MBEKI DETAILS QUEST TO GRASP
SOUTH AFRICA'S AIDS DISASTER

By Rachel L. Swarns

The New York Times 7 May 2000

Pretoria -- For months, President Thabo Mbeki says, he pored through medical journals, consulted with scientists and struggled to understand the epidemiology of the AIDS epidemic that is ravaging his country.

"The problem was so big that I personally felt that I wanted to understand this matter better," Mr. Mbeki said today as he addressed an advisory panel of international AIDS researchers here.

"I'm reading all these complicated things, language I don't understand," he said. "So I pile through lots and lots of research documentation. I've got dictionaries all around me in case there are words that are difficult to understand. I phone the minister of health and ask her what does this word mean and she explains."

In this strikingly personal speech, Mr. Mbeki offered his first detailed explanation of how he came to consult with two Americans who argue that H.I.V. does not cause AIDS. The decision, which became public two months ago, quickly touched off a firestorm of criticism.

Leading scientists have criticized him for wasting time on discredited theories while South Africa is suffering one of the highest H.I.V. infection rates in the world. Some researchers have called for a boycott of an international AIDS conference that is scheduled to be held here in July.

And as prominent American newspapers published editorials last month condemning his stance, some government officials here began to fear that the issue would overshadow Mr. Mbeki's first state visit to the United States, set for May 20, a visit that some had hoped would focus on South Africa's blossoming economy.

Today, Mr. Mbeki said that he and his ministers know that the human immunodeficiency virus causes AIDS. He said he reached out to the Americans when he discovered how differently the disease appeared in subSaharan Africa as compared with the United States and Europe.

According to the United Nations AIDS program, two types of H.I.V. are currently recognized, and the most common, H.I.V.1, has 10 genetically distinct subtypes.

Subtype B, which is most commonly transmitted through homosexual contact and intravenous drug use, is primarily found in the Americas, Europe, Australia, Japan and the Caribbean. Subtype C, most often found in South Africa and India, seems to be more infectious with a higher potential for heterosexual transmission, the United Nations says.

When he could not find satisfying explanations for such differences, Mr. Mbeki said, he began exploring the work of researchers who believe that poverty and malnutrition are likely causes of the disease in Africa.

"We were looking for an answer because all of the information that has been communicated says in reality that we are faced with a catastrophe," Mr. Mbeki explained in his speech at the Sheraton Hotel here. "And you can't respond to a catastrophe merely by saying, 'I will do what is routine.' "

Mr. Mbeki refused to dismiss the work of the American researchers David Rasnick, a biochemist, and Peter Duesberg, a professor of biochemistry and molecular biology at the University of California at Berkeley.

Both men are included in the government's 33member advisory panel, which met today for the first time and will advise Mr. Mbeki on the cause and best treatments for AIDS. The panel is evenly split between those who believe H.I.V. causes AIDS, including Luc Montagnier of the Pasteur Institute in Paris, whose research team discovered the virus and those who do not.

As Mr. Mbeki described his efforts to understand H.I.V., which has infected more than 3 million people in this country of 44 million, he portrayed an intensely driven, handson leader who is reluctant to leave critical decisionmaking to others.

Tom Lodge, a professor of political science at the University of the Witwatersrand in Johannesburg, said: "In one way, of course, it's an admirable indication of an extremely conscientious and intelligent chief executive. But I think he's also a compulsive interferer. There is a medical establishment. You leave, as it were, to the experts certain things that require expertise."

Similar criticisms come from doctors in the medical community here, on this and other aspects of policy.

In March, government officials scrambled to explain how $6.2 million of the country's $17 million AIDS budget went unspent last year. And last year, Mr. Mbeki stunned health experts by questioning the safety of the standard antiAIDS drug AZT. The government has decided not to distributed the drug in public hospitals here, even though the National Institutes of Health in the United States has determined that the benefits of the drug far outweigh the potential side effects.