MBEKI's MUDDLE South Africa's Aids Debate

Durban, South Africa: What was Mbeki going to say? That's what the press and the crowd packed into the Kingsmead Cricket stadium were buzzing about as they waited May 9th under an African sky threatening rain for South Africa's second democratically elected President Thabo Mbeki to address the opening ceremony of the 13th international AIDs conference.

The ten thousand strong AIDS 'community" had been outraged by earlier comments attributed to the Head of State now hosting the first world AIDS meeting ever held in a non western country. Was Mbeki with them or against them? It was a question that grew out of a simmering controversy that began month earlier when the South African President spent a few nights conducting personal research on the Internet. It led him to the views of a handful of dissident doctors and researchers who had been challenging the conventional scientific wisdom about the origins of the AIDS virus for years.

He quickly began wondering aloud if South Africa's AIDS fighting program was on the right track. Staring down the barrel of drug costs that could bankrupt his treasury and plans for economic development, he provoked a debate about the proper strategies to pursue that is still reverberating globally.

Critics quickly elevated his stance into a heresy after he invited some of those dissidents to take part in a presidential advisory panel (which also included many mainstream researcher.) The 30 member group was charged with investigating some critical issues, including the accuracy of Aids tests, the safety of certain highly toxic anti-viral drugs like AZT which has been relatively effective in blocking transmission of the disease from mother to child, and the charged issue of what causes AIDS. Does HIV lead to Aids, as most scientists insist, or are there other causes and contributing factors? It will make its report at the end of the year.

Mbeki never openly denied an HIV-Aids link but his aggressively inquiring attitude appeared to many as if he that's what he was doing. Such questioning was viewed as a distratcion, evidence that he was in denial about an infection that the UN says is present in ten percent of the country's population, or some 4.2 million people, more than in any other comparable country.

For daring to challenge the consensus, Mbeki fell, in the words of a high level White House AIDs official I spoke with, "off the program." Soon he turned into a pariah and subject for ridicule in the world press, trashed by 60 Minutes in the US and criticized by one of South Africa's leading intellectuals Dr. Mamphela Ramphele for "irresponsibility bordering on criminality."

5000 researchers and scientists world-wide issued a "Durban Declaration" to rebuke him, insisting that that HIV causes Aids, full stop. End of story. His defensive press secretary dismissed their statement as fit for the "dustbin." Local political pressure was then brought to bear on those behind the declaration to cancel a planned press conference that could turn embarrassing. Feelings polarized. Over coffee in my hotel, an HIV positive ACT UP militant from Brooklyn New York snarled, "Mbeki should be impeached and arrested."

Later he would join a small chorus of activists who booed and chanted at the President when he was introduced as part of a televised gala extravaganza that included a stage show, musical numbers, dance routines, scores of African drummers, and fireworks that rivaled what I had just seen in New York on July 4th.

I have known and respected Thabo Mbeki for over thirty years. I have reported on him as an ambitious but pragmatic politician more comfortable in the mainstream than the margins. He never was a bomb thrower of any kind, and has been a centrist, not a leftist. His whole career has been marked by consensus building, and not making waves. I think he is sincere and brave to pursue his inquiry and stand by his views. At the same time, he is obviously on the defensive and seemingly unable to understand why he is loosing sympathizers like myself on this issue, who thought he was being picked on unfairly until I came here.

I had last seen him at his own inauguration in South Africa a year earlier. (I was one of his least well visible foreign guests; Libya's Khadaffi was the best known.) At that time he spoke of his hopes for an African Renaissance after being elected by a bigger majority than the one that one that put Nelson Mandela into power five years earlier. The event was a celebration of a peaceful transition of power, a sign that a new well educated generation had taken over. Mbeki had been the darling of South Africa's business community for years, a champion of the type of neo-liberal economics that pleases cheerleaders for globalization. A close friend of the Clinton Administration, Mbeki was considered a man "we" could work with.

After laboring for years in Mandela's shadows, it was now his turn at bat.

But this AIDS controversy threatens to shred an image carefully woven over decades in exile and at the top levels of the ANC command. Unlike Mandela, the global icon whose charisma could often be mesmerizing, Mbeki is given to more studied scholarly pronouncements. Where Mandela combined moral appeals with legalistic precision, Mbeki is more the pipe smoking intellectual, known for tough strategic thinking and hard line backroom political horse-trading. More importantly, whereas Mandela , a tall man, was known for bringing people together, Mbeki, a far shorter one, now seems to be driving them apart.

Why? He has never been known as leader led by emotions, ideologies, or irrationality. His successes in the past were due to his unfailing ability to size up a situation, and neutralize potential enemies.

But on this issue, at least, he seems to have blown it-and for reasons that are still being hotly debated and speculated upon. At an event aimed at breaking "the silence" this President stirred a noisy debate not about AIDS but about his own ideas.

When Mbeki bounded to the stage the crowd hushed, not sure of what to expect. Even ACT UP quieted down. But those who wanted him to disavow his earlier concerns would soon be disappointed.

First, he welcomed the delegates and acknowledged the Conference's importance. But then, when he appealed for tolerance for other points of view, he was talking , unmistakably, about his own. "The question which I and the Government raised was akin to criminal and genocidal misconduct," he complained. He assured the delegates and those watching at home that South Africa is deeply concerned with HIV/AIDS and is committed to 'a national action plan,' a plan incidentally premised on the assumption that HIV is a cause of AIDS. He certainly was not in denial nor oblivious to the issue.

He acknowledged the health catastrophe facing Africa. But then took a turn that left sections of the audience stunned. Instead of focusing on AIDS, he delivered a lecture calling poverty Africa's biggest killer. "We cannot blame everything on a single virus," he said. "Poverty is the underlying cause of reduced life expectancy, handicap, disability, starvation, mental illness, suicide, family disintegration and substance abuse."

Quoting the World Health Organization, he argued that disparities in wealth in the world was behind Africa's affliction as that region of the world suffering the most with an estimated 23 plus million people targeted for death. He refused to buy the idea that a single virus with a single cause could be responsible for the high number of deaths attributed to AIDS. Poverty, and the diseases and malnutrition that accompany it is the world's biggest killer, he argued, and has rendered the continent so susceptible. The endemic poverty feeds the AIDS pandemic, he said, weakening individual immune systems on the one hand, and then making it impossible for countries such as his to afford expensive anti-viral drug therapies now used widely in the West.

He is not totally wrong on these points, nor is this a new issue for him. I remember covering Mbeki when he keynoted a conference on the grinding poverty in South Africa ten years ago at Duke University. He was there to endorse a well documented study by Mamphela Rampele and others showing how deadly economic gaps in South Africa were the source of national misery and Apartheid's principal legacy. Yet today, poverty expert Dr. Rampele is on one side of the AIDS debate here, Mbeki on the other.

He is not wrong in his desire to explore all options to fight AIDS, to insure affordable drugs and an approach that recognizes the social and economic nature of a crisis that can be solved just with the magic of medicine. Pioneering Aids scholars like Jonathan Mann had made that point clearly in his seminal writings. The deprivation of human rights and the marginalization of people has helped fuel this global public health emergency. As Albina du Bosrouvray, a philanthropist behind the FXB foundation, once active in backing Mann and now supporting projects to help AIDS orphans, put it in op-ed in a Durban newspaper " an overdue discussion about the global dangers of the HIV-AIDS pandemic is slowly emerging."

The speech-however valid many of its observation may be-went over like a lead balloon. "I was hoping and praying that he would find a way to gracefully back out of this madness, " African American AIDS activist Phil Watson told the Mercury, a local paper. "The House is on fire, and Mr. Mbeki is sitting around trying to decide whether it was started by a lighter or a match. He talks about a plan. He doesn't talk about action."

The next day, an eloquent response was heard from Conference keynoter, South African judge Edwin Cameron, himself HIV positive, who lashed out at the President for creating "an air of unbelief amongst scientists, confusion amongst those at risk of HIV and consternation amongst Aids workers." He blasted Mbeki's government for not doing enough to treat and support those suffering from AIDS. Five thousand babies a day, he charged, are born "unnecessarily" with HIV because of the government's refuse to provide drug interventions.

Mbeki's response to this furor was to play it down and reiterate that vigorous debate is good. "After15 years, we've still no solution. Nobody has come up with a cure, so I think it is important that everyone should be listened to," he said.

This flap reminded me of an earlier episode in South African history, also involving a speech by a South African President in Durban. It involved Mbeki's long time enemy PW Botha who also had come to this city on the Indian ocean to deliver a highly anticipated speech back in l989, when he was expected to end apartheid with a 'crossing of the Rubicon' address. Botha blew it then too, refusing to satisfy world opinion. He was later ousted by members of his own party.

Thabo Mbeki is also alienating many of his own supporters by his peculiarly intellectualized approach. Hours before his speech, a march led by AIDs sufferers in the streets of Durban demanded access to treatment from the government and lower drug prices from the giant pharmaceutical companies. Mbeki was criticized openly in a fiery speech by Winnie Mandela-Matsikela who is a fellow member of the ANC and a member or Parliament. People who spent decades marching against white governments were now marching against a black led one they elected.

This fight over AIDS issues mirrors other cleavages and discontents in South Africa. Whatever honeymoon the ANC may have enjoyed under Mandela is long gone. There is anger and resentments about unchanging realities, a slumping economy and government that says many of the right things but has serious problems delivering services.

There are also intriguing and contradictory theories that purport to explain Mbeki's stance. He is an Africanist, some say, contemptuous of being told what to do by arrogant white westerners who have so failed to stop the pandemic. He is just stubborn, say others, unwilling to concede his errors. Still others argue that Mbeki will bankrupt his country if he starts importing drugs that are so expensive to purchase and perhaps even impossible to administer, given the poor health infrastructure and so is right to look for alternatives.

There is even a rumor that he himself is HIV positive but is in denial, unwilling to say so. Finally, there were suggestions that his stance is actually a brilliant tactic to force pharmaceutical prices to come down or even to insist that local companies, in which the ANC has an interest, to get the lucrative business. There is no proof for any of these suppositions but many have been swirling around the conference.

Mbeki, bewildered by the anger and lack of tolerance shown by his critics., also seems unable to come up with a populist program for linking health and human rights and inspiring a people who are dying in droves.

Paying lip service to the AIDS crisis won't save lives or help South Africans cope with an intensifying epidemic or the AIDS orphans crisis which is just building steam.

Thabo: come out of your bunker and dialogue with your critics the way you did so brilliantly years ago with the white power structure. The posturing and polemics about AIDS on all sides is not helpful to you, South Africa, or the world.

Danny Schechter, editor of mediachannel.org, produced the South Africa Now public television TV series years ago and directed five documentary films about South Africa. He is the author of the newly published News Dissector (electronpress.com)