunistic infections and the use of anti-retroviral drugs where appropriate.

But it wasn’t all bad news. The drug addicts began fighting among themselves. Mandela had disassociated himself from the TAC march on Parliament. Cosatu had reversed itself concerning the TAC’s claims about the alleged Nepad agreement, for which the TAC attacked Cosatu in turn. The National Association of People with AIDS then assailed the TAC. First it banned its members from joining the TAC’s march on Parliament, then it distanced itself from the Nepad agreement dispute, and most surprisingly, the drugs themselves, with spokesman Thanduxolo Doro declaring: ‘Napwa is not part of the call for the signing of this document by government and business. Not only are we not happy about the process, [we are not] happy with the content of this document.’ He condemned the TAC for focussing on drugs: ‘The TAC in so doing is disregarding the real issues of people living with HIV/AIDS in rural villages, informal settlements and townships. … [The leadership of the TAC has a few token blacks] who cannot say or do anything without first asking their national chairperson [Achmat].’ The TAC was an elite group of urban campaigners out of touch with the country, he said, and the government shouldn’t be bothered with them. ‘Napwa also calls on the TAC to stop using Africans for their selfish ends. They must stop playing on the emotions of newly diagnosed Africans by claiming that these anti-retroviral drugs are a cure. There is no cure for HIV and AIDS. The fact is, without food the drugs are more of a poison than anything else.’

Here was truth-telling at its most dangerous. It called for a decisive retaliatory strike. A public assassination. So they got the expert in. Practiced in smearing his opponents in the media. Instead of answering Napwa’s case frontally, Cameron lunged low into the group’s back. A mellifluous open letter was sent to the newspapers, bearing his name along with a handful of others. Arsenic in lace, it claimed: ‘These attacks suggest uncomfortable overtones of racism and misrepresentation’, and concluded with the innuendo that Napwa’s executive were a bunch of embezzlers by calling on its members to open their books. But Napwa parried smartly: their body was accountable to its donors, it retorted, and its financial statements were audited annually. The 7 March issue of the Mail&Guardian covering the hullabaloo – under a regal portrait of Cameron in pin-stripes loitering between the Dorian columns of the Wits Great Hall – was led by a front-page cover story, Counting the cost of three million lives, reporting the claim of UCT researchers led by Nicoli Nattrass, commissioned by the TAC, that AIDS drugs at a cost of just R18 billion a year by 2015 would save them. Nicoli Bush?

For hinting that he might be kicking the drugs, Cameron now turned on Mandela. Wagging his finger like PW Botha. On 9 March the City Press on Sunday reported that the moral prophet, donning his mantle as deacon of his repressive sex cult, had reproached the former President in a BBC documentary: ‘He, more than anyone else, through his enormous stature, his almost godlike stature among young people in Africa, could have reached into the minds and behaviour of young people in the townships. He didn’t do it.’ It was an old complaint revived. He’d told the Washington Post on 6 July 2000: ‘There is such denial in this country. … If you believe that interventions by a political leader can make a difference then you have to believe that one of the most extraordinary icons of this century could have convinced young men and women to wear condoms.’ In the townships. A gripe repeated on 13 November 2001 in the Daily Dispatch: ‘Of all the leaders of the 20th century who might have had an impact on people’s behaviour, he was the one who could have done the most, but without a doubt this was one of the grievous omissions of his presidency.’ His omission to preach the use of condoms to township kids. Camille Paglia was summing up American feminists when she described them as a ‘bunch of clinging sob-sisters … desensualised, desexualised, neurotic[s] ... who, displacing their personal problems with sex on to society, purvey an appalling diet of cant, drivel and malarkey’, but it applies remarkably aptly, methinks, to Cameron’s racist moralism too. Mandela, however, accepted the judge’s reproof. On 6 April the Sunday Argus reported that, interviewed by the BBC in turn, he said he’d ‘failed’ South Africa by not fighting AIDS during his Presidency.

As the red-ribboned journalists who despise her like to do, they called Tshabalala-Msimang by her first name again in the Sunday Times on 9 March, complaining that Manto want Aids dissident as health advisor and reporting her appointment of Roberto Giraldo to advise the government on nutrition. Correcting the story on national radio the following day, she pointed out that her allowance of two salaried advisors was already full, but confirmed that was consulting Giraldo on nutritional approaches to AIDS, and that she would continue to do so. The false report generated demands for her head. Achmat faffed:

The minister is rubbing salt into a wound. Instead of trying to avert TAC’s civil disobedience campaign over her failure to commit to anti-retroviral treatment, she is giving people grounds to be even more angry. She is making it clear she doesn’t care about nutrition or drugs, but is trying to maintain an ideological position about HIV/AIDS. We call on the government to examine whether she is fit for her position.

As did the AIDS Law Project’s (and TAC’s) Jonathan Berger, another white gay making a nice living in South African AIDS drug activism: ‘It’s become clear over time that the health minister is not fit to be in her position. How can the government be negotiating over an anti-retroviral treatment plan when it is being advised by the very man who believes that the drugs are poisonous and cause AIDS?’ The DA’s Sandy Kalyan MP responded that Tshabalala-Msimang’s consultation of Giraldo was ‘the latest in a long series of blunders on the minister’s part. … The minister is the weakest link in South Africa’s fight against HIV/AIDS. Our country deserves a minister who is serious about fighting the disease.’ So she’d be calling for a snap parliamentary debate on ‘why the minister should vacate her post’. PAC MP Patricia de Lille, who’d left Parliament during Mbeki’s State of the Nation address to march with the TAC outside, commented: ‘Every time the minister comes up with weird ideas.’ Tshabalala-Msimang’s dalliance with Giraldo was ‘disgusting’, she said.

And ‘disgusting’ was the TAC’s take on Tshabalala-Msimang’s briefing of the parliamentary Health Committee as they walked out cursing on 17 March, in high dudgeon over her support for Giraldo’s emphasis on proper nutrition in managing AIDS, and her statement that ‘nutrition should be the legacy because it is so critical’. Not only antiretroviral drugs, but also foods such as ‘garlic, lemon, olive oil and African potatoes’ could keep people well – and affordably, unlike the drugs. ‘It is not expensive, it is food.’ That was just the end for the TAC. Spokesperson Sipho Mthathi announced that the Minister would no longer be permitted to speak in public: ‘For us this was her last chance without being disrupted and without us saying she’s lying and misleading. … This is the last time that she will be able to speak on a public platform without disruption and expressions of the anger of the people unless she commits publicly to a campaign of antiretroviral treatment for HIV/AIDS sufferers.’ The TAC attended the meeting wishing Tshabalala-Msimang would ‘give us hope’ by outlining a drug treatment plan, but instead she spoke about the importance of eating. Her statements, said Mthathi, were

astonishing. … She never came anywhere near to responding in a way which recognises the crisis and the need to be serious about the epidemic. The debate is not about the benefits of nutrition but about saving the lives of people who do not have the strength to cook a meal. We want antiretroviral treatment which gives them their lives back. … we are at a critical point in South Africa where six hundred people die every day, and there is no plate of food that can save those people.

But addressing the Health Committee Tshabalala-Msimang defended Giraldo’s approach: ‘All he’s saying is medicine alone without nutrition is useless.’ And that HIV-positive didn’t necessarily mean death: ‘Look at Zackie Achmat. He’s alive.’ And doing just fine without the drugs.

During the Budget Appropriations debate in Parliament the following day, Finance Minister Trevor Manuel sharply answered opposition criticism for not allocating more funds to buying AIDS drugs as

a waste of very limited resources. … There’s a lot of voodoo being spoken. This notion that it’s antiretrovirals or bust is bunkum. [It’s] a position that can only be taken by pharmaceutical companies. It is not supported by fact. The more people support this kind of nonsense, the more we will end up in difficulty. There is no need to polarise society on this issue. We need to recognise that medically appropriate treatment will cover a range of issues. But the bulk of our investment has to be in the prevention regime, because you can put people on antiretrovirals but it is not going to cure them. It might at times and in circumstances arrest the growth of the disease, but it does not cure.

So in public spending, KwaZulu-Natal Premier Lionel Mtshali of the Inkatha Freedom Party should not ‘waste those very limited resources in an exceedingly poor province’ by rolling out an antiretroviral treatment programme, he said, but rather build schools and implement poverty relief schemes.

The AIDS activists were incensed. Cameron came on air the following morning to ponce on about how the drugs had save his life, and that without them he’d have died three years ago. ‘All scientifically rational people accept that five million South Africans’ are HIV-positive like he is, and that the drugs can spare them ‘the most terrible death’. An hour later, complaining incidentally that the government could no longer be bothered with answering the TAC’s memoranda, Heywood came on air in defence of the drugs as well: ‘We know from uncontested science that they save people’s lives.’ Cosatu released a statement too; it was

shocked and horrified at the recent statements of the Minister of Finance on the efficacy of anti-retroviral treatment [and it was] concerned that the continued public adoption by government leaders of unscientific and unsubstantiated positions on the efficacy of antiretrovirals condemns hundreds of thousands to an unnecessarily early death, and makes South Africa the laughing stock of the world.

The South African Communist Party’s Mazibuko Jara thought Manuel’s statements ‘a step backwards’. Not forwards towards the multinational pharmaceutical industry. Former Health DG Olive Shisana, now employed by the HSRC in AIDS research, responded in an open letter: ‘The view represents an incomprehensible U-turn from the approach strenuously advanced until quite recently by our post-apartheid government. The government has been generous in giving R3.3 billion for HIV/AIDS programmes. Please let health professionals use this money to manage their patients with HIV-AIDS related illness the best way they know how.’ She said research showed that antiretroviral drugs improved and prolonged the lives of HIV-infected people, and allowed them to work longer. They also helped infected parents live longer, and relieved the state of the cost of caring for AIDS orphans. ‘Without antiretrovirals, SA is destined to follow the awful curve of rising total deaths.’ Saadiq Kariem, chief of the ANC’s health secretariat protested that Manuel’s comments were ‘most unfortunate against the overwhelming evidence from medical experts across the world who agree on the effectiveness of antiretrovirals’. Sharon Emkambaram, advocacy officer of the AIDS Consortium, complained hotly: ‘Today the Minister of Finance contradicts official government statements by making scurrilous statements about the effectiveness of antiretroviral treatment. We find the lies and misinformation being spread by leaders in our country depressing.’

The surprising thing about the furore over Manuel’s line on antiretroviral drugs was the absence of any equivalent fuss over a frank statement about them a couple of days earlier by Tshabalala-Msimang when launching a national anti-TB campaign: ‘In my heart I believe it is not right to hand them out to my people.’

That Mandela might increasingly have been feeling the same in his own heart was suggested by his public comments following a meeting with David Rockefeller in mid-March and his silence concerning all the TAC’s civil disobedience talk in the newspapers, including a full-page advertisement in the Mail&Guardian that appeared as the campaigners went out to try to get arrested. Preferring his Third World poverty sugar-coated – in AIDS mystification – the banker explained: ‘After reading numerous reports on the plight of AIDS orphans I decided to visit South Africa to see what the conditions are for myself.’ Responding, Mandela played up those conditions, and in doing so had nothing to say about too much sex or too few drugs: ‘Not knowing where your next meal comes from, and not being able to provide for your family is devastating.’ He had taken a group of business people on a tour of remote rural areas after his release from prison, he said: ‘Most places I took [them] were not accessible by road and we had to go by helicopter. They were shocked to see the conditions of filth and poverty, and said they could not believe such places still existed in South Africa. … I realised that I didn’t know my own country.’

CHAPTER

As the commencement of the TAC’s civil disobedience campaign approached, the ANC NEC worried in a formal statement that ‘wilful unlawful action would undermine the institutions of democracy for which so many South Africans had fought and made sacrifices. … Organisations should desist from statements which misrepresent government policy and programmes, and which create unrealistic expectations about what is possible in the ongoing struggle to combat HIV/AIDS.’ Tshabalala-Msimang announced that the government’s programmes to deal with AIDS would be spelt out in advertisements in the weekend. (Full-page ads appeared in the Sunday papers.) Cosatu’s central executive committee met on the 19th to debate taking part in the TAC campaign, after which it announced that it was considering supporting it, provided the TAC clarify its ‘proposals on civil disobedience’ – an unhappy expression, it thought, that connoted ‘breaking unjust laws, mainly against unjust governments’. The TAC’s Nonkosi Khumalo hastened to reassure the workers: ‘We are not protesting against an illegitimate government, but the government’s illegitimate policies related to AIDS.’

But neither the government nor the unions need have worried. The launch of the campaign on the 20th was a comic flop. Achmat began by announcing from the steps of St George’s Cathedral in Cape Town: ‘We voted for this government, we accept its legitimacy and its laws. But we cannot accept its unjust policy on HIV/AIDS that is causing the deaths of more than 600 people every day. Today we break the law to end an unjust policy not an unjust government.’ He then took off, marching arm-in-arm with about a hundred supporters through the city centre, and crowded into Caledon Square police station to file a criminal complaint charging Tshabalala-Msimang and Trade and Industry Minister Alec Irwin with culpable homicide. Tshabalala-Msimang, explained Heywood a bit earlier, ‘has known about the extent of the HIV epidemic, and ... has resources to alleviate [it], yet she has negligently failed to act to improve the situation’.

In his excitement Achmat got mixed up over the finer legalities and alleged that ‘people are being murdered in South Africa by the Health minister every day’. Irwin’s crime, went the complaint, was his failure to issue compulsory licences for generic AIDS drugs, despite ‘being aware of the capacity in South Africa for the manufacture of generic antiretrovirals and other medication’. The TAC charged both Ministers with

failure to provide adequate treatment, including antiretroviral therapy for people living with HIV/Aids … We further demand that the accused be arrested and charged with the offence of culpable homicide or negligently causing the death of ... many thousands of people who died from Aids or Aids-related illnesses and whose deaths could have been prevented had they been given access to treatment. ... We believe that many thousands of people can bear witness to these horrible crimes.

Achmat told the station commander: ‘You must understand we will be completely peaceful, but we insist you arrest the Ministers. … We’re going to stay here until you arrest us, or you arrest them.’ Two and a half hours later, the police lost patience with their little game and took Achmat and his party in. The comrades were then given a slice of white bread and a cup of water, just like real prisoners, and released after an hour on warning to appear in court in a few days for the impressively awful crime of attending an illegal gathering.

At the CR Swart police station in Durban things came to an even soppier end. As the TAC indignantly complained in a subsequent press release, ‘The police laughed off suggestions that a docket could be opened against the Ministers’, and chased off seventy insistent TAC members with mace and a squirt from a water cannon.

In a characteristically tasteless move, Mark Heywood led a march on the Sharpeville police station, ‘chosen for its symbolism of struggle against oppression’, as the Guardian put it the following day. ‘This is just the first shot in the campaign,’ Heywood said. ‘Later on we will have sit-ins and occupy government buildings.’ We will bring the running of the country to a halt until the government gives in to our demands.

Five days later, on 25 March, Tshabalala-Msimang was scheduled to open a Public Health conference jointly convened in Cape Town by the Health Systems Trust and the Public Health Association of South Africa. When he heard this, Achmat dispatched a demand to the HST that she be disinvited, threatening to disrupt the show if she wasn’t. The HST naturally wasn’t interested in such blackmail, and refused. Following further correspondence, a formal compromise agreement was struck: Tshabalala-Msimang would speak; fifteen TAC members would be allowed in to stage a peaceful poster protest; there would be no disruption.

The TAC reneged. Achmat and about thirty supporters pitched up intending to block her car by lying in the road and then blockading the hotel foyer in order to bar her entry, but were defeated when she made it into the building through the door to the underground parking garage, which she’d entered via a back route to elude them. Achmat and his group then swirled into the conference hall. ‘When she comes we will disrupt her speech,’ he promised, and duly did so – blowing whistles, waving large glossy ‘Wanted for Murder’ posters with Tshabalala-Msimang and Irwin’s heads on them, and chanting ‘murderer’, ‘criminal’, ‘resign’, ‘Manto go to jail’, and ‘Manto go home’. Several university researchers present aligned themselves with the TAC’s performance by holding its posters up. A journalist made a recording of the pandemonium, and played it over the radio a couple of hours later, giving a description of the mêlée as he did so. Completely beside himself, Achmat threatened to follow Tshabalala-Msimang to wherever she might speak and break up the proceedings.

‘You should be in jail,’ he screamed, jabbing his finger in her face. ‘You exploit the hunger of our people by talking nutrition. … You should take off your wig and sell it to feed the poor. People are starving and yet you eat five star meals. I know who you are having lunch with after this.’ When Tshabalala-Msimang tried getting a word in, Achmat or someone next to him shouted, ‘Shut up, Manto.’ Achmat warned: ‘I’m telling you and Mbeki once and for all....’ She interjected to pull him up for his disrespectful mode of address – ‘President Mbeki,’ she insisted, but was shouted down again. Tshabalala-Msimang was audibly shocked by Achmat’s aggressive incivility, and repeatedly deplored it. Noticing that he was perspiring heavily, she offered him a tissue to mop his troubled brow. He snapped back: ‘I have a sweat because I’m angry. … Does someone decent have a tissue?’ Tshabalala-Msimang had seen this behaviour before. Among upset children. Her maternal instincts now kicked in. Her voice gentle and soothing, and evidently practised at calming down infantile temper tantrums, she tried defusing the tension by inviting Achmat and his group to join her on the stage. ‘We don’t want to stand next to you,’ he shouted back, before going berserk at the threat that her invitation posed to his psychological script. He accused her of being ‘a coward’ for refusing to talk to him, of always ‘attacking’ him, and of going to any lengths to oppose him. Tshabalala-Msimang even tried to comfort him with the offer of a hug, but as he later explained to his supporters outside: ‘The time for hugs is over.’ He then demanded to read a windy prepared statement:

We are angry. … You have consorted (and continue to consort) with HIV denialists and have never once on record stated without condition that you believe that HIV causes AIDS, though you have claimed it is a premise, not a fact, of government policy. You have caused public confusion over the efficacy of antiretrovirals and it took a court case to get your department to implement mother-to-child transmission prevention. … Instead of embracing the dozens of opportunities we have given you to work with civil society to treat our people and reduce new HIV infections, your response has been to resort to pseudo-science. … Instead of leading government to adopt the Nedlac framework agreement on a treatment and prevention plan, you undermined and misrepresented it. You did not have time in the last few months to ensure that whatever concerns you have about the agreement were addressed, but you had time to seek publicity in Iraq and to consort with the charlatan, Roberto Giraldo. … We have heard a number of excuses from you as to why antiretroviral therapy should not be implemented. You have cited toxicity. You have said prevention rather than treatment. You have cited the cost. … all these excuses have been shown to be false … we also no longer believe that you have the will or competence to manage the HIV epidemic or the public health care sector appropriately. Inequity and quality of service in the public health care sector have worsened since you took over from your predecessor who made a valiant effort to transform the health care service. You have deceived, misrepresented, delayed and denied for too long. We hope you will prove us wrong by making an unequivocal and irreversible commitment to antiretroviral therapy and by signing the Nedlac agreement. If you fail to do this, we will take legal action and continue our civil disobedience to ensure that the public health care sector succeeds in spite of you.

Tshabalala-Msimang smiled benignly at Achmat throughout, and then when he was done said, ‘You’ve had your say, now I’m going to have my say. I think you can be decent now.’ But Achmat and his mob continued causing a scene. When eventually they packed it in, Tshabalala-Msimang gave her speech, with uniformed policemen flanking her lectern to protect her. In just a couple of sentences devoted to AIDS, she said, to the consternation of the TAC, that she wished to ‘highlight’ the role of nutrition: ‘For me, nutrition is very important for good health, especially for women and children. This reasoning was the basis for the Health Department’s food fortification programme. There wasn’t any talk of nutrition before I started it.’ She said Mbeki had moved her to do so, having urged her to ‘consolidate the quality of care’ provided by the health service. ‘Every Health Minister tries to reform the health system in some way,’ and she’d been working on this for the past five years. Before leaving under police guard, she condemned Achmat’s unnecessary disruption of the conference: ‘I would have gone out and listened to them.’ But she qualified her reproof with a remark along the lines of everyone having the democratic right to freedom of expression. For his part, Achmat was less indulgent. Apologizing afterwards for insulting Tshabalala-Msimang about her appearance, he persisted impenitently: ‘The organisers of the conference have only themselves to blame for inviting this criminal.’

At a cognitive, rational level Achmat’s performance was the usual mud. But unnerving to listen to was the disturbed emotional pressure behind it, a steaming fountain pumping up with great force from burning depths, out of control. The same fuel driving some of the world’s greatest demagogues and dictators. But the Mail&Guardian picked up none of this, and on the same day reported the incident uncritically under the heading, Aids activists target Manto the ‘deceiver’. In the UK four days later Lancet reported: S Africa’s AIDS activists accuse government of murder. Far from contrite, Achmat justified his behaviour – arising from his ‘uncontrollable ... anger against indifference’ – in an opinion piece, The Long Walk to Civil Disobedience, in the following issue of the Mail&Guardian. He did apologise for his reference to Tshabalala-Msimang’s appearance – but under an even more abusive swollen-lipped cartoon caricature in the classic tradition of white depiction of niggers, painfully explored in Spike Lee’s film, Bamboozled. Or lifted off a Nazi propaganda poster, missing only a saxophone. Just as he had done before the Rhodes scholars, Achmat continued bleating about feeling rejected: ‘Do you remember how the health minister spurned the TAC after the [generic drug] case?’ Do you remember how my dad rejected me when I said I was gay? (‘His last words to me were that I should be stoned to death.’) Accounting no doubt for his ‘clinical history of depression’ mentioned in an article about him in the Sunday Independent on 23 May 2004.

Even the New York Times journalist interviewing Achmat after the conference ruckus got the impression that he’s a neurotic mess. In its homage paid to him on 10 May for his work, his awards, and his decision not to take AZT until everyone could, the newspaper noted: ‘Mr. Achmat acknowledged ... fidgeting as if uncomfortable in his own reasoning. “The government won’t care one bit if I die,” he said. “I don’t think it will make a bit of difference in their policy.”’

On 3 April the Nelson Mandela Medical School’s Professor Barry Kistnasamy appeared on television, flanked by a bunch of white businessmen, announcing with a perfectly straight face that a clinical trial was about to commence at King Edward Hospital in Durban, to be conducted by his university (with him and Medical Faculty Dean Professor Umesh Laloo in charge), for the investigation of a new treatment: black volunteer AIDS patients were to be buzzed with electromagnetic waves to see what it would do for their HIV infections. They had R43 million for the trial (and marketing), put up by arms manufacturer British Aerospace Systems. Trying to look good by helping to fight AIDS. For a share of this sort of cash, who wouldn’t have stifled their giggles? The TV camera panned over the faces of a room full of journalists all taking notes. They weren’t laughing either. None of the newspapers slated it for the shameless scam it was. Perhaps because it was a Russian rather than an African idea. The subjects are sure to be reporting that they felt much better after basking in the electric rays. After going off the chemicals for a while.

Zuma accorded himself with Mbeki and Tshabalala-Msimang’s pro-food, anti-drug approach at a regional conference on AIDS and nutrition in early April. The Sowetan on the 4th reported some strong words: For the chronically hungry poor, antiretroviral drugs were ‘deadly without nutrition. How do they take the drugs on an empty stomach? In fact the drugs kill them even quicker.’ There was even more outrageous talk from him on the day of the report at Mokopane Hospital in Limpopo Province, where a pilot nutrition programme has been introduced for people unable to afford AIDS drugs. In view of remarkable recoveries seen by hospital staff, Zuma announced that he’d be lobbying the Cabinet to redirect part of the AIDS budget to finance a nutritional supplement programme. He may have switched from drugs to food, but he was still into the sex lie. On 14 May, at the televised launch of an AIDS awareness project by yet another candle-lighting white gay, he urged: ‘People must change their habits.’ Because screwing wildly is killing everyone: in the same week, at the National Union of Mineworkers’ national congress in Pretoria he ‘assured’ miners of the government’s determination to fight HIV-AIDS ‘which is affecting the worker constituency adversely’. As opposed to the white professional classes. Without the same urges to get their ends away.

But less happy than Zuma’s food talk: a snippet in the weekend papers also reported that the government had given the green light for the local production of generic antiretrovirals – an initiative of the Department of Trade and Industry – and that production was expected to begin in 2004.

On 8 April the action moved to Johannesburg. At a cocktail party held for Richard Feachem, executive director of the Global Fund for HIV/AIDS, TB and Malaria, attended by Health Ministry officials, churchmen and business types, the TAC staged another protest at the gates of the venue, Summer Place in Hyde Park, holding up their ‘Wanted for Murder’ posters, and chanting as the cars drove in. In her welcoming speech Tshabalala-Msimang explained that in view of the recent unpleasantness in Cape Town, and the TAC’s promise to follow her around and break up the party wherever she went, her security people didn’t want to risk another ugly confrontation and so had brought her in through a back entrance. She then let rip, accusing Heywood – referring to him anonymously as ‘the white man’ – of bussing in puppet blacks to dance in protest: ‘They come with two buses and go to the commissions where they wait for the white man to tell them what to do ... Our Africans say: “Let’s us wait for a white man to deploy us ... to say to us ... you must toyi toyi here.”’ She then objected to the fact that the TAC had lodged complaints against her and Irwin, the ‘two murderers’, with the Human Rights Commission. (The Gender Commission too. Neither took them seriously.) Among the guests present, Heywood shouted from the floor: ‘You are lying, Minister.’ Tshabalala-Msimang thereupon thanked him for identifying himself, and for relieving her of the need to do so. He responded by shouting again: ‘You are a liar.’ As Tshabalala-Msimang commenced her speech the pipsqueak continued to remonstrate until ordered to shut up by one of her security guards. A defiant speech it was too – Tshabalala-Msimang loudly omitted any mention of AIDS drugs and emphasized that the South African National AIDS Council, coordinating the disbursement of the Global Fund grant, ‘will put forward issues of nutrition and traditional herbal remedies’ for funding. In his speech in turn, Feachem said pointlessly, ‘It would be foolish of me not to be aware of the controversy around antiretroviral treatment’, but then rode roughshod over Tshabalala-Msimang’s concerns about the drugs, saying antiretroviral drug supply programmes were ‘inevitable’ and were already operating in the country. To rub her nose in it, he urged that applications be made to the Global Fund for subsidies to buy the drugs.

In its report of the incident later in the week, the Mail&Guardian had no sympathy for the National Minister of Health, now reduced to using the tradesmen’s entrance wherever she went. A poisonously skewed article by Nawaal Deane, The madness of Queen Manto, flagged on the front page by a photograph of the Minister laughing, as if she really was cracked, cast Heywood as victim, with Feachem ‘angered’, and everybody else embarrassed by Tshabalala-Msimang’s ‘racist comments’. Tshabalala-Msimang had now well and truly succeeded Mbeki as the politician the newspapers loved to hate, for one reason and one reason alone: deeply troubled about the toxicity of AZT and similar drugs, she was watching them being foist on the country by foreign agencies, and felt helpless to prevent it.

In its next issue on the 17th the Mail&Guardian’s AIDS writers, Nawaal Deane and Ferial Haffajee, wondered: What more must Manto do before she’s removed? – having ‘plunged the country into at least 13 crises about HIV/Aids, obscuring the Cabinet’s multibillion-rand efforts to end the damaging era of denial and confrontation. … Tshabalala-Msimang has become a caricature, a figure provoking derision instead of the leader needed to fill the gaps left by Mbeki’s lack of interest in the pandemic. In popular polemic, she is a “mampara”; in activist discourse, she is a “murderer”; to diplomats and the international Aids intelligentsia, as well as the ranks of her own party, she is an “embarrassment”. Her impact ripples beyond the sphere of HIV/Aids. Numerous surveys to determine why South Africa does not attract more foreign investors have found that the country’s management of the pandemic is considered a disincentive to investment. How did Tshabalala-Msimang, a physician, become an Aids dissident and how much longer will she stay in that camp? By all accounts, she was a hard-working chairperson of Parliament’s portfolio committee on health, with an orthodox view of HIV/Aids and how it should be tackled. But without the power of argument and without a constituency of her own, Tshabalala-Msimang has been unable to bring Mbeki around to accepting the conventional view of Aids spelt out in the Cabinet’s statement on April 17 last year.’ And so on. Steven Friedman of the Centre for Policy Studies offered a wise solution to the puzzle: ‘President Mbeki has set a virtual international record in loyalty to his Cabinet ministers,’ he said, and pointed out insightfully that ‘Tshabalala-Msimang’s position on the pandemic may have presidential approval’.

But the real shocker was a talk Cameron gave during the week at the Harvard Law School, published as the newspaper’s front-page headline story under the title, The dead hand of denialism. Humiliated by Mbeki’s nonsuit of his petition, the one he got the Rhodes scholars to sign, Cameron reverted to attacking him in a fine-tuned retread of the speech he gave to the London barristers in September the year before. Reading it was chilling. Chilling because it was so smooth, so fluid, so floridly loquacious, so shallow, so intolerant, so ignorant, so aggressive and so poisonous – like the speech of a medieval ecclesiastical court judge condemning a dangerously defiant heretic to die at the stake. Fuelled, to quote Mbeki himself in his letter to world leaders in April 2000, by ‘a religious fervour born by a degree of fanaticism, which is truly frightening’:

My theme touches on two momentous issues from the past century. The first is the Holocaust – the Nazi state’s methodical extinction during World War II of approximately six million people, mostly Jews. The second is the Aids pandemic – the global pandemic of disease and death, particularly in Africa and the developing world, resulting from infection with the human immuno-deficiency virus (HIV). Each in different ways seems emblematic of the past century’s terrible legacy of human vulnerability and failing – the Holocaust because of what it says about the capacity of supposedly cultivated humans to commit systematised murder on a vast scale; Aids because of what it seems to be saying about the incapacity of supposedly cultivated humans for systematised intervention, within their means, to prevent avoidable death from disease on a massive scale in the developing world. No one here would, I think, deny that nearly six million Jews, together with gypsies, homosexuals and other outcasts, were systematically done to death in German concentration camps during World War II. Nor would anyone deny that a virally specific contagious condition, mostly sexually transmitted, is ravaging the heterosexual populations of Central and Southern Africa. Yet both these facts are denied – persistently, vigorously, vehemently, and sometimes venomously. For denialists, the facts are unacceptable. They therefore set out to render them untrue. They engage in radical controversion, for ideological purposes, of facts that, by and large, are accepted by almost all experts and lay persons as having been established on the basis of overwhelming evidence. Holocaust denialism seeks to deny the systematised massacre of the Jews of continental Europe that took place during World War II. Aids denialism involves a group of dissident historians, social commentators and scientists who have set about denying the forbidding fact of Aids. Denialists assert that the ‘hypothesis’ that Aids is caused by a sexually transmitted virus is unproven and irresponsible. Aids in North America and Western European they attribute to ‘the long-term consumption of recreational drugs’ and to the widespread use of drugs as sexual stimulants by homosexual men and, more recently, to the administration of anti-retroviral drugs that doctors wrongly prescribe for Aids. They refute the ‘impression’ that there is a microbial epidemic in Africa, ascribing it instead to ‘non-contagious risk factors that are limited to certain sub-sets of the African population’. The millions of deaths attributed to Aids they characterise as ‘a minor fraction of conventional mortality under a new name’. The methods each group employs to controvert the facts include distortions, half-truths, misrepresentation of their opponents’ positions and expedient shifts of premises and logic. The denialists’ ‘standard recipe’ is described on one Holocaust website as ‘the half-truth, the distortion, and quite a lot besides the truth’. Both forms of denial make great play of the inescapable indeterminacy of figures and statistics. Precisely how many died at Auschwitz, and of what causes? Exactly how many HIV infections and Aids deaths are current in Africa? We shall probably never know. Denialists seek to suggest that the inability to achieve historical or epidemiological exactitude renders the Holocaust and Aids themselves imaginary. Both rely, spuriously, on the fact that history is replete with orthodoxies that have been supplanted by the heterodox, and invoke the memory of Galileo Galilei, who was nearly martyred for scientific truth. The analogy could be invoked by every non-Galilean absurdist to advance his or her theory. The difference is that heterodoxies that have achieved acceptance have complied with the basic logic of scientific and evidentiary postulates, whereas it is precisely these qualities that the denialists’ assertions lack. In each debate the antagonists need to account for their opponents’ conduct. Why, if the Holocaust never happened, would many thousands of reputable historians commit themselves to the assertion that it did? Why would more than 5 000 HIV/Aids specialist physicians and scientists from 82 countries subscribe to a declaration – as they did in the Durban Declaration of June 2000 – that the evidence that HIV causes Aids is ‘clear-cut, exhaustive and unambiguous’? To explain this, denialists in each case resort to conspiratorialism. In the case of the Holocaust, Jewish historians and Holocaust specialists have a close-knit racial interest in fabricating its existence. In the case of Aids, many scientists are mere fools, trapped in dogmatic error. But all too many of them have a baser motive. According to Professor Peter Duesberg, the ‘deceptive Aids propaganda’ alleging the existence of a microbial Aids epidemic in Africa has been ‘introduced and inspired by new American biotechnology’, one that – at least in the case of HIV testing – ‘provides job security’ for virologists and doctors, ‘without ever producing any public health benefits’. African Aids denialism also employs a theory of racial conspiracy. The deniers depict the facts about Aids as the product of a grotesque racist conspiracy of untruth and deception by corporations, doctors, scientists and healthcare workers – a monstrous plot against Africans because they are black. A document of disputed authorship, which was distributed last year under the authority of the ruling party in South Africa, the African National Congress, propagates the belief that a syndicate of white Western interests – an ‘omnipotent apparatus’, engaged in ‘a massive political-commercial campaign to promote anti-retroviral drugs’ – seeks to degrade, exploit and by the administration to them of toxic medicines, kill, Africans. For South Africa, the significance of Aids denialism is momentous. It has to be, since our president, President Thabo Mbeki, has publicly countenanced and officially encouraged it. The president’s stand has caused predictable confusion and dismay among ordinary South Africans – with unavoidably devastating consequences in an epidemic where public education about self-protection and the necessity for behaviour change is a life-saving centrality. But more important still, it has bedevilled and unfortunately continues to bedevil our national response to the disease. Instead of taking immediate and unflinching action to stem the epidemic and to minimise the devastation it is wreaking, the government has continued to respond with ambivalence and inaction and distraction and evasion. For some time Mbeki has maintained silence in regard to his endorsement or otherwise of the Aids denialists. Yet in one of his rare references to Aids earlier this year, he described it as a disease ‘of poverty and underdevelopment’ – echoing one of the key dogmas of denialism. In January 2003 his Minister of Health, Manto Tshabalala-Msimang invited a prominent Aids denialist, Dr Robert Giraldo, to address the meeting of the Southern Africa Development Community’s ministerial health committee, which she chairs. Giraldo, unsurprisingly, informed the meeting that ‘the transmission of Aids from person to person is a myth’ and that ‘the homosexual transmission of the epidemic in Western countries, as well as the heterosexual transmission in Africa, is an assumption made without any scientific validation’. The government has now apparently retained his services to advise it on ‘nutrition’. Recently the Minister of Finance, Trevor Manuel, doubtless unwittingly, echoed dissident talk by accusing proponents of anti-retroviral treatment of speaking ‘a lot of voodoo’ and ‘bunkum’. Until September 2002 the most the government would say was that its policies were based on the ‘assumption’ that HIV causes Aids. Even now, government will still say no more than that its policies are based on the ‘premise’ that HIV causes Aids. The ambiguity of expression, the ambivalence of the underlying belief, the doubt about the commitment, are all too tragically apparent. It is as if a formerly avowed racist were to undertake to treat black people on the ‘assumption’ or ‘premise’ that they are his equals. Some advocate criminal proscription of Holocaust denial, and several states have prohibited speech that denies events associated with the Nazi persecution of the Jews. The motivation is that these laws proscribe ‘hate speech’ with its attendant injury to the human rights protections of those whom it deliberately targets. But many have misgivings about the efficacy and justification of these laws, considering that they may be counter-productive, and that they obscure the role that public debate, refutation and education should play in resisting untruth. A second role that the law can play, however, is as an arbiter of fact and truth. And civil, rather than criminal, litigation may offer useful strategies in responding to denialism. Holocaust and Aids denialism have each recently been challenged in court, with momentous consequences. In the Royal Courts of Justice in the Strand, in the United Kingdom between January 11 and April 11 2000, the trial matter between David Irving, plaintiff, and the defendants Penguin Books and Deborah Lipstadt was conducted before Mr Justice Gray. The case arose from a libel suit the writer David Irving brought against the defendants for publishing Lipstadt’s assertions that Irving was a ‘Holocaust denier’ who had distorted historical materials in order to bolster Hitler’s reputation. The trial resulted in the dismissal of the plaintiff’s claim and the vindication of the defendants’ assertions about the plaintiff, including their claim that Irving was an anti-Semite. Even more importantly, the dispute required the trial judge to make detailed historical findings regarding the Holocaust and the central areas of difference between Holocaust historians and denialists. Justice Gray’s judgement scrutinises the contentions at the centre of the deniers’ claims, and finds them wanting not only in force but in integrity. His conclusions entail that those who persist in denying the Holocaust are devoid of professional integrity and lack commitment to truth. Of particular interest to the broader issue of denialism are his findings in relation to the ‘convergence’ of Irving’s historiographical errors. He found they all tended to exonerate Hitler, and to reflect Irving’s partisanship for the Nazi leader. ‘If indeed they were genuine errors or mistakes, one would not expect to find this consistency.’ The judge concluded that this was a cogent reason for supposing that Irving had deliberately slanted the evidence. The same pattern of convergence marks the ‘errors’ of Aids denialists. Eleven months to the day after Mbeki began his public endorsement of the Aids denialists, the Constitutional Court delivered a judgement in a case involving discrimination by a state agency against a work-seeker with HIV. Even though the medical issues were undisputed on appeal, the court went out of its way, in a pointed exercise in public education and affirmation, to set out in detail the uncontested scientific evidence that HIV is the cause of Aids. Eighteen months later the Constitutional Court was confronted with one of its largest challenges since the transition to democracy – the government’s refusal to introduce a national programme to counter transmission of HIV from pregnant mothers to their infants. Although exhaustively documented evidence supports the efficacy, attainability and simple monetary good sense of such programmes – leaving aside the humane imperative for them – and even though the drugs are available free, the government refused to implement such a programme. Its refusal, as documented in its court papers and in argument on its behalf before the High Court and Constitutional Court, was based in large measure on the alleged toxicity of the drugs – a tenet central to the entire conspiratorialist theory of the Aids denialists. Invoking its exposition in its earlier judgment of the causes of Aids, the court held there was no evidence to suggest that a dose of the anti-retroviral drug in question ‘to both mother and child at the time of birth will result in harm to either of them’. Observing that Aids was ‘the greatest threat to public health in our country’, the Court ruled that the Constitution required the government to devise and implement within its available resources ‘a comprehensive and coordinated programme to realise progressively the rights of pregnant woman and their newborn children to have access to health services to combat mother-to-child transmission of HIV’. The Constitutional Court’s judgements assert that irrationality and obfuscation have no place in South Africa’s response to the worst threat to its national life. It has directed the government onto a road that, if followed, would lead to the effective and coherent national response to the epidemic. There is unfortunately little evidence that the government has taken the path on to which the court has beckoned it. Despite two important and hopeful Cabinet statements in April and October 2002, there is increasingly a dualism between governmental statement and action concerning Aids. The evidence points to the dismal conclusion that the dead hand of denialism still weighs down all too heavily on the development of a rational and effective response to Aids. Although HIV is now a medically manageable condition, the government still refuses to commit itself to a national treatment plan for Aids – even though late last year substantial progress was made in negotiations between business, NGOs and the heads of two government departments in devising such a plan. The cost in human lives and suffering of denialist-inspired equivocation in national Aids policy can be described only as horrendous. A leading Aids activist, Zackie Achmat, has referred to government’s policies – with resonant imagery – as ‘a Holocaust against the poor’. Death from Aids is now avoidable. With carefully administered treatments, and subject to monitoring and with appropriate medical care, Aids is no longer a fatal disease. I know this from my own life, which without those treatments would have ended three or more years ago. Neither as a person living with Aids nor as a judge can I stand apart from the struggle for truth and for action about Aids, and the role lawyers and the legal system are called to play in it. Both Holocaust and Aids denial remind us of our own terrible weaknesses and vulnerabilities as humans, and of the reluctance we all feel to own them. But the struggle for truth they involve also inspires us to greater thought and action. For truth, classically, is freedom, and from freedom in truth comes the capacity to build and plan and act better. Aids in Africa calls us with imperative force to unleash that capacity.

Into a bucket? Like a vomiting drunk? Intoxicated with religious power? In the ‘truth’ of the gospel, ‘freedom’ from sin? Talking like Richard Nixon, the inveterate liar, giving his acceptance speech in 1968 following his nomination as Republican presidential candidate: ‘Let us begin by committing ourselves to the truth – to see it like it is, and tell it like it is – to find the truth, to speak the truth, and to live the truth.’ As in: ‘Nixon: A vote for honest government’, captioning a smiling mug-shot on an early campaign poster, reproduced on my favourite tee-shirt some years ago. Then asserting in office: ‘American policy has been to scrupulously respect the neutrality of the Cambodian people’, as he was carpet-bombing them. Followed by: ‘The tragic lesson of guilty men walking free has not been lost on the criminal community.’ Before telling his aides when his Watergate burglars were arrested: ‘I don’t give a shit what happens. I want you to stonewall it. Let them plead the Fifth Amendment, cover up or anything else if it will save the plan.’ But on the other hand: ‘The White House has had no involvement in [the Watergate break-in]. … In all my years of public life I have never obstructed justice. … I have nothing to hide. The White House has nothing to hide.’ All topped only by Billy Graham’s blessing: ‘I have asked you for a moral and spiritual restoration in this land and give thanks that in Thy sovereignty Thou hast permitted Richard M Nixon to lead us at this momentous hour of our history.’ Maybe Cameron should ask for a blessing from Archbishop Ndungane too.

In Frontiers Mostert characterized the nineteenth century German missionary, John George Messer, who vainly went around trying to convert the Xhosas in the Eastern Cape, as ‘hysterical in a certain Teutonic manner, that had a recriminatory and vindictive nature that so often seems to emerge in fundamentalist Christian zealotry’. A bird of the same feather, it seems to me. With his incandescent but infantile parley. Revealing always, like Achmat and Uys, the intellectual rigour of a collapsed arse. Furious over Mbeki’s obduracy as he gazes wearily upon his polished temper tantrums. Throwing his food in the form of insults. Attacking his integrity in the basest imaginable way, by associating him with the darkest moral and criminal depravity. Cameron’s core preoccupation being Africans having too much sex – for which a miserable death will be naturally visited on them (‘an epidemic where public education about self-protection and the necessity for behaviour change is a life-saving centrality’). Repeating the timeless threats of white missionaries in black Africa. Deeply offended by the absence of a sense of sinfulness attaching to lovemaking in African culture. And so casting it in terms of a basic characteristic rapine/promiscuity model. Pruriently fixated on African male virility, so offended by the idea of it that his language is always picked from the vocabulary of a Victorian prude. An attitude once lanced by HL Mencken: ‘There is only one honest impulse at the bottom of Puritanism, and that is to punish the man with a superior capacity for happiness.’ Easy-going guys like the impressionist August Renoir: ‘A painter who has the feel of breasts and buttocks is saved.’ But not to AIDS activists with mouths pursing at the thought. No mom and dad for us, we’re AIDS activists.

In January 1954, in the course of the inquisition he ran, sniffing out and punishing alleged communists in the US government and public life, another vindictive homosexualist, Joseph McCarthy (like FBI director J Edgar Hoover and McCarthy’s vicious sidekick, attorney Roy Cohn), made a baseless attack on Secretary of the Army Robert Stevens – having an oblique go at President Eisenhower in the process. As all of America watched on television, Joseph Welch, the US Army’s chief attorney, drew to his feet: ‘Until this moment, Senator, I think I never really gauged your cruelty or your recklessness. Let us not assassinate this lad further, Senator. You have done enough. Have you no sense of decency, sir, at long last? Have you no sense of decency?’ That moment marked the beginning of the end of the McCarthy terror, and in December the Senate passed a motion of censure against him for his abuse of his political position. With that he was gone, skulking on the back benches from which he’d suddenly emerged, and then dead of alcoholic liver failure a couple of years later. One might have hoped that Cameron’s colleagues might rebuke him in similar terms for overreaching himself in such a foul-mouthed tirade, and for his continual abuse of his seat on the Supreme Court of Appeal to attack the country’s President from public podia in the UK and the US – without the manners even to refer to him by his formal title, or manage ‘Dr’ when mentioning his Minister of Health. But there’s small chance of that, because Cameron’s brethren like the way he talks, they approve. He told us so on the radio a month earlier, on the 18th: ‘I have the support of my colleagues on the Appeal Court.’

Cameron equally enjoys widespread general support among the white middle and upper classes because he says what they want to hear. In the rogue’s patter. Like McCarthy’s at Wheeling, Virginia on 9 February 1950, commencing his witch hunt:

The reason why we find ourselves in a position of impotency is not because the enemy has sent men to invade our shores, but rather because of the traitorous actions of those who have had all the benefits that the wealthiest nation on earth has had to offer – the finest homes, the finest college educations, and the finest jobs in Government we can give. While I cannot take the time to name all the men in the State Department who have been named as members of a spy ring, I have here in my hand a list of 205 that were known to the Secretary of State as being members of the Communist Party and who nevertheless are still working and shaping the policy of the State Department.

They were totally false, but like McCarthy’s, Cameron’s claims sounded right. Fitting, like a key in an oiled lock, into white South Africa’s deeply held, culturally conditioned conscious and unconscious ideas about blacks: how they behave in bed and in government; that they’re all sick from random, meaningless, bestial sex; that the black President and his Minister of Health are mentally dull, dictatorial, inhumane, dishonest, uncaring and perverse. That’s why it goes down so well; and why, as McCarthy did, Cameron gets away with his vicious and obscene denunciations.

Which Oscar Wilde described a century ago: ‘As one knows the poet by his fine music, so one can recognise the liar by his rich rhythmic utterance, and in neither case will the casual inspiration of the moment suffice. Here, as elsewhere, practice must precede perfection.’ For instance: ‘Instead of taking immediate and unflinching action to stem the epidemic and to minimise the devastation it is wreaking, the government has continued to respond with ambivalence and inaction and distraction and evasion.’ In truth, as Mbeki noted in his State of the Nation address in February, UNAIDS director Peter Piot has described the government’s AIDS programme ‘as the largest and most comprehensive in Africa and one of the largest in the world; a programme, he says, with very high levels of government investment, which is starting to show results’. No country spends more per capita on AIDS programmes. And as the multi-agency investigation overseen by Statistics SA into the death rate and its causes reported in November 2002 revealed, when read against the figures in its preceding census, Cameron’s claim about the ‘devastation [that AIDS] is wreaking’ is a fairy tale. Beloved of sexually fraught white South African gays. Since there’s nothing out of the ordinary happening; in fact the country’s death rate is steady, and has been since the start of the nineties – not increasing at all. Actually dipped in 2000. Our population is growing at a healthy two per cent a year, according to Census 2001. In all that roiling, septic verbosity, Cameron’s real complaints boiled down to two: Mbeki’s personal disinclination to absolutely and unreservedly publicly proclaim Cameron’s faith as his own (that forbidden sex can kill you); and his concern, shared by Tshabalala-Msimang, about the toxicity of AIDS drugs, which Cameron dismissed in stupefyingly dumb ignorance as ‘alleged toxicity ... – a tenet central to the entire conspiratorialist theory of the Aids denialists’. So that when during a talk show on SAfm on 18 July 2000 my brother Paul read him the deadly toxic hazard warning on the Sigma AZT bottle, and pressed on him the implications of advocating this stuff for giving pregnant women, Cameron’s recklessly glib response, to avoid dealing with the implications, was: ‘You may be looking at a fifteen-year-old label which appeared in a satirical magazine recently.’ As if it was all a bit of a joke.

Following on Defiant Desire, Cameron might call his next book Fascism for Beginners. Unable to brook even silent dissent, and railing intolerantly against it: ‘For some time Mbeki has maintained silence in regard to his endorsement or otherwise of the Aids denialists. Yet in one of his rare references to Aids earlier this year, he described it as a disease “of poverty and underdevelopment” – echoing one of the key dogmas of denialism.’ Cameron’s rant was verily the stuff of the thirties. It worked for Hitler denouncing the blood enemies of the volk, and it works for him. The lawyer’s talk smoother than the painter’s, but just as déclassé. His appalling assault on Mbeki passing as an incantatory plaidoyer for life, truth and justice. With the violence of his philippic coming through as respectable to the civilized and the genteel, because of the prettiness of his foppery (‘truth, classically, is freedom, and from freedom in truth comes the capacity to build and plan and act better’). Tripe swimming in a French consommé. Out a no-name packet from Pick and Pay, just add water. Paper pansies in a plastic vase. Injection-moulded like a Grecian urn. But the Johannesburg liberals were dilly for it. And put it on the front page of their newspaper. For them it counted as the week’s main news. Cameron’s lies, threats and horrible charges. Rapturously applauded.

In her Continuum interview in 1993, Camille Paglia commented on the intense intolerance of Cameron’s fellow gay AIDS activists in the US, and the specific emotional powder firing it:

ACT UP in its earliest incarnation was an absolutely fascist organization. … The most insane and vicious and intolerant people I have ever met in my life are AIDS activists. I came into direct confrontations with them. … The way they controlled the discourse, their arrogance – they were like little Hitlers, stormtroopers, who believed that they had the truth, and anyone who tried to have a different view of AIDS, or the origins of AIDS, or anything like that, that we should not be permitted to speak. … I will never forget one of the first times I went out, one of the first times I was invited to a conference, at the State University of New York at Purchase, and I saw for the first time the incredible pressure. There’s this fellow who’s very active still in gay activism in New York City, a prominent gay activist there, I’d never heard of him, I had never had this experience before, and I gave my presentation whatever it was, it was on various topics, it wasn’t on AIDS, it was on things like feminism, there was this screaming. I have never in my life seen a character out of Dostoevsky, right, this man burning with rage! This man mentally occupied the borderline between rationality and irrationality. I, as a person who is very keyed to psychology, could clearly see that his rage, you know, had nothing to do with me, had nothing to do with AIDS, had nothing to do with homosexuality, it had to do with his own problems with his own family, okay? I say this again and again: these fanatics who took over the political discourse are in fact trying not to think about themselves, not to analyze themselves, and they’re projecting outward all their rage against Mommy and Daddy and everything else. But it was unbelievable, you could not believe the poor people in that room. The academics in that room, the people who came to the conference, were shrinking. No one would speak. That man effectively silenced an entire auditorium of people.

As the judge has silenced the President; and whose style in persistently tormenting Mbeki for his dissension is reminiscent of Winston Smith’s torturer in Orwell’s 1984:

O’Brien’s manner became less severe. He resettled his spectacles thoughtfully, and took a pace or two up and down. When he spoke his voice was gentle and patient. He had the air of a doctor, a teacher, even a priest, anxious to explain and persuade rather than to punish. … ‘How does one assert his power over another, Winston?’ Winston thought. ‘By making him suffer,’ he said. ‘Exactly. By making him suffer. … Power is in inflicting pain and humiliation. … The face will always be there to be stamped upon. The heretic, the enemy of society, will always be there, so that he can be defeated and humiliated over again. … Always we shall have the heretic here at our mercy, screaming with pain, broken up, contemptible – and in the end utterly penitent, saved from himself, crawling to our feet of his own accord. … What are you? A bag of filth.’

On the 22nd the South African Human Rights Commission released its 4th Annual Economic and Social Rights Report: 2000 – 2002 ‘on the effectiveness of measures taken by relevant organs of State towards the realization of economic and social rights’. The bit on AIDS seems to have been compiled by Achmat, or someone with his intelligence at any rate: ‘The HIV/AIDS Policy does still not provide for universal access of anti-retroviral drugs to people living with AIDS,’ noted the Executive Summary. The report itself recorded a ‘lack of strong leadership’ as one of the reasons for the ‘AIDS pandemic currently ravaging SA’. At the top, it implied. Under Recommendations, the HRC urged, from someone’s uncorrected high school competition essay:

A National Action Plan for universal access to ARVs should be the government’s top priority and it is highly recommended that the National Budget reflect this. The urgency of treating people living with AIDS requires not only political commitment but additional funding to tackle this pandemic which is affecting the lives of millions of South Africans especially the poor whose right to health and human dignity are being jeopardised. A culture of caring needs to be instilled so that a human rights approach falls on fertile ground not only amongst citizens but especially amongst care givers in all sectors of all society. Most importantly, life style changes and sexual behaviour patterns must be changed. Women and girls must be empowered and be regarded as potential victims of abuse. Leaders from all sectors of society must extend their influence in the call for a moral regeneration in our society.

No wonder the government laughed the whole thing off in its formal response.

The following day, at the launch of its Isiseko Sokomoleza (‘Building the Foundation’) programme, the Anglican Church announced an allocation of R220 million to train and pay ninety thousand counsellors over three years to propound the clergy’s insight, as Archbishop Ndungane explained it, that ‘AIDS is not a sin but a disease’. The disease you get from sin. But salvation in drugs. Indeed, the Church would ‘keep putting pressure on government’ said a representative on SABC3 TV news, because ‘life expectancy in Africa will soon be 26 years’. For those of us who didn’t do what we were told, and mated after our hearts instead. Like animals. So won’t be meeting up in heaven. To live happily ever after – forever too. The cash was put up – you guessed it – by USAID. A blessed child of God is His Holiness, the Archbishop. Pure of heart. To whom it never occurred that the Americans don’t give a dime in aid unless it advances US corporate interests. But for the Church it was nonetheless a sparkling scheme: a whole new congregation of lost souls to minister to, to control. Like locusts, a vast swarm of pastoral care givers would descend on homes, invoking the dread of AIDS to prop up the Church’s loosening hegemony, since the usual threats of damnation were proving shop-worn. Sexual indiscipline being the supreme offence. So material would be developed for sexual education that was ‘age appropriate and culturally sensitive’, the archbishop said.

Hot for some of Bush’s $15 billion, and a piece of the Global Fund grant to South Africa that was about to be unblocked, GlaxoSmithKline announced yet another price cut for its AZT and 3TC combo, Combivir, on 28 April. CEO Jean-Pierre Garnier said: ‘These price cuts demonstrate our commitment to making vital medicines more affordable through sustainable preferential pricing.’ And our commitment to competing effectively with generic manufacturers, since the Fund had made clear that in buying antiretrovirals it was less concerned with brand names than price; and when Bush announced his $15 billion endowment, he referred to AIDS drugs costing less than $300 a year – which the generic manufacturers were putting out, not GlaxoSmithKline. The already heavily discounted price of Combivir was halved to 90 cents a daily dose – compared with $18 dollars a day in the US. Michael Weinstein, president of the Aids Healthcare Foundation thought the company kind: ‘We congratulate GSK on their humanitarian action today to significantly lower the preferential prices of their Aids drugs for the world’s poorest nations. In light of Glaxo’s intention to reduce prices, AHF will withdraw our California lawsuit against GSK, and continue our work to see that these drugs can be made both available and affordable throughout the world.’ The local media were predictably full of how humane the company was too.

Cosatu formally announced that it was disassociating itself from the TAC’s civil disobedience campaign on the 29th, whereupon the TAC immediately suspended it, pending a meeting with the South African National AIDS Advisory Council on 17 May (later rescheduled). Cosatu’s spokesman Patrick Craven explained the TAC’s decision: it was ‘to give the government the opportunity to prove its good faith and to demonstrate that the TAC’s campaign was about saving lives. Too many lives have been lost for any further delays. We must stop the counting of bodies and start administering life-saving medicines.’ We must stop relying on the newspapers for our information and start thinking for ourselves.

The month ended with some turbulence on a flight from Frankfurt. Tshabalala-Msimang was sitting in the first class compartment before take-off, anxious to return to her husband who was unwell at home, when German businessman Jentz von Wichtingen, sitting next to her, asked her whether she was whom he thought. When she confirmed it, he requested the flight attendant to fix him another seat, because he didn’t want ‘to sit next to someone responsible for the deaths of thousands of people with HIV/AIDS’. Her response to the obnoxious remark was to mutter that he should ‘fuck off’. To this deeply offensive invitation he took exception: ‘Is this the Minister of Health swearing at me like this?’ She answered by repeating her remark since he hadn’t got it the first time. When he moved to another seat, Tshabalala-Msimang followed him over and took him to task: ‘What gives you the right to harass me in public?’ she demanded, prodding him on his shoulder. ‘You Germans just come over to our country but you know nothing about South African politics.’ Von Wichtengen didn’t like that. The black woman standing up for herself. Rebuking him for his disgusting accusation. Segregating himself on the public transport. From the African mass-murderer. The sub-human. Not the response he’d expected. Since he’s used to seeing the kitchen girl lowering her head when dressed down. Not talking back insolently. His reaction was to explode: ‘I screamed at her that I have been here for ten years and that she should be ashamed because her policies were causing people to die. I didn’t know that I could still get so emotional. … I was in a state and shaking.’ No one thought ill of the German businessman with the erupting historical conscience. Screaming on the aeroplane. Like a pig being loaded into a cattle truck. Off to the abattoir. Least of all the German businessman himself: ‘I called the captain over and complained that she had verbally and physically assaulted me. The captain asked her to calm down. Luckily I was sitting in front of her. I did not have to look at her for the rest of the flight.’ Especially not at those full warm brown lips. His own thin tight wintry ones got gabbing to the newspapers as soon as he landed. Whereupon journalists and opposition politicians condemned Tshabalala-Msimang one and all.

The DA’s Sandy Kalyan MP remarked: ‘President Mbeki should have fired Tshabalala-Msimang long ago. Surely among the ANC’s about three hundred MPs there is someone who would be less of an embarrassment and who could do a better job. We are still waiting for Minister Tshabalala-Msimang to apologise for raising groundless fears about the safety and effectiveness of nevirapine. She should add to this, by apologising to the passengers who witnessed her reported behaviour on this flight.’ United Democratic Movement spokeswoman Nonhlanhla Nkabinde couldn’t understand Tshabalala-Msimang’s resentment: ‘We find it quite surprising that the minister should express such indignation when confronted with a simple statement of fact that she is directly responsible for the deaths of thousands of HIV/Aids sufferers. Once again, the minister has demonstrated with her unbecoming behaviour that she is unfit to serve in Cabinet.’ Patricia de Lille MP, of the just-formed Independent Democrats, suggested von Wichtengen sue her, and said, ‘Problems just never end with the Minister. People have been calling for her head but she has the protection of the highest in the land, so that call is superfluous.’ Indeed, Mbeki’s spokesman Bheki Khumalo confirmed that there was ‘no possibility of her being removed from her position’. Essop Pahad, Minister in the President’s Office, came out in her support: ‘It is appalling that somebody should go into a plane and accost somebody else, accusing them of murder, and then plead innocence.’ He thought opposition reaction in siding against Tshabalala-Msimang ‘disgraceful’. All because, as she’d intimated in March, she feared the mass poisoning of the black poor by AZT and similar drugs – ‘In my heart I believe it is not right to hand them out to my people.’ And put in old English for the rude German the message the media had been giving her for months.

All the TAC’s talk of people dying every day without the drugs went straight to former ANC MP Andrew Feinstein’s head. In a teary letter to Zuma at month-end he ‘implore[d]’ him to ‘provide anti-retrovirals … The hundreds of daily deaths due to HIV/Aids in South Africa are a tragic consequence of government and ANC inaction. … Continuing failure to due so will be a criminal betrayal of our beloved country and will undermine the judgment of history on our movement and our struggle.’ (Feinstein would later become chairman of London-based Friends of Treatment Action Campaign.) But in a letter sent at about the same time to the Sowetan, the ANC Youth League saw it all very differently. Spokesman Khulekani Ntshangase wrote that the TAC was just like the outlaw Cape vigilante group, People Against Gangsterism and Drugs (PAGAD), and that its leaders should be arrested for campaigning for the ‘poisoning of our people’. And by going along with the TAC, the trade unions were ‘participating in the killing of its membership and the entire community’. But in an editorial on the 25th, Another clown in the cast, the Mail&Guardian deprecated Ntshangase’s letter as ‘ridiculous … imbecilic … There are places where people of such intellectual disposition are confined.’

CHAPTER

On 1 May the US House of Representatives voted to approve Bush’s proposed allocation of $15 billion to fight AIDS in Southern Africa – fifty-five per cent of which was to be spent on drugs. But not before Vice President Dick Cheney had successfully lobbied House members to pass an amendment requiring that a third of the grant go to sexual abstinence programmes in tune with a White House statement that it wished the legislation to ‘prioritize the abstinence component of the ABC approach … “A” for abstinence, “B” for being faithful and “C” for condom use when appropriate.’

‘It’s important that we not just send them money, but we send them values that work,’ said Republican Representative Mike Pence. Meaning the niggers. As if Africans are in need of moral regeneration and new values. From America.

Representative Christopher Smith from the same benches, who proposed the amendment, explained that he was concerned to ‘strengthen protections’ for religious groups, including Roman Catholic organisations objecting to the distribution of condoms – which care, he said, for a quarter of AIDS sufferers worldwide. Full of zest after taking over Iraq, Henry Hyde, chairman of the House International Relations Committee enthused: ‘Not since the bubonic plague swept across the world in the last millennium, killing more than 250 million people, has our world confronted such a horrible, unspeakable curse as we are now witnessing with the growing HIV/AIDS pandemic.’ Democratic Representative Barbara Lee added: ‘It sends a message to the world that the United States will not sit idly by and allow AIDS to wreak havoc.’ While African politicians like Mbeki twiddle their thumbs. Bush signed the amended bill on the 27th, explaining: ‘We have a moral duty to act and we are acting.’ To push about $8 billion worth of useless and toxic AIDS drugs on Africans. And to spend $5 billion dollars teaching them not to be so immoral. There was no opposition in the House to the incorporation of Bush’s bizarre amendment, since all Americans know that Africans’ uncivilized sexual behaviour has caused the ‘HIV/AIDS pandemic’, just as it caused the ‘population explosion’.

Amendments to the Medicines and Related Substances Control Act, which the massed pharmaceutical companies had tried to block the year before, came into operation on 2 May. By legitimising the parallel importation of generic drugs, the Act opened a further breach in the government’s defences, because the cost argument against antiretroviral drugs now became harder to sustain.

On the 5th and 6th hospital doctors belonging to the South African Medical Association wore tee-shirts to work to protest against the government’s failure to provide antiretrovirals to AIDS sufferers. Chairperson Kgosi Letlape explained:

We plan to do a lot more work this year. You have to understand that what needs to be done is a collective effort from all of us, not only from the TAC. Today and tomorrow is just to highlight to society that what the TAC is doing is excellent work and civil society should support them. This is our initiative. [The government is] hiding behind a task team with the finance minister looking at the cost [of providing the drugs]. That should take them half an hour; they are wasting time and playing Russian Roulette with life in this country. Botswana has been providing Aids treatment in their public sector so if the people in the task team have problems with their calculators, Botswana can tell them what the cost is, we can tell them.

Thank you, Mr Chairperson. Good dependable chap you’ve got there, Richard. Yes, he certainly is, Peter, and he doesn’t even look to me for wages.

A second telling blow to Mbeki and Tshabalala-Msimang’s opposition to the TAC agenda came on the 8th: the Joint Health and Treasury Task Team, established in September the previous year to make a cost/benefit analysis of HIV-AIDS treatment options, presented a provisional report to a two day meeting of Minmec, the committee of provincial health MECs headed by Tshabalala-Msimang, in order to gather critical comment for working into the final report. Claire Bisseker and Carol Paton reported in the Financial Mail on the second day:

The confidential report ... shatters the myth that SA cannot afford to provide free antiretrovirals through the public health sector. … A national antiretroviral treatment plan is affordable and achievable and cabinet should give it the green light as soon as possible. The most likely scenario, says a task team member, is that by 2008, SA will be comfortably treating 500 000 people (about 50% of those in late-stage AIDS) for about R4bn/year. If it succeeds, it will be the largest and cheapest antiretroviral treatment programme in the world. … the team has estimated that treatment will cost R7 000-R12 000/person/year, including drugs, laboratory tests and consultations. It assumes the mean life span of a person on antiretrovirals will be five to six years.

The enormous waste of national resources, let alone the epidemic of toxic ill effects in wait, didn’t engage the earnest lady journalists for a second. Or the shortened life span. Tshabalala-Msimang was reportedly subdued throughout the Minmec presentation – completely isolated, apart from Mbeki’s support for her. Even the chairman of her parliamentary Health Committee, James Ncgulu, was on the other side; commenting afterwards, he remarked: ‘We are unequivocal that antiretrovirals, where they are used appropriately, are effective. There are seventeen of these drugs that have been registered by the Medicines Control Council, but a large part of the problem has been the cost of the drugs.’ The toxicity and efficacy issues raised by Mbeki had been wiped from the slate.

On the 13th Tshabalala-Msimang was due to give her speech on the Department of Health’s budget vote. The newspapers and the Opposition were interested only in what she’d have to say about providing AIDS drugs. Minister Under Pressure to Deliver On Aids Treatment Plan went Business Day’s breakfast read on the day. ‘This presents a golden opportunity for the Minister of Health to turn her back on the failed and discredited approaches of the past,’ said Tony Leon. If she took it, she’d have the full support of his party, as well as ‘the enthusiastic backing of the local and international activist community. … [It was] extremely urgent that Cabinet meet to approve a roll-out treatment plan.’ On the day she spoke, the TAC packed the gallery. Only to hear: ‘Honourable Members will be aware that Government appointed a Joint Health and Treasury Task Team to undertake a comprehensive projection of the costs of various treatment options, including the use of ARVs. The report of this team will be presented to Cabinet in the very near future and a decision will be taken on this issue that has come to dominate the public debate on HIV/AIDS.’ And that, to the TAC’s dismay, was where she left it. Causing the South African Communist Party to protest in a public statement about the government’s delay in getting the drugs to the proletariat.

The US preoccupation with Mbeki’s AIDS scepticism was evident in more bad press in mid-May. Following the New York Times’ ode to Achmat on the 10th, the New Yorker ran a sonnet by Pulitzer winner Samantha Power on the 13th: The Aids Rebel: An activist puts his beliefs to an extreme test. The ‘most important dissident in the country since Nelson Mandela’, she called him, whose

real adversary is not the ANC bureaucracy but its leader, Thabo Mbeki. A cerebral, proud man [he] celebrated the idea that African solutions could be devised for African problems. Mbeki’s insistence on self-reliance became corrosive, however, when he applied it to AIDS. He denounced Western antiretrovirals, which suppressed the HIV virus, as “harmful to health”. He even questioned the link between HIV and AIDS. Mbeki’s stance not only bewildered people outside South Africa: it alienated many of his supporters at home, including Achmat.

Power noted what had caused all the trouble: ‘A high-ranking official in the health ministry had given Mbeki an advance copy of a book “Debating AZT”, which suggested that the drug is toxic. Mbeki, a micromanager who juggled a wide range of intellectual pursuits, decided to research the matter.’ Unlike Ms Power. (For a sense of her portrait of Achmat, swig a jug of corn syrup.)

Not surprisingly therefore, when Power requested an interview with Mbeki, it was refused. If her later account of this is anything to go by, she probably sounded too stupid on the phone to bother talking to:

Mbeki’s PR person said he hadn’t given an interview about HIV-AIDS in over 15 months and didn’t want to return to that debacle. It is bizarre to have a president not willing to speak about a disease that will soon kill three million of his countrymen and cause life expectancy to fall below 40 by 2010. A diagnosis of HIV is interpreted as a death sentence in rural areas and when I spoke to people, they wondered why their loved ones had to die. There is that desperation on one side and muteness of the leadership on the other side. … For now, the African renaissance is dead because of the AIDS devastation.

Three days after Power’s piece, an editorial by Science editor-in-chief Donald Kennedy, AIDS and Africa: Still a sad story, went sadly: ‘This journal has paid close attention to the African AIDS crisis since its early days. Jon Cohen of Science’s news staff was embedded in the problem long before anyone thought to use that term for deeply engaged journalism. His accounts followed the ... strange doubts of South Africa’s President Mbeki about the linkage between HIV and the disease.’ Embedded indeed.

Noting the flare up of Mbeki-roasting that Cameron had re-ignited, Makgoba thought he’d throw a few faggots on the fire too, in two speeches he gave, the first at the launch of the Wits HIV/AIDS Research Institute on the 14th, and the second in Switzerland on the 23rd at a symposium held by the International Human Rights Network to discuss politics and science in AIDS research in South Africa. In neither speech did Makgoba mention Mbeki by name, but then he didn’t need to. He opened his Wits talk by saying:

It is a pleasure for me to be given the opportunity to speak at today’s launch of the HIV/AIDS Research Institute, an initiative that constitutes another step forward in the response to the HIV/AIDS crisis in South Africa. I would have like to have said another step forward in ‘the national response’, but this creates the impression of a concerted national campaign, which unfortunately does not yet exist in South Africa to an adequate extent.

What he meant was that the government wasn’t buying drugs – as he made plain in Switzerland, where he dusted off his old lines: ‘Politics’ had ‘inappropriately taken centre stage’ in the government’s response to AIDS, particularly in regard to ‘antiretrovirals’, and it needed ‘urgently to address’ this, he said. He warned that ‘pseudoscience’ was the result of ‘amalgamating scientific truth with ideology’, and went on to repeat his ‘pseudoscience’ mantra throughout his speech like a Hindu sadhu. ‘We need to be very aware of the potential for such pseudoscience to gain a foothold in the public understanding of HIV-related issues’ due to sensationalist reporting, he said. The misrepresentations and distortions of eminent scientists, their refusal to accept scientific findings, and their publicity-seeking due to failed career ambitions was also a manifestation of pseudoscience, he counselled. Another instance of pseudoscience was when politicians and South Africa’s intelligentsia distorted or misrepresented scientific facts for ideological purposes and used science to promote ignorance and confuse. ‘All these examples diminish the authority, value, integrity and independence of science in society.’ The ‘major distortions’ in the government’s ‘excuses’ for not rolling out AIDS drugs ‘constitute deadly weapons in the “dead hand of denialism” lamented by Cameron and other South Africans who understand very clearly the potential danger of the intersection between science and politics.’ It was incredibly lame. But then it was Makgoba.

When in April Tshabalala-Msimang publicly accused Heywood of fixing rent-a-crowds for TAC demonstrations, he’d repeatedly shouted back that she was lying. She wasn’t. On 26 May my girlfriend at the time Daphne had just left Parliament in Cape Town, after delivering a copy of Debating AZT to every member of the Cabinet ahead of their imminent debate, when she ran into a crowd of black protesters on the Parade. All wearing the TAC’s ‘HIV positive’ tee-shirt, they’d been called out to support eighteen accused appearing in court for their police station sit-in in March. As a medical technologist specialising in haematology she’d been disconcerted by a commonly recurring pattern of anomalous morphology in blood smears from HIV-positive patients – low white blood cell count in combination with neutropaenia, activated or reactive lymphocytes, red blood cell rouleau formation, blue pigmented background stain and frequent anaemia – and after reading about AZT’s haematological toxicity in Debating AZT understood why. So she tried to find someone on antiretroviral drugs to chat to. But had a hard time of it. They’d all gone to the shop, she was told; she would have to wait for them to return. ‘Are you a journalist?’ the protesters asked, suspicious of her nosing. ‘No,’ she answered, ‘I’m just trying to find someone on the drugs and how they feel about them.’ After about forty-five minutes ‘they’ returned: a single Xhosa woman with an interpreter, the only male in the group. Aged about thirty-five, she looked about fifty; her face was hollow, and she was the only one there looking sick; her handshake was ice-cold, her grip weak. She said that she now felt accepted within her community, was being looked after and getting food. Although the drugs had made her very sick at first, she was feeling better – even as she looked horribly frail and wasted.

‘How do you get all these people here?’ Daphne asked a TAC marshal in her early twenties, who appeared to be formally educated, unlike the rest. ‘We’re the best mobilizers,’ she replied. Indeed they were – by unabashedly employing the oldest, time-tested incentive around. Noticing some of the protesters busy in huddles, Daphne went over to find out what they were up to. They were entering their names and telephone numbers on lists, in exchange for which organisers were doling out crisp R100 notes, peeled off fat wads from plastic bank bags. It was for ‘transport and refreshments’, they explained to her when she quizzed this extraordinary apparition. It would also feed the protesters’ families for the next few days, they didn’t add. Not forgetting the free tee-shirts to take home, just for showing up, worth half as much again. Which is a lot if you’re poor.

Or free drugs as one of the perks of signing up as a TAC member, worth thousands more. In September Achmat launched the TAC Treatment Project. The new love of his life Eduard Grebe explained in an interview with Health-e on the 9th that ‘The board of the TAC Treatment Project has recently decided to make an equal number of treatment slots available to treatment access activists and to people in community who are not directly involved with the Treatment Action Campaign. So we want to treat equal numbers of activists and people in communities.’ In other words, sign up and you automatically qualify. Take your chances in the queue if you won’t.

Die Burger reported some local fruit of the TAC’s campaign in the Cape on 27 May. Translated the report went: ‘The Western Cape has intensified its fight against paediatric AIDS. Until now, mothers have received a single tablet of nevirapine before giving birth to block the transmission of the HI virus to their babies. As from July this year these women will receive a supplementary six-week course of the AIDS drug AZT from the thirty-fourth week of their pregnancies.’

As the month drew to an end the TAC and NAPWA had another go at each other. Heywood renewed the TAC’s insinuations of financial irregularity, and after denying the slurs, Doro repeated his counter-charge that the TAC ‘was pretending to speak on behalf of people living with HIV-AIDS and was using Africans for short-term victories and publicity-seeking purposes’. Just as Daphne had caught the TAC doing on the Cape Town Parade.

Under the title, Mbeki Still in Denial Says HIV Treatment Activist, published a breezy interview of Achmat by Ofeibea Quist-Arcton on the 29th – still on a high from the $20-grand prize he’d won from the Global Health Council on the same day. ‘A veteran left-wing journalist, Max du Preez, said that the Treatment Action Campaign has given the country a conscience about HIV/AIDS,’ he boasted. It was Achmat at his wettest and most epicene, foppishly blathering about what a ‘saint’ Mandela is for backing the TAC, how five million people are going to die without the drugs and what are we all going to do when they go, how he yearned to start taking ‘my medicines’ which he had already picked, and so on, the whole cream puff starting and ending with criticism of Mbeki:

on HIV and AIDS ... the government’s policy, which was one of the best under Nelson Mandela [his deputy Mbeki running it], has changed to one of denial under President Thabo Mbeki. And by denial I don’t simply mean psychological denial, but also scientific denial in which our government is flirting openly and now collaborating openly with people who are HIV ‘denialists’, people who don’t believe that HIV causes AIDS and that AIDS leads to death and people who don’t believe that HIV is sexually transmitted. Therefore, this year alone – in our country – 250 000 people will die of AIDS-related illnesses, that’s over 600 people a day. This is the worst catastrophe, it’s worse than apartheid. It really is worse than apartheid. Apartheid hasn’t killed as many people as HIV has already killed in our country. I think the fundamental problem is our government and particularly our president’s stand: he doesn’t believe that HIV causes AIDS. He still does not believe that HIV causes AIDS. He cannot bring himself to mention the word HIV. He will speak about AIDS, because he has been convinced by dissidents that it is a politically correct way of denying that HIV exists. But he is not prepared to use the word HIV.

Asked why, Achmat laughed: ‘Your guess is as good as mine. I don’t know what motivates the president in this understanding or lack of understanding.’ Finally, when it was all over, thank Christ, Achmat was asked what he’d like his legacy to be?’ He replied:

You know, when I die one day – and I’m quite ready to die, because I think I’ve lived enough, but also I want to live because there are lots of things I still want to do; I want to make some movies, I want to write a novel, I want to be a lawyer and all those things and I’m going to do them and I’m going to live longer than Thabo Mbeki! I’d like someone to write on my tombstone one day, ‘Here’s a man who lived longer than Thabo Mbeki.’

Under which someone could spray-paint: ‘That’s because this stupid putz was born a whole generation after him.’

June was quiet but not idle. Tutu bobbed up again in support of AIDS drugs on the 5th, flying in to Beverly Hills, Los Angeles to take Carlos Santana’s side at his announcement that he would be donating $3 million from the proceeds of his forthcoming tour to the Artists for a New South Africa’s Amandla AIDS Fund. The charity’s executive director, Sharon Gelman, explained that the money was for buying medicines for those suffering from HIV and AIDS, caring for orphans and AIDS education. The more the merrier, urged Tutu: ‘Pack out those concerts, man, and make sure we get lots of money.’ The guitarist’s generosity was ‘staggering, staggering … almost inexpressible’, he said. Turning to the gathered entertainment celebrities present, he wooed: ‘You helped us overcome apartheid. We are going to overcome AIDS.’ With AIDS drugs.

Reacting to Mbeki’s warning in Parliament on the same day to arms deal critics not ‘to perpetuate the negative stereotype of the African which we inherited from our past’ in bandying around corruption charges without evidence, Leon responded in a speech in mid-June accusing Mbeki of ‘flaming’ critics of the government with racism allegations:

again and again, the President has used race to deflect legitimate criticism. He has tried to turn HIV/AIDS from a medical issue into a racial one. In May last year, Professor Makgoba, president of the Medical Research Council, said President Mbeki’s office had waged a campaign of vilification against him for challenging the President’s views on HIV/AIDS. [In truth, as the record shows, it was Makgoba who had fired an endless fusillade of disparaging public comments in Mbeki’s direction, and not vice versa.] According to Professor Makgoba, President Mbeki’s office appealed “to a very basic instinct: that I am an African like them and therefore I should be in their camp, and if I’m not, I’m a stooge of whites, I’m less of an African”. [Apparently the subtlety of the appeal to him had been too fine for him to understand: that AIDS serves racist ideology and Western commerce.] Yet HIV/AIDS should not be an issue of black and white. It is a matter of life and death. Thirty-five thousand South Africans died in 2001 because President Mbeki refused to give them the nevirapine that would have saved their lives at the cost of a few rands.

And I was just as inventive with the numbers when I was an attorney drawing bills of costs.

Mbeki coolly took Leon’s legs off at the hip the next day. In an address gliding high above Leon’s yapping, he responded:

When we speak of racism and racial stereotypes we do so because we know the hurt caused to those who are victims of this racism. … When we speak of the hurt that affects millions, a few tell us that we are neither entitled to feel such hurt nor allowed to state what we feel. My advice to these is they should desist from telling us what to feel, think and say. I would like to advise them that we fought for our liberation precisely because we refused that anybody should tell us what to feel, think and say. We did not achieve our liberation in order to perpetuate a master-servant relationship in our country.

Leon had no idea what he was talking about, much less any sympathy. Nor did Mail&Guardian staff writer Drew Forrest, squawking from the lower frequencies in a negative commentary on the 22nd.

Professor Jerry Coovadia used the podium at the award of an honorary doctorate by the Wits Medical School on the 24th to keep the flames licking at Mbeki’s feet. In a syntactically and conceptually incoherent acceptance speech (it’s chilling to think he actually marks students’ papers), whose theme was ‘the corrosive conflict between science and the state’, Coovadia raised a hue and cry about ‘the explosive burst of HIV/AIDS ripping through millions of our people’. Then he got onto Mbeki:

There was another serious fallout from the AIDS epidemic in which science appeared to be pitted against the state. … The public expression of this disjuncture was support for the discredited and unproven views on the cause and diagnosis of HIV/AIDS, the epidemiology of the disease, and the safety and efficacy of treatments. This was a political miscalculation of monumental proportions, with global dimensions, and inscribed for times to come into the historical record. In essence, scientifically established facts were challenged, doubted and disputed, in the absence of any reasoned arguments or proof. A critical question troubling many good people is the reason for this profound error of judgment at high reaches of government.

The ‘Professor of HIV-AIDS Research’ thereupon proceeded to provide a sociological answer: The ‘unprecedented reaction to modern science’ of those concerned, meaning Mbeki and his top aides, was explained by a ‘residual outrage against the excesses of colonialism and apartheid’, and a cultural tendency among the indigenes ‘to exclude considerations of intimacy and sexuality in human affairs’. With that penetrating insight into Mbeki’s denialism concerning the uncontrolled promiscuity of blacks as the cause of the AIDS epidemic, Coovadia’s speech collapsed into a mystical ramble, closing with what appeared to be a final needle for Mbeki: ‘The indispensable mission for ... all of us is to remove the shadows of ignorance and deceit and unbridled self-interest which obscure what is real and what is just.’ The doctors old and new, and all the proud mums and dads present, then rose to clap their hands at this person. They thought he was tremendous.

As did Liz Clarke reporting in a osculatorary paean to Coovadia, Democrat continues to clash with silence on the Aids, in the Sunday Independent the following week:

In poetic form, he refers to the clash of science and politics as a ‘modern-day re-run of the epic battles for truth’ between Galileo and the Inquisition. It’s this singleness of purpose, unclouded by meaningless compromise that earned him an honorary doctorate from Wits. Like all other awards, it confirmed yet again that his vast academic insight into ‘the worst pandemic in recorded human history’ is blisteringly clear.

Thanks Liz. That was nice. You can get off your knees now.

Effortlessly repulsed in Parliament by an eminently superior enemy, Leon turned to a softer target in the Minister of Health, and spent the rest of the month overseeing the preparation of his party’s next onslaught. The ‘Fire Manto’ campaign was launched by the DA on 1 July with bumper stickers and a website asking, ‘Can South Africa afford to keep a minister who is incapable of discharging her responsibilities for nurturing the nation’s health and who remains prey to the pseudo-science of the President?’ With an eye on the mid-2004 elections, Leon was on to a winner and he knew it: the HSRC/Mandela study released six months earlier found that ninety-five per cent of the South African public supported the provision of AIDS drugs to people ‘living with HIV/AIDS’. The party intended milking the issue for every last drop. It would be difficult deflecting the challenge.

The next day, on the eve of his African tour, Bush appointed a director for his $15 billion African AIDS programme: ‘Randy Tobias has a mandate directly from me to get our AIDS initiative up and running as soon as possible.’ It was to be no sideshow to placate local AIDS activists, Bush was serious. Tobias would be directing a specially created new State Department office, reporting directly to Secretary of State Colin Powell. It didn’t matter that he had no experience in AIDS; what counted was that he was a former chairman and chief executive of Eli Lilly & Company, part of the American pharmaceutical cartel that had teamed up to resist the commercial threats of the Third World generic manufacturers. Accepting the appointment, Tobias said goddang, ‘the statistics that describe the HIV/AIDS pandemic are really nearly incomprehensible’, but that he’d be approaching the job ‘with enthusiasm and with optimism’. He’d better; his boss Colin Powell had recently stated that he regarded AIDS as ‘the pre-eminent crisis facing the world today’ (in New York Times paraphrase). Addressing which the United States would be applying its united resources.

Statistics South Africa presented Mbeki with Census 2001 on the 8th, reflecting a healthy increase in the population from 40.5 million people in October 1996 to 44.8 million five years later – an increase of ten per cent, or two per cent annually, somewhat at odds with Coovadia’s talk at Wits the month before that ‘HIV/AIDS is ripping through millions of our people ... worse than the fourteenth century Black Death’. As usual with ‘AIDS experts’, by ‘our people’ he wasn’t meaning his own South African Indian people, or ‘coloured’ or white people. He meant blacks. Dying from their ‘unbridled sexuality’.

On the South African leg of his African tour, Bush met Mbeki on the 9th, following which they held a joint press conference. Bush outlined the US’s role as white night riding in to rescue Africans from their sex disease:

The President [Mbeki] also discussed our action to combat HIV/AIDS. South Africa has recently increased its budget to fight the disease, and we noticed and we appreciate that. America is now undertaking a major new effort to help governments and private groups combat AIDS. Over the next five years, we will spend $15 billion in the global fight against AIDS. People across Africa had the will to fight this disease, but often not the resources. And the United States of America is willing to put up the resources to help in the fight.

(Mbeki was too polite to mention the African proverb that the hand that feeds is the hand that rules.) The very first question from the media concerned the purchase of AIDS drugs:

I’d like to direct the question to both Presidents. And it does concern the issue of HIV/AIDS and the $15 billion grant. Did you manage to reach some kind of understanding or consensus on the issue of how South Africa will access that money, on what terms South Africa will be able to access that money? And, President Bush, did you give any undertakings in terms of using your influence to ensure that there will be cheaper access – access to cheaper drugs and medicines? And to President Mbeki, sir, did you ... give any undertaking in terms of the running out [sic] of the national treatment plan?

Mbeki answered first, and deftly too:

Well, as the President had indicated, we did indeed discuss this. The situation is that we received a request from the US government to say, can we make proposals as to how to access the fund, for what purposes – a program, a program that we would present. So we are working on that. We want to respond to that request from the United States government as quickly as is possible. We will do that, and convey it. So it will be out of that process of discussion that will result, out of that proposal between the US government and ourselves, that then will come a program, particular concrete kind of action, with the necessary costing when we get to that stage. So that’s where we are. So the matter will be discussed in that way. And, as President Bush had indicated in our discussions, that of course the US government is taking a comprehensive approach to this, which would therefore include questions of awareness, questions of health infrastructure, questions of treatment and so on. So we will look at the totality of those and in the proposal that we would make.

Presumably in considering the shape of the proposal to be submitted, Mbeki didn’t have in mind asking for any of the $5 billion that Bush had mandated for the instruction of Africans like him in the need to abstain from having sex. And wasn’t thinking of taking a cue from President Arap Moi, who asked Kenyans in 2001 to be celibate for at least two years – ‘extraordinary leadership’, former US President Jimmy Carter called it on a visit to that country in March the following year, to combat the ‘national disaster’ of AIDS.

But in his gushing answer to the journalist’s question, Bush swung the focus to the whole point of his mission – peddling drugs:

We just named Tobias to be the ambassador, nominated him to be the ambassador, and he’s, upon confirmation, will be working with the countries such as South Africa to develop a strategy – is what we need, we need a common-sense strategy to make sure that the money is well spent. And the definition of well-spent means lives are saved, which means good treatment programs, good prevention programs, good programs to develop health infrastructures in remote parts of different countries so that we can actually get anti-retroviral drugs to those who need help. The cost of anti-retroviral drugs has dropped substantially. But we did talk about the pharmaceutical union in a broader context. As you may know, the United States supported a moratorium on the enforcement of patent laws concerning those drugs related to diseases that were causing pandemics. And we will continue to work with South Africa, as well as other countries, to see if we can’t reach a common-sense policy that, on the one hand, protects intellectual property rights, and on the other hand, makes life-saving drugs or treatment drugs for, in some cases, life-saving, in some cases that are proper for treatment more widely available at reasonable costs. But one reason I felt emboldened to ask the Congress for a substantial amount of new money for the AIDS initiative was because of the cost of anti-retrovirals, and it’s significantly lower than it was a couple of years ago. So we’re making good progress. And I look forward to working with the President on putting together a sound strategy that saves lives. That’s what our country is interested in. We’re interested in dealing with this pandemic in a practical way.

When the press conference was over, Mbeki echoed Bush’s ‘Thank you all very much’ to the journalists by wryly ripping off his opening Okie patter (‘Mr President, thanks. Gosh, we’re honoured to be here’) with some of his own: ‘Thanks a lot.’

Secretary of State Powell held a press conference of his own the following day at which he explained the purpose of Bush’s African tour:

We have put before the people of Africa a solid agenda [that] talks about aid and trade. It talks about investment. It talks about HIV/AIDS. … The purpose of the trip was not a political exercise; it was not designed to influence the elections of next year. It was designed to deal with real problems facing people in need in Africa. It was designed to reinforce our relationship with those countries that are moving in the right direction [politically and economically], dealing with the crisis of HIV/AIDS.

About which he had more to say to Larry King on CNN the next day. Asked, ‘How bad in relation to [Africa], how bad is the AIDS crisis?’, he replied:

The HIV-AIDS crisis is bad. It’s a pandemic. It’s a weapon of mass destruction. Millions and millions of people are at risk and it’s not just a human issue. It’s a political issue. It’s the destruction of society, the destruction of country, the destruction of hope for a better life. It’s something we all must come together to fight and I think the United States has been in the forefront of leading this effort and we will continue to do so. The president has a passion for this issue and he has been demonstrating this passion throughout this week in his visit to Senegal and to South Africa and to Botswana and will do it tomorrow when we go to Uganda, then on to Nigeria.

What Powell seemed to be saying was that AIDS had determined Bush’s itinerary. Indeed, why else visit a backwater like Botswana? He said he was ‘confident and hopeful’ that Congress would approve Bush’s $15 billion AIDS plan: ‘We ... were spending billions and billions of dollars already. But the president recognized that the need was so great that we really had to ratchet up our level of spending and that’s why he asked the American people to share our wealth, share the benefits that we enjoy in our country with others around the world who are in need and especially those who are suffering from the pandemic of HIV/AIDS.’

Mandela was needless to say completely taken by all this. Speaking at the annual scientific meeting of the International AIDS Society in Paris on the 14th, he praised the promised Bush billions as a ‘quantum leap’ in the fight against AIDS that had ‘moved the debate from hundreds of millions of dollars to tens of billions of dollars. … Given the size of its collective population and economy, Europe should at least be matching if not exceeding the United States contribution.’ At least twenty-six million people have already died of AIDS, ninety-five per cent of them in the developing world, and forty-five million have HIV, he said,

a shocking reality that we cannot hide from. … These numbers are staggering, in fact incomprehensible. By all accounts we are dealing with the greatest health crisis in human history. By all measures, we have failed in our quest to contain and treat this scourge. Why have we failed? In the end, it boils down to one inescapable fact – we have failed to translate our scientific progress into action where it is most needed, in the communities of the developing world. This is a global injustice which cannot be tolerated. It is a travesty of human rights. The single most important step we must now take is to provide access to treatment throughout the developing world. We must act now for the sake of the world.

No confusing him with Libyan President Moammer Gadaffi, who told African heads of state at the closing of the African Union summit in Maputo two days earlier: ‘AIDS, AIDS, AIDS. We hear about nothing else. This is terrorism. This is psychological warfare. AIDS is a peaceful virus. If you stay clean there is no problem. If you are straight, you have nothing to fear from AIDS.’ He then identified what the whole show was all about: multinational corporations were using AIDS for ‘trade to build up their wealth’. Obviously. But not to dear old Nelson Mandela.

Mbeki delivered the closing address of a four-day multi-denominational meeting of the South African Christian Leadership Assembly on the 11th, convened to discuss the country’s critical challenges, which he identified as poverty, the housing shortage, unemployment and ‘As religious leaders, perhaps it would be important to take and active role in fighting the legacy of racism.’ But the Christians preferred a sexier programme. Opening speaker was Ugandan First Lady Janet Museveni, who stated what was on top of it: ‘Today Uganda is widely cited as a success story in the fight against HIV-AIDS. The clearest indicator of progress towards success is that the HIV infection [rate] dropped from thirty per cent between 1995 and 2002 to five per cent.’ (Wow, in Uganda, by not having sex or wearing condoms, you cure yourself of HIV.) Uganda’s eleven million young people under eighteen ‘are exposed to great danger as they become aware of their sexuality’. With the agenda thus set, AIDS was the hot topic of the congress, taken up by Archbishop Ndungane in his speech: ‘We fought against the divide brought by apartheid. Why must we now allow AIDS to divide us?’

The following day Inkatha leader Mangosuthu Buthelezi soared on similar flights of Christian doomsday fancy at his party’s AGM, preaching the coming cataclysm: AIDS would halve the country’s population, he claimed, playing with his computer: twenty-one million dead by 2025: ‘There are no words which can overstate the challenge which HIV-AIDS has posed to all of us.’ It would inflict more suffering on South Africans than ‘all of the conflicts our country has been witness to in the past three hundred years’. Including the bloodbath he unleashed in his home province with money and guns supplied by the apartheid security forces? One surmised that the reason Buthelezi was punting AIDS was because his party lacked any vision or policy beyond prosecuting a narrow ethnic chauvinism.

Three weeks after a meeting with Zuma’s SANAC, the TAC tried embarrassing the government by leaking to the Cape Times a copy of the joint Health/National Treasury Task Team Report on the cost implications of funding antiretroviral drugs in the public sector. The newspaper published it on the 14th. The sum of it was that at an annual cost of between $3.4 billion and $4.3 billion by 2010, seven hundred and thirty-three thousand lives would be saved by immediate treatment of half of those who were HIV-positive, and a further million by treatment for all. The cost would rise as the numbers of the infected developed full-blown AIDS, it said. Achmat justified his behaviour in leaking the document: ‘Our actions only publicly express the frustration and pain of people who die quietly at home and in our hospitals, in the face of a torrent of excuses and delays.’ But if it was intended to force the pace, it failed. A formal statement issued by the Government Communication and Information System on the same day criticized the TAC’s show of bad faith, dismissed its ‘theatrics’, and pointed out that the report leaked was ‘a very first draft, which they had leaked to Business Day many weeks ago. It seems likely to us that, because there is a Nedlac meeting tomorrow, where this matter would arise, and because the TAC knows the issue will come before Cabinet soon, they are trying opportunistically to place themselves at the centre of attention.’

For his eighty-fifth birthday on the 18th, Mandela was presented with a birthday gift – a book, Nelson Mandela: From Freedom to the Future, with a foreword written by Clinton: ‘At 85, President Mandela is still building bridges, especially those that unite us in the battle against HIV/AIDS, which he calls an “even heavier and greater fight” than the struggle against apartheid. … Now he gives us hope that our work to eradicate HIV/Aids around the world is not in vain, and that one day this awful scourge will exist alongside apartheid only in the history books.’ Nobody commented on the profanity of the comparison. Mandela was pleased with the present: ‘I did not know that I would be honoured in this way. I am a has-been. I’m not President any longer and I am an ordinary person. I want you to treat me that way.’

It wasn’t true, and he didn’t mean it: by leading the charge for AIDS drugs as a puppet of American foreign policy (indeed, Mandela had been described in certain top circles of the ANC as ‘the CIA choice’ for President), he was upstaging, opposing and frustrating the incumbent in his opposition to the drugs, and wilfully too: Inaugurating loveLife’s Orange Farm Y-Centre at Clinton’s side a year earlier, we recall his contrary statement that his children and grandchildren ‘tell me I have lost power and influence, that I am a has-been. They tell me to sit down. That I must stop pretending I am still the president. Now, you have heard all these important people here today, you have heard what they say about me. So, now you must stop telling me to sit down!’ In a birthday tribute, Icon, enclosed on the happy day as a souvenir supplement to newspapers in the Independent stable, John Battersby wrote: ‘In a recent BBC film, The Living Legend ... Mandela candidly admits that there is one thing that he fears more than any other: to wake up in the morning and not have a programme. In other words, the prospect of having nothing to do frightens him.’ AIDS gives him something to do, something to be: ‘He has remained true to his promise to stay out of politics, with the exception of his calculated and sustained broadside against the government’s HIV/Aids policy – or lack thereof – which brought him the closest he has come to a direct confrontation with his successor, Thabo Mbeki. Mandela made it clear that he would never relinquish his right to speak out on moral issues.’ Like the immorality of the government not providing people with AZT.

CHAPTER

I persist with the question I asked in Debating AZT: How long will it take before doctors who have been prescribing this drug wake up and ask themselves, ‘What the hell have we been doing?’ In violation of the Hippocratic Oath: ‘I will prescribe medicine for the good of my patients ... and never do harm to anyone. To please no one will I prescribe a deadly drug, nor give any advice that may cause his death.’ The history of Western medicine isn’t encouraging. An earlier practice to deprive the patient of his blood cells by bleeding, rather than the contemporary chemical way, was medicine’s mainstay from the fifth century BC until well into modern times. The benefits of venesection and phlebotomy were eulogized in a classic exposition published in London in 1840, On the Proper Administration of Blood-Letting, for the Prevention and Cure of Disease, by Henry Clutterbuck, a member of the Royal College of Physicians. It was a panacea for every imaginable ill. The more severe, the more they drew. In the case of US President George Washington – who sought relief for a sore throat – nine pints in twenty-four hours. Which of course was the end of him. Like AZT, it was the time-tested, irrefutably beneficial, standard of care. By the second half of the nineteenth century, however, it was being condemned as useless and often murderous quackery. That’s entirely obvious to us now. But not to the eminent physician Sir William Osler, whose authoritative Principles and Practice of Medicine continued esteeming it highly until as late as 1942 as just the thing for pneumonia. Indeed, the centrality of bleeding to scientific medicine until quite recently is reflected in the title to one of its leading journals, Lancet – a broad, two-edged, sharp-pointed surgical knife specifically designed for puncturing and opening veins. It’s rather like calling a journal of contemporary psychiatry Lobotomy, of Jewish history Vermin.

Since doctors are so useless perhaps it’s lawyers who are going to have to end the slaughter. Justice Departments around the world could start indicting GlaxoSmithKline’s directors. The old common law crime of administering poison should stick as an alternative charge (merely supplying it, knowing it will be fed, suffices as an essential element), if murder (with reckless, indirect intention) or culpable homicide as main counts, before a dim or weak judge, don’t.

There’s a precedent for such a prosecution and it took place in the town of Aachen, Germany in 1964.

First synthesized in 1953, thalidomide was initially marketed by German drug maker Chemie Grünenthal in November 1956 as a new kind of antibiotic for the treatment of respiratory infections – to kill bacteria infesting lungs. A cell-poison, in plain talk, to nail single-cell bacteria. The drowsiness experienced by thalidomide-treated people with chest complaints arising from the immediate neurotoxicity of the drug was read not as a warning but as a new market opportunity. So by October the following year the company was hawking it intensively as a sedative instead. Doctors in turn praised it effusively as safe and effective. For some people thalidomide’s neurotoxicity didn’t end with grogginess, but showed up in telltale tingling then numbness and coldness in the extremities, moving from the feet up to ankles and calves, the same in the fingers and hands, until general painful cramps and muscle weakness set in. Followed by the usual: motor discoordination, loss of balance, facial tics, generalised muscular trembling, impaired speech, double vision and epileptic seizures.

On 27 August 1959 a Swiss company representative reported to HQ: ‘Twenty well-known physicians have now informed our public relations men that they themselves, or their patients, have still had severe side-effects the morning after taking one whole tablet of Softenon Forte [thalidomide] in the form of extreme tiredness, tremor of the hands etc. Professor Ludwig, head doctor of the second medical section of Burgerspital, Basel, added: “Once and never again. This is a horrible drug.”’ In September serious adverse reactions led to discontinuation of the use of thalidomide in a German hospital. In November a German neurologist, Voss, wrote to Chemie Grünenthal to report more such ill effects; the company’s response, established as false at the criminal trial, was that this information had come in as news to it.

Seeing thalidomide take off as a sedative in Europe thanks to heavy marketing, British Distillers (Biochemicals) Company applied for and won a licence from Chemie Grünenthal to make and sell it too. But perturbed about reports coming in of these adverse effects, conflicting with Distillers’s specific marketing plug that the drug was safe, an in-house scientist, Somers, filed an internal memo in December 1959: ‘Hitherto thalidomide has shown no demonstrable toxicity and mice have survived oral doses as high as 5 g/kg ... The observations that our formulated suspension is toxic is disturbing for it means that if we market it in this form our claims are no longer justified and it is suggested that the formulation is amended to avoid this situation.’ He wrote again a month later: ‘The fact that it can be toxic is the worry. You will appreciate that our claim for non-toxicity would not be valid with this preparation.’ Back home in Germany, as grave neurotoxicity reports piled up, Chemie Grünenthal took the necessary precautions: its research director, Muckter, revealed at the criminal trial that its records were no longer available; they had ‘disappeared’ in 1959.

As Somers noted, mice seemed unaffected by the drug’s toxicity (it’s why the prosecution failed), so the thalidomide debacle remains a signal lesson in the limitations of animal models for establishing drug safety – but not so much for its cytotoxicity as much as for for the ill effect for which thalidomide is horribly notorious: its teratogenicity.

Soon after marketing thalidomide as a tranquilliser for general consumption, Chemie Grünenthal cottoned on to an ideal special class of patient to exploit: pregnant women already in the clutches of medical practitioners, as tight as a steel gin-trap. Forty thousand letters went out to doctors in 1958: ‘In pregnancy and during the lactation period the female organism is under great strain. Sleeplessness, unrest and tension are constant complaints. The administration of a sedative and a hypnotic that will hurt neither mother nor child is often necessary.’ The company turned commonplace discomfort into a malady, medicalizing pregnancy for profit. Tapping the market for every penny, Distillers invented a further marketing pitch in Britain and commonwealth countries: it put thalidomide out under a different name as a cure for morning sickness, and plugged it with claims such as ‘Distavel [thalidomide] can be given with complete safety to pregnant women and nursing mothers without adverse effect on mother or child. … Outstandingly safe, Distavel has been prescribed for nearly three years in this country [UK]. … a harmless, safe and effective sedative with no side effects. … Harmless even over a long period of use … completely harmless even for infants.’

The targeting of pregnant women by Chemie Grünenthal and Distillers, assisted by fourteen international distributors, resulted in the notorious thalidomide horror, popularly considered modern medicine’s worst failure. But only because it was so graphic. Andres Goth noted in Medical Pharmacology (Mosby, 9th edition, 1984): ‘The piperidinedione hypnotic thalidomide was responsible for thousands of children with disastrous defects such as absence of limbs. This occurred especially in Germany. Pregnant women ingesting a single hypnotic dose of the drug between the twenty-fourth and thirty-sixth day of their pregnancy have delivered severely deformed babies.’

In April 1961 an Australian doctor, William McBride, wrote to Distillers to report his suspicion that thalidomide was the cause of the epidemic of monstrous birth defects suddenly upon the world. Later claiming not to have received McBride’s dossier, Distillers’s reaction was to pump out a quarter of a million flyers alleging that thalidomide was ‘harmless even over a long period of use’ and ‘completely harmless even for infants’. By November public alarm resulted in the drug being withdrawn from the British market. McBride’s and his German counterpart Lenz’s evidence for the causal link between thalidomide and birth defects was published in a series of articles in Lancet in December, and in January and February the following year. When thalidomide was ordered withdrawn from the shelf in West Germany in March, Chemie Grünenthal protested that it was unjustified. But business remained brisk. After losing their local markets in West Germany and Britain, both Chemie Grünenthal and Distillers continued shipping thalidomide for administration to pregnant women in other countries, both First and Third World, for several months thereafter: Belgium, Brazil, Italy, Japan and Canada, and Angola, Ghana, Guinea, Egypt, Eritrea, Ethiopia, Sudan, South Africa, Mozambique, and Nigeria.

The extent of the disaster has never been quantified. By all accounts about ten thousand children were born in the West with mangled or missing limbs – in the Third World no one counted. The birth defects were conspicuous evidence of the drug’s noxious effect in pregnancy; less noticeable would have been innumerable foetuses killed in the womb and miscarried early. And treated as natural misfortune. At its sales peak, thalidomide was being sold under thirty-seven trade names – alone and in combination with aspirin and other drugs – as a panacea for every imaginable petty ill. It was a best-seller. Even though indisputably an extremely dangerous chemical compound.

Thalidomide offers so many object-lessons. First, in view of how many millions of thalidomide doses were ingested without reports filed of harm caused, one could argue from the numbers that it was a relatively safe drug. Just as one could contend for AZT. Part of the trouble lies in the pronounced inter-individual variability of human response to nearly all drugs, as well as in the recognition and reporting of unexpected events. Secondly, what ended the sale of thalidomide to pregnant women was public pressure, media heat, political action and the odd stray doctor speaking out of turn. Not the industry – the drug manufacturers and their local suppliers, nor the drug licensing boards, which can always be relied on to doze. The Americans escaped thalidomide, not because the FDA was sharper than its licensing counterparts in the rest of the world, but because an FDA staffer, Francis Kelsey, sent up an informal handwritten memo noting her concern about reports of ‘peripheral neuritis symptoms in adults’. That delayed things just long enough for the teratogenicity of thalidomide to become evident elsewhere. The US would otherwise have enjoyed a similar crop of look-alike babies. Thirdly, things have hardly improved since the turn of the sixties for the official monitoring of the ill effects of dangerous drugs. In fact they are much worse. The fourth lesson is provided in a brief review of the thalidomide tragedy in the 3rd edition of the Oxford Illustrated Companion to Medicine:

There seemed no reason to doubt its safety. The tragedy was without precedent and unlike anything that had gone before. It was then widely believed that the human placenta was impervious to poisons except in such doses as killed the mother. Yet there was already widespread evidence that this was untrue and that fetuses could be deformed by external influences, including poisoning and therapeutic drugs ... but most of it had been ignored because this suited the contemporary mind-set or Denkstil. … Why did the medical profession ignore the extensive existing evidence that teratogenic substances (causing developmental abnormalities in the fetus) could cross the placenta? It is useful to look at the question as part of a mind-set or a shared view of reality that controls, organizes, and limits perception and understanding. We all tend to ignore what does not fit the theories and beliefs with which we live.

And so believing that AZT saves lives, because the newspapers say so – and doctors and journalists believe each other – Mbeki’s statement in Parliament that there was a ‘large volume of scientific evidence alleging that, among other things, the toxicity of this drug is such that it is in fact a danger to health’ was just too fantastic to be true. And so it was ignored, but not before it was spat upon. Especially since it came from an African. The final lesson is that when it comes to the hazards of exposing the young to dangerous drugs, doctors never learn.

The monstrous babies born in the years around 1960 were trailed by gasping grey ones: in the preceding fifteen years about two hundred American casualties of the sulphonamide antibiotic, chloramphenicol, were documented in the US, with many thousands more in the Third World, where the drug was sold over the counter. Something doctors called ‘blood dyscrasias’ – to beat about the bush, instead of admitting straight out that the medicine they’d given young Vernon Jr had irreversibly destroyed his bone marrow. An effect also known as ‘fatal aplastic anaemia’, more plainly called. Causing the babies to turn a telltale grey before they gave up the ghost. Chloramphenicol is now permitted for administration to adults as a drug of last resort only, yet remains popular for pet animals. But wash your hands thoroughly after handling it, the manufacturer advises, and do not give it to any animal destined to end up on the table. Like AZT, apart from killing cells, it also maims them: the National Toxicology Program, a wing of the NIH, added chloramphenicol to its list of known carcinogens in December 2002.

But what lifts the case of AZT out of any equation with thalidomide is the urgency of their purpose when doctors administer the former. Unlike thalidomide, which was sold as a salve for minor discomforts such as nausea, headache, cough, cold, flu, asthma, neuralgia, nervous agitation and fatigue, and as a sleep aid for pregnant women and restless babies, doctors give AZT to save lives. Moved by the myth that HIV-positive means death down the track. Without the medicine. There’s a kind of religious resolution. And a sort of lockstep trance. And so no room to think. This is why the most damning data evidencing AZT’s foetal toxicity, for instance, have generally been reported by researchers without comment – or with discount. Concerns noted, when occasionally they are, are quickly forgotten. It’s because the horrible facts don’t fit the medical schema. The marketed one. Studies that didn’t find ill effects, on the other hand, always make the news.

There are countless studies announcing shocking findings about the effect of AIDS drug therapy, but whose obvious significance gets missed in the report. For instance in AIDS in June 2002, Collazos et al. discussed three cases of [B cell] Lymphoma developing shortly after the onset of highly active antiretroviral therapy in HIV-infected patients: ‘We report here three patients who developed rapidly growing lymphomas of different cell lineages within the first 2 months of the initiation of HAART.’ And then brightly blamed HIV not the toxins: ‘Consequently, we conclude that, like other opportunistic conditions, lymphomas may flare up during the weeks after the initiation of HAART, and that this diagnosis should be strongly considered in all HIV patients who develop masses, lymphadenopathy or constitutional symptoms within that period.’ Just like ‘paradoxical flares of diverse opportunistic conditions shortly after the onset of HAART [six reported studies are cited], which have been related to the immune reconstitution that follows the initiation of antiretroviral therapy’ – ‘related to the immune reconstitution’ by ‘AIDS experts’, not by us ordinary fatties, with the common sense to realise that cell poisons poisoning cells create a feast for fungi and bacteria to sup on: those cells killed or dying as opposed to those turned cancerous, reported by Collazos et al., and others before them.

In their literature review of ninety-five studies reporting Inflammatory Reactions [‘involving opportunistic infections, AIDS-associated malignant conditions, and other noninfectious diseases’] in HIV-1-Infected Persons after Initiation of Highly Active Antiretroviral Therapy, published in the Annals of Internal Medicine in September 2000, a group of doctors led by DeSimone also dithered about in identifying the drug culprit – stating that the ‘pathogenesis of these reactions has not yet been clearly defined’ – but finally had the sagacity to consider: ‘It is possible ... that HAART may actually promote the clinical expression and development of such infections, as well as AIDS-related malignant conditions and other noninfectious diseases.’

But doctors can’t leave bad alone. In 1998, with the backing of the WHO, thalidomide was ‘fast-track’ licensed by the FDA for the treatment of lepers, and it’s currently also being tried out against about seventy forms of cancer, and other diseases. Why, if it maims babies so spectacularly, there must be some use for it. It’s reportedly still causing ‘neuritis’ (a medical euphemism for nerve cell damage) and ‘severe rash’ (a sure-fire sign of a drug’s profound general metabolic toxicity) but heck, we’re doctors, we know what we’re doing. I mean we’re the professionals. So just leave it to us. We lower the dose a bit and ‘treat’ nerve cells poisoned off with other pills. The ‘inevitable result’, reports the Oxford Illustrated Companion to Medicine, is that ‘“thalidomide babies” are again being born’. All over South America in particular; you can find pictures of them posted by doctors (of the unusual, thinking sort) on the Internet.

Actually the marketing of deadly dangerous useless drugs by pharmaceutical corporations in full knowledge is perfectly normal. Cocking a snoot at the WHO’s plea not to, Bristol-Myers Squibb (the company’s current name) continued marketing Quixalin, a halogenated hydroxyquinolone drug in Third World countries, even after Ceiba-Geigy had settled a class action in the 1970s by eleven thousand Japanese claimants – bereaved, paralysed and blinded by clioquinol, a similar drug, sold under the trade names Entero Vioform and Mexaform. Ceiba-Geigy had caved after a finding against it on the merits of the case by the Tokyo High Court, issuing as it did so an unequivocal acknowledgement of wrongdoing coupled to an apology (having first fought the suit tooth and nail for nearly a decade): ‘We who manufactured and sold clioquinol drugs deeply sympathize with the plaintiffs and their families in their continuing unbelievable agony; there are no words to adequately express our sorrow. In view of the fact that medical products manufactured and sold by us have been responsible for the tragedy, we extend our apologies, frankly and without reservation, to the plaintiffs and their families.’

A suitably obsequious profession of contrition from a company alive to the neurotoxicity of its product as early as 1935 when the first case of an English woman in Argentina partially paralysed by the drug was reported in the medical literature. Animal studies reported neurotoxicity in 1939. Its inventors accordingly issued a warning in 1944 that its administration be controlled and limited to a week or two, but this wasn’t included with the packaging until 1963 – and then in the First World only. In 1960 the FDA restricted clioquinol sales to prescription. In 1964 another report of human neurotoxicity was published. In 1965 a Swiss veterinarian published a report that a dog given the drug had died of nerve poisoning, so the manufacturer inserted a warning in the drug packaging that it should not be given to pets – in England only. But for people, fine. Two more reports of human neurotoxicity in the US and Sweden were published in 1966, the latter paper in Lancet mentioning how optic nerve atrophy had ruined a Swedish boy’s sight. The manufacturer’s response was to include a warning about this in its package insert in 1968 – but again, in certain European countries only.

And it wasn’t going to be put off by subsequent published research investigations that refuted the drug’s claimed activity as an anti-diarrhoetic, and showed that it actually caused the very malady it was supposed to cure. Like AZT, mercury salts, quinine, and on we could go. Throughout the seven-year Japanese litigation the drug was freely available over the counter in Britain – until 1977, when the writing was on the wall for the defendant. It was then restricted to prescription only, instead of being immediately withdrawn. Following the Tokyo judgment in 1978, Parke-Davis, another manufacturer, stopped making it. But Bristol-Myers Squibb’s cool reaction was to announce in England that it would start phasing the drug out over the next few years. But not because like AZT it was useless and deadly, but because like AZT it was ‘old’. Better to wind down the trade slowly for the company’s convenience than immediately avoid any more blindness, paralysis and death.

Ceiba-Geigy’s grovelling Tokyo abnegation sounded sincere enough, in a characteristically Japanese sort of way. Only to immediately thereafter embark on a flat-out marketing offensive for the drug in India and other developing countries to make up for lost sales. Where it’s still sold. Even over the counter in some. But no longer in the US and other First World countries, where it’s now banned. Travel advisories currently urge international holidaymakers getting Delhi-belly to ‘avoid’ clioquinol-containing products and their analogues ‘like the plague’ in their exotic destinations – where the rules and policing are looser and the drug companies get away with murder, no problem. The US Centers for Disease Control warns that the drug has ‘serious neurological side effects’. Blinded and paralysed people in more than twenty-five countries all over the world don’t need reminding.

A good share of multiple sclerosis cases are thought by some to be a delayed manifestation of clioquinol injury. But not by doctors, for whom such a thesis is as appealing as a poke in the eye with a blunt stick. Their latest theory, published in September 2002 in the Journal of Neurology, Neurosurgery and Psychiatry by Hawkes et al., proposes that MS is – wait for it – a sexually transmitted disease, particularly associated with teenage sexuality. ‘Differences in morality in underdeveloped areas compared to the more developed countries could account for the increased prevalence of MS in industrialised countries.’ Whereas it’s prevalent in Western cultures with more permissive sexual attitudes, it’s rare in indigenous populations separated from white people, they said. [‘AIDS experts’ claim the opposite; it’s blacks who shag around, they say.] Apart from frowning on sex, it’s difficult to work out what the doctors are driving at: whether promiscuous whites are the carriers of yet undiscovered MS-causing germs, or whether youthful sexuality itself spontaneously causes MS. Andrew Jamieson, editor of the South African medical news service, Medinfo, liked the theory though – his confused reading of it anyway. The local doctor said MS was increasingly prevalent in the post-apartheid era: ‘Racial variation in the incidence of MS in this country reflects the previous physical and cultural separation of black and white communities and this cannot be discounted.’ What? You mean black and white are suddenly rocking together so much that whites have started infecting blacks with multiple sclerosis germs?

Actually when it comes to pharmaceutical corporations consciously marketing poisonous chemicals as medicines in developing countries the list is endless. Doyal and Pennell cite Silverman’s study of different drug descriptions in the US as compared with Latin American countries: The Epidemiology of Drug Promotion published in 1977 in the International Journal of Health Services. Numerous dangerous drugs tightly restricted in the First World are widely available in the third, frequently over the counter, with ‘listed indications far more numerous, while the hazards [are] minimised, glossed over, or totally ignored. In some cases only trivial side effects [are] described, but [not] potentially lethal hazards.’

London medical documentary filmmaker Joan Shenton screened her investigation of clioquinol-class drugs, The Story of SMON, on the British Channel 4 programme Despatches in 1983. Watching crippled Japanese women dragging themselves blindly across the floors of their flats, a vast wheelchair parade of victims rolling through one of Tokyo’s high streets, and the sight of clioquinol-treated dogs bounding up with wagging tails, then collapsing, first backwards and then forwards on their chins, lets in just a glimmer of the kind of motivating sentiments boiling in those wild guys who stop at nothing in targeting hard symbols of ruthless, brutal, unbridled, global capitalism.

CHAPTER

The World Bank caused a passing flutter in the third week of July 2003 with the release of a report threatening that unless the South African government combated AIDS more urgently the country faced complete economic collapse within three generations. Of course the additional cost to the state involved in tackling the epidemic would be large, it pointed out. By which it implied the additional cost of drug purchases. Finance Minister Trevor Manuel dismissed the report out of hand: ‘If the objective was to scare people I am sure that they succeeded, but the problem with these kinds of models is the assumptions that go into them. We must guard against the old computer adage of “garbage in, garbage out.”’ Garbage such as the bank’s assumption that a quarter of the South African population is HIV-positive. Standard Bank Chief Economist Iraj Abedian joined in the government’s scoffing in an opinion piece in Business Day on the 28th: ‘We think the probability of predictions of this World Bank study coming true is as high as that of the bank halving global poverty in the next two generations.’ Nobody noted the World Bank’s palpable commercial interest in painting such an alarming scene: it’s in the lending business, and since July 2000 it had been soliciting the South African government to borrow its money, on interest, to buy AIDS drugs.

Mbeki voiced some now rare public thoughts about a new round of controversy in the AIDS arena, generated by the MCC’s dramatic announcement on the 29th that it had rejected the Ugandan HIVNET 012 study on account of serious data integrity problems (closely examined in The trouble with nevirapine), and that it had put the manufacturer to come up with other proof that the drug worked to immunize babies against their HIV-positive mothers. This was the clinical trial on which the TAC had based its successful case against his government in the High and Constitutional Courts, so the drug’s fans were noisily upset. But the MCC’s decision was squarely within its jurisdiction, Mbeki affirmed on national radio a day later, pointing out that the body’s function was to ensure the safety of licensed drugs. In his regular Friday letter in ANC Today at the end of the week, Mbeki commented incidentally on the decision, and scorned Achmat and his TAC as he did so:

Some questions burst suddenly over our heads, such as … the decisions of the Medicines Control Council (MCC), about the anti-retroviral drug, nevirapine. This announcement illustrated the challenge we face, to ensure that even on this vexed question, we honour our commitment to let a hundred flowers bloom, and a hundred schools of thought to contend, refusing to allow the never-ending search for scientific truth to be suffocated by self-serving beliefs. Critical to the success of the historic African transformation project is our courage to stand up for what we think and feel is correct. We must have the confidence in ourselves to say and do what we believe is right, and openly to admit and correct any wrongs we might commit. We must free ourselves of the ‘friends’ who populate our ranks, originating from the world of the rich, who come to us, perhaps dressed in jeans and T-shirts, as advisers and consultants, while we end up as the voice that gives popular legitimacy to decisions we neither made, nor intended to make, which our ‘friends’ made for us, taking advantage of an admission that perhaps we are not sufficiently educated.

Mbeki’s delectably sarcastic allusion sprung from Rory Carroll’s unintentionally foolish portrait of Achmat in the Guardian six months earlier, A good man in Africa. On 10 December 2002 Carroll related:

At a reception in Johannesburg last week, South Africa’s former president turned to Achmat and asked him, with cameras rolling, to take the antiretrovirals. ‘Give me, as an old man, your promise that you will now take your medicine.’ Not for the first time, the national hero, dressed as ever in T-shirt and jeans, said no. A few days later, in a suburban Johannesburg garden, between mouthfuls of cake, he explains why. ‘It is a personal issue of conscience. I have become middle class but my brothers are working class, and if they were infected they could not afford the medicines.’ … Achmat is HIV positive, yet refuses to take the antiretroviral drugs that could prolong his life. But he does boost his immune system with protein – with chocolate cake.

A good immune booster, apparently, and full of protein. ‘The country braced itself for an emotional funeral several months ago when the 40-year-old became too weak to do more than whisper, yet still rebuffed friends’ pleas to relent.’ Yet without the drugs to ‘prolong his life’, the ‘good man in Africa’ with the fatal disease sprung right back, ‘even put on weight’. Nursing the fame he’d carefully crafted as a brave martyr, Achmat told Carroll: ‘I wouldn’t recommend anyone to take this stand.’ It’s incredibly hard not taking AIDS drugs. Fortunately, though, ‘Nelson has given us protection’ while ‘We were really under siege’. By which he meant ignored by the government, with the occasional irritated snap back. Achmat turned to ponder, ‘Why is the president like this?’ before proposing: ‘The central problem is the absence of political will. … Unfortunately, there is no God, so you won’t get an answer there. We may never know.’ But with no hope of finding his answer by looking into the heavens, Achmat arrived at his own theory: ‘The president doesn’t want to believe that people in Africa have a lot of sex.’ Not difficult to understand why Mbeki regards Achmat with the regard one has for lice in a blanket.

At the first South African AIDS Conference commencing on 2 August 2003, a three-day meet financed largely by UNAIDS, Achmat announced on the last day that he was giving up in his chicken game with death by forswearing AIDS drugs for himself until the government folded. The TAC’s national congress had voted that the time had come; their leader should start taking his medicines. Announcing that he’d accordingly to decided to pack in his moral theatrics – since the government hadn’t yielded to them – the chicken spun his cowardice to stick it to Mbeki and Tshabalala-Msimang like this: ‘I won’t die for Mbeki and Manto. … We do not want Manto and Thabo to get their way. Manto and Thabo want me to die and I am not going to hang in there and let them kill me. … I am not going to die because they want us to die.’ I’m not that brave, really, that I’m prepared to die for my cause. I was imitating Bobby Sands purely for show. I was only pretending to be in his moral class. Basically I’m a fake. But anything for attention. ‘We say, Manto, come with us to our homes and our graveyards, and see what is happening to our people.’ Come and see how people like me are dying.

His CD4 cell count was below 250, he said – for more than a year, indicating full-blown AIDS, added Heywood. But Achmat said he was ‘feeling OK generally’. Looked it too, noted Di Caelers in the Cape Argus the next day: ‘In spite of his apparent ill health, Achmat was at his feisty best in Durban yesterday as he ... negotiated vigorously with police to let a group of about 250 TAC demonstrators through the roadblocks to the Durban International Convention Centre.’ With more lined up: the TAC’s civil disobedience campaign would be re-launched he said, and he was consulting the unions and other allies to resume it within a month. ‘We will be marching, that is for sure,’ insisted TAC spokesman Desmond Mpofu. Another, Siphokazi Mthathi, explained: ‘We want to believe the government is committed and has the best interest of our people at heart, but we are not seeing that, we are not getting it, so we are preparing to make sure we get that kind of leadership.’

But Tshabalala was in no mood to be pushed around, as she made clear in her opening address: South Africa would determine its AIDS strategies ‘without influence from foreign agendas’. Promoted by local stooges: TAC members heckled her, holding placards flashing the slogans: ‘Save Our Youth, Save Our Future’ and ‘Two pills a day saves lives’. Getting AIDS drugs into South Africa was ‘the highest priority’ said UN Special Envoy for HIV/AIDS in Africa Stephen Lewis. In a projected videotaped speech, UNAIDS Executive Director Peter Piot pushed for drugs too: ‘Throughout the world the debate is not whether to offer antiretroviral treatment, but how to do it. For heaven’s sake, let’s not wait until we have the perfect solution.’ The final solution.

As Achmat was arguing with the constables at the barricades, Professor Alan Whiteside, director of the Health Economics and HIV/AIDS Research Division at the University of Natal, urged about a hundred priests packed into St Cyprian’s Anglican Church in Retreat near Cape Town to put pressure on political leaders ‘at the most senior levels – the President, Ministers and our provincial governments’ to fight AIDS. ‘We need to start at the top and if we can’t make a difference there, there are many other levels where we can make a difference.’ Because unless we keep the fire going, I might have to pack things in and go back to my university in England. Archbishop Ndungane responded with an exhortation for Mbeki: ‘... whenever you speak, you must speak about HIV/AIDS – just as we’ve told our clergy they must talk about it from their pulpits. … As a church we’ve always said that HIV/AIDS is a national human emergency. It requires all sectors of society to respond as if we’ve got an enemy on our borders and are marshalling all our forces.’ Back in Cape Town the following day Ndungane had hard words for Tshabalala-Msimang, condemning her for the Medicine Control Council’s just-announced decision to reject the Ugandan HIVNET 012 study of perinatal nevirapine (discussed in The trouble with nevirapine). As if the MCC dances to the Health Department’s tune:

The [Health] Minister is quite right when she says the AIDS pandemic is the responsibility of every government department, and I believe it is time her fellow ministers accepted responsibility for what has become a world disgrace as serious as apartheid. How can our government not acknowledge that nevirapine is recommended in dozens of countries in the world, including our own, as a safe chronic medication? The fact that six hundred people are dying daily is a serious indictment of our elected government and leaves the impression that it doesn’t care whether we live or die.

Who cares was declared on slick, professionally produced placards waved by TAC demonstrators at the opening of the Durban AIDS Conference: ‘WHO CARES? WE CARE AIDS TREATMENT NOW’.

Achmat’s timing was unfortunate. In his closing address at the conference on the 6th, KwaZulu-Natal Health MEC Zweli Mkhize announced that he was speaking on behalf of Tshabalala-Msimang, who had had to leave before the last day on a trip abroad, in stating that an antiretroviral drug programme was ‘a reality’ to which the government was committed, and a matter not of if, but when: ‘There is no question about this.’ Bitter about the government’s impending capitulation Tshabalala-Msimang had switched contemptuously to Zulu midway through her own address before she left: ‘We are prepared to work together ... but we are not prepared to work with agents who are bent on misleading the people of South Africa.’ Agents like James McIntire of the Chris Hani-Baragwanath Paediatric AIDS Unit, smiling cherubically, whose hand she refused to shake when he stuck it out. Like Bertrand Russell refusing to shake Harold Wilson’s. Despising him. It’s no wonder that she got Mkhize to make the announcement for her, and left on other business before the end of the conference: she probably anticipated that she would have choked on it. In his speech at the end, South African Medical Association president Kgosi Letlape made a direct call on Mbeki: ‘Lead us in this fight, Mr President’, and offered his organisation’s doctors as ‘troops’ in the war. But he rather blew any prospect of his appeal finding favour with the king by chasing his appeal with a personal insult: ‘Pseudo-science’ had created ‘havoc in this country’, he said. Leaving no one in any doubt about who’s.

Atoning effortlessly for supporting the apartheid regime until it folded, Die Burger in the Cape published a morally indignant front-page editorial on the same day alleging that more than a thousand South Africans died from AIDS daily. It accordingly called on the government to declare a state of emergency and demanded that Mbeki apologise for not admitting his mistakes over the disease. Editor Arrie Rossouw explained (I translate): ‘It is the strongest form of protest available to us to express the concern and disapproval of our editorial staff and our readers over the government’s handling of the crisis. This insanity must stop.’ We at Die Burger care about blacks now. We newly progressive-minded Afrikaners like talking about AIDS in Africa. That black people have all got.

It was reported on the 7th that Mbeki had finally signed the Global Fund agreement. KwaZulu-Natal in particular stood in line to receive an allocation of R500 million for AIDS programmes, including the provision of antiretroviral drugs. As anticipated by Mkhize’s announcement at the South African AIDS Conference, the cabinet announced a rollout of antiretroviral drugs at its meeting on the 8th, directing Health Director General Ayanda Ntsaluba to table a detailed ‘operational plan’ by the end of September. But not for all HIV-positives, only those who had ‘progressed to an advanced stage of AIDS … In other words, not everyone who is infected with HIV would need antiretroviral treatment.’ Not the TAC’s vigorous street dancers, in other words.

A unanimous tactical decision it might have been to defuse the immense pressure on all fronts that the government was under, but it upset Tshabalala-Msimang profoundly to have had to put her seal to it. A professional colleague whom she telephoned in the weekend following the announcement told me she was ‘almost in tears’ over having had to vote with the rest of Cabinet, and thereby appearing to be writing a prescription for the hateful medicine. For the newspapers, though, she put on a brave face. In a statement shortly before the announcement, she woodenly reiterated the Cabinet’s language in its famous 17 April 2002 statement: ‘Antiretroviral drugs can help improve the condition of people living with AIDS when administered at certain stages in the progression of the condition in accordance with international standards’, adding: ‘Appropriate support systems [‘infrastructure, capacity to safely administer and monitor the effects’] are critical for the success of such a programme.’

Which made the big rollout demanded by the TAC a distant prospect. Peter Barron, director of the Health Systems Trust, pointed out that the country was critically short of doctors and nurses, particularly in the rural areas where the HIV seroprevalence rate was highest. Many hospitals and clinics lacked the facilities to deliver good quality primary health care, never mind administer antiretroviral drugs under close monitoring with regular, expensive blood tests: ‘Between 10 and 20% of facilities do not have access to electricity, sanitation and consultation rooms.’ Of course the Cabinet knew all this, Mbeki most keenly – as evidenced by a crafty question to Clinton during the latter’s visit to celebrate Mandela’s eighty-fifth birthday in July. And to talk about drug trafficking together in their retirement. Interviewed by Time on 3 November, Clinton said Mbeki had asked him: ‘“Now, if I do this, you’ll promise me that these drugs will be administered with the same high quality [of clinical support] that the [National Institutes of Health] would use in America?” I said, “I give you my word.” He said, “O.K., I’ll do it.” What Clinton didn’t know was that privately Mbeki was furious about his interference, and that he held him personally in too little regard to bother arguing the toss with him. With the result that Clinton left the meeting as ignorant of Mbeki’s actual position on AIDS drugs as before it, and with the impression that he’d ‘brought him round’, as he put it: ‘You can only stay in denial so long … He was exposed to two articles by people – I’m ashamed to say they were Americans – who said HIV doesn’t cause AIDS, and the medicine could kill you [actually a lot more than ‘two articles’]. He also had a legitimate substantive issue: South Africa had given out anti-TB medicine without a proper protocol and they wound up spawning some more virulent, drug-resistant strains. But we just kept on working on it.’ We just kept on selling drugs to him.

But Mbeki had a second reason not to get too worked up over his government’s forced capitulation: Africans are not stupid, he commented privately; they won’t carry on taking toxic drugs that make them ill.

Tshabalala-Msimang commented after the rollout announcement: ‘As Minister of Health I am part of the Cabinet and therefore this was a collective decision owned by all of us Ministers.’ That is to say it was a political decision, not hers – notwithstanding that it was in regard to a matter falling squarely within her portfolio. She was explicit about this in a statement made on Women’s Day: ‘I am not the one making the decisions. The Cabinet decides collectively.’ The political rationale behind the decision was given up by a disclosure attributed to ANC election strategist Manne Dipico in the Mail&Guardian that the party would have no ready answer to an Opposition campaign centring on the government’s failure to provide AIDS drugs – letting on that the decision was designed to draw the fangs of the principal plank of the Opposition’s campaign against the ANC in the 2004 election.

But the newspapers missed this. The Sunday Times headlined Mandela’s joy at Aids decision on its front page on the 10th, describing the decision as a state U-turn in the title to a feature piece inside. Mandela was ‘overjoyed’, said his foundation’s chairman Jakes Gerwel. So was Cameron, ‘elated and optimistic’, he bounced: ‘I think this is going to translate within months into many lives being saved. … There is a long hard road ahead and at least we’ve now embarked on it.’ Long walk to save South African lives: Government’s change of heart comes after years of dithering was the title to another article in the newspaper. It may have been good for the cat litter box, but at least it wasn’t made up as the Mail&Guardian’s was: Aids: Ministers revolt. But the New York Times equalled the thumb-sucking in South Africa Addresses AIDS on the 18th: ‘

After years of unconscionable obtuseness about treating AIDS, the South African government has finally accepted modern medical practices. South Africans will soon begin to get AIDS treatment through the public health system, and the health ministry has been ordered to present a detailed national plan for dealing with the virus. One in five adult South Africans is infected – nearly five million people – the largest number of any nation. AIDS is devastating the economy and cutting food production. A thousand people die each day, the vast majority in their productive years. … Ms. Tshabalala-Msimang, who should have been dismissed long ago, is now warning that there may be delays in rolling out the anti-AIDS plan. This is no surprise, as her ministry has spent its time fighting treatment instead of preparing for it. Now that the government has endorsed AIDS treatment, it must race to make up for lost time lest thousands more die needlessly.

This is the stuff informing American political opinion. This is their newspaper of record.

Small surprise then that a group of seven US senators, who were visiting South Africa and other countries nearby to learn all about the terrible AIDS epidemic firsthand, so that they could go home and advise the Bush administration on how best to spend his $15 billion, should get testy talking to journalists on the 21st, after Trade and Industry Minister Alec Irwin had told them that AIDS was not having any measurable impact on the economy, nor was it reducing life expectancy. ‘I told him I find that hard to believe based on world literature,’ said Senate Majority Leader Bill Frist. Why, the World Bank had just published a scary report to the contrary. ‘I want to encourage the political leadership here to recognise the magnitude of the problem.’ And stop being in denial, because: ‘If the United States government is going to be investing tax payer money, we need to make sure that money is invested with the full cooperation and support of governments who will be recipients.’

After visiting the Chris Hani-Baragwanath hospital to listen to some desperate woman sobbing, ‘I can’t afford [AIDS] medicine, it’s too expensive; I know with your help my dream can come true’, the senators popped into an ‘AIDS orphanage’ nearby, run on American grants, to sit on little red plastic chairs with the HIV-positive children on their knees and play cards and sing along with them, ruminating out loud for the accompanying journalists that they could die without AIDS drugs. ‘It’s a human tragedy’, added Senator Mike DeWine sadly, all the way from Ohio; ‘That is why we have to do everything we can to get drugs to these kids.’ Presumably his government’s funding for the place was sufficient for all the tissues they needed to blow their noses. Broken-hearted over all the poor little children who couldn’t get their AZT.

Whether they ever would, grownups too, was undecided, said Tshabalala-Msimang, addressing delegates at a primary healthcare conference on the 29th: ‘Should we as Cabinet decide to give antiretrovirals, we will not be influenced by toyi-toying in the streets. We must not use our hearts, we must use our minds. We can’t base policy on emotions.’ As the TAC would have us do.

Achmat announced on the same day that he would commence taking a cocktail of stavudine, lamivudine and nevirapine from the beginning of September: ‘I am in a lucky position because I have a strong set of organs,’ he said, whatever that was supposed to mean, but nonetheless signifying that he was aware that taking the drugs would be no cakewalk. He was still healthy twelve years after his diagnosis, he explained, because he had never smoked and had drunk alcohol ‘occasionally only over the last four years’. Pretty useless virus, he might have thought.

At a media briefing on 8 September Achmat said that he’d swallowed his first dose of Triomune, an Indian-made generic cocktail in one tablet, four days earlier in the company of a few friends and family members. No serious side effects from it, he reported, apart from a terrible headache and a light-headedness that made him feel ‘high’. He held up a pill for the adoring journalists: ‘That’s what I have to take to keep me alive – I hope for the next twenty years.’ He explained his big decision to Stephanie Nolen, the Canadian Globe and Mail’s African bureau head, writing A victory for South Africa’s martyr-in-chief on the 13th: ‘I don’t want to kill myself for Thabo Mbeki. I can’t think of a dumber thing to do.’ Or as he’d put it at the Durban AIDS Conference on 4 August: ‘I am not going to die, because they want us to die.’ But anyway, as he told Stephanie: ‘I was never made for a halo. Now, I don’t have to be a hero or a saint or any of those things. I’m pretty glad the halo’s gone.’ ‘He laughed again, a little darkly. “Now I just hope the medicines work.”’ (How they worked you’ll learn at the end of this book.)

A letter by Tshabalala-Msimang in ANC Today on the 12th disabused anyone imagining from the Cabinet’s measured retreat over AIDS drugs, and from Mbeki’s own studied silence in the matter, that that he had again bought into the claims of AIDS Inc.:

Do we know what it is that is killing the people of Africa? Do we have a good sense of the health challenges facing them? And are we in a position to conceptualise strategies and advise African Heads of State and Government on appropriate responses? This was a challenge thrown by President Thabo Mbeki to the thirty-seven Ministers of Health and delegates from forty-six African countries on the eve of the 53rd Session of the World Health Organisation’s Regional Committee for Africa convened in Johannesburg last week.

By impertinently insisting that such questions were open, and by implying that the answers of the ‘AIDS experts’ were unconvincing and warranted another look, Mbeki made his own opinion abundantly clear – and significantly too, since, as Tshabalala-Msimang noted, ‘we become Vice President of the World Health Assembly in Geneva next year’.

Three days later Mbeki appointed her Acting President while he was away attending peace talks in Burundi with Zuma – to which DA spokesman Mike Waters reacted charitably that not only was she unfit to be Health Minister, ‘she is most definitely not fit to be acting President’. Columnists and cartoonists across the country expressed the same sentiments. But the remove between what her spokesman Sibani Mngadi called ‘the DA and other reactionary forces in this country’ and the majority of the country’s people was highlighted by him the next day:

The majority of South Africans reiterated their confidence in Tshababala-Msimang by putting her at number fifteen among sixty members of the ANC National Executive Committee during the ANC national conference in December last year. Last month the representatives of women of this country put her at number two in the NEC of the ANC Women’s League. None of the DA leaders, including Tony Leon, can stand in a general election against Tshabalala-Msimang and win. Tshabalala-Msimang’s secret is her loyalty to the ANC and willingness to implement its policies even when its means being under perpetual siege.

An aide commented: ‘It is clear that the community where the media is pitching is not her main constituency, but at a community level they are absolutely mad about her.’

In a radio interview by Khopotso Bodibe of Health-e, one of his ‘friends’, as he calls him, which was broadcast by John Perlman in two parts on 18 and 25 September during his regular Thursday AIDS slot on SAfm, Cameron lowed some more about his AIDS drugs in the manner of a happy patient returning from one of those alternative cancer clinics in Mexico just over the US border, where for a goodly sum of cash a quack will squirt black coffee up your arse with an enema to cure whatever cancer the regular guys have diagnosed you with: ‘My tummy would go into cramps twice a day after I took the drugs. … [I suffered] violent gastric side effects.’ But nonetheless the experience gave him ‘a zest for life, which had been depleted over the preceding 18 months … within a few weeks I realised that something incredible was happening in my body. The virus had been stopped in its tracks.’ The pills he was taking were Zerit (d4T, Bristol-Myers Squibb’s AZT lookalike, which Achmat began enjoying in generic form), 3TC (GlaxoSmithKlines’s similar nucleoside analogue) and the protease inhibitor Norvir. Which also caused ‘peri-oral neuropathy’, he said: ‘I had severe pains in my facial bones and my sinuses and in my teeth, which I think were caused by either the protease-inhibitor or by the Zerit, which they now know has neurological side effects as well.’ (They always did, brû.) The aches and the squirts that made him feel so good moved Cameron to switch to AZT and 3TC and nevirapine. That his medication had put him on the high road to liver failure didn’t worry him one bit: ‘My tummy is getting a bit larger and people tell me I’m putting on weight. In fact, I’m not putting on weight. My liver and some of the other inner organs are growing a bit larger from lipodystrophy’ – ‘organ thickening’ he noted lightly: a ‘minimal side effect’. Actually, hepatomegaly, resulting from fatty degeneration of the liver: according to the findings of Justice et al. mentioned earlier, the ‘most common cause of death among HIV positive people’ is not AIDS-defining diseases, but ‘liver failure’. Like Larry Kramer’s. But Cameron was just so overjoyed to be able to afford the blessings (‘I feel blessed’) of GlaxoSmithKline and Boehringer Ingelheim. Which had sold him the promise that he’d have been dead without them: ‘It’s absolutely certain. I would have been dead within thirty to thirty-six months after my [AIDS] diagnosis.’ The intellectual actually believed the drug merchants:

That is a medical certainty. And today I’m living. … For me a miracle happened and I want that miracle to be available to other people where they can be given their lives back, be given a sense of well being and efficacy and engagement and joy back in their lives. And I believe we can do that, we as South Africans can prevent four to five million deaths through effective medical care and treatment through the next decades.

I also believe we should all hold hands now and give praise. And sing together: I’m a believer…

In New York in the last week of September to attend the opening of the UN General Assembly, Mbeki acceded to requests for interviews by CNN, the New York Times and the Washington Post, and was pressed regarding his position on AIDS in each one. On the 24th CNN’s Wolf Blitzer quizzed him on his controversial past statements, to which Mbeki responded that his government was taking a broad approach to AIDS. His response to a second question concerning the country’s use of AZT was that South Africa follows the US Department of Health and Human Services protocol for the use of the drug. The following day, in South African Leader Defends Delay in Offering AIDS Drugs, he explained to the New York Times that

it had been necessary to create a critical mass of public health care workers who knew how to instruct patients on the drugs’ use. ‘It’s incorrect merely to say, “Distribute anti-retroviral drugs, problem solved.” It can’t be correct. It isn’t. You’ve got to come at it in a more comprehensive way. The assumption in a country like the United States is of a health infrastructure and system that is as good as here.’

But it’s what he told the Washington Post on the same day that caused a right royal row back home. A front-page headline in the Cape Argus exploded on the 26th: Five million South Africans have HIV. More than 600 people die each day in this country from Aids-related diseases. 250 babies are born every day with the virus. Yet our president says: I DON’T KNOW ANYONE WITH HIV.

Shock, anger and a good deal of sarcasm – along with a call for President Thabo Mbeki to apologise – have greeted his insistence in the United States that he does not know anyone who has died of Aids. Another furious response [by Independent Democrat Patricia de Lille MP] to the comments from the man who leads South Africa, where nearly five million people are infected with HIV and more than 600 people die of Aids every day, is that his statements are the ultimate confirmation that he is a ‘dissident’. … The latest storm around the president and his approach to HIV/Aids centres on an interview at the Plaza Hotel in New York, where Mbeki was attending the opening of the United Nations General Assembly. In the interview he was adamant he knew of no person who had succumbed to the disease. ‘Personally, I don’t now of anybody who has died of Aids,’ Mbeki is quoted as saying. Asked whether he knew anybody with HIV, he added quietly: ‘I really, honestly, don’t.’ Political parties and AIDS activists here jumped to express their anger, shock and disappointment at what they said was an ideal opportunity for the president to help break through the stigma surrounding HIV/Aids in South Africa. About one in 10 South Africans is infected with HIV, with 250 babies being born with the virus a day. Democratic Alliance spokesman on HIV/Aids Mike Waters has called for the president to apologise and to move quickly to address his error by committing himself publicly to the planned national rollout of anti-retroviral drugs to prolong the lives of South Africans with Aids. … ‘It is clear that members of president Mbeki’s inner circle are rich enough to afford their own anti-retrovirals [because, being black, they have AIDS, unlike Tony Leon’s white inner circle], and that the president has little understanding of the epidemic sweeping our country. When both the president and the minister of health are fervent supporters of dissident views on HIV/Aids, it can mean only bad news for our country’s fight against this deadly disease,’ Waters said. Leader of the Independent Democrats Patricia de Lille, who has a long history of fighting for the rights of people with HIV/Aids, said Mbeki’s comments where ultimate proof that he was a ‘dissident’. ‘This confirms that he believes HIV does not cause Aids and that he should be ashamed of himself,’ she said.

After quoting Achmat’s contribution to the fuss, the Argus report concluded by mentioning Mbeki’s statement that although the antiretroviral rollout report was imminent, the country ‘did not have the health infrastructure to make these drugs available to whoever needs them’. The report dishonestly omitted the awkward rest of what Mbeki told the Washington Post: ‘Because of the nature and sensitivity of these drugs, it’s important that the people who dispense them and supervise their use must be specially trained. You can’t just give them to some doctor or nurse. It’s not like people coming in with a stomach ache and you give out whatever thing deals with a stomach ache. Because indeed what you could be doing, you’d be giving out these things and killing people.’

Presidential spokesman Bheki Khumalo tried defusing the outrage by pointing out that Mbeki had been asked a personal question: ‘It was these questions specifically about people close to him that the President answered, and his negative replies do not support any broader interpretation.’ None of which assuaged the indignation of drag-queen Pieter-Dirk Uys, who threw a fit in the Cape Times three days later. In a long letter flagged by an approving covering article, Pieter-Dirk Uys adds voice to anger over Mbeki’s Aids denial to US newspaper, he called for Mbeki’s head:

It is time to replace this man with a leader who cares about his people. … He condemns his nation to death. … Replace this failed leader with a comrade of compassion. … Replace this failed civil servant in denial with a citizen who can heal and help. … No more Thabo Mbeki. We need leadership to inspire confidence and optimism in our time of national fear and need … Replace this man now with a committed leader and let him, or her, lead and help us to live.

Off the fortune I’ve earned from AIDS. Which is why I’ve filled out so nicely like a chubby-jowled, claret-cheeked Dominican in all my finery. And looking just like one too in my academic robes on the day the University of Cape Town awarded me an honorary PhD in English, earlier in June. Yes in English. Followed by another in Education from the University of the Western Cape in the middle of the commotion on the 26th.

But in calling for Mbeki’s ouster, Uys hadn’t noticed that he was out in last year’s frippery. And that the tide of public opinion had turned Mbeki’s way: an ACNeilsen poll reported by Business Day on the 29th found that his government’s polularity shares had risen twenty-five per cent since the same poll the year before.

In a letter of his own, Mbeki’s Minister in the Office of the Presidency, Essop Pahad, dismissed Uys’s ‘clown’ antics as ‘a complicating irritant of minor scale’. But the Cape Argus loved Uys for the trivial controversy he generated, just the right stuff for a full-page interview on the 13 October featuring four bright colour photos, pride of place going to Uys in drag holding a banana in one hand and a plastic phallus in the other. ‘If the leader doesn’t care, the people don’t know what to do’ Anti-apartheid satirist Pieter-Dirk Uys is fighting the greatest battle of his life – in the forefront of the war against Aids. His battleground? The schools of South Africa – where ignorance and fear are driving our children to deadly anal sex. So went the headline, with the quotation in bold type. The PhD in English, and in Education too, was quoted thus:

I keep saying that the safest sex is no sex, but this is not a musical, it’s going to happen, so know what it is. … Sex is a very taboo thing when it comes to religion, but I’m not talking about morality, I’m talking about hygiene. If you don’t brush your teeth, you will lose your teeth. If you don’t protect yourself, particularly during sex, you will get the virus, which will not go away when you take a pill. … The bottom line is we are not attacking anybody. All we are trying to say is, ‘For God’s sake, we are dying. We are dying of a virus that has no cure, but we can care. And if the leader cares, the people care. And if the leader doesn’t care, the people don’t know what to do and they make mistakes. If they make a mistake they are not going to live long.’

And this aging dad has really become quite pathetic.

The doctor of education contributed a piece, Education AIDS, to the Laugh it off Annual: South African Youth Culture (Double Storey Books, 2003) in which he recalled a conversation with one Christine, a young woman ‘with AIDS’ at a ‘coloured’ school he was visiting in Hout Bay: ‘And how’s your medication going?’ he asked.

No, Pieter, it’s going very very well. Truly. I get a free pill every day, because you know the pharmaceuticals are being blamed for making money out of AIDS, and so they want to be seen to give free medicine and so I get this pill and I’m so grateful, you know, Pieter? But really this pill is terrible for me. It makes me so mad in my head and so sick, that I’d rather die from AIDS than from this terrible pill, you know, Pieter?

But Uys isn’t listening – a paragraph later he’s climbing into Mbeki for not buying AIDS drugs, and is educating Christine to disregard the neurotoxicity she’s experiencing:

But then I’m sure President Thabo Mbeki knows what he’s doing! I mean, Jesus Christ, he’s got to know what he’s doing? Hey? Maybe he refuses to give the needed anti-retroviral drugs to sick mothers and dying babies because Thabo has information on their toxicity. Oh rubbish, he gives those drugs to his own Cabinet and comrades and they need them! … So Christine in Hout Bay? … Swallow that free pill and have a nice day.

This was the sort of peroration that had the country’s university professors falling over themselves to bestow honorary doctorates on this arse.

Tshabalala-Msimang was given the rollout report on the 30th – but to read before presenting it to the Cabinet and not to splash around the newspapers, she said. The day after she got it, the New York Times weighed in with a scabrous diatribe against Mbeki, As Millions Die, ratcheting up the intensity of the US propaganda offensive. Truly the American press had succeeded the English in the virulence of their morally inflamed denunciations:

A generation ago, Americans protested and held divestment rallies in a snowballing movement against the injustices of South African apartheid. These days, an incomparably greater injustice – random sickness and death, often striking infants – ravages South Africa. Yet the response in America and Europe, as in Africa itself, has been tepid. The South African president, Thabo Mbeki, for years pursued a disgraceful policy of raising doubts about whether H.I.V. causes AIDS and questioning basic policies to confront the crisis. ... Mr. Mbeki’s know-nothing obstructionism has killed incomparably more South Africans than any apartheid leader ever did. … In America, we think of AIDS simply as an epidemic. In fact, like the Holocaust, it is a moral challenge to the world, one we are failing. ‘It’s mass murder by complacency,’ declared Stephen Lewis, the United Nations special envoy for AIDS in Africa, adding: ‘The time for polite, even agitated entreaties is over. This pandemic cannot be allowed to continue, and those who watch it unfold with a kind of pathological equanimity must be held to account.’

Git yer lasso, Will. This here no-good crazy nigger sonofabitch needs stringin’ up.

The Mail&Guardian played follow my leader to American opinion on 3 October in a lengthy commentary by Ferial Haffajee, entitled Africa’s Leader or its Laggard?

Has Mbeki changed his mind; is his government’s embrace of conventional Aids science wholehearted; and does he support the methods of prevention, treatment and care of Aids that the rest of the world now recognises as optimal? Mbeki will trip up again and again on the Aids issue because the answer to each of the above is no, no and no again … We cannot have a president burying his head and withdrawing from a policy and a debate that is our most serious challenge. … For most other modernist leaders of his ilk there is no obsessive dissembling of HIV and Aids; no flirting with dissidents and no awkward conflation of racism and Aids. … To read the president’s musings on Aids is to see how he views the pandemic as one that strips African dignity and pride. … When Mbeki’s political résumé is written, his stasis, his doubting and his ambivalence on Aids will count as much in his disfavour as his tireless campaigning for a self-sufficient, equal and prosperous Africa will count in his favour. This, surely, is reason enough to change his script and his mind.

In his column Uys about Face in the October edition of The Big Issue, Uys had more spit for ‘our closet dictator’ and his ‘Mbekivellian Politics’: ‘Not only is the denial of the Aids pandemic [by ‘our leadership’] affecting millions ... but thousands of youth are showing a healthy contempt for the coming election. … “What’s the point of voting?” … F**k them!” These are some of the answers I get when I ask the young potential voters if they will make their cross in the 2004 election.’ After I’ve told them how ‘infuriated I am with the carelessness and indifference of our leadership towards the youth and their survival’ and I’ve rubbished Mbeki’s government for its ‘genocidal neglect’.

Reporting to the US Congress on 2 October following the US senators’ recent ten-day AIDS tour of South Africa, Mozambique, Botswana and Namibia, ‘to assess the HIV/AIDS crisis in these countries … to see where things are now and where we need to go in the future to help these nations deal with the terrible crisis they face’, Senator DeWine wove a colourful tapestry of all the standard mythology that had become the urgent new threat to American prosperity and contentment. As he did so he criticised Mbeki without actually naming him:

let me just talk for a moment about government attitude and political leadership in regard to the issue of AIDS. We visited four countries. The governments of Namibia, Mozambique and Botswana are all fully engaged in this struggle against AIDS. That political leadership is essential in the battle against AIDS. … Some local units of government from South Africa have been aggressive, but unfortunately the tragedy is that the central government has not been as aggressive. And, while we talked to many people in South Africa who are doing wonderful things, unfortunately there are some people in the South African Government who still would appear to be in a form of denial about this problem.

For the rest, DeWine’s long speech evidenced American determination to run the show completely, endowing fortunes on willing and compliant local agencies, with no regard for South Africa’s national sovereignty. US neo-colonial mentality was in evidence throughout; DeWine sounded like a European prince discussing the carving up of Africa for the benefit, civilisation and salvation of the savages – the only difference was that saving their lives was now the formal rationale.

Although Mbeki’s essay, We must defend our right to determine our future, published in ANC Today on 3 October, was targeting different foes, it could have been written as a direct answer to these insistent local and foreign advice purveyors. Mbeki began by recounting the triumph of the Haitian slave revolution of 1804:

As happened with the liberated African slaves of Haiti, there are some in our country and the rest of the world who do not accept that we can make a success of our project to transform our country into a truly democratic, stable, non-racial and prosperous country. … they do the best they can to present themselves, as they did to the victorious Haitian Revolution, as the unique representatives of what our own revolution should legitimately seek to achieve. Those who did nothing or very little to secure the victory of the slaves, positioned themselves as the best friends of the liberated slaves, the best advisers of what the free slaves should do with their freedom. We too have received all manner of advice and prescription about how we should conduct ourselves. This has encompassed almost everything. … We have been told that there are some, at home and abroad, who know our country, our people and our interests better than we do, being better representatives of what is good for our people than those freely elected by these people to govern them. Among other things, this has resulted in some seeking to instruct us what we should do about such issues as the health of our people and our relations with our neighbours. Fortunately for them, they have the means loudly to propagate these instructions internationally, thus creating a global constituency that, because it knows no better, will pose the question to us – why do you not act as you are told!

Why do you not take our medicine?

Three days later Randall Tobias was sworn in as coordinator of Washington’s new Global Aids Office. Next thing he was on a plane to Botswana, on a ‘fact-finding mission’. Following a meeting with President Festus Mogae on the 11th, he told reporters that his country intended

to devote fifteen billion dollars to fourteen countries which account for fifty per cent of the world’s HIV infection. Twelve of those countries are in Africa and Botswana is one of them. … The money will be used to pay for drugs, but the biggest challenge we are facing is human resources. We need people who can administer and care for the sick. People have to be tested and be cared for.

People who’ve been scared out of their wits, and then poisoned. Commenting on this news in a private note, Rasnick made the astute observation that ‘Bush’s new Global AIDS Office is simply a mechanism for transferring the wealth of American taxpayers via Africa into the bank accounts of the pharmaceutical companies. On the way, millions of dollars will be skimmed by some African officials and bureaucrats while the people of Africa will get to share the American experience of drug-induced AIDS.’

In addressing the journalists, Tobias overlooked the compulsory one-third allocation of the money to sexual abstinence education, the need for which was underscored by a breathless report in the Star on the 22nd headed, ‘Half of boys aged 15 will be dead by 2015’: Up to three-quarters face risk of dying from Aids, says report:

Although there have been recent declines in incidence of HIV/Aids in a few countries, South Africa and Zimbabwe still stand to see three-quarters of boys now aged 15 dying of the epidemic. … This is according to research published in 2000 by the John Hopkins University, commissioned by the United Nations agency Unaids. … ‘Even if the HIV risk were cut in half by 2015, in some countries 20% to 30% of today’s 15 year old boys still would die of Aids,’ the report stated. The prediction for South Africa is that 65% of now aged 15 year olds will die if the risk remains the same, if halved by 2015, 47% are still likely to die of the epidemic. That means that boys aged 15 have a 50% chance of living beyond 2015.

Black boys.

Still fidgeting unhappily in his retirement, Mandela appeared in London on the 21st to launch his ‘Give one minute of your life to stop Aids’ fundraising campaign. By dialling a telephone number ending in his Robben Island prison number, 46664, at a premium call-rate, donors would be treated to a one-minute reading by him from his autobiography, Long walk to freedom (not that he’d actually written it himself). The money collected would go to his Nelson Mandela Foundation to fight AIDS. The whole thing was to culminate in an all-star rock concert in Cape Town, to be broadcast by about ninety television stations to two billion people. So it was claimed. ‘No longer is AIDS just a disease; it is a human rights issue,’ he said. ‘For the sake of Africa and the world, we must act and act now. For eighteen years I was imprisoned on Robben Island, known just as a number. Millions of people today infected with AIDS are just that: a number. They too are serving a prison sentence for life.’ Quite what any of this actually meant he didn’t say. Other than that he was still rather pathetically trying to recover his position on centre stage by identifying his twenty-seven year personal sacrifice with his new cause, and devaluing it on the way. But the numbered prisoners must have been relieved to learn that their death sentences had just been converted to life.

On 19 November the Cabinet issued a statement approving a national antiretroviral treatment plan, promising one service point in every health district within a year and one in every municipality within five years. The cost of this to the country, Finance Minister Manuel noted a week earlier, would be R12 billion over three years. As apartheid’s victims starved. And the pharmaceutical conglomerates thrived. The three-hundred page treatment plan had been approved ‘in principle’ only, explained government spokesman Joel Netshitenzhe, meaning that it had not yet been debated and approved clause by clause – leaving plenty of wriggle-room. Mbeki wasn’t present when the galling decision was made; instead, faraway in France on a state visit. Tshabalala-Msimang dampened prospects for a large-scale rollout any time soon: ‘I don’t want to raise false hopes,’ she said, pointing out the absolute prerequisite of providing medical infrastructure and training to monitor the toxic effects of the drugs on people taking them. Without which, she implied, the pills would not be dispensed.

As the TAC read it, the government had finally caved in to its demands: ‘This is brilliant. We’re very happy,’ said Nathan Geffen. Not completely though, wrote Mark Heywood in the Sunday Times on the 30th under the edict, President must lead the war on Aids. (Following Nixon’s example in leading the War on Drugs, he might have added, when at a press conference on 17 June 1971 he declared them ‘America’s public enemy number one’.) There must be ‘unambiguous and loud political commitment from the President … an announcement of a policy does not take away our sense of a vacuum of leadership. … The transformation that is needed in government has not taken place. [The] culture of denial [and the] political interrogation of the mainstream science of HIV has caused confusion and delay.’ But Achmat was elated. In Los Angeles at the time, panhandling a gathering of officials representing American corporate philanthropies, he beamed: ‘Have you heard the news? The government released the plan. In five years there will be access in every part of the country. It’s huge. I’m going to stand because I feel like dancing today. Because it’s really a historic moment for South Africa. When they called me at my hotel, I danced. And I’m a black brother who hasn’t got rhythm.’ It’s ‘really an enormous victory,’ he repeated later on. ‘I danced the whole morning.’

Practising for the 46664 concert. Which I also attended with my sons, getting in with complimentary tickets from a friend in the music business. Since I’m crazy for Youssou N’ Dour and Angelique Kidjo. But the show was as flat as a pancake. In view of the high cost of the door for the paying revellers, the crowd was predominantly lily white. The sort of folk inspired by the idea that black Africans in their shacks pressing against their suburban limits are being ravaged by AIDS. Aging multimillionaire English and Irish rock stars dominated the concert, offering AIDS advice and condolences. Thought up in their mansions back home. The presumptuousness of which struck a fellow standing near me: ‘What do they know about AIDS in Africa?’ he grumbled to his girlfriend. Soporific would be the best description I can think of for the most of the music, including perfectly irrelevant songs composed especially for the occasion such as American Prayer and Freedom is Coming. But not when Peter Gabriel did Biko and Johnny Clegg Asimbonanga (‘We don’t see him’ (Mandela)), during which I found myself weeping silently, hoping my children wouldn’t notice, overwhelmed by the tragedy of our past, the crushing poignancy of the tributes, and my revulsion at the AIDS papacy’s corruption of the legacies of the men being lauded – effectively too, directing the drug marketing at our softest psychological spot: apartheid’s still-fresh wounds. But for such a massively hyped do, with the aristocracy of rock on parade in set after set, the audience was surprisingly subdued – I’m told even Mandela was seen falling asleep in the television broadcast of the event. The only real excitement of the evening occurred when he arrived to take his seat in the stands, and later to appear on stage waving and smiling. And be pawed by the rockers. But not to speak. The show was so plastic that even his speech had to be canned: after he walked off, a video clip on enormous screens behind the stage had him mouthing AIDS homilies that had the crowd roaring. Like how AIDS was killing more people than all wars, famines and floods put together: his standard shit. Girls around me screamed and nearly wet themselves for him, just like at a Beatles concert. ‘Isn’t it wonderful that we have a former President that the whole world worships,’ gushed a young mall-rat at me. (I didn’t want to spoil her moment by suggesting that thinking usually ends where worshipping begins.) Between acts, repeated video presentations had one show-biz celebrity after another thumping the AIDS tub and soliciting donations – Robert de Niro, Paul McCartney and so on. A vast brass-coloured likeness of Mandela’s smiling face towered behind the stage in North Korean ‘Dear Leader’ cult-of-personality style. Indeed, a Nelson Mandela Foundation banner to my left proclaimed ‘good leaders lead’. Unlike the current guy. The thing was Orwellian, screens and everything, and after my experience of the opening ceremony at the 13th International AIDS Conference in Durban, it felt appallingly déjà vu. But who would have predicted that despite their adamantine personal opposition to AIDS drugs, Mbeki and Tshabalala-Msimang would be drummed into committing the government to buy them for wide-scale provision to the black poor, and that in his senescent political simplicity South Africa’s living patron saint would prostitute himself to the pharmaceutical industry so fecklessly.

On 1 December, World AIDS Day, the old man made his first disbursement from the cash he’d raised via his 46664 campaign: a donation of R5 million to GF Jooste Hospital in Manenburg for the purchase of antiretroviral drugs: ‘We must make sure that treatment is made available to those who need it, most especially those who cannot afford it. Health should not be a question of income. It is a fundamental human right. We must give people hope.’ This announcement was crowned by another the day after: Achmat and his TAC had just been nominated for the Nobel Peace Prize. ‘This is a proud moment for South Africa,’ brayed Human Rights Commission chairman Jody Kollapen. ‘It’s just recognition of the wonderful work that the TAC has been doing over the years.’ And it recognises that there’s nothing AIDS doesn’t debase. The South African National Press Club also thought Achmat and his TAC had been doing wonderful work in marshalling ‘legal and moral arguments’ to compel the government to provide AIDS drugs: ‘This victory raised hope for millions of Aids sufferers to finally gain access to drugs that could prolong their lives.’

But as far as Mbeki was concerned, the domestic policy issue that had been his albatross, his biggest liability and distraction since the beginning of his first term as President, was now a thing of the past: in his televised New Year’s message on the last day of 2003, canvassing the country’s achievements and challenges on the eve of the tenth year of the revolution, about HIV and AIDS he had not a word to say. Having regard to Achmat’s demand in September 2000 for ‘the dignity of knowing that there is recognition at top levels in the government that there is a disease in this country that is affecting millions of people’ and Cameron’s claim in April the following year that AIDS is

the most urgent current question in our national life’ and that ‘a crisis ... of leadership [and] of truth-telling [had been] engendered by those in our country who deny the facts about AIDS …deny us the dignity of our suffering … deny us the dignity of our struggle for life against the workings of a viral agent [and] deny us the dignity of the truth, and the power and hope, and the opportunities for action, that acceptance of the truth brings

Mbeki’s talk to the nation must have left these buggers feeling hell of undignified.

CHAPTER

Delivering his State of the Nation address on 6 February 2004, Mbeki was again scant on AIDS – referring only to the country’s burden of diseases ‘including AIDS’ – leading Achmat to fume on television: ‘He makes a mockery of our disease. … He shows no compassion.’ Interviewed on the box himself two days later, interviewers John Perlman and Redi Direko took Mbeki directly to task for just that. But he fenced like a champion:

JP: Mr President, you have delivered six opening of Parliament addresses and, on Friday, as in the previous five, with the eyes of the country on you, you did not speak about HIV/AIDS with a sense of compassion or a sense of identification with those who are suffering from the disease. Given that you speak with compassion and with a sense of identification on so many other issues, why is that?

Mbeki: Well, I do not know what that means, John. You see, what happens, and what has been happening now for a number of years, is that in January the government holds a Cabinet Lekgotla. We meet for three days. And part of what happens is that we do a review of the year – that is, the financial year that has come to an end – and have a final look at the budget to be presented, as it is to be presented later this month. It is a more global look. But because we are dealing with the tenth anniversary year we also had a look at that, and there would be some issues that will be raised in government, which would be reflected in that State of the Nation Address. Because we are dealing with the tenth anniversary, the general agreement was that we have to deal with the more global issues, in particular, because quite shortly we will have another State of the Nation address, it will become possible then to deal with all sorts of detailed matters. So, for instance, the budget is going to be presented this month. There will not be a discussion of the budget votes, because of the forthcoming elections. The budget votes will come after the elections, at which people will then deal with the specific programmes. It is a peculiarity of this particular State of the Nation address. So, we did not deal with any of these detailed matters in detail, all the questions that you are raising because it is the particular nature of this particular State of the Nation address. The entirety of government will come back to all of these other issues when those budgets would...

JP: But I am going back on five other speeches as well. And I ask the question, because when people look at the success of a country like Uganda, in tackling HIV/AIDS, one factor that is spoken of, and I am sure you have read similar reports, is a strong sense that from the top of the country the problem is embraced and embraced wholeheartedly by the President.

Mbeki: Well, I do not know what you want us to do. You know, we have been running this campaign on HIV and AIDS for a long time. When President Mandela was President of South Africa, the Deputy President was asked to lead this campaign. Mandela never led it. There was no complaint about it and the government continued that practice. This is what has happened over the last ten years. As far as government is concerned, in attending to this matter there are very large budget allocations. You will see it now in the new budget that is going to come out. All sorts of work are being done. I do not think that there is any country in the world that really can hold a candle to South Africa with regard to this.

JP: But you, yourself, have said that money alone would not solve the problem. And, in a disease like this, where shame and secrecy and stigma is such a big part, do you not feel it would make a big difference if the President were to speak about it in that compassionate tone?

Mbeki: I have said many things about this matter over the years. I do not think the government is going to change its stance on this thing. We have got a programme, we have announced it, and it is a campaign that runs all the time. If you look right through government, from local government to national government, it is a very big programme. I challenge anybody to produce any other country of the world that runs a comparable programme. That is what we will continue to do and the Deputy President leads us on this matter, and in instances where the President has got to speak, of course the President speaks about it. So that is what will happen. But there is also another responsibility here. You know, tuberculosis is a very important disease in this country. I do not know why South Africans do not want to talk about it. My doctors have said to me, ‘President, do you understand that diabetes in this country has reached epidemic proportions.’ I said, ‘Epidemic?’ They said, ‘Yes, epidemic proportions.’ Why are we not talking about these things? There are many, many things that impact on the health of our people. We have got to intervene. Nobody complains and says: ‘President, why are you not making noise about TB?’ The World Health Organisation says South Africa is one of the nine worst countries in the world, in relation to TB. But why are we not talking about it?’

RD: But maybe because those diseases are controllable. AIDS has proved to be the most difficult one.

Mbeki: No, it is not. It is not the reason. It is not the reason. It is not because they are controllable.

RD: Why is it?

Mbeki: I do not know why, it is a reluctance to talk about the general burden of disease on our people.

RD: But, Mr President, when organisations like the World Health Organisation released the report just last year December, predicted the worst is yet to come, that Africa has entered a phase of upward spiralling and made particular mention of South Africa. Is that just melodrama or would our government...

Mbeki: The WHO will answer for itself. As South Africa, of course, we will answer for ourselves. I have said this thing publicly. South Africa does not have, up to today, a proper record of mortality statistics. It does not exist. We do not know what are the things that kill South Africans, not from mathematical models and extrapolations but from Home Affairs. Home Affairs receives notices of death by law. If any South African dies, a medical doctor must certify that this person has died and this is the cause of death. All of these medical certificates are with the Ministry of Home Affairs. But if you ask anybody in government to say whether these things have ever been put together so as to be able to say – during the year 2003, this is how many people died, this is what the doctor said these people died from – this does not exist.

RD: But what does it say about what we are reading about, AIDS related deaths?

Mbeki: I do not know what it says. Obviously, as government, you have to have your health policy, and by health policy I do not just mean intervention with drugs and medicines. Everything has to do with the health of people – clean water, good nutrition, all of these things. Surely, we must have some idea as to what are these things that are killing our people.

RD: Does it irritate you when people keep expecting you to expatiate on HIV/AIDS?

Mbeki: No, it does not. What puzzles me is why people do not want to think. We have collected all of these notices of death from Home Affairs from 1996 to June 2003, altogether two and a half million. We have given them to people to say: Now, can you please work on this, sort out all of these things systematically, to say: in 1996 so many people died and this is what killed them. Those documents would also indicate places – where did these people die, gender, these kinds of things. So, when that process is done – I do not know when it will get done, Statistics South Africa and other people are working on that – for the very, very first time you will get a picture based on actually what has been recorded by the medical profession in this country in terms of causes of mortality. For the first time. So, you will see the numbers and all of these things will be checked, even the presumptions that I make by saying that my own team of medical doctors who have got to do regular check-ups, tell me: ‘President, we have an epidemic of diabetes in the country and it is killing people and nothing is being said and nothing is being done.’ I do not know that, it is what they say. We will be able, whenever this process is done to get for the first time, the very first time, a picture of the causes of death that will include areas, incidence of disease and death from various causes in particular areas. The only figure there is, now, is death from road accidents. And the reason for that is because there was a judicial commission of enquiry into the Road Accident Fund. And they went into it in depth, into this particular matter, to say: what is happening to the Road Accident Fund and its financing? They had to understand the burden on the Road Accident Fund of death and injuries. We will get that and I hope that South Africans will discuss those figures rationally.

He was hoping for too much. Achmat’s response to the interview was that ‘Mbeki was deeply disappointing and wrong. First and foremost, there have been studies of AIDS mortality. He is interfering with science. What worries us deeply is that the President is once again signalling that he probably won’t accept responsibility for the antiretroviral and prevention programme and this sends a message to other health department officials and other politicians to do the same.’ The AIDS Consortium’s Sharon Ekambaram said she was

really angry. … This attitude is one of the reasons that the anti-retrovirals rollout hasn’t even begun. His statements have an impact we face daily, that of people not wanting to come out about their status and people not wanting to be tested, which is one thing that could make a real difference to this epidemic. What an insult this is to all the poor people whose loved ones have died of HIV/AIDS. Why hasn’t Zuma said a single word, if he is responsible?

DA health spokesman Mike Waters thought Mbeki’s position was ‘an utter disgrace. ... Many countries with fewer resources have had greater successes in combating HIV/AIDS than we have – for example, Uganda, where the President talks about AIDS unashamedly and at every opportunity.’

At a media briefing in Cape Town on the 9th Tshabalala-Msimang caused a fresh row by suggesting again that garlic, lemon, onion and olive oil were good for HIV and AIDS sufferers, and that traditional medicine shouldn’t be ridiculed either. But her proposal that AIDS patients might benefit from eating nutrient rich foods was just the most ridiculous thing journalists had ever heard; they guffawed in their columns and cartoons for weeks. Even if the UN Food and Agricultural Organization stood behind her: ‘Food is the first medicine for HIV/AIDS.’ Six days later, opening the Medical Research Council’s Centre for Traditional African Medicine on the 15th, Tshabalala-Msimang told about two hundred applauding traditional healers present that she was ‘trying to wean our people from antiretrovirals and to convince them rather to use traditional medicine’. Speaking for herself she said, ‘I can honestly not remember when last I took antibiotics; I rather use our own medicine. And I feel better. Nobody can tell me that I do not feel better.’ But such talk made the TAC’s Heywood feel worse:

This is another example of the minister creating a damaging and confusing situation surrounding the issue of HIV and AIDS education. We accept that traditional medicines play a part in our health system. There are some that show efficacy and some that boost the immune system, but the notion that traditional medicines should replace anti-retrovirals is nonsensical, and it is very unwise for the minister to suggest this. [Substituting traditional medicines for AIDS drugs] could be of great danger.

To our jobs in the TAC. And, since I come from England, I have no regard for African traditional medicine; if the medicine doesn’t come from the West, it can’t possibly work. Another TAC spokesman, Denis Matwa, concluded: ‘It is clear to me that the Health Minister and President are reverting to denialism. Her recent statements indicate that she is shifting away from the treatment plan and we are warning the people of South Africa about what is coming with Manto and the President after the elections. … We are going to encourage our members and other community members to vote for the party with a coherent HIV and AIDS plan.’ Reactionary parties like the DA, with its campaign poster, ‘FREE AIDS DRUGS’, and its allies the IFP appealing for ‘A VOTE FOR LIFE’, its poster decorated with an AIDS ribbon no less prominently than the party crest. Anxious to defend his principals’ business, the DA’s Leon commented: ‘There is no reason that traditional healers and medical doctors cannot work together in fighting HIV and AIDS. But as Dr Kgosi Letlape, chairperson of the SA Medical Association, has said, traditional medicine should not seek to replace or interfere with life-saving anti-retroviral drugs prescribed by medical doctors.’

The Mail&Guardian scattered some fresh manure on AIDS drug mythology on the 27th, spiked with some sniping at Mbeki: Roll-out or cop-out was Nawaal Deane’s cover story about ‘the life-prolonging drugs … Basically if you are HIV-positive, your life depends on where you live.’ Just as the TAC cried: ‘... the delay in the ARV roll-out is killing us.’ A covering editorial muttered that ‘The lack of progress in the Aids war is neither financial nor intellectual, nor is it about capacity. It is about the absence of political will at the centre. And with Aids increasingly an election issue, this is especially troubling. If so little leadership is being shown at election time, what will happen after the ballot?’

On the campaign trial in Kimberley on 30 March Mbeki was asked at a meeting of religious leaders how soon the Kimberley Hospital could expect the government to deliver AIDS drugs. He replied calmly but with discernible exasperation over persisitent derisory media reaction to Tshabalala-Msimang’s peculiar ideas about food:

Why does everybody mock the Minister of Health? People behave as though she comes from the moon when she explains that antiretrovirals are not a global panacea. The fundamentals of good health are clean water, hygiene and proper nutrition. … You can’t say the response to a healthy body is drugs. Your first response is proper feeding. The Minister of Health repeats this every day and what do they do, they mock her. It’s like she’s some crazy person from the moon! Doctors know extremely well that you need proper nutrition; you need clean water; you need these health conditions. That’s the broad spectrum of a response you can say to the people in the hospital and that’s what the government will do.

It would have been ‘thoroughly irresponsible’ to have rushed the antiretroviral rollout, he said. ‘It requires incredible organisation and training to dispense and monitor such complex drugs. How could I, as a President, allow the antiretroviral rollout to be rushed to people? It might have done them terrible harm. … We give people hope that antiretrovirals kill the HIV virus. Well, they do not. Why do we tell people they do?’ He reiterated his points made in Parliament in February about the lack of proper statistics as to causes of death in South Africa, and how tuberculosis and diabetes were leading killers, yet no one was fussing over them as they were over AIDS.

Vainly trying to set the national agenda, as always, with its perspectives ever those of the boom-controlled, electric-fenced suburbs of Johannesburg, the Mail&Guardian’s 8 April issue, the last before the voting, identified what it considered to be the country’s principal election issue: Mbeki’s insufferable AIDS heresy. Zapiro’s weekly cartoon, captioned The presidential wardrobe, featured Mbeki in three outfits: in a suit with a lapel button ‘Statesman’ (‘Tried and tested’), in a cap and teeshirt with ‘Man of the People’ on his chest (‘New. Fits surprisingly well’), and in a mad hatter’s clown outfit with the lapel button ‘AIDS dissident’, (‘Hideous! Chuck this now’).

In the last of his ten-question interviews with party representatives concerning their policies, Drew Forrest opened by asking ANC Deputy Secretary-General Sankie Mthembi-Mahanyele whether the ANC’s ‘recently changed tack on Aids drugs’ was ‘because an election was imminent’. His second question was stuck in the same groove: ‘You would agree that the ANC has been damaged by the handling of HIV/Aids.’ As was his last: ‘Surveys consistently show that the ANC is more popular than its leader. Is Thabo Mbeki – and particularly his eccentric views on Aids ... – a liability for the party?’ (In fact, a Markinor poll released on the eve of the April 14 election found Mbeki to the country’s ‘most trusted’ and ‘favourite’ politician.)

Perhaps Forrest should be asking himself why white journalists are so fixated on their notion of sexually dissolute blacks spreading fatal disease. Western drugs that can save them. And why they consider Mbeki’s doubts about it all to be ‘damaging’. Doubts shared by most Africans – according to the findings of an Afrobarometer survey released by the Institute for Democracy in South Africa in Cape Town a week before Forrest’s interview: a survey of twenty-three thousand people in fifteen Southern and Eastern African countries found that ‘Ordinary Africans do not share the experts’ forecasts of the dire consequences of the Aids pandemic on the continent’, as PlusNews reported it; ‘Africans were undecided about whether their governments should divert resources from other scarce priorities to fight Aids in their country. With some exceptions ... African citizens were not even convinced Aids constituted a public problem worthy of government attention.’ Just as their ancestors didn’t think their souls needed saving before those aggressive albino people pitched up to insist they did.

The ANC pointedly omitted AIDS from its election campaign altogether. At a press conference on the 16th, after his party’s seventy per cent majority win had been announced by the Independent Electoral Commission, Mbeki was asked by a BBC journalist why during his campaign he had not mentioned HIV-AIDS, the country’s greatest threat. In no mood to suffer her foolery, he drilled her: ‘Have you been following the election campaign?’ When she didn’t reply, he sternly repeated the question. She had, she said. Mbeki then pounced: ‘Well then you know we have repeatedly said that the issue does not form part of our campaign.’ In his Letter from the President in ANC Today on the same day, Mbeki set out the vast challenges facing his government, given the nation’s ‘350-year-old legacy of colonialism and apartheid’ – turning Bush’s autobiography, A Charge to Keep: My Journey to the White House, brilliantly to his purpose, and quoting him on

the gap of hope … I worry that we are being divided into two nations, separate and unequal: one nation with the tools and confidence to seek the American dream; another nation that is being left behind. We risk becoming two societies: one that reads and one that can’t, one that dreams and one that doesn’t. Some think they can protect themselves through wilful apathy. Some put up big fences and live in gated communities. Some close the shutters, turn on the television, and withdraw.

Mbeki commented that notwithstanding that ‘The American Revolution preceded ours by more than two centuries ... Our political opponents, echoed and supported by “Afro-pessimists” from the developed world of the North, have worked hard during and before the 2004 elections to propagate the dishonest view that problems that could not be solved in the United States for two centuries, could be solved in South Africa in one decade.’

But about AIDS, at the top of the white liberal agenda, Mbeki was again entirely mum – taking no notice of a cartoon in the Mail&Guardian on the day of his victory, depicting him as St George fighting a dragon with three heads, labelled, in ascending order, unemployment, poverty and, above them, AIDS. Being the big bogus but useful bogey of the reactionary Opposition and the media, with their ‘deep-seated contempt for the masses’ whom they ‘consider to be but a contemptible and irrational mob’ – thrashed and shamed by Mbeki with acrid sarcasm in his essay.

Ironically, singled out for a special flogging was his solitary champion in the newspapers concerning his position on AIDS, the Citizen’s acting editor, Martin Williams. Williams had mid-wifed the genesis of the South African AIDS controversy by publishing my essay AZT: A Medicine from Hell in March 1999 and had been the only local newspaper journalist to come out in support of Mbeki’s subsequent directive that the safety of the drug be investigated, in consideration for which Mbeki had spoken appreciatively of him in Parliament. Only to blow it by writing an appallingly ill-considered liberal editorial on the day of the election five years later, Voting to be crucified, in which he judged the ANC to have ‘failed’, likened the ANC leadership to ‘demagogues’ and the electorate to the ‘baying mobs’ demanding Christ’s crucifixion in the Mel Gibson movie, and proposed that ‘the poor’ continuing to vote for the ANC ‘know not what they doeth. They’re crucifying themselves.’ But contrary to his scripture, the only person hoisted and crucified in the election was Martin Williams.

And then, a couple of weeks after the ANC’s resounding victory was announced, the puzzle was solved: why Achmat and his TAC had been so strangely mute in the run-up to the election, and not acting as attention-hungry spoilers as usual. His chickens had come to roost: Achmat had discovered after just a few months on his medicine that it didn’t taste so good. An article in the Daily Dispatch on 28 May 2004 revealed that not only had the toxicity of his triple-combination antiretroviral drug regimen crippled and incapacitated him both physically and mentally, he had also been determinedly concealing this from the South African people – for the reason that he had not wanted to lose face to Mbeki and Tshabalala-Msimang over this, since he had been vilifying them without any kind of decent restraint throughout their first terms as President and National Health Minister. All because they did not share his zeal for the potions that he himself was finding too hot to stomach.

‘Things have changed in Zackie Achmat’s life,’ went the report.

Once readily accessible and always quick with a sound bite, a personal assistant now monitors the cellphone and diary of the chairperson of the Treatment Action Campaign (TAC) and screens visitors before ushering them into Achmat’s study. ... As much as these changes signify a new level of structure in Achmat’s life and the need to manage multiple requests for interviews, the more profound changes emerge from his first six months of anti-retroviral therapy and how this has forced the charismatic activist to review his life. … a frightening setback ... occurred in February and March ... which shook Achmat’s self-confidence. ... ‘Going into my fifth month I started feeling a sensation in my feet. At first I dismissed it, thinking I’d done something at the gym. The second week it was clear to me and I thought, “I can’t let Manto win and I can’t let Mbeki win”, and I kept quiet for three more weeks.’ When Achmat finally told his doctor about his symptoms, the nerves in his feet were so sensitive that he could barely walk. A change of drugs (from d4T to AZT) has arrested the situation and his left foot feels better, but he still can’t put any weight on his right foot for any length of time, nor can he walk long distances. ... Achmat, who has a clinical history of depression, says that the fact that he was immobile for a week while his doctor tried to bring the side effects under control brought on a terrible depression, the worst he’s had in two years.

In point of fact AZT is no less neurotoxic than d4T: as nucleoside analogues the drugs are in precisely the same chemical class, and have substantially the same toxic pharmacology. Sadly though, lacking even the rudiments of High School biology and general science, Achmat had been unable to make sense of any of the scores of research reports concerning the mitochondrial toxicity of the AIDS drugs that were killing the muscle tissue and nerve cells in his legs and feet (though I’d sent him an early draft of my easy-to-read book Debating AZT). Not only that, the neurotoxicity of the drugs that had incapacitated their salesman also appeared to have caused him conspicuous mental deterioration by late 2004:

The early indications of this in the Daily Dispatch report were confirmed by journalist Willemien Brümmer, who observed Achmat during an interview published by on 1 December 2004. She was perturbed to observe that

His words were bats that flew into each other in the dark. His sentences ended in mid-air. It was as if he looked at you through a dense layer of fog. It was during these times that I wondered what was happening to him. Especially when he cancelled press conferences and public appearances at the eleventh hour. … Between gulps [‘of soup and a glass of orange juice’] he talks about his past and the complex interaction between the chemicals in his brain, his genes and the virus with which he was diagnosed in 1990.The HI virus already penetrates the brain during cero-conversion [sic]. In other words, shortly after infection, when antibodies change from negative to positive. Every patient’s reaction to this penetration is different. Chances are good this can lead to depression and cognitive reduction and, during the final stages, even to dementia – a condition that usually only afflicts the elderly.

Achmat’s own subjective appreciation of his declining mental condition was conveyed by his concern expressed to Brümmer that ‘Losing control of his mind [was] his biggest fear’ – worrying: ‘As long as I hold onto my dignity.’

It was evident from Brümmer’s article that Achmat was having difficulty reconciling himself psychologically with the unpleasant reality that he was being poisoned by the drugs at the centre of his world:

And then came the physical side effects of the antiretrovirals. Especially peripheral neuropathy – a condition that takes place when the nerve endings are impaired; burning pains are felt in the feet and legs. It was so bad for Achmat, that by the fifth month of antiretroviral treatment he could no longer walk. ‘I was totally melancholic and dysfunctional at the beginning of the year. I fought with my nearest and dearest, and I did not want to accept that I was experiencing side-effects.’

Actually it was a lot more than just excruciatingly painful ‘grade 2 peripheral neuropathy [i.e. painful nerve damage in his limbs, still] being treated [in 2005] with … neurological pain adjuncts’, according to his doctor Steven Andrews, in an affidavit filed in the Cape High Court (in Case 12156/05), his neurotoxic drugs had also gone to his head causing him CNS (central nervous system) injury ‘manifesting in sensory, motor and proprioceptive’ disturbances – meaning in plain terms: impaired ability to feel, see, hear, taste, smell and balance; control his limbs properly; and sense his limb positions and movements. (Curiously the learned doctor denied that Achmat had suffered CNS injury, so one must presume that Achmat keeps his brains in his bottom.)

Anxious to maintain an impression that he was thriving on his pills, not sinking on them, Achmat insisted to Brümmer: ‘I have been fine since June. In September I went to London, Germany, Addis Ababa and back to London, and I managed three appointments a day. I returned from Durban on Tuesday.’ Since June the drugs weren’t poisonous anymore, apparently. (Nevirapine, which Achmat also takes, is neurotoxic too, and was reported to cause severe mental deterioration by Wise et al. in the British Medical Journal on 13 April 2002, under the title Neuropsychiatric Complications Of Nevirapine Treatment.)

In fact, in Achmat’s case, these ‘neuropsychiatric complications’ were in evidence almost immediately. He told Jennifer Barrett during an interview published in Newsweek on 24 November 2003 that ‘The most remarkable thing after I started taking the medicines actually is that in the first three weeks, I became so depressed – I’d never been as depressed in my life.’ (He proceeded to provide an involuted, nonsensical psychological reason for this.) Less than a week later, appearing on the ‘Let’s Talk’ SABC 1 television programme on the 30th, Achmat dishonestly suppressed this: ‘I started taking medicine on 30 August this year for the first time [at a media briefing on 8 September 2003, he’d claimed to have started on 4 September], and so far the only side effect I’ve experienced has been dizziness in the first few weeks, but since then I’ve had no real problems. I’ve had my liver monitored. And mostly I feel my energy is coming back and I’ve been able to work for almost three months without taking two or three days off, and having no infections. It’s really been good.’ I’ve never felt better! More full of beans! Even though I’ve never been ‘as depressed in my life’!

Anyway, having substituted d4T in his drug combo with much-the-same AZT, and continuing with a daily fix of AZT, 3TC and nevirapine, what happened next was predictable to anyone familiar with the research literature. About a year later, on 28 March 2005, Achmat suffered a heart attack at the age of forty-three, following which he was rushed to hospital by ambulance and kept there for several days.

No surprise to Reisler et al., who in December 2003 had reported in the Journal of Acquired Immune Deficiency Syndromes that Grade 4 events are as important as AIDS events in the era of HAART. An understatement actually, considering the findings they noted after reviewing the cases of 2947 patients treated with AIDS drugs between 1996 and 2001 with the stated objective: ‘To estimate incidence and predictors of serious or lifethreatening events that are not AIDS defining, and death among patients treated with highly active antiretroviral therapy (HAART) in the setting of 5 large multicenter randomized treatment trials conducted in the United States.’ In other words to determine the toxicity of AIDS drugs having regard to the incidence of dangerous side effects, sometimes fatal. Noting that ‘All 4 classes of antiretrovirals (ARVs) and all 19 FDA approved ARVs have been directly or indirectly associated with life-threatening events and death’, they found that more than twice as many people (675) had suffered a drug related (grade 4) life-threatening event as against an AIDS event (332.) The most common causes of grade 4 events from drug toxicities were ‘liver related’. On AIDS drugs, then, one’s greatest risk of death was not from an AIDS-defining disease but from drug-induced ‘Cardiovacular events’. They concluded: ‘Our finding is that the rate of grade 4 events is greater than the rate of AIDS events, and that the risk of death associated with these grade 4 events was very high for many events.’

In plain speech, they found the cure to be deadlier than the disease, and that heart failure caused by AIDS drug toxicity is the leading cause of death among people treated with them.

But from his sick bed Achmat blamed the virus. It had statistically been proven, he claimed, that people with AIDS are more prone to suffer heart attacks. No, said his devoted flunky Nathan Geffen (with the teacher’s pet voice to match); contradicting him, he reported: ‘The doctor said it was unlikely to be related to his HIV.’ Geffen then rendered a couple of diagnoses of his own. First he blamed Achmat’s bad genes, without actually having the facts to hand: ‘I am not sure about the Achmat family’s cardiac history but I don’t think it’s very good.’ Then he blamed the patient: ‘Zackie is also not very active and he is under tremendous stress, which probably caused his heart attack.’ Not only physically lazy, too fat too: he was ‘an overworked 42-year-old [sic: 43] who does not get enough exercise and is overweight’. Achmat nodded: ‘This is a signal that I have to start improving my lifestyle by doing more exercise and working more regular hours.’ Bit late, mate.

Although nobody around him had actually suggested this, Achmat was quick to volunteer that he was ‘convinced’ that it wasn’t the drugs that had sent him kicking to the floor. Now with this the doctors agreed: Jantjie Taljaard, head of the Infectious Diseases Unit at Tygerberg Hospital, said there was ‘no indication’ that any of the three drugs Achmat was taking could cause heart problems so ‘his antiretroviral treatment [was] unlikely to be related’ to his heart attack. ‘There are other antiretrovirals that can give you diabetes and cholesterol, which in turn could lead to heart problems, but we only give these in instances where other medicines don’t work.’ And not only does ‘antiretroviral triple-therapy’ not lead to heart trouble (as Reisler and colleagues, and dozens of other researchers had found) it actually ‘decreases the risk of heart attacks among people with HIV-AIDS’, said Geffen, referring to some ‘American study’.

Actually, as Achmat was falling down having his heart attack, the latest ‘American study’, by McKee et al., was reporting how AZT nails hearts in Cardiovascular Toxicology (2004;4(2):155-67) under the title, Phosphorylation of Thymidine and AZT in Heart Mitochondria: Elucidation of a Novel Mechanism of AZT Cardiotoxicity: ‘Antiretroviral nucleoside analogs used in highly active antiretroviral therapy (HAART) are associated with cardiovascular and other tissue toxicity associated with mitochondrial DNA depletion.’ The reason: ‘… our work shows that AZT is a potent inhibitor of thymidine phosphorylation in heart mitochondria.’ (We wouldn’t want to embarrass the sick boy by asking him what any of these big words mean.) And as far back as January 2001, when the US Department of Health and Human Services was announcing its abrupt renunciation of its ‘hit early, hit hard’ approach to AIDS, a year after Mbeki had drawn public attention to the dangerous toxicity of AZT, NIAID director Anthony Fauci explained: ‘We are very concerned about a number of toxicities associated with the long-term use of anti-retroviral drugs. … We are seeing an increasing number of patients with dangerously high levels of cholesterol and triglycerides. … The bad news is that we now must find ways to deal with unanticipated toxicities, including the potential for premature coronary disease.’

Like Achmat’s. ‘The primary event is coronary heart disease with a rupture of a fatty plaque and blockage of the vessel,’ diagnosed his cardiologist Zaid Mohamed on the basis of an angiograph showing ‘an atherosclerotic plaque rupture with non occlusive thrombus (clot)’. The patient, he also found, suffered from ‘dislipidemia’ [sic: dyslipidaemia], before hastening to conclude: ‘While ARVs are incriminated in heart disease, it [sic] is certainly not playing a pivotal role here.’ But ‘Dyslipidemia is common among patients receiving antiretroviral therapy for HIV infection’ reported Stein et al. in their paper in Arteriosclerosis, Thrombosis and Vascular Biology (2005 Feb;25(2):399-405); and as Koppel et al. noted five years earlier in the International Journal of STD and AIDS (2000 Jul;11(7):451-5), Serum lipid levels associated with increased risk for cardiovascular disease is associated with highly active antiretroviral therapy (HAART) in HIV-1 infection: ‘The long-term effects of fat metabolism, storage and utilization in HIV-1 infected patients on highly active antiretroviral therapy (HAART) including a protease inhibitor are profound and cause increasing concern. The main importance of these lipid/metabolic disorders lies in their assumed contribution to an increased risk of coronary heart disease (CHD). In the general population increased levels of lipoprotein(a) [Lp(a)] constitute an independent risk factor for CHD by itself.’

Lipoatrophy (resulting in wasting) is a toxic metabolic ill-effect of AZT and similar AIDS drugs that is related to dyslipidaemia. On 26 April 2005, a month after Achmat was rushed to hospital gasping and clutching his chest, the British HIV Association released its latest draft treatment guidelines, drawn by leading AIDS doctor Professor Brian Gazzard, warning that ‘as evidence accrues that AZT (zidovudine, Retrovir) is associated with lipoatrophy, the guidelines move away from firmly recommending an AZT-containing regimen as part of a nucleoside backbone’. We’re not so keen on AZT anymore. We see what it does to people who we give it to.

Anyway, Zackie was much relieved to hear Geffen, Taljaard and Mohamed’s assurances about his harmless drugs, and to know that truly he was in expert hands – he was ‘receiving excellent medical care’, said his personal doctor Steve Andrews.

State of the art, Steve, state of the art.

And God bless America.

Epilogue

I was right about AIDS – Mbeki, headlined a report wired by the South African Press Association on 21 April 2005. Mbeki had just given a speech in Singapore during a state visit, after which he was asked from the floor ‘if you would like to comment on the … controversy with AIDS in South Africa … during your Presidency’. The President gladly responded:

Well, I would hope that the controversy is no longer there. There is a conference that’s just concluded in South Africa, it concluded last week. It was organised by the WHO, and what they were discussing was the challenge of AIDS and how to respond to it, and in particular they were focused on the issue of nutrition, and they were saying that in order to deal with the challenge of AIDS it is critically important that there must be this focus on nutrition, because without that, being badly fed, underfed, that in itself was a major contributor to the problem of immune deficiency. Now that’s what caused the controversy because we were saying that, you see, you’ve got this big challenge of AIDS and therefore it required a big response. Here you are faced with a huge problem so you must make sure that you have a response that corresponds to the size of the problem; and therefore it was important that we should understand the problem as comprehensively as possible and respond to it comprehensively. And indeed this is one of the things that we raised and said. It is perfectly clear, it’s simple, it’s in ordinary medical textbooks, it’s quite clear that the issue of poverty is one of the issues that is central in the fight against AIDS, so you’ve got to deal with it.

Mbeki concluded by mentioning the need for an extensive public health infrastructure for monitoring the ill effects of toxic AIDS drugs, without which they

can create dangerous problems … So that by the time you then dispense antiretroviral drugs in the public health system you are absolutely sure that you are not in fact worsening the lives of people, but you are actually helping them. These are the matters that we raised. Quite why they became controversial, I don’t know, because to me they seem perfectly reasonable, perfectly simple, and indeed, as I was saying, the WHO was saying last week indeed it’s perfectly simple. You must make sure that your people have healthy bodies and part of that means giving them good food.

Entirely absent from Mbeki’s answer was the notion that intimacy had become life-threatening in South Africa, especially since the democratic revolution in 1994, due to a brand-new, inevitably fatal virus (without Western drugs) that ‘AIDS experts’ claimed was stored in and spread by our sexual organs – or rather, the sexual organs of Africans, to put a point on it, being unfortunately very promiscuous, they all said or implied – ideas that had been the centre of his startling midday address to the nation on television on 9 October 1998, delivered when he was still an AIDS evangelist: ‘HIV spreads mainly through sex. You have the right to live your life the way you want to. But I appeal to the young people, who represent our country’s future, to abstain from sex for as long as possible. If you decide to engage in sex, use a condom. In the same way I appeal to both men and women to be faithful to each other, but otherwise to use condoms.’

According to the SAPA report, Mbeki’s answer was ‘well received by many of the audience who later said it had explained Mbeki’s thinking on the matter, which attracted international attention in 2000’.

But to Cameron such thinking represented The dead hand of denialism, as the Mail&Guardian dubbed his speech to the Harvard Law School in mid-April 2003 (quoting a line from it as its title), bits of which he proudly recited in his silly book, Witness to AIDS, published in the same month that Mbeki spoke. Here was Mbeki, in his ‘denialist-inspired equivocation’, still describing AIDS ‘as a disease “of poverty and underdevelopment” – echoing one of the key dogmas of denialism’, and referring to ‘the alleged toxicity of the drugs – a tenet central to the entire conspiratorialist theory of the Aids denialists’. Drugs that were Cameron’s friends, he’d said on Carte Blanche on 4 November 2001: ‘I talk to them. I say, “You’re my allies. I want you to enter my virological system [sic] and I want you to fight with me against this alien invader [in my anus].”’ More like the dead head of fanaticism.

Among ordinary folk in South Africa, though, there was scant interest in Cameron’s friends: at a press conference on 5 May Tshabalala-Msimang revealed that within the public health system only about 42 000 people were being prescribed AIDS drugs (although ‘I don’t know how we jumped from 28 000 to 42 000’, she said, signalling that she didn’t trust the new number given her). Commenting on WHO HIV/AIDS Programme director Jim Yong Kim’s criticism at the 12th Conference on Retroviruses and Opportunistic Infections in Boston in February, bemoaning the fact that 90% of people who ‘need’ AIDS drugs in South Africa don’t have them, and that the country had to improve its efforts to get the drugs out for the WHO plan to succeed, Tshabalala-Msimang bridled at the way the AIDS drugs agenda was being imposed on the government from without:

I don’t want to be pushed or pressurized by a target of three million people on antiretrovirals by 2005. WHO set that target themselves. They didn’t consult us. … It is not about chasing numbers. It is about the quality of health care we provide for our people. … When we were being pressurized to use antiretrovirals, we did warn of the side effects. … There was a time when we were told to give everyone ARVs and we resisted. We were right, I think. … It is absolutely critical that our people know about the side effects, particularly because these are new medicines and not much is known about them. … When I get reports of people on antiretrovirals, nobody reports to me how many have fallen off the programme or died of the side effects. I don’t know what happens to those who started on antiretrovirals. … When it comes to talking about the side effects, I will always do it. … I will continue to educate the people in this country about the side effects of ARVs.

In any case, there was a better way; she felt ‘vindicated’, she said, by the WHO statement on the pivotal role of nutrition in AIDS, to which Mbeki referred two weeks earlier in Singapore. What’s more, ‘I have no information that nutrition has got side effects’. Micronutrient and antioxidant rich foods such as ‘your garlic, your lemon, your olive oil, your beetroot’.

‘I am surprised by the manner she draws up her amazing beliefs … to speak of side effects [of AIDS drugs] is contrary to what the scientific evidence suggests,’ responded Jerry Coovadia (from the very A team of the ‘AIDS experts’). She was making ‘careless and dangerous statements’, he said. Actually they were ‘criminal’, said the TAC’s Mark Heywood. ‘The Minister is a disgrace. Her conduct is undermining and embarrassing the government’s own programme and policy.’

But she persisted. On 7 June, at the Second South African AIDS Conference in Durban, she said that ‘when our President started talking about nutrition and poverty, the whole world was laughing, but those people who said his hands were dripping in blood, I hope they can stand up one day and say they were wrong’. No, responded Heywood again, she had blood on her own hands by exaggerating the side effects of AIDS drugs and confusing people about treatment.

So did Mbeki, shouted Achmat on the steps of the Cape High Court on the 21st (taking legal exception (unsuccessfully) to his TAC being described a drug industry front): ‘Mbeki is responsible for the deaths of thousands of people.’ For disliking AIDS drugs.

Which were taking their toll on him. ‘Zackie is getting tired,’ said general secretary Sipho Mthathi at the start of the TAC’s national congress in Cape Town on 23 September 2005, explaining his decision to call it quits as chairman after his next and final term. ‘Our President is the biggest AIDS denialist in the world,’ declared spokeswoman Vuyiseka Dubula at the opening rally, and this ‘meant death and confusion’.

The day before which Achmat told a meeting of the South African Clothing and Textile Workers Union that Mbeki’s meagre mention of AIDS in his State of the Nation address was symbolic of ‘the silence, invisibility and obfuscation’ surrounding the disease, and showed the ‘crisis of leadership’. It was evidence of ‘denialism’, he said; and in the four years left of his second term, Mbeki should lead the country, Achmat urged; he should break the silence.

Giving his chairman’s report at the conference, Achmat went on: ‘President Thabo Mbeki tragically still shows symptoms of AIDS denialism,’ he complained, before swinging into conspiracy theorist mode: ‘The TAC has been under sustained attack. NAPWA, THO, ANC Today, the Rath Foundation – there is one thing they all have in common and that is the Health Minister and the President’s office. All of them have links directly to the Health Minister and the President’s office and every one of them has tried to attack us and undermine us. It is a strong allegation we are making. What we are saying is that Health Minister, with the support of the President, has met with Rath, has met with Anthony Brink, has used the traditional healers [the THO] against us. We say that we want to know unequivocally from the President’s office what is his stand on HIV and AIDS and if he is supporting people like Rath. … We are dying. We are still dying.’ If only.

It had been the same sort of talk after Mbeki’s State of the Nation speech on 11 February: ‘We were really disappointed with the speech,’ said the TAC’s Western Cape co-ordinator, Thembeka Majali – dissatisfied with Mbeki’s assurance that the ‘comprehensive plan’ against AIDS was being implemented with ‘greater vigour’ and complaining that there were ‘just a few lines or a paragraph that was mentioned by the president with regards to addressing HIV/AIDS. … HIV/AIDS is really devastating our economy and killing our people. It does clearly indicate there is still some denial within our government and within the cabinet … even the President himself is denying the fact that HIV is the cause of AIDS.’

Speaking at the TAC conference, Cosatu secretary-general Zwelinzima Vavi justifiably credited Achmat for his remarkable political victories over the country’s democratic government in having rammed billions of Rands worth of the pharmaceutical industry’s AIDS drugs down its unwilling throat: ‘In the past few years you have set the agenda for the nation on this critical challenge of HIV and AIDS.’ Indeed he had. Vavi then attacked ‘the failure of leadership, beginning with the presidency and the Ministry of Health … when did any of us last hear our President mentioning the words HIV and AIDS?’ Mbeki himself couldn’t be bothered responding, but in a press statement released by her Department on the 26th, Tshabalala-Msimang hit back with a fabulously sarcastic démarche about Vavi’s ‘high level of ignorance’, something ‘to be expected as Cosatu’s positions on health are determined by the Treatment Action Campaign and the AIDS Law Project’. Vavi had ‘abdicated his responsibility and allowed Cosatu’s policy positions to be driven by an antiretroviral drug lobby group – the TAC’. The statement went on to show, by quoting Cosatu’s resolutions and the TAC’s policy presentations to it one after the other, how the Cosatu had dumbly adopted TAC policy proposals holus-bolus as its own resolutions more or less word for word.

But the Mail&Guardian saw it differently, opining in an editorial on the 30th that Health spokesman Sibani Mngadi’s slur about Vavi being a ‘TAC mouthpiece’ was ‘no shame but an honour. The Treatment Action Campaign … deserves heralding and mimicking. … With its tactical mix of using the legal system and building up a formidable generation of (largely young black) activists, the TAC is carrying the torch, doing what a caring state should be. Long may it survive and may it corral many more mouthpieces into its stable. … And what Vavi said is quite correct: from denialism, President Mbeki and his health minister have slumped into something as dangerous – a sullen silence on this most chilling of pandemics.’

In a closing speech at the conference, treasurer Heywood announced that the TAC would be seeking a meeting with Mbeki to ‘achieve a common statement of intent after a frank exchange of views’ about the epidemic and to discuss rumours of a boycott order from high: ‘We hear from very senior officials, including Cabinet Ministers that they have been told by Mbeki “don’t work with TAC”. It’s hard to see why.’ It’s really very difficult.

That Mbeki had no intention of granting these clowns an audience was rubbed in on the 29th, just after the conference ended. In a speech to the consultative conference of the African Peer Review Mechanism (APRM) in Midrand, Mbeki pointed out how hollow the TAC’s claim to speak for ‘civil society’ was. He didn’t mention the organization by name, or need to, when he stated that African society was questioning whether ‘we actually have an independent civil society, because you have civil society organizations funded by the Americans and the Swedes, and the Danes and the Japanese and so on who set agendas. … Do [these organizations speak for] the ordinary people they say they represent or do they represent other interests?’ Those of the pharmaceutical industry. He raised the issue again at a meeting of the African Editors Forum in Kempton Park on 15 October: ‘…quite a lot of money’ had been offered NGOs before the 1994 elections to pursue ‘civil advocacy – which meant they must challenge the ANC on this and that matter’. Namely on the purchase and provision of AIDS drugs, advocated by the TAC. That’s whom he was obviously referring to, commented Tony Leon: an organization ‘with whom the President has something of an obsession’. In fact, this wasn’t Mbeki’s lonely eccentric view; the ANC as a whole had long shared it, noting at its 51st national conference in Stellenbosch in December 2003: ‘Foreign actors with significant resources are backing domestic organisations in an offensive against the mass democratic movement and the government. Some so-called watchdog groups here have been enticed by funding and other forms of persuasion to act as an opposition.’

Had Mbeki noticed that these ‘foreign actors’ had a friend ensconced right inside his office? On 17 February, Achmat had bussed a TAC mob over to march on Parliament to deliver another one of his interminable demands for more AIDS drugs into more people faster – disparaging Mbeki and Tshabalala-Msimang as usual: ‘This injustice exists because there is insufficient political leadership to make the programme a success.’ Mouthing off at the demo he made a similar point: ‘There is no decent word said in Parliament about the deaths caused by AIDS. Our President needs to wake up to AIDS. Murphy Morobe, head of communications in the Presidency since July the year before, strode out to receive it, full of smiles for the TAC and lavishing praise on it as he did so: ‘You are our conscience,’ he said, you highlight ‘blind spots in society’ neglected by the politicians. Like my boss. It’s why ‘I bury my own cousins every week and every month, six already in three years.’ So ‘You have a right to come here and prick our conscience every time,’ he said, promising to hand the memorandum to Zuma. When Minister in the Presidency Essop Pahad heard this, he was seriously pissed. ‘He shouldn’t have done that,’ he fumed to journalists immediately afterwards. Had anybody told him that as a board member of George Soros’s Open Society Foundation, Morobe had just voted the TAC millions in funding? The conscience of the nation.

Among the paid believers in South Africa, the ‘stupid enthusiasm’ described by Joachim Fest in Hitler, was as lively as ever. Still lively in the US and at the UN too: at an HIV/AIDS briefing on Capital Hill in Washington DC on 28 September, Richard Holbrooke, former US ambassador to the UN and now head of the Global Business on HIV/AIDS, lambasted the President and his Health Minister: ‘But why [does] Manto remain? Why your President keeps Manto, who continues to give her monthly sermons on garlic and lemon juice, is beyond me.’ Putting us out of business. Celebs present such as John Kerry, Richard Branson, Angelina Jolie and Anglo American chairman Sir Mark Moody-Stuart wondered too. As did Hillary Clinton and Condoleeza Rice at gala event afterwards.

And in his book released in October, Race Against Time (House of Anansi Press, 2005), the UN secretary-general’s special envoy on AIDS Stephen Lewis thought Tshabalala-Msimang’s statements about AIDS

unfathomable … She perpetually and publicly advocates nutritional remedies for a deadly disease … it is going too far to let garlic and sweet potatoes appear to equal or transcend anti-retroviral treatment in importance; nor should wantonly exaggerated rumours about the side-effects of treatment be allowed to stir confusion in the public. … I would have thought that the latest figures would strike the fear of the Almighty into the heart of the government; that they would accelerate the rollout … as though there were no tomorrow. … Something has gone wrong with the post-Mandela government. Every senior UN official, engaged directly or indirectly, in the struggle against Aids, to whom I have spoken about South Africa, is completely bewildered by the policies of President Mbeki.

Maureen Isaacson offered a bright liberal comment on all this in the Sunday Independent on the 30th, urging that

we need Lewis and people like him. Worn down from staring into the eye of the Aids storm and the indifference of those who hold the strings of power, Lewis speaks fearlessly. … President Thabo Mbeki’s fetish for unhealthy health ministers is affecting us all. Why does he allow Manto Tshabalala-Msimang to continue her bombastic bumbling? Yes, she acts out the Aids denialist approach he has been forced to keep under his belt. But she’s a bat out of hell. … Our president should act decisively on our own situation. Then we can begin to build on the systems the minister has helped break down.

Lewis had more to say in a telephone interview with Clare Nullis of AP on the 3 November: ‘The slowness in treatment has less to do with questions of capacity ... than the sense of energy of the government to promote the treatment regimens. … Only the most energetic, uncompromising political leadership can turn this thing around.’ Which we’re not getting from Mbeki and Tshabalala-Msimang.

Grasping at AIDS as a populist straw after Mbeki deposed him as Deputy President in June pending his corruption trial – but vying determinedly against Mbeki for the leadership of the ANC in the 2007 party election nonetheless – Zuma told students at Vaal University of Technology on 20 October that ‘I will be making a mistake if I don’t raise this issue with you. The disease is there. You can’t run from it.’ ANC Youth League president Fikile Mbalula and Young Communist League national secretary Buti Manamela stood on each side of him to signal that they’d wouldn’t be running away from the disease either. Unlike out of touch ‘academic politicians’ who ran away from it such as the guy who’d sacked him, said Zuma in a barbed allusion.

Supporting Lewis’s criticism, DA spokeswoman on health, Diane Kohler Barnard, shared Zuma’s view in the Star on 2 November: ‘The key problem in our country is the ongoing lack of enthusiasm in top levels of government when it comes to confronting AIDS.’ 86% of 2000 South Africans polled by Research Surveys in October agreed that the government ‘should be doing more to supply medicine to people infected with HIV/AIDS’.

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