Sunday Times, South Africa - May 7, 2000
Laurice Taitz and Carol Paton

He said the disease had developed from one that infected predominantly homosexual men, intravenous drug users and haemophiliacs in the US and Western Europe in the '80s to one that affected a vast African heterosexual population less than a decade later.

"This is not an idle question for us because it bears directly on the question of how should we respond if this change is for reasons we cannot explain.

"I've asked myself over the past few months whether the matters we've raised are folly or grace," Mbeki said, after reading out the poem The Fool , by Patrick Henry Pearse.

He cited a 1999 World Health Organisation report which said that, of the 5.6 million people infected with HIV, 3.8 million lived in sub-Saharan Africa. The report said an estimated 2.2 million people had died from AIDS in the region last year - 85% of the global total even though it is home to only 1% of the world's population.

For the first time since his shock statement in October on the toxicity of the anti-retroviral drug AZT, the President went to great lengths to explain the process that had led to his decision to convene the panel, saying: "It seemed the problem was so big that, if the reports were correct, I personally thought I wanted to understand this matter better."

He said he was embarrassed to admit that he had then discovered there had been a controversy around HIV/AIDS for a number of years. He said: "I was a bit comforted later when I checked with a number of our ministers and found that they were as ignorant as I."

Mbeki reaffirmed the government's commitment to responding to the pandemic. He said: "Some have put out the notion that, because we asked certain questions . . . that constituted an abandonment of the fight against AIDS.

"We are looking for answers because all the information shows that in reality we are faced with a catastrophe and you can't respond merely by saying, 'I will do what is routine.' We need to respond in a way that recognises it is a catastrophe. We are talking about people here, not a herd of animals."

He said he had been surprised by the storm generated by his desire to question AIDS orthodoxy.

"It must surely be because people are exceedingly worried about the large numbers of people who are dying, and therefore any suggestion that dealing with that is being postponed because somebody is busy looking at abstruse scientific theories, constitutes a betrayal."

The 33-member international panel is almost evenly split between those who hold the view that HIV causes AIDS and those who dispute it - the so-called dissidents.

Professor David Rasnick, a dissident US scientist, who had been contacted by the President earlier this year, said: "I believe this meeting has already been a success, just by bringing all of these people under one roof."

Professor Malegapuru Makgoba, president of the SA Medical Research Council, said he was optimistic about the meeting's objectives. "But solutions will lie in the policy domain - science is closed on these questions," he said.

Another member of the panel, David Scondras, an AIDS activist and a former public health commissioner based in Boston, Massachusetts, said: "I don't think you need to reach consensus. You need the truth. People should speak their minds and the President will decide who makes the most sense."

He added: "If you look at where everyone is coming from you will see the denialists [or dissidents] are not those who treat people for the disease every day. I would suggest that the President look carefully at those who do rather than at those who sit in their ivory towers and speculate."

As the experts met behind closed doors in a Pretoria hotel, there was a growing sense among South African scientists, activists and policymakers in the AIDS sphere that the debate had shifted away from controversial scientific questions to finding practical solutions. Last weekend, the Minister of Health, Dr Manto Tshabalala-Msimang, held an emergency meeting of provincial health MECs to brief them on the panel. Sources close to the meeting said "a shift had taken place" towards focusing on "practical issues".

The panel will continue discussion in a "closed Internet debate" for the next six weeks.

Late yesterday afternoon, panel mediator Professor Steven Owen of the Institute for Dispute Resolution at the University of Victoria, British Columbia, said that despite fundamental disagreements, "there is an awareness of the critical need for action". He said the ambiguity surrounding the cause of AIDS needed to be dealt with in such a way that it did not immobilise policymakers.

"We cannot simply wait. There is a recognition among both sides that they have to act on the best evidence." He said: "So far there has been abundant evidence of a connection between HIV and AIDS but how direct the connection is, is not known."

THE FOOL by Patrick Henry Pearse

(quoted by President Thabo Mbeki at the opening meeting of the Presidential AIDS Review Panel)

Since the wise men have not spoken, I speak that am 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 done never 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?

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