South Africa’s AIDS Policy Opens Worldwide Debate


The July 9 opening day speech to the 13th International AIDS Conference by South Africa President Thabo Mbeki sent shock waves across the globe and opened a critical debate about how to fight the AIDS pandemic that has already infected 34.3 million people worldwide, mostly Africans.

As President Mbeki, the successor to Nelson Mandela, spoke to 12,000 people at the Kings Mead outdoor cricket stadium, hundreds of delegates left to protest his refusal to state what scientists around the world have known for more than a decade, that HIV causes AIDS.

The Durban, South Africa, conference marked the first time the event has been held in an underdeveloped country. This was certainly appropriate since an estimated 4.2 million South Africans, or 20 percent of the adult population, are believed to be infected with HIV.

An additional 20 million sub-Saharan Africans are also HIV positive, giving Africa substantially more than half of the world’s HIV/AIDS population. In some African nations the HIV rate is estimated at nearly 40 percent and rising.

As Mbeki spoke, thousands demonstrated outside the stadium, carrying signs protesting the impossible cost of AIDS drug therapy.

The French-based Nobel Peace Prize recipient medical group, Doctors Without Borders, has released a stunning report revealing that the combination of antiviral drugs that had saved the lives of countless thousands in the richer nations, at a cost of $12,000 per year, could be sold by generic producers for less than $200 for a year’s supply.

But drug patents held by the multi-billionaire pharmaceutical corporations prohibit the use of so-called intellectual property rights, including drug patents, from being used without paying the full cost of the drugs. What is routine treatment for AIDS in the imperialist countries is virtually unknown in Africa, where an estimated 95 percent of HIV-infected persons do not know they have HIV.

The vast majority of the world’s people at risk from AIDS have never used a condom and cannot read the literature, posters, and billboards that warn about the disease’s sexual transmission, nor do they have access to the most elementary medical care and testing.

In South Africa, the richest of all sub-Saharan nations, some $40 per year per person is expended on medical care.

The United Nations agency UNaids reports that this lack of medical care means that an astounding one-third of all 15-year-olds are destined to die even if infection rates somehow drop. A South African report indicated that more than half of the nation’s youth could be expected to contract HIV in the next few years.

UNaids chief epidemiologist Bernhard Schwartlander reports that even if the current $12,000 per year drug therapy cost were reduced by 90 percent by the year 2005, the cost would be about $1.7 billion per year to get the cheapest (least effective) care for the dying to 40 percent of all infected Africans and the AIDS cocktail (the most effective) to 10 percent of them.

The cost to give Africans the same level of care as in the United States would rise to hundreds of billions, because, according to Schwartlander, one would have to start from ground zero, building the hospitals and importing doctors.

Of the 34 million people on earth with HIV, at least 30 million are poor, not in the U.S. sense, but people living on less than $2 a day, according to the July 2 New York Times. “AIDS specialists rarely say this bluntly,” says The Times, “but the truth is that most of those 30 million people have simply been written off, because the first priority for the first few billion dollars is prevention [condoms], not treatment.”

The advanced capitalist countries are certainly able to afford the hundreds of billions of dollars needed for a “Manhattan Project”-type battle to find a vaccine for HIV/AIDS, as well as to provide the most modern drug treatment and medical care for all who are afflicted worldwide.

However, the system of private production for profit prevents a serious challenge to AIDS as well as all other diseases that unnecessarily take the lives of millions the world over.

Doubts about HIV/AIDS linkage?

Mbeki’s remarks at the Kings Mead stadium implicitly accepted the framework of medicine for profit. Furthermore, he pointedly ignored a statement issued the week before the “Durban Declaration,” signed by 5000 AIDS researchers and physicians around the world.

“HIV causes AIDS,” the declaration states, the evidence is “clear cut, exhaustive and unambiguous. … It is unfortunate that a few vocal people continue to deny the evidence. This position will cost countless lives.” The declaration was published in the July 6 issue of the respected scientific journal Nature, after review by scientific peers.

Mbeki accused his critics of intolerance. “Some in our common world consider the questions that I and the rest of our government have raised around the HIV/AIDS issue … as akin to grave criminal and genocidal conduct,” he said. “What I hear being said repeatedly, stridently, angrily, is, ‘Do not ask any questions.'”

A press conference announcing the Durban Declaration was canceled minutes before it was scheduled when, according to signer Dr. Charles van der Host, professor of medicine at the University of North Carolina, “the South African government put pressure on all of us” and threatened to dismiss any signer who worked for the government (New York Times, July 10).

To investigate Mbeki’s doubts about the HIV/AIDS linkage the government has appointed a panel of scientists-including two American biochemists, Peter Duesberg and David Rasnick, who contend that poverty and malnutrition, not HIV, cause AIDS. Duesberg, the author of the sensationalist book, “We Will Never Win the War on AIDS,” argues that the notion of a direct link between HIV and AIDS is “the biggest scam in medical history.”

Conference participants were outraged that Mbeki’s government-appointed panel was given several months to complete its work while the government’s policy of denying drug treatment remains in force.

But a few days later, the government did announce that it would at least slightly modify its opposition to anti-HIV drug therapy by reversing its previous ban on the use of AZT on pregnant women with HIV, a common practice in the developed world that has significantly reduced the transmission of the virus from pregnant mothers to children.

Mbeki’s speech called for increased education to encourage the use of condoms and for additional work on research to find a vaccine. But he also presented the thesis that poverty, rather than HIV or AIDS, was the biggest killer in the underdeveloped world. This is an obvious truism, but unrelated to the debate at hand, especially when Mbeki offered little to challenge the corporate monopoly on drugs and the savage inequities imposed on poor nations by world imperialism.

“If poverty was such a big issue,” said Chris Rodell, a South African with AIDS living in London who was a conference delegate, “then why are we spending billions on defense?” Rodell’s modest comment is an appropriate starting point for a real debate on how to deal with the HIV/AIDS pandemic.

ANC’s pro-capitalist framework

South Africa is the wealthiest nation in Africa, with natural resources of diamonds and gold and a vast array of minerals that rival most of the advanced capitalist nations.

These resources, totaling at least in the hundreds of billions of dollars, are sufficient to educate the entire nation, begin to build a world-class health-care system, and move to wipe out AIDS once and for all. But they are in the hands of the billionaire white capitalist few who rule the economy as they did in the apartheid era, along with foreign corporations.

The Mbeki government and its African National Congress officials respect the rules of the world capitalist order, including refusing to break with WTO-type laws that prohibit the unimpeded use of generic life-saving drug therapies for all who need it, not to mention the South African constitution that enshrines private property.

Revolutionary Cuba, with many fewer resources, today stands out as perhaps the sole exception to the apocalyptic fate now facing the poor nations of the world.

Cuba, embargoed by the world’s most powerful country, cut off from its trading partners of a decade past, and constantly threatened by U.S.-instigated terrorist assaults, has the lowest HIV rate in the world and the highest proportion of doctors to citizens. Its HIV/AIDS treatment programs, education, and testing-not to mention its promising research on a vaccine cure-are rivaled by few in the world.

Cuba, unlike South Africa, abolished the capitalist system, which previously enslaved its people to the laws of profit and stole its natural resources.

The African National Congress, originally led by Nelson Mandela and by Mbeki today, long ago rejected the socialist option. They brokered a deal with South African and world capitalism allowing them to retain the country’s vast capitalist infrastructure in return for an election that placed a Black reformist, pro-capitalist leadership at the nation’s helm.

The fruits of the mass struggles to end the U.S.-backed racist apartheid system have thus been denied to the vast majority.

The end of the South African HIV/AIDS pandemic and South Africa’s poverty more generally can only be envisioned in the framework of the abolition of capitalism. This remains the key fight ahead for the workers and farmers of that nation.

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