REEXAMINING AIDS IN SOUTH AFRICA

By Tom Bethell

The Washington Times 10 May 2000

AIDS has been back in the news, with the Clinton administration claiming the global spread of the disease is a threat to U.S. national security, and President Thabo Mbeki of South Africa expressing skepticism about the causes of the disease. Despite widespread criticism, Mr. Mbeki convened an advisory panel to discuss the cause and treatment of AIDS.

The 33member panel met in Pretoria last weekend. Included were Luc Montagnier, the codiscoverer of the virus (HIV) that is said to cause AIDS, and Peter Duesberg, the University of California, Berkeley biochemist who says HIV is harmless.

Dissident and orthodox sides were equally represented, which caused alarm, because the great majority of scientists accept the conventional theory of AIDS. Mr. Mbeki doesn't, however. The panel agreed on very little, according to news reports. But a subgroup said to include Mr. Duesberg and Helene Gayle, director of HIV prevention at the U.S. Centers for Disease Control and Prevention will meet to suggest further questions and experiments. A joint statement may be forthcoming in time for the International AIDS Conference in Durban, South Africa, in July.

Mr. Mbeki's skepticism has stirred up great controversy, both in South Africa and in Western capitals. AIDS is now a huge international program, lavishly funded, and any threats to its future are unwelcome. Dr. Mark Wainberg, head of the International AIDS Society, said the other day that AIDS dissenters should be jailed. Dr. John Moore of the NIHfunded Aaron Diamond AIDS Center in New York compared AIDS dissenters to Holocaust deniers. Public health officials have grown accustomed to unquestioned deference where AIDS is concerned, and journalists who pride themselves on their skepticism make an exception for AIDS. "We don't have a license to practice medicine," they say.

Nelson Mandela's successor, Thabo Mbeki, was elected president of South Africa last year. Now, he is viewed as just a little bit unreliable. Does he not know his attitude puts at risk the continued inflow of Western funds to his health department, his myriad AIDS educators and condom distributors? John Moore said Mr. Mbeki's defiance should be brought to the attention of "very serious levels" of the U.S. government. It was, and still Mr. Mbeki didn't back down.

He has a point. In Africa, AIDS is not a science. In the U.S., AIDS is said to be caused by HIV. But in Africa, it can be diagnosed without an HIV test. This relaxed rule was promoted by U.S. health officials in 1985, at a conference in the Central African Republica. They were eager to find that men and women were equally infected. In no time, sick people in Zaire were called AIDS cases. Now, with a heterosexually transmitted epidemic on the front pages, public health budgets would soar.

The "Bangui definition," as it was called, published in Science in 1986, allowed an AIDS diagnosis for those with a persistent cough plus two of these three conditions: "prolonged fevers (a month or more), weight loss of 10 percent or greater and prolonged diarrhea." At that point, millions of deaths on the African continent could be attributed to AIDS, without blood tests, and without fear of contradiction. Even where tests are carried out, indigenous germs cause a high percentage of "false positive" readings.

As AIDS in this country has shown, heterosexual transmission is difficult to achieve. Most cases involve either homosexuals or intravenous drug users. One study showed that, for maletofemale transmission, a thousand unprotected sexual contacts are needed. Since no one claims that homosexual contact or intravenous drug use cause African AIDS, public health authorities must explain the African epidemic by imputing Hollywood morals to African villagers. Horny truck drivers have been conveniently conjured up. No wonder Mr. Mbeki isn't buying it.

Meanwhile the continent is overrun with civil conflict and famine. Sanitation and sewage infrastructure is eroding or nonexistent, and drinkable water is a luxury. Poverty and war have given rise to public health conditions more than sufficient to account for reduced lifeexpectancy, without having to ascribe mortality to a hardtofind, hardtotransmit retrovirus.

Finally, Mr. Mbeki has questioned the antiAIDS drug AZT. It may be "a danger to health," he said. Again, he has a point. AZT was designed as cancer chemotherapy but never approved for that use because it was considered too toxic. When it was tried out as an AIDS treatment, in 1986, its safety trials became unblinded when patients realized who was getting the drug, who the placebo. They swapped doses. Trials were ended after only four months, before adverse effects appeared. FDA approval came only after 1,500 AIDS activists demonstrated in the grounds and corridors of the Food and Drug Administration's building. A later study called Concorde showed that AZT conferred no benefit.

Mr. Mbeki, therefore, has good reason to question both AIDS and its treatment in South Africa.

Tom Bethell is the Washington correspondent of the American Spectator.