MBEKI'S VISIT TO U.S. PUTS
AIDS ACTIVISTS IN A QUANDARY

By Daniel J. Wakin

The New York Times 21 May 2000

When President Thabo Mbeki of South Africa said last year that AZT was too dangerous to give to H.I.V.infected pregnant women, AIDS researchers and activists were taken aback. The drug is commonly used to prevent transmission of the disease to newborns, and many of the people who advocate its use said thousands of lives would be lost in a country where the epidemic is burning at white heat.

That reaction turned to shock when Mr. Mbeki appointed an AIDS advisory panel that included researchers who have postulated that H.I.V. does not cause the disease, a position long rejected by the overwhelming majority of scientists.

Now Mr. Mbeki is embarking on his first state visit to the United States since succeeding Nelson Mandela as president last year, and activists and those who treat AIDS are wondering how to greet him. Most seem to have decided that the best offense is to give no offense, an approach that they say is being counseled by the Clinton administration.

"The suggestion has been not to press him hard," said Martin Delaney, founding director of San Franciscobased Project Inform, a treatment information and advocacy group. "The fear here is that he'll dig in worse if he gets pressured."

Some activists are preparing a statement to be signed by prominent scientists worldwide reaffirming their view that H.I.V., or human immunodeficiency virus, causes AIDS. Others are planning to try to speak to Mr. Mbeki when he appears in San Francisco on Wednesday, two days after meeting President Clinton at the White House.

"We're all struggling with how best to make a difference," said Jane Silver, vice president for public policy at the American Foundation for AIDS Research in Washington. "Finally the world is focusing on AIDS in Africa. Part of the challenge is making sure it is not sidetracked."

"There are no simple answers to what to do about the president coming here, how to respond to the challenges he's created," she said.

Some scientists are hoping the government will arrange a meeting with prominent American researchers to put Mr. Mbeki on what they consider the right path, although administration officials say they have no such plans.

About six weeks ago, several scientists wrote to Sandra L. Thurman, the White House director of national AIDS policy, to express concern about South African government contacts with the dissident scientists, who are led by Peter Duesberg and David Rasnick, both professors in California.

For advocates and scientists, the stakes are high in a country where nearly 1 out of 10 people is infected with H.I.V. They say that by reopening the debate, Mr. Mbeki is hampering efforts to control the disease.

The effects could go further, Mr. Delaney and others argue. If the message seeps in that AIDS does not spread by a transmittable virus, people may ignore admonitions to practice safe sex.

And given Mr. Mbeki's stature in Africa and among blacks elsewhere, any comfort that he gives to the H.I.V. "denialists" will feed the fires of those who claim that AIDS is a conspiracy by the West aimed at third world people, Mr. Delaney said.

Mr. Mbeki's 33member AIDS panel met on May 6. According to an activist who attended the meeting, David Scondras of Boston, the dissidents voiced their view that H.I.V. does not cause AIDS. They said screening blood supplies was a waste of money and accused the moderator of bias. Mr. Scondras said South African officials who were present were taken aback. Mr. Mbeki addressed the scientists, and appeared to distance himself from the dissidents.

He said he knew that H.I.V. caused AIDS, but wanted to explore why a certain subgroup of the virus is more prevalent in Africa than in the West, and whether poverty and malnutrition are likely causes.

Those factors, along with drug use, antiAIDS drugs themselves and parasites, are often cited by the dissidents as causes.

Mr. Mbeki adopted a different tone in a letter to President Clinton and other world leaders last month, accusing those condemning his approach of waging a "campaign of intellectual intimidation and terrorism."

In the past, Mr. Mbeki has said the expense of providing AZT is far greater than South Africa can afford.

Many activists praise the South African leader for striving to understand AIDS in an African context, where femaletomale transmission is much more common than in the West. And few question his commitment to fighting the disease.

"What he's done here is akin to if President Clinton decided that he's going to determine the orbital trajectory of the next space mission," Mr. Delaney said. "It's an intrusion of a leader into an area that's not his expertise."