San Francisco Examiner - July 10, 2000
Ulysses Torassa, Examiner Medical Writer

AIDS activists and scientists had hoped Mbeki would use Sunday's high-profile address to announce new measures in his country's fight against HIV, which infects more than 20 percent of young adults.

In particular, they were looking for him to reverse his opposition to giving cheap and simple treatment to pregnant women and their babies to stop the transmission of the virus to newborns. He made no mention of it in his speech.

He also did not back away from his puzzling decision to invite dissidents who believe HIV is not the cause of AIDS onto a presidential advisory panel on the disease.

Leading scientists who had planned a press conference Sunday to denounce such ideas abruptly canceled it at the last minute.

One of the organizers said that South African members of the group had been told they would lose their jobs if the event went forward, although government officials denied it.

Mbeki quoted at length from a 1995 World Health Organization report on the many poverty-linked health problems facing Africa, including malaria, tuberculosis and malnutrition.

"As I listened and heard the whole story about our own country, it seemed to me that we could not blame everything on a single virus," he told the crowd gathered at a local cricket stadium. The audience was polite but clearly disappointed.

Like many of his previous statements on AIDS, Mbeki's speech was enigmatic, neither embracing nor endorsing the dissident views and highlighting the need for the use of condoms and other measures to halt the spread of the sexually transmitted virus.

"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," he said. But he chastised his critics, saying they were denouncing him for simply asking questions.

His words provided little comfort to the thousands of delegates at the conference, the first of its kind being held in a developing country. Ninety-five percent of the people infected with HIV worldwide live in developing nations.

"I personally yearned for an unequivocal statement" from Mbeki that HIV causes AIDS and that anti-retroviral therapy is needed, said Judge Edwin Cameron, an HIV-positive gay white South African and AIDS activist. "To my grief and consternation, the president's speech was bereft of any of this."

Also disappointed were people such as James McIntyre, who runs a clinic for pregnant and nursing women with HIV and their children.

While he and others agreed that poverty plays a crucial role in the epidemic, he said there is no reason the country can't begin a widespread program to give neverapine to pregnant women to prevent transmission.

On Friday, the Boehringer Ingelheim pharmaceutical company of Germany said it would provide neverapine free to pregnant women and their newborns for five years, but the offer has so far received a cool reception from South African government officials.

"It's disappointing," McIntyre said of Mbeki's failure to raise the issue. "This was the opportunity to do it."

Douglas Ross, who runs a hospital in the hard-hit KwaZulu-Natal province, said he is sympathetic with the government's worries about embarking on an expensive campaign to get anti-retroviral drugs into the hands of the 4.2 million people estimated to have HIV in South Africa.

"Even if we had the drugs for free, we wouldn't necessarily have the infrastructure to manage four million-plus people on anti-retroviral therapy," he said.

Still, he said he was disappointed that the president did not at least embrace a program to reduce mother-to-child transmission.

"Poverty is an issue, there is no question about it, but we've got to start somewhere," he said.

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