Mail and Guardian (Johannesburg) - September 15, 2000
Belinda Beresford, Jaspreet Kindra and Nawaal Deane

Triggered by an interview with President Thabo Mbeki in the international news magazine, Time, the upsurge of unease was reinforced by the leak of an internal ANC document that called on Mbeki and Minister of Health Manto Tshabalala-Msimang to publicly acknowledge that the retrovirus, HIV, causes Aids.

The document was the second draft of a discussion paper produced by the ANC's national health committee, which is headed by the minister of health and which advises the government on policy.

The leaked paper, which had been sent to key ANC members on Monday, also called on the government not to wait for the report of the Presidential Aids Advisory Panel before continuing with anti-HIV programmes to counter the pandemic. It also recommended the party recognise mistakes in its handling of the HIV/Aids epidemic, and move on to properly manage the epidemic.

A senior doctor in the ANC says "from a medical point of view we are probably at the point where the epidemic has gone beyond the point where we can control it, we must have to provide care".

The leaked document follows another internal circular from early July, addressing the question whether HIV causes Aids. That document, circulated before the international AIDS 2000 conference in Durban, argued that the virus is indeed the root cause.

ANC representative Smuts Ngonyama dismissed the leaked document, saying that: "It wasn't even a subcommittee document, it was one man's opinion on the subject." The Mail & Guardian has been told by several sources that there is widespread support within the party for the point of view expressed in the document.

The M&G understands that the paper was circulated by the deputy chair of the national medical committee, Dr Confidence Moloko. Moloko said the paper was intended to stimulate "robust discussion" about the HIV/Aids pandemic and was part of an ongoing dialogue within the ANC. It is not an official ANC policy document.

The confusion surrounding the president's stand on the cause of Aids was exemplified by responses to the Time interview. Asked if he would acknowledge a link between HIV and Aids, Mbeki said: "No, I am saying that you cannot attribute immune deficiency solely and exclusively to a virus."

The Government Communication and Information Service (GCIS) has said that there was a "misunderstanding over [Mbeki's] (generic or non- specific) use of the word 'no'".

The statement went on to say that "neither the president nor his Cabinet colleagues have ever denied a link between HIV and Aids."

However in other parts of the GCIS statement, the stance is more ambiguous. "The context of the full transcript makes it expressly clear that he [Mbeki] was prepared to accept that HIV may 'very well' be a causal factor."

Mbeki is also quoted as saying: "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 will never be able to solve the Aids problem."

Mbeki's government makes a point of saying that HIV is not the exclusive cause of immune deficiency in humans - a point which has not been disputed since many genetic, environmental and infectious conditions can cause immune deficiency. But although other factors can exacerbate the progress of the disease known as Aids, the sole cause is HIV. So far the government has failed to state this unequivocally.

Three years ago the ANC national conference in Mafikeng, in its first resolution on HIV/Aids, noted that "secrecy, ignorance and myths about the disease contribute to its spread".

The ANC's alliance partners in government, the Congress of South African Trade Unions (Cosatu) and the South African Communist Party, have both said the Aids pandemic is caused by HIV and asked the government to acknowledge this.

The SACP this week referred to its general secretary Blade Nzimande's address in April this year where he had made a direct appeal to Mbeki saying: "Comrade president, let us not cheat ourselves, we know that Aids kills, and that Aids is caused by the HIV virus." Last week, Cosatu asked the government to end its "scientific speculation" about the cause of Aids and concentrate on providing affordable treatment to people infected with HIV.

The ANC's coalition partner in national and provincial government, the Inkatha Freedom Party, said this week it believes HIV causes Aids.

The confusion within the ANC is shown by the differing stances adopted by secretary general Kgalema Motlanthe. In July his report to the national general council assumed that there was a link between the virus and the disease.

However before that, Motlanthe had expressed support for Mbeki's questioning of the link between HIV and Aids. He said: "If the debate over the cause of Aids had been sorted out, why then did the dissidents and the scientists in the newly constituted Aids panel admit that they have come together to debate the issue for the very first time?"
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